## 2 Literature Review
### Review of the Literature
#### 2.2.3 Explicit IoT Research for Older Adults to Age in Place  
An increasing number of IoT technologies called smart home devices were in the consumer market explicitly designed for older adults. These included remote monitoring, automatic stove shutoff, voice activated assistants, smart phone applications to control lights, and emergency alert systems. [PERSON] et al. [46] examined older adult ownership of these types of smart home devices. The researchers explicitly targeted the population of adults 60 years or older. Women ages 60 to 70 years old who had an impairment, fall history, and were experienced with technology were early adopters of the devices. The researchers reported that the IoT technologies promoted or used in experiments for older adults to age in place longer were the least desired by them. Older adults rejected remote home monitoring, using a smartphone to control appliances, motion activated cameras, voice activated assistants, and emergency alerting systems.  
Conversely, they reported that a significant number of older adults in the study were using carbon monoxide alarms, manually programmable or automatic set thermostats, motion sensing lights, and backup generators. The results indicated that older adults who were concerned about safety were interested in purchasing water leak detectors, backup generators, and automatic shutoff technologies for the stove. However, they did not own these technologies at the time of the study. This study confirmed others in that older adults who perceived their independence or health declining were more likely to adopt the solutions to compensate for their condition [15, 46, 63, 65]. The adoption of technology also presumes that the beneficiaries (older adults) will have Internet access in their homes or use a smartphone to go online [46, 112].  
[PERSON] et al. [112] studied older adults' perceptions of a health portal as a means for them to receive laboratory results, communicate with caregivers, and ask questions. The themes that emerged support many other studies. The researchers reported that older adults required training and support for technology (facilitating conditions). Many of the study's participants stated they had little to no experience with computers and no Internet access in their homes. Although persons in the U.S. are increasingly using their smartphones to go online over in-home broadband [113], prior research showed that older adults held onto older technology longer than younger persons, as previously stated [15, 63]. Seriously or chronically ill participants found the health portal convenient for obtaining lab results. Still, they felt their conditions were too complicated to effectively communicate with caregivers through secure messaging as the only means [112]. They perceived the portal as a poor substitute for direct interaction with clinical personnel.  
Researchers reported that technology contributed to further isolation of older adults and less communication with the broader community in several studies [15, 58, 65, 83, 84]. Developers of IoT solutions for adults to age in place longer should consider the potential isolation caused by implementing remote monitoring sensors, pushing health portals as a single solution, and supplementing caregivers with autonomous robots. The Technology in Later Life study was designed to determine if there was a digital divide between rural and urban adults aged 70 and above in the U.K. and Canada [114]. This qualitative study found that facilitating conditions, access to technology, and security influenced older adults' technology use. Detractors to technology use were apprehensions, lack of interest, and difficultly in learning how to use it [30].