Autonomy in the Balance: Incorporating User Preferences for Ethical Decision-Making About Remote Monitoring Technologies in Elder Care

Remote monitoring technologies that include GPS, activity sensors, and monitoring cameras are now allowable in some state Medicaid Home and Community-Based Services waiver programs. The spread of these technologies presents an urgent need to identify the considerations that shape older adults’ preferences for how and when they are monitored. The development of these technologies has largely been divorced from an understanding of the perceptions and desires of older adults, and research indicates that older adults are unlikely to understand fully what data are collected about them. This disconnect presents a bioethical problem when respect for the autonomy of older adults falls out of focus against a concern for their safety and restrictions on human and financial resources. This research is designed to identify what is needed to ensure comprehension by older adults of GPS, sensor systems, and cameras to enable informed consent. It will examine how older adults and their adult children weigh values at play in the use of these technologies. This study will inform future guidelines to ensure that these potential differences between the preferences of older adults and their family members are considered in decision-making as remote monitoring technologies are implemented in long-term care.