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“I’m not ready yet”: Intrapersonal and Interpersonal Processes Shaping the Adoption of Personal Emergency Response Systems Among Older Adults


The goal of this dissertation was to explore older adults’ perceptions of and experiences with quality of life technologies and the meanings they ascribe to a specific subset of quality of life technologies: personal emergency response systems (PERS). Specifically, the purpose was to analyze how older adults perceive the need for PERS and how they negotiate the uptake and use of PERS with themselves and with others.

In collaboration with three community-based organizations in western Los Angeles, California, 18 persons (age 71-97 years) were interviewed. The sample was comprised of eight PERS subscribers and ten non-subscribers. The interviews were conducted using a semi- structured interview guide that included questions about perceptions of PERS prior to subscription and experiences with the use of PERS. Data collection and analyses were guided by constructivist grounded theory methodology. Analytic techniques included initial coding, focused coding, theoretical sampling, and memoing.

The results are presented in a substantive theory that is grounded in the words and narratives of study participants. The theory situates participants’ pre-subscription experiences in the context of their efforts to counteract the impacts of aging. It is comprised of three processes: reclaiming control, protecting personhood, and walking the balance beam. Participants took action to reclaim control they had lost over their bodies due to aging-related changes. Interviewees also sought to protect their personhood from social forces that encroached on their sense of self. Participants appraised PERS with regards to the extent to which the technology could thwart or support these goals. In many cases, these appraisals stood in opposition to each other and participants’ repeatedly used phrases like “I’m not ready yet” to describe this conflict. Thiss internal conflict led participants to walk the balance beam, which entailed postponing their decision with regards to PERS while re-evaluating the meanings of PERS. Over time, participants edged closer to acquiring a PERS through imagined, vicarious, and actual experiences of emergency situations. Additionally, input from members of their social environment facilitated interviewees’ progression towards PERS.

This research is the first to provide crucial insights into the decision-making process specifically prior to PERS subscription. Future research and interventions should conceptualize PERS adoption can be productively conceptualized as behavior change in future research and intervention, which should take into account older adults’ level of readiness to adopt a PERS.

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