using technology to support wellness and aging-in-place jennifer boger, m.a.sc., p.eng. may 27, 2009
TRANSCRIPT
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Using Technology to Support Wellness and Aging-in-place
Jennifer Boger, M.A.Sc., P.Eng.
May 27, 2009
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Changing Demographics (US Census Dept, 2005)
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Changing Demographics (US Census Dept, 2005)
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Changing Demographics (US Census Dept, 2005)
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Changing Demographics (US Census Dept, 2005)
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Changing Demographics (US Census Dept, 2005)
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The Problem
Number of older adults
Health challenges with age
Number of caregivers
Environmental support
This true in terms of both the built environment and medical care
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The Need
Support for aging needs new and different approaches
These solutions need to:
• enable aging-in-place
• be easy to use
• be robust, yet sensitive to the changing needs of all users
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Technology as a Solution
Researchers have been looking at the use of technology as part of the solution
Once installed, technology can provide affordable, dynamic, customisable, 24/7 support…
…if it’s appropriate, that is!
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Our Goal
To develop intelligent assistive technology that can promote wellness and aging-in-place, without extra burden to the users
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Our Goal
To develop intelligent assistive technology that can promote wellness and aging-in-place, without extra burden to the users
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Some Definitions…
Wellness and aging-in-place:
The quality or state of being in good health especially as an actively sought goal.
Merriam-Webster's Medical Dictionary
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Some Definitions…
Wellness and aging-in-place: • “…means growing older without having to move.”
BCACL
• “…is not having to move from one's present residence in order to secure necessary support services in response to changing needs.” Journal of Housing for the Elderly
• “…is the ability to live in one's own home - wherever that might be - for as long as confidently and comfortably possible.” Wikipedia
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Some Definitions…
Wellness and aging-in-place:
…is growing older in the home of ones’ choice.
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Some Definitions…
Wellness and aging-in-place:
The quality or state of being in good health especially as an actively sought goal in the home of ones’ choice.
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Our Goal
To develop intelligent assistive technology that can promote wellness and aging-in-place, without extra burden to the users
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Assistive Technology
“Any item, piece of equipment, or product system, whether acquired commercially or off the shelf, modified, or customized, that is used to increase, maintain, or improve functional capabilities of individuals with disabilities”
Cook & Hussey (2000)
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Some Examples
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Some Examples
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Some Examples
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Some Examples
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Our Goal
To develop intelligent assistive technology that can promote wellness and aging-in-place, without extra burden to the users
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Our Design Philosophy
Develop for real-world contexts, to solve problems encountered in real-life
Involve the user from the start to the finish of the design process
Test new technologies as often as possible throughout the design process
Apply Universal Design principles to accommodate all potential users
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Zero-Effort Technologies
Technology should operate without any effort from the users
This means the systems must autonomously: • Interact with users and their environment
• Continuously collect and redistribute data
• Use contextual information to operate and make good decisions
• Dynamically address to changes in user requirements
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Example of Assistive Technologies
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Courtesy of BIME (http://www.bath.ac.uk/bime/)
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Example of Assistive Technologies
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Courtesy of BIME (http://www.bath.ac.uk/bime/)
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Example of Assistive Technologies
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Courtesy of BIME (http://www.bath.ac.uk/bime/)
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Our Goal
To develop intelligent assistive technology that can promote wellness and aging-in-place, without extra burden to the users
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Smart vs. Intelligent
Smart: Performing actions based on direct input of information or data
Intelligent: Performing actions based on common sense, experience, and the ability to adapt, taking context into account
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Intelligent Systems
Sensing: Contextually rich information is collected about the person a rational manner (develop task, user, and system models)
Planning: System decides what the state of the environment is, what the person is doing and how best to react
Response: System reacts to its environment in a contextually-appropriate manner
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Jen, don’t forget to use
the soap.
You have fallen. Do you need
help?
It’s time for your
medication.
Are you feeling okay?
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Our Goal
To develop intelligent assistive technology that can promote wellness and aging-in-place, without extra burden to the users
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DataSharing
HELPER(ERS)
Anti-collisionWheelchair
Robotic StrokeRehabilitation
ArtsTherapy
BalanceAssessment
Examples of Our Research
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The COACH(ADL Cueing)
HELPER(ERS)
HELPER(ERS)
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The Problem
With age, events such as heart attacks and falls become more likely
A fast and appropriate response drastically increases a person’s probability of recovery (and survival!)
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Existing Solutions
http://www.lifelinesys.com/howworks/index.php http://ntec.org.uk/gm2.doc
Call Buttons & Communicator Fall Detector
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Existing Solutions
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Panic buttonTelephone
Need Help
Friends, Family, or Emergency
Services contacted
24 hr Emergency Call Centre live operator
Assistance Arrives
Hands On
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Example Scenario
You are a 86 year old female, living alone
High BP – Asthma – Coronary Vascular Disease
On edge of bed – clammy, accelerated heart beat, sweating, light headed, trouble breathing
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Get Neighbour
Use ‘Lifeline’(push button personal emergency response
system)
Choices:
Phone 911
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Example Scenario
Breathe and stand up to grab for it
Legs give out - you fall to the ground
Hear a crack at your hips
Can’t move without feeling intense sharp pain
Try to get up several times - but cannot
Your friend is coming in 3 hours
So you wait…
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HELPER: A New Solution
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Panic buttonTelephone
Need Help
Friends, Family, or Emergency
Services contacted
24 hr Emergency Call Centre live operator
Assistance Arrives
Hands On Hands Free
Health/Fall MonitoringSpoken Dialogue
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HELPER: System Overview
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HELPER: System Overview
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HELPER: System Overview
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HELPER: System Overview
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Camera
Microphone
Speaker
Patent Pending
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HELPER: System Overview
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Patent Pending
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HELPER: Tracking
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OriginalImage
BackgroundSubtraction
Blob withshadow
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HELPER: Planning
Short-term health:
• Decide if there is an acute (emergency) event
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HELPER: Planning
Long term health:
• Learn the occupant’s normal patterns of activity
• Detect abnormal, non-emergency events that might signal a health change
• Ability to share trends with user, family, and care professionals
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HELPER: Response
Adverse event actions the system can take include:• Call a neighbor
• Call a family member
• Call an operator (e.g. Lifeline)
• Call an emergency service (e.g. ambulance)
• Share data with family and health professionals
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HELPER: Example
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A video of the fall detection system was shown here
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HELPER: Pilot Study Results
Twenty-one subjects simulated various postures and falls within a mock-up of a home environment
Total of 315 postures (126 “falls”)
100% correct assistance decision (88% correct recognition)
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HELPER: Current/Future work
Build an older adult speech database
Test system with older adult actors
Test system in community
Make system available to consumers
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DataSharing
HELPER(ERS)
Anti-collisionWheelchair
Robotic StrokeRehabilitation
ArtsTherapy
Examples of Our Research
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The COACH(ADL Cueing)The COACH(ADL Cueing)The COACH(ADL Cueing)
BalanceAssessment
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Alzheimer’s Disease
The number of people with Alzheimer's worldwide is expected to grow from 18 million to 24 million by 2050
There is approximately one new case of Alzheimer’s every 7 seconds!
70% of people with Alzheimer’s and other dementias live at home
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Alzheimer’s Disease
Alzheimer’s impairs explicit memory, making activities of daily living difficult to do
Currently, a caregiver must always be with the person to provide prompts, support, and monitoring
This is a very difficult and frustrating experience for everyone
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However…
Procedural memory is generally relatively spared
While completion of a task can be difficult, completion of a step is much easier
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The COACH
An intelligent cognitive device that tracks a user through an ADL, providing cues when necessary
Cognitive Orthosis for Assisting Activities in the Home
The
COACH
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The COACH
Digital Video Camera
Flat Screen Monitor & Speakers
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COACH: System Overview
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COACH: Tracking
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A video hand tracking was shown here
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COACH: Planning
System chooses the best action to take based on the state of the environment, such as:• Current user action
• Progress through task
• Preferred pathway
• User attitude / responsiveness
• Dementia level
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COACH: Response
Do nothing
Give a prompt• e.g. “Dawn, you’re doing great. Try turning on the
water”
• 3 levels of specificity (minimal, moderate, maximum)
Call the caregiver
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Putting it all together…
Usesoap
Turn onwater
Wethands
Turn onwater
Usesoap
Turn offwater
Dryhands
Dryhands
Turn offwater
START
Rinsehands
FINISH
Hands = ?
Water = ?
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Putting it all together…
Hands = sink
Water = off UsesoapUsesoap
Turn onwater
Wethands
Turn onwater
Turn onwater
Usesoap
Turn offwater
Dryhands
Dryhands
Turn offwater
START
Rinsehands
FINISH
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Putting it all together…
Hands = tap
Water = on Usesoap
Turn onwater
WethandsWet
hands
Turn onwater
UsesoapUsesoap
Turn offwater
Dryhands
Dryhands
Turn offwater
STARTSTART
Rinsehands
FINISH
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Putting it all together…
Hands = water
Water = on Usesoap
Turn onwater
Wethands
Turn onwater
Turn onwater
UsesoapUsesoap
Turn offwater
Dryhands
Dryhands
Turn offwater
STARTSTART
Rinsehands
FINISH
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Putting it all together…
Hands = towel
Water = on Usesoap
Turn onwater
Wethands
Turn onwater
Turn onwater
UsesoapUsesoap
Turn offwater
Dryhands
Dryhands
Turn offwater
STARTSTART
Rinsehands
FINISH
That’s not the next step….
That’s not the next step….
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Putting it all together…
Hands = towel
Water = on Usesoap
Turn onwater
Wethands
Turn onwater
Turn onwater
UsesoapUsesoap
Turn offwater
Dryhands
Dryhands
Turn offwater
STARTSTART
Rinsehands
FINISH
Dawn, try using the soap
Dawn, try using the soap
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Putting it all together…
Hands = soap
Water = on Usesoap
Turn onwater
WethandsWet
hands
Turn onwater
Turn onwater
Usesoap
Turn offwater
Dryhands
Dryhands
Turn offwater
STARTSTART
RinsehandsRinsehands
FINISH
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Putting it all together…
Hands = water
Water = on Usesoap
Turn onwater
WethandsWet
hands
Turn onwater
Turn onwater
UsesoapUsesoap
Turn offwater
Turn offwater
Dryhands
Dryhands
Dryhands
Turn offwater
STARTSTART
Rinsehands
FINISH
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Putting it all together…
Hands = tap
Water = off Usesoap
Turn onwater
WethandsWet
hands
Turn onwater
Turn onwater
UsesoapUsesoap
Turn offwater
Dryhands
Dryhands
Dryhands
Turn offwater
STARTSTART
RinsehandsRinsehands
FINISH
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Putting it all together…
Hands = towel
Water = off Usesoap
Turn onwater
WethandsWet
hands
Turn onwater
Turn onwater
UsesoapUsesoap
Turn offwater
Turn offwater
Dryhands
Dryhands
Turn offwater
STARTSTART
RinsehandsRinsehands
FINISHFINISH
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Putting it all together…
Hands = away
Water = off Usesoap
Turn onwater
WethandsWet
hands
Turn onwater
Turn onwater
UsesoapUsesoap
Turn offwater
Turn offwater
Dryhands
Dryhands
Dryhands
Turn offwater
STARTSTART
RinsehandsRinsehands
FINISHFINISH
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Examples of Use
Two videos of clinical trials were shown here
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Does it work?
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Number of steps completed without human assistance for S4
0
1
2
3
4
5
0 10 20 30 40
Trial
Nu
mb
er o
f S
tep
s
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Conclusions
Non-traditional tools and techniques, such as AI, have the potential to make environments more usable and safe
Intended user must be kept in mind and involved often for successful outcomes
In addition to technological challenges, development must focus on the social and ethical implications
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Conclusions
In a nutshell:
“Can technology help us age in place?”
YES!
We think high-tech technologies can, too But…
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Considerations When and where is this type of technology
appropriate?
What funding programs are required?
Who chooses when this technology is used?
Who installs and supports it?
How do we educate potential users (including user, nurses, family members) about these systems?
How will these issues be affected in the future when new user populations exist (e.g. baby boomers)?
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Team Members / Contributors
Alex Mihailidis, Sony Allin, Axel von Bertoldi, Tammy Craig, Kate Fenton, Dave Giesbrecht, Tuck-Voon How, Tracy Lee, Melinda McLean, Jasper Snoek, Tony Tam, Vicky Young (IATSL)
Craig Boutilier (University of Toronto)
Jesse Hoey (University of Dundee)
Pascal Poupart (University of Waterloo)
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Acknowledgements
Research has been supported through generous research grants and industrial support from:
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