Analyzing the use of videoconference by and for older adults in nursing homes: an interdisciplinary approach to learn from the pandemic

Introduction During the Covid-19 pandemic and the resulting visitation restrictions, digital tools were used in many nursing homes in France to allow the older adults and their relatives to maintain social contact via videoconferencing. This article adopts an interdisciplinary approach to analyze the processes that affect the use of digital technologies. Methods Drawing on the concept of "mediation," it seeks to shed light on how individuals embrace these tools in a relational situation. The interviews and observations undertaken among residents, their relatives, professionals, and the management head of seven nursing homes in 2021, make it possible to outline the different forms of practices and uses and to identify the factors leading to the variations observed. Results While the key objective of these technical and technological tools is to compensate – on a functional level – for the communication problems and the isolation of individuals in order to promote residents' "quality of life" by maintaining "social contact," our study reveals that these tools' uses and practices largely differ. It also shows considerable inequalities in terms of residents' acquisition of subjective feelings of ownership of the tools. These are never attributed to isolated physical, cognitive, psychic, and social difficulties, but are influenced by specific organizational, interactional, and psychic configurations. Some of the structures analyzed revealed situations in which mediation failed, occasionally exposing the risk associated with seeking "ties at all costs," or revealing a disturbing strangeness when residents were placed in front of screens. Some configurations, however, showed that it was possible to set up an intermediate space for the experience to unfold, which in turn opened up a space where individuals, groups, and institutions could experiment, allowing them to develop subjective feelings of ownership of this experience. Discussion This article discusses how the configurations that failed to promote the mediation process reveal the need to assess the representations of care and assistance in the relationships between older adults, their loved ones, and nursing home professionals. Indeed, in certain situations, the use of videoconferencing, while seeking to produce a positive effect, risks displacing and increasing the effects of the "negative" associated with dependency, which may worsen individuals' difficulties within nursing homes. The risks associated with the failure to take into account residents' requests and consent explain why it is important to discuss how certain uses of digital tools may renew the dilemma between concerns for protection, on the one hand, and respect for autonomy on the other.