Table 3 Summary of the 12 CMO configurations

Security at home

CMO1:

Connection to help.

Perceived risk of losing independence.

Feeling vulnerable.

Concern from family.

Having telecare that offers a connection to reliable help in an emergency (mechanism - resource) will allow the user to gain trust and faith in the technology to keep them living at home for longer, which will provide peace of mind and reassurance (mechanism – response) that they will receive the help they need.

Reduced anxiety related to risk management at home.

Increased confidence to live at home.

CMO2:

Ensuring privacy.

Perceived poor health/high risk of losing independence.

Passive monitoring which provides 24-hour monitoring (mechanism-resource) may provide additional support and peace of mind and reassurance to people willing to give up some privacy and control for additional safety support (mechanism-response).

Increased confidence in detecting risk/emergencies.

CMO3:

Detecting subtle changes in health.

Conscious about declining health.

If telecare detects health and cognitive decline through data collection and informing users/carers of potential decline (mechanism-resource), this may provide opportunity to users to change their lifestyle or intervene at an earlier stage (mechanism-response).

Increased sense of active ageing.

Likely to enhance ability of individuals to avoid disease/frailty.

CMO4: Meeting future needs.

People who want to plan for the future.

Telecare that is installed to meet anticipated future needs (mechanism-resource) may help older adults feel reassured that they have resources already in place (mechanism-response).

Preparedness for ageing.

Reassurance of support

Proactive support.

2) Autonomy and choice

CMO5: Assessing needs.

Perceived risk of losing independence.

Access to social services for assessment.

Conversations with telecare provider to assess individual needs and customise/match the telecare device to the individual needs (mechanism-resource) may increase sense of self-care (mechanism-response).

Increased control over perceived health-risk.

CMO6: Choice in using telecare.

Feels open towards using telecare.

Giving users the choice to use telecare and what kind of device they can use (mechanism – resource) may help the person feel empowered to self-govern oneself (mechanism-response).

Increased confidence to make decisions about own independence.

CMO7: Choice in how telecare is used.

Fear of being framed as frail or vulnerable.

Telecare that encourages control and choice in how it is used before and after an incident (mechanism-resource) may reduce feelings of being “burdensome” to those who provided support, and reduce the perceived image of being frail and needing support (mechanism-response).

Sense of control.

Supporting personal and social identities.

3) Feeling connected to social resources

CMO8: Providing social connections.

Limited social resources.

Having telecare that provides continual reassurance of connection to a wider system of support (mechanism – resource) may increase feelings of connectedness (mechanism – response). Having access to a social network that is accessible, friendly and welcoming (mechanism – resource) may help empower individuals to ask for help and use the network for social interaction (mechanism – response).

Reduced loneliness and social isolation.

4) Integration into everyday life

CMO9: Understanding telecare.

Anxious about losing independence.

Ensuring understanding of how telecare works, how it can support independence and what will happen in the event of an alarm being raised (mechanism – resource) will enable trust in telecare to support independence and peace of mind (mechanism – response).

Reduce anxiety around losing independence/having a fall.

CMO10:

Customising telecare.

Individual expectations and needs.

If the telecare technology can be customised and personalised to suit individuals need and preferences (mechanism-resource), then it will be more appropriate to a wider population with differing needs (mechanism-response).

Improved integration into everyday life.

Improved ease of use.

CMO11: Familiar design.

Anxiety related to technology.

If the telecare technology has a design that the user is aware of and used to using (mechanism-resource), then the user will feel more confident that they can use it and help integrate better into daily routine (mechanism-response).

Improved efficiency in use.

CMO12:

User expectations.

Older adult wishes to use telecare to achieve a specific goal.

When telecare matches user’s expectations (mechanism-resource), this will increase trust in technology to support the user to live independently (mechanism-response).

Increased feeling of safety.

Increased confidence to live at home.