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The power(s) of observation: theoretical perspectives on surveillance technologies and older people


There is a long history of surveillance of older adults in institutional settings and it is becoming an increasingly common feature of modern society. New surveillance technologies that include activity monitoring, and ubiquitous computing, which are described as ambient assisted living (AAL), are being developed to provide unobtrusive monitoring and support of activities of daily living and to extend the quality and length of time older people can live in their homes. However, concerns have been raised with how these kinds of technologies may affect user's privacy and autonomy. The objectives of this paper are (a) to describe the development of home-based surveillance technologies; (b) to examine how surveillance is being restructured with the use of this technology; and (c) to explore the potential outcomes associated with the adoption of AAL as a means of surveillance by drawing upon the theoretical work of Foucault and Goffman. The discussion suggests that future research needs to consider two key areas beyond the current discourse on technology and ageing, specifically: (a) how the new technology will encroach upon the private lived space of the individual, and (b) how it will affect formal and informal caring relationships. This is critical to ensure that the introduction of AAL does not contribute to the disempowerment of residents who receive this technology.

Corresponding author
Address for correspondence: Ben Mortenson Department of Occupational Science and Occupational Therapy, University of British ColumbiaT325-2211 Wesbrook Mall Vancouver, British Columbia V6T 2B5, Canada. E-mail:
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Altheide D. L. and Michalowski R. S. 1999. Fear in the news: a discourse of control. The Sociological Quarterly, 40, 3, 475503.
Altman I. and Low S. 1992. Place Attachment. Plenum Press, New York.
Batsch N. L. and Mittelman M. S. 2012. Overcoming the Stigma of Dementia. World Alzheimer Report 2012. Alzheimers Disease International, London.
Bentham J. 1995. Panopticon. In Bozovic M. (ed.), The Panopticon Writings. Verso, London, 2995.
Beringer R., Sixsmith A., Campo M., Brown J. and McCloskey R. 2011. The ‘acceptance’ of ambient assisted living: developing an alternative methodology to this limited research lens. Lecture Notes in Computer Science, 6719, 161–7.
Bharucha A. J., London A. J., Barnard D., Wactlar H., Drew M. A. and Reynolds C. F. 2006. Ethical considerations in the conduct of electronic surveillance research. The Journal of Law, Medicine and Ethics, 34, 3, 611–9.
Brownsell S., Blackburn S. and Hawley M. S. 2008. An evaluation of second and third generation telecare services in older people's housing. Journal of Telemedicine and Telecare, 14, 1, 812.
Buckingham D. 2008. Introducing identity. In Buckingham D. (ed.), Youth, Identity, and Digital Media. MIT Press, Cambridge, Massachusetts, 124.
Cottle S. N. 2004. Big brother and grandma: an argument for video surveillance in nursing homes. Elder Law Journal, 12, 1, 119–23.
Courtney K. L., Demiris G., Rantz M. and Skubic M. 2008. Needing smart home technologies: the perspectives of older adults in continuing care retirement communities. Informatics in Primary Care, 16, 3, 195201.
Cvach M. 2012. Monitor alarm fatigue: an integrative review. Biomedical Instrumentation and Technology, 46, 4, 268–77.
Demiris G., Hensel B. K., Skubic M. and Rantz M. J. 2008. Senior residents’ perceived need of and preferences for ‘smart home’ sensor technologies. International Journal of Technology Assessment in Health Care, 24, 1, 120–4.
Demiris G., Oliver D. P. and Courtney K. L. 2006. Ethical considerations for the utilization of tele-health technologies in home and hospice care by the nursing profession. Nursing Administration Quarterly, 30, 1, 5666.
Demiris G., Rantz M., Aud M., Marek M., Tyers H., Skubic M. and Hussam A. 2004. Older adults' attitudes towards and perceptions of ‘smart home’ technologies: a pilot study. Medical Informatics, 29, 2, 8794.
Doughty K., Cameron K. and Garner P. 1996. Three generations of telecare for the elderly. Journal of Telemedicine and Telecare, 2, 2, 7180.
Essen A. 2008. The two facets of electronic care surveillance: an exploration of the views of older people who live with monitoring devices. Social Science and Medicine, 67, 1, 128–36.
Foucault M. 1978. The History of Sexuality. Translator R. Hurley, Vintage, New York.
Foucault M. 1980. Power/Knowledge: Selected Interviews and Other Writings, 1972–1977. Pantheon, New York.
Foucault M. 1982. The subject and power. In Dreyfus H. and Rabinow P. (eds), Michel Foucault: Beyond Structuralism and Hermeneutics. University of Chicago Press, Chicago, 208–26.
Foucault M. 1988. Technologies of the self. In Martin L. H., Gutman H. and Hutton P. H. (eds), Technologies of the Self: A Seminar with Michel Foucault. University of Massachusetts Press, Amherst, Massachusetts, 1649.
Foucault M. 1991. Discipline and Punish: The Birth of the Prison. Translator A. Sheridan, Penguin Books, London.
Foucault M. 1997. Governmentality. In Burchell G., Gordon C. and Miller P. (eds), The Foucault Effect. Studies in Governmentality. University of Chicago Press, Chicago, 87104.
Friedman D. 2008. Future Imperfect: Technology and Freedom in an Uncertain World. Cambridge University Press, Cambridge.
Giddens A. 1991. Modernity and Self-identity. Self and Society in the Late Modern Age. Polity, Cambridge.
Goffman E. 1959. The Presentation of Self in Everyday Life. Doubleday and Co., Garden City, New York.
Goffman E. 1967. Interaction Ritual. Doubleday and Co., Garden City, New York.
Goffman E. 1968. Asylums. Penguin, London.
Goffman E. 1971. The Presentation of Self in Everyday Life. Penguin, London.
Hagestad G. and Dannefer D. 2001. Concepts and theories in ageing: beyond microfication in social science approaches. In Binstock R. H. and George L. (eds), Handbook of Ageing and the Social Sciences. Academic Press, San Diego, California, 321.
Ice G. H. 2002. Daily life in a nursing home: has it changed in 25 years? Journal of Ageing Studies, 16, 4, 345–60.
Illes J., Rosen A. C., Huang L., Goldstein R. A., Raffin T. A., Swan G. and Atlas S. W. 2004. Ethical consideration of incidental findings on adult brain MRI in research. Neurology, 62, 6, 888–90.
Kayser-Jones J., Schell E., Lyons W., Kris A. E., Chan J. and Beard R. L. 2003. Factors that influence end-of-life care in nursing homes: the physical environment, inadequate staffing, and lack of supervision. The Gerontologist, 43, supplement 2, 7684.
Kazdin A. E. 1979. Unobtrusive measures in behavioral assessment. Journal of Applied Behavior Analysis, 12, 4, 713–24.
Koch S., Marschollek M., Wolf K. H., Plischke M. and Haux R. 2009. On health-enabling and ambient-assistive technologies. What has been achieved and where do we have to go? Methods of Information in Medicine, 48, 1, 2937.
Lett D., Hier S. and Walby K. 2010. CCTV surveillance and the civic conversation: a study in public sociology. Canadian Journal of Sociology, 35, 3, 437–62.
Lippert R. 2009. Signs of the surveillant assemblage: privacy regulation, urban CCTV and governmentality. Social and Legal Studies, 18, 4, 505–22.
Lyon D. 1994. The Electronic Eye: The Rise of Surveillance Society. Polity Press, Cambridge.
Lyon D. 2001. Surveillance Society: Monitoring Everyday Life. Open University Press, Buckingham, UK.
Mann S., Nolan J. and Wellman B. 2003. Sousveillance: inventing and using wearable computing devices. Surveillance & Society, 1, 3, 331–55.
Marx G. 1998. Ethics for the new surveillance. The Information Society, 14, 3, 171–85.
Mattek N., Ruhl M., Dodge H. and Kaye J. 2013. Willingness of older adults to share data and privacy concerns after exposure to unobtrusive in-home monitoring. Gerontechnology, 11, 3, 428–35.
Mattimore T. J., Wenger N. S., Desbiens N. A., Teno J. M., Hamel M. B., Liu H., Califf R., Connors A. F., Lynn J. and Oye R. K. 1997. Surrogate and physician understanding of patients' preferences for living permanently in a nursing home. Journal of the American Geriatrics Society, 45, 7, 818–24.
Minuk L. 2006. Why privacy still matters: the case against prophylactic video surveillance in for-profit long-term care homes. Queen's Law Journal, 32, 3, 224–77.
Moffatt P. 2008. Should we tag people with dementia? International Journal of Palliative Nursing, 14, 2, 56.
Mortenson W. B., Oliffe J. L., Miller W. C. and Backman C. L. 2012. Grey spaces: the wheeled fields of residential care. Sociology of Health and Illness, 34, 3, 315–29.
Norris C., McCahill M. and Wood D. 2002. The growth of CCTV: a global perspective on the international diffusion of video surveillance in publicly accessible space. Surveillance and Society, 2, 2/3, 110–35.
Orwell G. 1983. Nineteen-eighty-four. Penguin, Toronto.
Percival J. and Hanson J. 2006. Big brother or brave new world? Telecare and its implications for older people's independence and social inclusion. Critical Social Policy, 26, 4, 888909.
Powell D. H. 2004. Treating individuals with debilitating performance anxiety: an introduction. Journal of Clinical Psychology, 60, 8, 801–8.
Reder S., Ambler G., Philipose M. and Hedrick S. 2010. Technology and Long-term Care (TLC): a pilot evaluation of remote monitoring of elders. Gerontechnology, 9, 1, 1831.
Riikonen M., Mäkelä K. and Perälä S. 2010. Safety and monitoring technologies for the homes of people with dementia. Gerontechnology, 9, 1, 3245.
Rogers E. M. 1995. Diffusion of Innovation. The Free Press, New York.
Rose N. 1997. Inventing Ourselves: Psychology, Power and Personhood. Cambridge University Press, Cambridge.
Rothiot J. P. 1998. Comités de surveillance et terreur dans le département des vosges de 1793 à l'an III. Annales Historiques de la Révolution Française, 314, 1, 621–68.
Rowley J. 2005. Customer knowledge management or consumer surveillance. Global Business and Economics Review, 7, 1, 100–10.
Salzmann-Erikson M. and Eriksson H. 2012. Panoptic power and mental health nursing. Issues in Mental Health Nursing, 33, 8, 500–4.
Savage R. 2010. An exploration of the needs and concerns of potential ambient assisted living users within the context of the meaning of home. Master's thesis, Simon Fraser University, Vancouver, Canada.
Shorr R., Chandler M., Mion L., Waters T., Liu M., Daniels M., Kessler L. P. and Miller S. 2012. Effects of an intervention to increase bed alarm use to prevent falls in hospitalized patients: a cluster randomized trial. Annals of Internal Medicine, 157, 10, 281–98.
Sixsmith J. 1986. The meaning of home. Journal of Environmental Psychology, 6, 4, 281–98.
Sixsmith A. 2013. Technology and the challenge of ageing. In Sixsmith A. and Gutman G. (eds), Technologies for Active Ageing. Springer, New York, 725.
Sixsmith A. and Sixsmith J. 2000. Smart home technologies: meeting whose needs? Journal of Telemedicine and Telecare, 6, 1, Supplement, 190–2.
Sixsmith A. and Sixsmith J. 2008. Ageing in place in the United Kingdom. Ageing International, 32, 3, 219–35.
Sixsmith A., Woolrych R., Bierhoff I., Mueller S. and Byrne P. 2012. Ambient assisted living: from concept to implementation. In Glascock A. and Kutznik D. (eds), Essential Lessons for the Success of Telehomecare. IOS Press, Amsterdam, 259–86.
Steele R., Lo A., Secombe C. and Wong Y. K. 2009. Elderly persons’ perception and acceptance of using wireless sensor networks to assist healthcare. International Journal of Medical Informatics, 78, 12, 788801.
Turner B. S. 1997. From governmentality to risk: some reflections on Foucault's contribution to medical sociology. In Peterson A. and Bunton R. (eds), Foucault, Health and Medicine. Routledge, London, ix–xxi.
UK Department of Health 2011. Whole System Demonstrator Project: Headline Figures. Available online at [Accessed 20 March 2013].
Verbeek P. 2009. Ambient intelligence and persuasive technology: the blurring boundaries between human and technology. Nanoethics, 3, 3, 231–42.
Vuokko R. 2008. Surveillance at workplace and at home: social issues in transforming care work with mobile technology. Journal of Information, Communication and Ethics in Society, 6, 1, 6075.
Walther J. B. 1996. Computer-mediated communication: impersonal, interpersonal, and hyperpersonal interaction. Communication Research, 23, 1, 343.
Welsh S., Hassiotis A., Omahoney G. and Deahl M. 2003. Big brother is watching you – the ethical implications of electronic surveillance measures in the elderly with dementia and in adults with learning difficulties. Ageing and Mental Health, 7, 5, 372–5.
Wild K., Boise L., Lundell J. and Foucek A. 2008. Unobtrusive in-home monitoring of cognitive and physical health: reactions and perceptions of older adults. Journal of Applied Gerontology, 27, 2, 181200.
Woolrych R. and Sixsmith A. 2012. Challenges of user-centred research in the development of ambient assisted living systems. In Donnelly M., Paggetti C., Nugent C. and Mokhtari M. (eds), Impact Analysis of Solutions for Chronic Disease Prevention and Management. Springer, Berlin, 18.
Zwijsen S. A., Niemeijer A. R. and Hertogh C. M. 2011. Ethics of using assistive technology in the care for community-dwelling elderly people. Aging and Mental Health, 15, 4, 419–27.
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