From experience to policy: safeguarding autonomy and privacy in digital elder care

Purpose This study aims to explore in depth the perceptions, attitudes and experiences of older adults residing in an institutional care facility regarding digital care technologies. Based on these findings, it seeks to develop age-sensitive, privacy-oriented and user-centered digital care policies. Design/methodology/approach A total of 43 participants were selected through purposive sampling from a professional elderly care center located in Narlidere, Izmir. Participants were introduced to IoT-based digital care systems through visual scenarios designed to simulate real-life situations. Data were collected via semi-structured, tablet-assisted personal interviews (TAPIs). In addition to thematic analysis, natural language processing (NLP) techniques, including sentiment analysis, Term Frequency-Inverse Document Frequency, topic modeling (Latent Dirichlet Allocation [LDA]), and concept network mapping, were used. Findings Participants evaluated digital technologies not only in terms of functional benefits but also through values such as privacy, emotional security and social interaction. While fall sensors and emergency alert systems received high acceptance, camera-based surveillance applications were largely rejected due to concerns about privacy violations and emotional discomfort. Acceptance levels varied according to participants’ demographic characteristics such as age, gender and educational background. The findings underscore the need to develop context-sensitive and ethically grounded digital care policies informed by users’ lived experiences. Research limitations/implications This study is limited to institutional elder care settings, excluding home-based and rural contexts, which may affect generalizability. The use of qualitative methods and a cross-sectional design limits temporal insights and empirical testing of acceptance models. NLP techniques were applied to a small dataset, restricting automation potential. Moreover, the focus on individual perspectives overlooks institutional, legal and market dynamics. Practical implications Digital care technologies should balance support and autonomy by prioritizing privacy, ease of use and emotional connection. Nonintrusive tools like fall sensors are more acceptable, while preserving human interaction, is essential to prevent isolation. Age-sensitive literacy and consent-based models are key to adoption. Social implications Digital care systems affect not only functionality but also emotional well-being, privacy and social connection. Older adults favor supportive technologies like fall detectors, while rejecting surveillance tools due to ethical concerns. These findings stress the need for human-centered, trust-based designs and inclusive policies that align with users’ social and emotional realities. Originality/value This study presents a comprehensive analysis that integrates individual experiences of digital aging with spatial and emotional contexts, enriched through NLP techniques. By developing policy recommendations based on the preferences of older adults in institutional care settings, it addresses a critical gap in the literature and proposes culturally adaptable, rights-based strategies for digital care in Turkiye.