Empowering Older Adults: A Self-Determination Theory-Based Transformative Design Framework for In-Home Monitoring

While global aging intensifies the need for in-home monitoring, existing passive surveillance positions older adults as monitored subjects, undermining their autonomy and health engagement. Thishighlights a lack of design frameworks dedicated to empowering older adults in behavioral monitoring. To address this gap, we conducted a formative study with 30 older adults (mean age = 67.9) to identify their psychological and contextual needs. By integrating formative findings with Self-Determination Theory (SDT), we developed a transformative design framework comprising contextual dimensions and SDT-based design pillars. We then designed and evaluated the HomeCare system as a proof-of-concept through a pre-post experiment. Results revealed significant improvements in health consciousness (Z = 3.86, p < 0.001), autonomy (Z = 3.24, p < 0.001), and competence (Z = 4.49, p < 0.001), alongside high digital engagement (6.26± 0.32 scores) and positive user experiences. This study demonstrates SDT's potential to shift in-home technology from passive monitoring to active empowerment, providing actionable strategies for aging-in-place.