Detangling experiences of agency in welfare technology use by home care recipients and their staff.

Abstract

Welfare technology (WT), defined as digital technology enabling individuals to live securely, actively and independently at home, is often viewed as a solution to care resource shortages. This solution discourse has increasingly been problematised, and ethical issues specifically connected to WT have emerged, e.g., regarding quality of care. The existing array of WT is developed with limited user involvement; primary user perspectives are thus inadequately voiced in research. This study aimed to disentangle how older adults and their homecare staff experience and influence WT use in homecare situations. The qualitative approach encompassed individual semi-structured interviews with homecare staff (n = 26) and older adults (n = 26) receiving homecare as well as utilising WT. Interviews were conducted in five Swedish municipalities, transcribed verbatim and analysed using thematic analysis. Three main themes were developed: (1) Lack of agency in WT obtainment, in which a lack of influence in the receiving of WT is illustrated. (2) Contradictory user perspectives regarding WT and agency, in which staffs' perceptions of specific WT are contrasted to older adults', highlighting how WT perceived positively by staff often detract from older adults' agency. (3) Agency and WT use inextricably linked with time, in which it is illustrated how influence over time is intricately connected to experienced agency in WT use. Our findings demonstrate a problematic lack of agency in WT use. Further improvements to current WT, aided by stronger user involvement, as well as certain municipal routines, are necessary if user agency is to be strengthened in relation to WT use.