Independence for Whom? A Critical Discourse Analysis of Onboarding a Home Health Monitoring System for Older Adult Care

Abstract

Home health monitoring systems (HHMS) are presented as a cost-effective solution that will assist with collaborative care of older adults. However, instead of care recipients feeling like collaborators, such systems often disempower them. In this paper, we examine the dissemination, onboarding, and initial use of an HHMS to see how the discourse used by developers and participants affects users’ collaborative care efforts. We found that the textual information provided often contrasted with how our participants managed their care. Instead of providing participants with ‘independence,’ ‘safety,’ and ‘peace of mind,’ care recipients were placed in a more dependent, less proactive role, and care providers were pressured to take on more responsibilities. We position HHMS, as they are currently marketed and onboarded, as normalizing pseudo-institutionalization. As an alternative we advocate that the discourse and design of such systems should reflect and re-enforce the varied roles care recipients take in managing their care.