Colloquium Presentation with Clara Berridge

Autonomy in the Balance: The Fraught Terrain of Technology-Based Remote Monitoring in Home and Community-Based Services

A Colloquium Presentation with Clara Berridge

Tuesday, January 19, 2016
12:15p.m. – 1:15p.m.
Room 548
A pizza lunch will be provided

We are at a critical moment grappling with questions about how to understand privacy in today’s context where ubiquitous trackability, digitized selves, and predictive analytics proliferate. Passive monitoring technologies that include GPS, activity sensors, and monitoring cameras are now allowable in some U.S. state Medicaid Home and Community-Based Services (HCSB) waiver programs if they reduce or replace the amount of personal care provided. This rapidly evolving policy presents an urgent need to identify the considerations that shape older adults’ preferences for how and when they are monitored and to translate them into decision-making guidelines. Findings will be presented from U.S. Medicaid policy analysis and a qualitative study involving forty-nine in-depth interviews conducted with ethnically diverse and immigrant elder residents, family members, and social work staff in low-income, independent living apartments where a passive monitoring system had been offered for six years.

Dr. Berridge’s research reveals ways passive monitoring may change elder care in ethically problematic ways. It illustrates conflict between values of autonomy and risk management and describes how respect for privacy and autonomy falls out of focus against hope that the technology will enhance safety. Techniques developed by social workers will be discussed to navigate this tension and the importance of understanding what is at stake in these negotiations.

Clara Berridge, PhD, MSW, is a Postdoctoral Fellow at Brown University’s Department of Health Services, Policy & Practice in the Center for Gerontology and Healthcare Research. Clara has a broad-based approach to the study of social, cultural, and ethical implications of technology-based services intended to enable most-integrated housing and reduce vulnerabilities among low-income older adults and people with disabilities. These include telepresence robots and remote monitoring of biometrics and behavioral data. Her research examines the ways diverse stakeholders interact with and assess these technologies as well as the ways policy is taking shape around monitoring technologies in Home and Community-Based Services. Clara has studied decision making about adoption, discontinuation, actual use, creative ‘misuse’, and resistance to explain how values of privacy, autonomy, independence, and risk management are evolving along with new monitoring practices. Her second area of focus concerns the use of surveillance cameras in assisted living and nursing home resident rooms. Clara received her PhD in Social Welfare at the University of California, Berkeley with the University Designated Emphasis in Women, Gender and Sexuality, and her MSW with a specialization in public policy and multigenerational practice from the University of Washington, Seattle.