## 4 Discussion
### Stigma and Negative Connotations Are Barriers to Adoption  
Although ambient sensing technologies are less intrusive, the feeling of being watched over by someone regularly remains a privacy concern. Suggestions emerged in the reviewed literature that password-based and customisable data gatekeeping to control the release of information could be solutions to uphold security and dignity [43].  
Stigma and negative associations with disability due to the mere presence of the technology harmed users' experiences, although they were not directly related to the quality of the technology. As reported in one of the studies [43], some technologies might involve changes in living patterns, such as closing the door regularly to avoid triggering a sensor. Together with the inferences drawn from stigma, the design of technology should ensure it is integrated subtly into the environment to minimise awareness and to accommodate users who might differ slightly in terms of lifestyle patterns. As suggested in recent research, the design of sensing technologies should be more appropriate to users' needs and expectations using a person-centred, participatory approach [62]. This also relates to customisation, as mentioned above, in that not only the release of information should be controlled, but the application of technologies should enable slight adaptation to suit individual lifestyle patterns.  
These barriers were critical factors affecting adoption as they were consistent with the key constructs identified in motivation and environmental press theories.  
Self-Determination Theory [63] is one of the motivational theories that considers the adoption of technology as dependent on competence, autonomy, and relatedness to others. Behavioural change is more likely if the assisted person felt competent in using the technology and was based on personal free will, where the results encouraged connection with others. As observed in the discussion above, there were barriers associated with all three constructs. For instance, forced changes in lifestyle patterns to adapt to technology represent a challenge in competence. Loss of privacy could be an example of decreased autonomy. Negative associations and stigma inflicted by technology were associated with social relatedness. Therefore, addressing all three factors was critical to initiating behavioural change in adopting technologies.  
However, the three constructs are not equally weighted regarding their impact on initiating a behavioural change among older adults. Environmental Press Theory [64] suggests that environmental stimuli have a greater demand quality as the competence of the individual decreases. Older people will be affected disproportionately by their environments as their 'competence' is reduced. Therefore, in addition to changing the appearance of design to alleviate stigma, which is associated with relatedness, the two theories combine to suggest that the design of technologies needs to cater to different levels of competence as older adults tend to be more affected by the environment. There should be consideration of customisation to enable more seamless integration with their living pattern.