JERAJournal of Electronic Research and Application2208-35022208-3510Bio-Byword Scientific Publishing Pty. Ltd.10.26689/jera.v9i3.10804ArticlePerceptions of Digital Monitoring Technology for Activities of Daily Living (ADLs): A Semi-Structured Interview Study of Older Adults and Informal Caregivershttps://artdesignp.com/journal/JERA/9/3/10.26689/jera.v9i3.10804XiaoZhiyuan,HouYu,LiHaorui2025932025-06-05With China’s rapidly aging population and the growing preference for aging in place, digital monitoring technologies have emerged as potential tools to support older adults in managing their activities of daily living (ADLs). This study explores the perceptions and acceptance of these technologies among elderly individuals living alone and their informal caregivers (ICs) in Nanshan District, Shenzhen. Grounded in the Unified Theory of Acceptance and Use of Technology (UTAUT), the study employed semi-structured and photo-elicitation interviews to analyze how performance expectancy, effort expectancy, social influence, and facilitating conditions shape technology adoption. The findings reveal clear intergenerational differences: caregivers show higher acceptance and a better understanding of the benefits and functionalities of wearable and environmental monitoring devices, while older adults often express skepticism due to concerns over privacy, usability, and cost. Many elderly participants also cite discomfort, technical complexity, and lack of training as barriers to adoption. Despite these obstacles, both groups acknowledge the potential safety and health benefits of such technologies. The study highlights the need for privacy-by-design features, customized user interfaces, and enhanced digital literacy programs tailored to both elderly users and their caregivers. The research contributes to a sociotechnical understanding of aging-in-place technologies in China and provides actionable insights for developers, policymakers, and healthcare practitioners aiming to enhance home-based elder care.

National Bureau of Statistics of China, 2021, The Seventh National Census, viewed April 13, 2025, https://www.stats.gov.cn/sj/sjjd/202302/t20230202_1896487.html

Wang X, 2024, Survey Shows Increase in Elderly Living Alone, China Daily, viewed April 13, 2025, https://www.chinadaily.com.cn/a/202410/23/WS67185286a310f1265a1c90ea.html

Camp N, Johnston J, Lewis M, et al., 2022, Perceptions of In-home Monitoring Technology for Activities of Daily Living: Semistructured Interview Study with Community-dwelling Older Adults. JMIR Aging, 5(2): e33714. https://doi.org/10.2196/33714

Verloo H, Kampel T, Vidal N, et al., 2020, Perceptions About Technologies that Help Community-dwelling Older Adults Remain at Home: Qualitative Study. Journal of Medical Internet Research, 22(6): e17930. https://doi.org/10.2196/17930

Wilkowska W, Offermann J, Spinsante S, et al., 2022, Analyzing Technology Acceptance and Perception of Privacy in Ambient Assisted Living for Using Sensor-Based Technologies. PLOS One, 17(7): e0269642. https://doi.org/10.1371/journal.pone.0269642

Centers for Disease Control and Prevention (CDC), 2020, The Benefits of Aging in Place, viewed April 13, 2025, https://www.cdc.gov/aging/pdf/the-benefits-of-aging-in-place.pdf

Ratnayake M, Lukas S, Brathwaite S, et al., 2022, Aging in Place: Are We Prepared? Delaware Journal of Public Health, 8(3): 28–31. https://doi.org/10.32481/djph.2022.08.007

Owusu B, Bivins B, Marseille BR, et al., 2023, Aging in Place: Programs, Challenges and Opportunities for Promoting Healthy Aging for Older Adults. Nursing Open, 10(9): 5784–5786. https://doi.org/10.1002/nop2.1872

Edemekong PF, Bomgaars DL, Sukumaran S, 2023, Activities of Daily Living, in StatPearls, StatPearls Publishing, Treasure Island (FL).

Moore K, O’Shea E, Kenny L, et al., 2021, Older Adults’ Experiences With Using Wearable Devices: Qualitative Systematic Review and Meta-synthesis. JMIR mHealth and uHealth, 9(6): e23832. https://doi.org/10.2196/23832

Camp N, Johnston J, Lewis M, et al., 2021, Perceptions of ADLs and In-Home ADL Monitoring Technology among Community-Dwelling Older Adults. JMIR Aging, 5(2): e33714. https://doi.org/10.2196/33714

Kim D, Bian H, Chang CK, 2022, In-Home Monitoring Technology for Aging in Place: Scoping Review. Interactive Journal of Medical Research, 11(2): e39005. https://doi.org/10.2196/39005

Schomakers EM, Ziefle M, 2019, Privacy Concerns and the Acceptance of Technologies for Aging in Place, in Zhou J, Salvendy G, (eds), Human Aspects of IT for the Aged Population. Design for the Elderly and Technology Acceptance, HCII 2019. Lecture Notes in Computer Science, vol 11592. Springer, Cham, 174–183. https://doi.org/10.1007/978-3-030-22012-9_23

Bertolazzi A, Quaglia V, Bongelli R, 2024, Barriers and Facilitators to Health Technology Adoption by Older Adults with Chronic Diseases: An Integrative Systematic Review. BMC Public Health, 24(1): 506. https://doi.org/10.1186/s12889-024-18036-5

Australian Institute of Health and Welfare, 2023, Informal Carers, viewed April 13, 2025, https://www.aihw.gov.au/reports/australias-welfare/informal-carers

Parzen M, O’Keefe-McCarthy S, Salfi J, et al., 2021, Perceptions of Informal Caregivers Use of Smart Technology in Caring for An Older Adult. Journal of Nursing Occupational Health, 2(3): 230–239.

Wang Y, Luo P, 2022, Exploring the Needs of Elderly Care in China from Family Caregivers’ Perspective via Machine Learning Approaches. Sustainability, 14(19): 11847. https://doi.org/10.3390/su141911847

Chen LH, Liu YC, 2022, Interface Design for Products for Users with Advanced Age and Cognitive Impairment. International Journal of Environmental Research and Public Health, 19(4): 2466. https://doi.org/10.3390/ijerph19042466

Dermody G, Fritz RB, Glass C, 2023, Family Caregiver Readiness to Adopt Smart Home Technology to Monitor Care—Dependent Older Adults: A Qualitative Exploratory Study. Journal of Advanced Nursing, 80(2): 628–643. https://doi.org/10.1111/jan.15826

Alkhatib S, Waycott J, Buchanan G, et al., 2021, Privacy by Design in Aged Care Monitoring Devices? Well, Not Quite Yet! Proceedings of the 32nd Australian Conference on Human-Computer Interaction, 492–505. https://doi.org/10.1145/3441000.3441049

Sklar T, Carmona R, Insel K, et al., 2019, Digital Health Privacy in Active-Aging Settings: Will the Law Let You Age Well? Journal on Active Aging, 18(7): 34.

Harrington CN, Jelen B, Lazar A, et al., 2021, Taking Stock of the Present and Future of Smart Technologies for Older Adults and Caregivers. ArXiv (Cornell University). https://doi.org/10.48550/arxiv.2104.00096

Morris J, Allen C, 2023, Teaching Older People New Tricks: Tackling Digital Exclusion in Post-COVID Service Provision. FPOP Bulletin Psychology of Older People, 1(163): 52–56. https://doi.org/10.53841/bpsfpop.2023.1.163.52