Article Text

Many older people felt that electronic care surveillance increased their safety and enabled them to live alone in their own homes

Statistics from

A Essén

Dr A Essén, School of Business, Stockholm University, Stockholm, Sweden; aes{at}


How do older people who live with telemonitoring devices feel about their privacy?


In-depth interviews.


Participants’ homes in Sweden.


A purposeful sample of 17 participants 68–96 years of age (53% women) who had been monitored for at least 6–7 months by a telemonitoring device, lived alone, and were exposed to potential health risks in their own homes.


In-depth, face-to-face interviews were conducted, each lasting 90–120 minutes. Questions were asked about participants’ experiences with their telemonitoring devices followed by a discussion of privacy and privacy threats. Interviews were recorded, transcribed, translated, and analysed for themes using an iterative process; notes were taken on non-verbal cues (ie, appearance, anxiety).


2 contrasting perspectives were found. (1) Care surveillance as enabling (n = 16). Most participants with telemonitoring devices felt privileged and cared for. They felt that telemonitoring was reliable and increased their safety (eg, getting help during accidents), especially when they were alone in their own homes. In fact, telemonitoring devices increased participants’ privacy because it enabled them to live in their own homes rather than move to nursing homes. Participants felt that telemonitoring devices allowed them to escape the intrusions of being observed by other people they did not know, as well as being forced to observe others in nursing homes or hospitals. Some participants found it useful that telemonitoring allowed healthcare professionals to remind them if they forgot to wear the device. Although they did not necessarily understand everything that was monitored or the technology associated with telemonitoring devices, participants did not feel uncomfortable being monitored and wanted healthcare professionals to gather as much information as possible about them. One participant indicated that “…the more they know, the better they can understand my problems… I really trust them…” Participants did not feel forced to wear telemonitoring devices and felt that they could stop the service at any time. (2) Care surveillance as constraining. One participant, who appeared to be anxious and exhibited signs of low self-esteem, felt that the telemonitoring device violated her privacy; she felt as if she was under suspicion. She disliked being observed in her own home because she did not want anyone to know of her habits (eg, sleep patterns). Use of the telemonitoring device also affected the decisions she made. For example, when she wanted to sleep in the late morning or wake up in the middle of the night, she was reluctant to do so because of telemonitoring. She was already visited twice a day by community care personnel and felt that telemonitoring did not add much to her care.


Many older people who lived alone and used telemonitoring devices felt that care surveillance increased their safety and enabled them to live in their own homes.


Essén A. The two facets of electronic care surveillance: an exploration of the views of older people who live with monitoring devices. Soc Sci Med 2008;67:128–36.


Increasingly, older people are living alone,1 and their preference to “age in place” as their health changes1 is well documented. Research is needed to develop interventions that enable frail, vulnerable older people to safely continue living alone at home. The findings reported by Essén might have been strengthened by linking the study methods to an overarching qualitative research methodology. However, the study contributes important new knowledge about privacy as a barrier or facilitator of the acceptance of in-home electronic healthcare surveillance among older people who were actively being monitored. Additionally, the importance of sustained relationships with trusted care providers informs an issue concerning the replacement of people by technology.2 3 The findings have 2 main implications for practitioners in support of surveillance systems. First, practitioners can integrate the dual character of privacy into discussions about the risks and benefits4 of such technology with older people who are considering its use. Second, the vital role of continued therapeutic relationships and contact with older people who are monitored is highlighted.2 3 Further research is needed to understand decision making related to use of surveillance systems and varied approaches to privacy among older people.4 5


View Abstract


  • Source of funding: no external funding.

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.