Skip to main content

Exploring factors that impact the decision to use assistive telecare: perspectives of family care-givers of older people in the United Kingdom


In the United Kingdom (UK), an ageing population met with the reduction of social care funding has led to reduced support for older people marked with an increased demand on family care-givers. Assistive telecare (AT) devices are viewed as an innovative and effective way to support older people. However, there is limited research which has explored adoption of AT from the perspectives of family care-givers. In-depth, semi-structured interviews were conducted with 14 family care-givers of patients who used the Assistive Telehealth and Telecare service in Cambridgeshire, UK. Family care-givers were either the spouse (N = 8) or child of the patient (N = 6). The patients' age ranged from 75 to 98, and either received a telecare standalone device or connected service. Framework analysis was used to analyse the transcripts. This study revealed that family care-givers play a crucial role in supporting the patient's decision to adopt and engage with AT devices. Knowledge and awareness, perceived responsibility, usefulness and usability, alongside functionality of the equipment, were influential factors in the decision-making process. AT devices were viewed positively, considered easy to use, useful and functional, with reassurance of the patient's safety being a core reason for adoption. Efforts to increase adoption and engagement should adapt recruitment strategies and service pathways to support both the patient and their care-giver.

Corresponding author
Address for correspondence: Erica J. Cook, Department of Psychology, University of Bedfordshire, Park Square, Luton, LU1 3JU, UK E-mail:
Hide All
Beesley, L. 2006. Wanless Social Care Review: Informal Care in England. Kings Fund, London.
Botsis, T., Demiris, G., Pedersen, S. and Hartvigsen, G. 2008. Home telecare technologies for the elderly. Journal of Telemedicine & Telecare, 14, 7, 333–7.
Cahill, S., Begley, E., Faulkner, J. and Hagen, I. 2007. ‘It gives me a sense of independence’: findings from Ireland on the use and usefulness of assistive technology for people with dementia. Technology & Disability, 19, 3, 133–42.
Cardon, T. A., Wilcox, M. J. and Campbell, P. H. 2011. Caregiver perspectives about assistive technology use with their young children with autism spectrum disorders. Infants & Young Children, 24, 2, 153–73.
Carers UK 2013 a. Carers UK for DAP Connect: Project Report. Carers UK, London.
Carers UK 2013 b. Supporting Working Carers: The Benefits to Families, Business and the Economy. Carers UK, London.
Carretero, S., Centeno, C. and Stewart, J. 2013. Telecare and telehealth for informal carers: a research in 12 Member States on their benefits and policy role for the success. In International Journal of Integrated Care (ed.), International Congress on Telehealth and Telecare. Igitur Publishing, London.
Cook, E. J., Randhawa, G., Sharp, C., Ali, N., Guppy, A., Barton, G., Bateman, A. and Crawford-White, J. 2016. Exploring the factors that influence the decision to adopt and engage with an integrated assistive telehealth and telecare service in Cambridgeshire, UK: a nested qualitative study of patient ‘users’ and ‘non-users’. BMC Health Services Research, 16, 1, 137.
Dahlberg, L., Demack, S. and Bambra, C. 2007. Age and gender of informal carers: a population-based study in the UK. Health and Social Care in the Community, 15, 5, 439–45.
Demiris, G., Rantz, M., Aud, M., Marek, D., Tyrer, H., Skubic, M. and Hussam, A. 2004. Older adults’ attitudes towards and perceptions of ‘smart home’ technologies: a pilot study. Informatics for Health and Social Care, 29, 2, 8794.
Department of Health 2008. Carers at the heart of 21st-century families and communities. HMSO, London.
Department of Health 2009. An Overview of Telecare and Telehealth. HMSO, London.
Department of Health 2012. Long-term Conditions Compendium of Information. HMSO, London.
Doran, T., Drever, F. and Whitehead, M. 2003. Health of young and elderly informal carers: analysis of UK census data. British Medical Journal, 327, 7428, 1388.
Hoffman, F. and Rodrigues, R. 2010. Informal Carers: Who Takes Care of Them? European Centre for Social Welfare Policy and Research, Vienna.
Jones, D. and Peters, T. 1992. Caring for elderly dependants: effects on the carers’ quality of life. Age & Ageing, 21, 6, 421–8.
Livingston, G., Manela, M. and Katona, C. 1996. Depression and other psychiatric morbidity in carers of elderly people living at home. British Medical Journal, 312, 7024, 153–6.
Magnusson, L., Hanson, E. and Nolan, M. 2005. The impact of information and communication technology on family carers of older people and professionals in Sweden. Ageing & Society, 25, 5, 693713.
Maher, J. and Green, H. 2002. Carers 2000. The Stationery Office, London.
May, C., Finch, T., Cornford, J., Exley, C., Gately, C., Kirk, S., Jenkings, K., Osbourne, J., Robinson, A. and Rogers, A. 2011. Integrating telecare for chronic disease management in the community: what needs to be done? BMC Health Service Research, 11, 1, 131.
McCreadie, C. and Tinker, A. 2005. The acceptability of assistive technology to older people. Ageing & Society, 25, 1, 91110.
Morris, M. G. and Venkatesh, V. 2000. Age differences in technology adoption decisions: implications for a changing work force. Personality & Social Psychology, 53, 2, 375403.
Mortenson, W. B., Demers, L., Fuhrer, M. J., Jutai, J. W., Lenker, J. and DeRuyter, F. 2012. How assistive technology use by individuals with disabilities impacts their caregivers: a systematic review of the research evidence. American Journal of Physical Medicine & Rehabilitation, 91, 11, 984–98.
Nicholson, J., Coates, L., Mountain, G. and Hawley, M. 2013. Barriers and facilitators to mainstreaming telehealth in the community – exploring staff views and roles at the implementation and delivery phase. In International Journal of Integrated Care (ed.), International Congress on Telehealth and Telecare. Igitur Publishing, London.
Nicolson, A., Moir, L. and Millsteed, J. 2012. Impact of assistive technology on family caregivers of children with physical disabilities: a systematic review. Disability and Rehabilitation: Assistive Technology, 7, 5, 345–9.
Office for National Statistics 2013. 2011 Census Analysis: Unpaid Care in England and Wales, 2011 and Comparison with 2001. Office for National Statistics, London.
Office for National Statistics 2011. Census Glossary of Terms. Office for National Statistics, London.
Pickard, L., Wittenberg, R., Comas-Herrera, A., Davies, B. and Darton, R. 2000. Relying on informal care in the new century? Informal care for elderly people in England to 2031. Ageing & Society, 20, 6, 745–72.
Pinquart, M. and Sörensen, S. 2007. Correlates of physical health of informal caregivers: a meta-analysis. Journals of Gerontology: Psychological Sciences and Social Sciences, 62B, 2, 126–37.
Prince, M., Wu, F., Guo, Y., Robledo, L. G., O'Donnell, M., Sullivan, R. and Yusuf, S. 2015. The burden of disease in older people and implications for health policy and practice. The Lancet, 385, 9967, 549–62.
Ritchie, J. and Lewis, J. 2003. Qualitative Reserch Practice: A Guide for Social Science Students and Researchers. Sage, London.
Rosenberg, L., Kottorp, A. and Nygård, L. 2012. Readiness for technology use with people with dementia: the perspectives of significant others. Journal of Applied Gerontology, 31, 4, 510–50.
Sanders, C., Rogers, A., Bowen, R., Bower, P., Hirani, S., Cartwright, M., Fitzpatrick, R., Knapp, M., Barlow, J., Hendy, J., Chrysanthaki, T., Bardsley, M. and Newman, S. 2012. Exploring barriers to participation and adoption of telehealth and telecare within the Whole System Demonstrator trial: a qualitative study. BMC Health Services Research, 12, 1, 220.
Social Care Institute for Excellence 2010. At a Glance 24: Ethical Issues in the Use of Telecare. Social Care Institute for Excellence, London.
Sugarhood, P., Wherton, J., Procter, R., Hinder, S. and Greenhalgh, T. 2014. Technology as system innovation: a key informant interview study of the application of the diffusion of innovation model to telecare. Disabilbility Rehabilitation: Assistive Technolology, 9, 1, 7987.
Thompson, G. (ed.) 2015. Key Issues for the 2015 Parliament. House of Commons Library, London.
Topacan, U., Basoglu, N. and Daim, T. 2009. Health information service adoption: case of telemedicine. In 42nd Hawaii International Conference on System Sciences. Hawaii.
Topo, P. 2009. Technology studies to meet the needs of people with dementia and their caregivers. Journal of Applied Gerontology, 28, 1, 537.
Topo, P., Saarikalle, K., Begley, E., Cahill, S., Holthe, T. and Macijauskiene, J. 2007. ‘I don't know about the past or the future, but today it's Friday’ – evaluation of a time aid for people with dementia. Technology & Disability, 19, 2–3, 121–31.
Turnstall Alzheimer's 2008. Support for People with Alzheimer's: Issues of Ethics and Consent. Available online at [Accessed 9 February 2017].
Van Houtven, C. H. and Norton, E. C. 2004. Informal care and health care use of older adults. Journal of Health Economics, 23, 6, 1159–80.
Wittenberg, R., Hu, B., Comas-Herrera, A. and Fernandez, J.-L. 2012. Care for Older People: Projected Expenditure to 2022 on Social Care and Continuing Health Care for England's Older Population. Nuffield Trust, London.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Ageing & Society
  • ISSN: 0144-686X
  • EISSN: 1469-1779
  • URL: /core/journals/ageing-and-society
Please enter your name
Please enter a valid email address
Who would you like to send this to? *



Full text views

Total number of HTML views: 11
Total number of PDF views: 104 *
Loading metrics...

Abstract views

Total abstract views: 640 *
Loading metrics...

* Views captured on Cambridge Core between 2nd May 2017 - 18th August 2018. This data will be updated every 24 hours.