Abstract
New technologies such as smart sensors improve rehabilitation processes and thereby increase older adults’ capabilities to participate in social life, leading to direct physical and mental health benefits. Wearable smart sensors for home use have the additional advantage of monitoring day-to-day activities and thereby identifying rehabilitation progress and needs. However, identifying and selecting rehabilitation priorities is ethically challenging because physicians, therapists, and caregivers may impose their own personal values leading to paternalism. Therefore, we develop a discussion template consisting of a series of adaptable questions for the patient–physician encounter based on the capability approach. The goal is to improve geriatric rehabilitation and thereby increase participation in social life and well-being. To achieve this goal, we first analyzed what is considered important for participation on basis of the capability approach, human rights, and ethics of care. Second, we conducted an ethical analysis of each of the four identified dimensions of participation: political, economic, socio-cultural, and care. To improve compliance with rehabilitation measures, health professionals must align rehabilitation measures in an open dialogue with the patient’s aspiration for participation in each dimension. A discussion template based on the capability approach allows for a proactive approach in patient information and stimulates a critical assessment of treatment alternatives while reducing the risk of imposing personal values.
Highlights
Mobility is generally seen as a prerequisite to participate in a wider range of social, cultural, economic, and religious activities
An extensive dialogue between patients and health professionals can identify future rehabilitation strategies and develops patient support and compliance with sensor monitoring by linking rehabilitation measures with achievable future activities
Depending on their ideas of a good life, older adults may decide on different rehabilitation priorities, e.g., to recover walking abilities to enjoy the woods or arm movement to play chess with their grandchildren, to which monitoring needs to be adapted
Summary
Mobility is generally seen as a prerequisite to participate in a wider range of social, cultural, economic, and religious activities. To make sure older adults have the opportunity to participate in the diverse activities that constitute a good life, it is imperative to improve their mobility and reduce hurdles to access public sites New technologies such as smart sensors promise to improve rehabilitation processes. Traditional hospital-based rehabilitation comes with significant challenges, such as allowing older adults to maintain their daily routines, the hassle of commuting to and from the site, and providing person-centered therapy New technologies, such as smart sensors (see Box 1 for an overview) can be used at home and thereby alleviate these challenges. Technology developers have managed to reduce the size of many of such sensors so that they can be worn comfortably to track daily activities while collecting important data This allows a certain degree of discretion to avoid possible stigmas of wearing medical devices [3]. The effective use of smart sensors and the success of long-lasting rehabilitation therapies depend largely on patient compliance, as patients themselves can decide on whether and when to wear the sensors [5]
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