User Experiences of Assistive Living Technologies for Fall Prevention, Detection, and Monitoring in Older Adults: A Thematic Synthesis.

ABSTRACT:

BACKGROUND

Falls are a leading cause of morbidity, functional decline, and premature care entry among older adults. Assistive living technologies (ALTs) are increasingly used for fall prevention, detection, and risk monitoring, but their value depends on how older adults, caregivers, and care staff experience them in practice.

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OBJECTIVES

The objective of this study is to synthesize user-reported experiences of ALTs used for fall prevention, detection, or monitoring across private homes, retirement villages (RVs), and residential aged care homes (RACHs), examining perceived value, implementation friction, adaptation over time, and contextual differences.

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METHODS

A thematic synthesis was conducted within a scoping review. Searches of Embase, MEDLINE, CINAHL, and Scopus covered 2010 to June 2025. Studies reporting user experience data on real-world ALT deployment in nonhospital settings were included. Line-by-line codes were developed into descriptive subthemes and three analytical themes: negotiated value, implementation friction, and adaptation as relational work. Findings were compared by setting, technology, and evidence source.

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RESULTS

Twenty studies published between 2012 and 2024 were included. Eighteen reported at least one implementation challenge; the remaining two did not provide evidence challenges were absent. Perceived value was negotiated by setting: autonomy and self-management dominated in private homes, whereas RACH evidence was staff or family mediated and tied to situational awareness and workflow. Implementation friction stemmed from unreliable alerts, device burden, privacy concerns, infrastructure, and organizational integration. Twelve studies described some changes during deployment, but reporting was heterogeneous and did not support a universal familiarization timeframe. The single RV study offered no user experience evidence.

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CONCLUSION

ALT value is produced through alignment among technology, user roles, care context, and available resources. Sustained use requires user-centered design, workflow integration, infrastructure and financial planning, and support tailored rather than assumed. Future research should prioritize RVs, direct resident perspectives in RACHs, cost and socioeconomic reporting, and prospective cross-setting comparisons.