# Towards Caring Technologies in Older Adult Care Through the Co-Creation of an Ethical Process Guide

## TL;DR

This paper creates a practical ethical guide for developing and using caring technologies in older adult care to ensure inclusion, autonomy, and equity.

## Contribution

The study introduces a step-by-step ethical process guide for implementing caring technologies in older adult care.

## Key findings

- Abstract ethical frameworks are insufficient for practical use in care settings.
- A structured guide with examples and tools supports inclusive technology adoption.
- The guide can act as both an implementation aid and a quality label for stakeholders.

## Abstract

Public health relevance—How does this work relate to a public health issue?
Ageing populations and care workforce shortages are driving the rapid adoption of caring technologies in older adult care, often without sufficient ethical guidance to ensure inclusion, autonomy, and equity.Existing ethical frameworks in digital health remain largely abstract, which limits their practical use in public health and care settings.

Ageing populations and care workforce shortages are driving the rapid adoption of caring technologies in older adult care, often without sufficient ethical guidance to ensure inclusion, autonomy, and equity.

Existing ethical frameworks in digital health remain largely abstract, which limits their practical use in public health and care settings.

Public health significance—Why is this work of significance to public health?
This study provides an empirically grounded blueprint that translates ethical principles into practical guidance for caring technology development and implementation.By focusing on older adults as a vulnerable population, the study supports public health goals related to digital inclusion, equitable access, and mental well-being.

This study provides an empirically grounded blueprint that translates ethical principles into practical guidance for caring technology development and implementation.

By focusing on older adults as a vulnerable population, the study supports public health goals related to digital inclusion, equitable access, and mental well-being.

Public health implications—What are the key implications or messages for practitioners, policy makers and/or researchers in public health?
Public health practitioners and innovation managers can use process-based ethical guidance to support responsible and inclusive technology adoption in care settings.Policymakers and researchers are encouraged to further validate and embed ethical process guides within innovation governance and public health evaluation frameworks.

Public health practitioners and innovation managers can use process-based ethical guidance to support responsible and inclusive technology adoption in care settings.

Policymakers and researchers are encouraged to further validate and embed ethical process guides within innovation governance and public health evaluation frameworks.

As populations age, the gap between care needs and available support systems is widening, leading to critical vulnerabilities in staffing, infrastructure, and funding. The need for accessible, human-centred, and ethically grounded care technologies is growing. However, the development of digital health tools often lacks inclusivity and practical guidance. Existing ethical frameworks tend to remain abstract, which limits their real-world application. This study examines how such frameworks support the responsible development and implementation of caring technologies in older adult care. To achieve this, in-depth interviews were conducted with care providers, technology developers, and policymakers from partner organisations of the EMPOWERCARE project in the four participating countries: the UK, the Netherlands, Belgium and France. A core challenge was the limited applicability of abstract ethical principles in daily care settings. While existing initiatives often define ethical domains, few offer a structured, actionable process to guide implementation in practice. The proposed guide responds with a step-by-step structure, practical examples, and participatory tools to support inclusive, value-driven technology adoption. It is envisioned both as an implementation aid and a quality label to align stakeholders. Future research should validate the guide’s usability, explore its role across care contexts, and examine how ethics can be more firmly embedded in innovation governance.