The Potential of New Technologies for Healthy and Active Ageing
Prepared by: PP-10 University of Ljubljana – (UL), Slovenia
SLOVENIA
Assistive technologies, both basic and advanced, supported by information and communication technologies have enormous potential for healthy and active ageing. They can make everyday life easier for older people, helping them with basic tasks and personal care, promoting their sense of security and independence, and enabling them to live independently and autonomously in their own homes for longer. However, older people are often unaware of these solutions. This module therefore aims to familiarise older people with assistive technologies and the potential positive impact they can have on their daily lives.
| Objectives of the training: | Expected learning outcomes: | Target group: |
| - Familiarise trainees with demographic trends of population ageing. - Introducing the concept of assistive technologies and presenting their types and subtypes. - Introducing the potential of smartphones to contribute to active and healthy ageing. |
- Understanding the concept of assistive technologies. - Understanding the basics of assistive technologies. - Understanding the differences between them and the purpose of different types of assistive technologies. |
- Older adults (people over 55) - Relatives of older people – (potential) informal carers |
No prior knowledge is required to join the training programme. The training is self-paced online.
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| ASSISTIVE TECHNOLOGIES |
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Population ageing is one of the most significant demographic trends and one of the major problems facing developed countries. The ageing process is the result of a decreasing birth rate, decreasing mortality rates, as well as the outflow of young people and the influx of a large number of migrants from third countries (Šircelj, 2009; Vertot, 2010). The proportion of people who are 60 years or older is growing rapidly. Currently, 10% of the world's population is 60 years or older and projections show that this number will increase to 20% by 2050. While the world population is growing at 1% per year, the number of people over 80 is increasing by 4% and will almost triple by 2060 (Piper and Hollan, 2013; Sixsmith, 2013; Vertot, 2010).
Figure 1: Population growth projections 2010-2060 – Slovenia. (Source: Statistical Office of the Republic of Slovenia)
Demographic change is also a political problem that policymakers are trying to address and solve. An orderly social policy is important not only for the elderly population, but also for society as a whole - policies must ensure that younger generations can go to school (for free), that there are enough jobs for the middle generations, and that the elderly have pensions and adequate health care. It is also important that no sector runs out of resources, which is particularly important at a time when the proportion of the elderly population is rising while the number of working people contributing to health and pensions is falling. Finally, an ageing society cannot afford to have a large proportion of its population, which in the future will consist of older people, as passive bystanders or as a group that imposes costs and burdens on the active population (Penger and Dimovski, 2007).
In the context of change, the concept of intergenerational solidarity is very important. While rapidly changing social and economic conditions around the world have implications for intergenerational relationships within families and the welfare state, intergenerational solidarity that is lifelong can help individuals, families and societies in times of global economic challenges and growing inequalities. At the same time, intergenerational solidarity plays an important role in the emotional and physical well-being of individuals (Timonen et al., 2013; Szydlik, 2008; Merz et al., 2007).
Another important phenomenon of the 21st century, in addition to ageing, is the remarkable progress and development of new technologies. New technologically sophisticated devices are appearing every day to make our daily tasks, work, communication with other and many other tasks easier. Devices and assistive devices, collectively known as assistive technologies, can make a significant contribution to the quality of life of the ageing population, enabling them to remain in their own homes for longer, often independently of the help of their relatives of carers. These include mechanical devices such as handrails and walking aids, a red button to quickly call for help, sensors and alarms such as fall detector, bed occupancy detector or gas detector. From interactive and virtual services that can look after the well-being of the elderly via an interactive video link and telemedicine that allows remote health monitoring, the range extends to complex ambient intelligence services that turn the ordinary home into a smart home (Cook et al., 2009; Rudel, 2008; Doughty et al., 2007; Dolničar, 2009). Assistive technology can also be a smartphone with an app installed that works on the basis of sensors embedded in the device. This is an area that has a great potential and can make a significant contribution to the quality of life of older people and improve the availability of assistive technologies (European Comission, 2010).
Another important phenomenon of the 21st century, in addition to ageing, is the remarkable progress and development of new technologies. New technologically sophisticated devices are appearing every day to make our daily tasks, work, communication with other and many other tasks easier. Devices and assistive devices, collectively known as assistive technologies, can make a significant contribution to the quality of life of the ageing population, enabling them to remain in their own homes for longer, often independently of the help of their relatives of carers. These include mechanical devices such as handrails and walking aids, a red button to quickly call for help, sensors and alarms such as fall detector, bed occupancy detector or gas detector. From interactive and virtual services that can look after the well-being of the elderly via an interactive video link and telemedicine that allows remote health monitoring, the range extends to complex ambient intelligence services that turn the ordinary home into a smart home (Cook et al., 2009; Rudel, 2008; Doughty et al., 2007; Dolničar, 2009). Assistive technology can also be a smartphone with an app installed that works on the basis of sensors embedded in the device. This is an area that has a great potential and can make a significant contribution to the quality of life of older people and improve the availability of assistive technologies (European Comission, 2010).
TELECARE AND TELEHEALTH
We have already seen that assistive technologies are used in different situations and for different purposes, some are quite simple, others are more technologically sophisticated, and the most sophisticated even allow remote monitoring of the user. This also leads to different classifications. Robitaille (2010) introduces a classification in ten groups according to their basic purpose. However, technologies can also be used for telecare and telehealth services.
Telecare refers to the use of systems or devices supported by information and communication technology to deliver care directly to the user, which in practice means using sensors and other technologies to help people with disabilities and chronic health conditions to live independently. Users are typically accompanied at home by devices that transmit information to a care provider (formal or informal) at a remote location. Telecare can be deemed active or passive. In active systems of telecare, the user consciously initiates the connection with services when they need to. Passive systems connect to services automatically, usually through sensors or other mechanisms that detect and trigger contact when a relevant situation arises (NDA 2018). The devices can detect hazards such as falls, bed occupancy and immobility, or monitor whether the user has taken medication. The concept first emerged in Britain in the 1960s and from there spread rapidly through Western and Nothern Europe and to markets in Eastern Europe, Latin America, Israel, and some Asian countries (Sorell and Draper, 2012).
There are seen to be three waves of sophistication of telecare – first, second and third generation telecare (NDA, 2018):
There are seen to be three waves of sophistication of telecare – first, second and third generation telecare (NDA, 2018):
- First generation telecare (sometimes known as basic telecare) can refer to active systems which rely on the user to initiate an alert. Traditionally, first generation refers to monitored personal alarms that utilise call centres to pick up alerts. Example: personal alarms (red button).
- Second generation telecare systems are proactive, intelligent systems that utilise sensors to automatically alert designated call-centres or healthcare staff. Example: worn fall detectors; door sensors.
- Third generation systems process and analyse information coming from sensors to construct user profiles of activity patterns and lifestyles. There may also be an emphasis on user assessment and learning to inform care. Third generation systems usually involve broadband, wireless, and/or Audio-Visual technology, allowing virtual contact between users and their care team. Example: global positioning system (GPS) monitoring of persons with dementia who may be at risk of getting lost.
The second type, telehealth, is a tool in long-term condition management and proactive monitoring of a patient’s health status. The data obtained by monitoring devices is uploaded to an internet portal that is accessed by medical staff. As the data is not necessarily immediately accessible, we cannot speak here of the management of urgent conditions (Stowe and Harding, 2010). Telehealth incorporates a broad set of activities using electronic devices and ICT to support the remote delivery of services that go beyond the doctor-patient relationship. These services include remote reventative and curative healthcare, health promotion, and patient and provider education. As with telecare, telehealth applications are continuously expanding as technology evolves and methods of implementation are developed.
Telehealth technology, applications and services often focus on:
- the long-term management of chronic conditions, and
- shorter-term, post-hospital discharge support.
Telehealth takes place in the home and online, through a range of health and wellness services and health-related smartphone apps. Examples of services include telecounselling, online support groups, education provision and video conferencing with health professionals. Telehealth in the home often takes the form of telemonitoring, for example, of vital signs and using (often nurse-led) telephone-based services.
Figure 2: Illustration of telecare and telehealth ecosystems (Cullen et al. 2012)
In the context of older people, assistive technologies mainly focus on issues related to safety and security and reducing the risk of hospitalization (Astell 2013, 169). They play an important role in preventing the decline in strength, endurance and flexibility that is commonly associated with ageing (Hojnik Zupanc, 1999). They help older people to maintain their quality of life, increase their independence and make an important contribution to safety. They enable them to continue to carry out activities that younger people take for granted.
Although the term "assistive technology" often carries the connotation of a sophisticated, expensive, or medically relevant gadget, it can actually be any custom-built or store-bought device that helps people with everyday tasks and activities. Often, these are very simple devices that can make a significant contribution to daily activities and can have a positive impact on a person's sense of independence and safety. In addition, a simple device can prevent the need for high-tech interventions - for example, a bath seat can prevent pelvic injury and treatment in the event of a fall (Guerette and Anthony 1999, 18). Traditional forms of assistive technology include low-tech devices such as walking sticks, eyeglasses, booster seats, or adapted bathtubs, while new devices developed in the last twenty years are mostly electronic, computer, and telecommunication interventions (Doughty et al., 2007).
Assistive technologies also help to increase the independence and reduce the social isolation of older people, helping them to live in their own homes for as long as possible. In terms of their practical use, they refer to a heterogeneous field of applications ranging from relatively simple devices such as smart tablet dispensers, fall detectors and bedside presence detectors to complex systems such as interactive services and ambient intelligence (Dolničar, 2009). While we will discuss individual devices in more detail later, as Robitaille (2010) writes, assistive technologies can be divided into ten classes depending on their primary purpose:
Although the term "assistive technology" often carries the connotation of a sophisticated, expensive, or medically relevant gadget, it can actually be any custom-built or store-bought device that helps people with everyday tasks and activities. Often, these are very simple devices that can make a significant contribution to daily activities and can have a positive impact on a person's sense of independence and safety. In addition, a simple device can prevent the need for high-tech interventions - for example, a bath seat can prevent pelvic injury and treatment in the event of a fall (Guerette and Anthony 1999, 18). Traditional forms of assistive technology include low-tech devices such as walking sticks, eyeglasses, booster seats, or adapted bathtubs, while new devices developed in the last twenty years are mostly electronic, computer, and telecommunication interventions (Doughty et al., 2007).
Assistive technologies also help to increase the independence and reduce the social isolation of older people, helping them to live in their own homes for as long as possible. In terms of their practical use, they refer to a heterogeneous field of applications ranging from relatively simple devices such as smart tablet dispensers, fall detectors and bedside presence detectors to complex systems such as interactive services and ambient intelligence (Dolničar, 2009). While we will discuss individual devices in more detail later, as Robitaille (2010) writes, assistive technologies can be divided into ten classes depending on their primary purpose:
- Architectural elements such as adaptations to the home and other spaces.
- Sensory aids such as communication and hearing aids.
- Personal computers with hardware and software.
- Monitoring devices, including room monitoring.
- Independent living aids, such as personal care items.
- Prostheses and orthoses.
- Personal mobility aids, including wheelchairs.
- Individually adapted furniture and furnishings.
- Recreational and sports equipment.
- Services such as selection of assistive devices and training in their use.
Assistive technologies have the essential purpose of extending the time that older people can live independently in their own homes, while telecare can be seen as a way of enhancing it. We have already noted that assistive technologies aimed at the general public cover a wide spectrum, ranging from simple gadgets to more advanced electronic devices linked to the 'smart home' - a newly built or adapted high-tech dwelling. Telecare uses sensor technology to inform about medication intake, bed or chair occupancy, and bedwetting. It can also include user-controlled alarms such as automatic fire extinguishers, gas and smoke detectors, and automatic lighting in a smart home (Sorell and Draper, 2012). Some of the assistive technologies are presented below, from the simplest to the most advanced. Due to the ever-increasing range of different devices and gadgets, it is impossible to present them all, so we will focus on the most common and widely used ones.
Assistive technologies cover a very broad spectrum, and you would be very hard pressed to find an elderly person who does not own or even use at least one of the simplest assistive technologies. The simplest are fixed or mobile devices that facilitate everyday tasks and movements. These include (Guerrete and Anthony, 1999; Sorell and Draper, 2012):
- lifts and platforms,
- various handles,
- adaptations for shower and bath,
- walkers, rollators and wheelchairs, etc.
Figure 3: Stair lift chair
(Retrieved from: http://wwomers-with-elderly-parents.com/assistive-technology-stair-lift-chairs-have-really-helped-us)
Figure 4: Safety Grippinh Bath Handle
(Retrieved from: https://www.assistivetechnologyservices.com/images/SAFETY_GRIP_HANDLE1.jpg)
(Retrieved from: https://www.assistivetechnologyservices.com/images/SAFETY_GRIP_HANDLE1.jpg)
Figure 5: Adapted bathtub
(Retrieved from: https://therapyfocus.org.au/wp-content/uploads/2020/08/1910-shower-transfer-bench-700x467.jpg)
(Retrieved from: https://therapyfocus.org.au/wp-content/uploads/2020/08/1910-shower-transfer-bench-700x467.jpg)
Figure 6: Rolator
(Retrieved from: https://lh3.googleusercontent.com/proxy/WuYOsqjBy6Ir0mbmkHZMFQAX2-VWusemUfgyHIddjRIa0Qn1_tQH-qpAlQkhM07mifevoycvV5VMbVeYthViQO6Ncimyh-5PromT3ZvvkWGV1Xy2xZoVE8g3mMHo2FgSji5W2lTg7kv6HrFo)
Red Button is a wireless remote trigger that works in conjunction with a special phone and can be classified as a telecare service. It is a phone that allows the user to contact a selected person with a single press of a button, and is plugged into a phone socket or connected to the mobile network via the card SIM. Several numbers of people who could help are entered into the phone, and the phone calls them in the order in which they were entered. The pendant or bracelet worn around the neck or wrist has a built-in speaker and microphone, so it is possible to walk without a phone, which is one of the main advantages of the red button over the same service via a traditional cell phone. The phone can be activated from a distance of 25 meters. The phone can also be upgraded with additional personal safety devices - pull cord button for bathroom or toilet, fall detector, burglar alarm, etc.
Figure 7: An example of red button system
(Retrieved from: https://www.mks.si/lifeline/images/telefoni/Lifeline_Vi-amie.png)
In addition to user-triggered triggers, telecare devices and systems contain sensors and alarms. These either continuously monitor the situation and trigger an alarm if there is no response, or trigger an alarm if a threat is detected. These include fall detectors that check on the person at regular intervals. If the person does not get up, an alarm is activated, sending a signal that the person is in danger. A bed occupancy detector (or chair occupancy detector) works in a similar way. The detector has a pre-programmed time for the patient to return to bed after getting up. If the sensor does not detect the person after the set time, it will sound an alarm. There are also smoke, carbon dioxide, and other gas detectors, as well as sensors that respond to extreme increases in temperature (MKS, 2014; Cook et al., 2009).
Although their principle of operation is somewhat different, we can also mention smart medicine dispensers at this point. This is a device with compartments in which the caregiver prepares tablets for a certain number of days. At a certain time, which can be several times a day, the dispenser prompts the user to take a tablet and opens the corresponding tablet compartment.
Although their principle of operation is somewhat different, we can also mention smart medicine dispensers at this point. This is a device with compartments in which the caregiver prepares tablets for a certain number of days. At a certain time, which can be several times a day, the dispenser prompts the user to take a tablet and opens the corresponding tablet compartment.
Figure 8: Sensara HomeCare system
(Retreived from: https://www.sensara.care/how-it-works#start-0)
(Retreived from: https://www.sensara.care/how-it-works#start-0)
Figure 9: Fall detector system
(Retrieved from: https://www.techsilver.co.uk/wp-content/uploads/2018/03/Fall-Alarm.png)
TELEMEDICINE SERVICES
(Retrieved from: https://www.techsilver.co.uk/wp-content/uploads/2018/03/Fall-Alarm.png)
TELEMEDICINE SERVICES
In addition to the aids that help them with everyday tasks, regular monitoring is also important for older people with health problems or chronic illnesses. This can be greatly facilitated by home telemedicine services, which include monitoring of vital health parameters (ECG, bloog pressure, heart rate, blood sugar level, body weight, lung capacity, exhaled CO2 level, body temperature…); communication of health or well-being assessments related to the disease; review of patient-reported (aggregated) data; and personalized education of patients to live sustainably with their disease (Rudel, 2008). Telemedicine allows health care professionals to evaluate, diagnose and treat patients at a distance using telecommunications technology.
Figure 10: An example of telemedicine system
(Retrieved from: https://image.made-in-china.com/44f3j00QTgtdOrEJbhw/Telemedicine-Android-APP-Uretero-Renoscope-Android-Based-Telemedicine-System.jpg)
INTERACTIVE AND VIRTUAL SERVICES
Systems exist to overcome the problems of distance and isolation and to advise, train and empower people to improve their quality of life (Doughty et al., 2007). Such systems can be used for entertainment and relaxation, communication with carers, family members, friends, medical staff, etc. Personalised applications can be used via TV, computer, smartphone or table. An example of such a project is Finnish Caring TV. Caring TV is an interactive television with two channels through which the user can access advice and support, as well as various programmes to improve and present options for living at home. The system works like an enhanced video conference. The user's TV is connected to a simple touch screen and a small camera. The operation is identical to that of a television. The programme takes care of the user's well-being through an interactive video connection. It offers supervised activities, interactive talk shows and meetings with experts. The content is planned together with the customers according to their ideas and supervised by experts. Research and development is done by the university and implementation is done by private companies. Medical experts are also involved as the project can provide an excellent starting point for the development of a virtual clinic (Raij and Lehto, 2008).
Figure 11: A remote nurse's visit to older people in Finland
(Retrieved from: https://i.guim.co.uk/img/media/42c20070c39c1f122617accfe761e797da080af6/40_283_5881_3529/master/5881.jpg?width=445&quality=45&auto=format&fit=max&dpr=2&s=668ad934198590c8924e3d85a7bac755)
AMBIENT INTELLIGENCE AND THE SMART HOME
Ambient intelligence is a convergent environment that combines computers, advanced network technologies and specific interfaces for recognition and interacting with the user (Dolničar 2009). It enables the ordinary home to become a smart home. It includes resources that support ageing at home by monitoring the person, delaying the need for expensive institutional care, and increasing the sense of security for both the patient and their loved ones (van Hoof et al., 2011). A key element are sensors that combine computer technology with physical applications. This is the integration of the individual devices already listed into a single system connected to a remote administrator. These are: floor, door, bed occupancy; position, direction, distance, and motion sensors; light, radiation, and temperature sensors; liquid, solid, and gas sensors; and sound and light sensors. They can be either wired or wirelessly connected to the control panel (Cook et al., 2009).
An example of a smarthome is IRIS Home in Ljubljana, Slovenia. Its acronym consists of the first letters of the words "Intelligent Solutions and innovations for Independent Living". It is a demonstration home that can be visited at Rehabilitation Institute of the Republic of Slovenia in Ljubljana. The apartment is equipped with various technologies that can help older people. The immediate goal is to familiarize users with technological solutions that are accessible for more independent living. It is a place where the potential user can get all the information and guidance to implement a solution that is suitable for them in their home environment. The user will take the solution presented by the IRIS home into their own home and engage with the services (Zupan et al., 2007). The home is equipped with standard communication devices (telephone, mobile phone, intercom, television, computer) and the following assistive technologies - available for people with physical and mobility disabilities: for the blind and visually impaired: electronic magnifier, text reader, Braille display and speech synthesizer. The Home is also equipped with a voice recognition system and voice control for the computer. The IRIS Home with multimedia platform enables control of lighting, heating and blinds, remote health monitoring, services for safe, independent living and entertainment applications operated by hand, switches, remote controls, TV or computer, joystick via wheelchair or voice. Movement and living are facilitated by a range of architectural solutions - flat floors, adapted widths, low switches and adapted furniture. Although it is an extremely important smart home pilot project in Slovenia, the IRIS home is not a liveable home (Dom IRIS, 2015).
An example of a smarthome is IRIS Home in Ljubljana, Slovenia. Its acronym consists of the first letters of the words "Intelligent Solutions and innovations for Independent Living". It is a demonstration home that can be visited at Rehabilitation Institute of the Republic of Slovenia in Ljubljana. The apartment is equipped with various technologies that can help older people. The immediate goal is to familiarize users with technological solutions that are accessible for more independent living. It is a place where the potential user can get all the information and guidance to implement a solution that is suitable for them in their home environment. The user will take the solution presented by the IRIS home into their own home and engage with the services (Zupan et al., 2007). The home is equipped with standard communication devices (telephone, mobile phone, intercom, television, computer) and the following assistive technologies - available for people with physical and mobility disabilities: for the blind and visually impaired: electronic magnifier, text reader, Braille display and speech synthesizer. The Home is also equipped with a voice recognition system and voice control for the computer. The IRIS Home with multimedia platform enables control of lighting, heating and blinds, remote health monitoring, services for safe, independent living and entertainment applications operated by hand, switches, remote controls, TV or computer, joystick via wheelchair or voice. Movement and living are facilitated by a range of architectural solutions - flat floors, adapted widths, low switches and adapted furniture. Although it is an extremely important smart home pilot project in Slovenia, the IRIS home is not a liveable home (Dom IRIS, 2015).
Figure 12: Adapted kitchen in the smart home Iris in Ljubljana, Slovenia
Retrieved from: https://www.vzajemnost.si/media/arhiv/img/priponke/clanki/big/107a964b66bd3b3ef39595c8734087cf.jpg)
Figure 13: Adapted bathroom in smart home Iris in Ljubljana, Slovenia
(Retrieved from: https://64.media.tumblr.com/b3ed40a2fe8f756a0997a39249ae1f95/tumblr_inline_my23twk2Yg1r54ej1.jpg)
(SMART) PHONES FOR OLDER ADULTS
It is a well-known fact that older people often have problems and prejudices against new technologies. This also applies to mobile phones. Older people are often discouraged from using them because the buttons are too small, they have difficulty hearing and seeing, they are afraid to use them, and they think that such devices are for a younger generation. They often find a compromise in using a mobile phone adapted to older people. This is a device with larger buttons and large text on the screen, usually with only the basic functions, but often with a special SOS button on the back that can be programmed to a selected emergency number. The button usually works even when the device is switched off.
Figure 14: Smartphone for older adults - Doro 8050
(Retrieved from: https://www.doro.com/globalassets/_images/produkter/8050/phones_8050_3.jpg)
Figure 15: Smartphone for older adults – emporiaSMART.5
(Retrieved from: https://www.emporia.eu/en/products/overview/emporiasmart.5)
SMARTPHONE AND MOBILE APPS
While older people's personalized mobile phones offer only a limited set of functionalities, smartphones with the ability to install various apps and built-in sensors can provide them with an advanced user experience and can offer them both customizations of basic functionalities and personalized functionalities that are assistive technologies in purpose.
According to Doughty (2011), mobile apps on newer smartphones can be a tool for older people with a variety of conditions. For patients with vision and hearing problems, they can be used to magnify text and compare colors with a color palette or to identify objects. The phone's camera can also detect obstacles and provide GPS, especially for people with vision problems, location information. The phone's built-in accelerometer can be used to prevent and detect falls and is complemented by GPS to communicate the user's location - it can also be used to locate the nearest hospital or health center. Speech synthesizers and voice monitoring systems can help the user communicate. At the same time, the camera can be used to make low-cost voice calls. For patients with diabetes, a mobile phone can help monitor physical activity, check activity history or diet. Last but not least, applications on a smartphone can help individuals with various interventions from exercise to mood analysis.
Similarly, Joe and Demiris (2013) write about the use of mobile phones for health purposes. They list areas where mobile phones can serve as a tool for health maintenance and monitoring: They can be a support for daily activities, a tool for people with certain medical conditions (Alzheimer's disease, dementia, heart failure, chronic obstructive pulmonary disease, diabetes, osteoporosis, dermatological conditions), a tool for monitoring side effects of chemotherapy, a tool for monitoring symptoms in palliative care, or a sensor for detecting and monitoring fall risk (Joe and Demiris, 2013). Lamonaca et al. (2015) present in more detail the technical possibilities and functions of sensors embedded in smartphones. According to them, sensors enable smartphones to expand from the realm of communication devices to the realm of measurement devices for monitoring health parameters and improving quality of life. Their division of applications according to the mobile phone’s sensor used is shown in the table below:
According to Doughty (2011), mobile apps on newer smartphones can be a tool for older people with a variety of conditions. For patients with vision and hearing problems, they can be used to magnify text and compare colors with a color palette or to identify objects. The phone's camera can also detect obstacles and provide GPS, especially for people with vision problems, location information. The phone's built-in accelerometer can be used to prevent and detect falls and is complemented by GPS to communicate the user's location - it can also be used to locate the nearest hospital or health center. Speech synthesizers and voice monitoring systems can help the user communicate. At the same time, the camera can be used to make low-cost voice calls. For patients with diabetes, a mobile phone can help monitor physical activity, check activity history or diet. Last but not least, applications on a smartphone can help individuals with various interventions from exercise to mood analysis.
Similarly, Joe and Demiris (2013) write about the use of mobile phones for health purposes. They list areas where mobile phones can serve as a tool for health maintenance and monitoring: They can be a support for daily activities, a tool for people with certain medical conditions (Alzheimer's disease, dementia, heart failure, chronic obstructive pulmonary disease, diabetes, osteoporosis, dermatological conditions), a tool for monitoring side effects of chemotherapy, a tool for monitoring symptoms in palliative care, or a sensor for detecting and monitoring fall risk (Joe and Demiris, 2013). Lamonaca et al. (2015) present in more detail the technical possibilities and functions of sensors embedded in smartphones. According to them, sensors enable smartphones to expand from the realm of communication devices to the realm of measurement devices for monitoring health parameters and improving quality of life. Their division of applications according to the mobile phone’s sensor used is shown in the table below:
Figure 16: Smartphone applications for each embedded sensor
(Lamocana et al. 2015)
The smartphone's motion sensor can detect the user's position, whether they are lying, sitting or walking. A major advantage over conventional sensors, which are usually connected to a central unit in the house and therefore have a limited range, is that the smartphone can detect movement outside the house. In addition, the smartphone does not require the installation of support systems and is convenient to use. Also, for fall detection, the smartphone can provide information immediately and does not require additional user intervention. The motion sensor detects the user's posture and can help prevent muscle injuries.
The second group is camera-based applications. Blood pressure can be estimated from a photoplethysmographic signal or by measuring the pulse wave velocity of a viewfinder placed on the camera by the user. By varying the blood flow over time, the phone determines the shape of the signal and the blood pressure. Heart rate is determined by recording the face, and eye examination is performed by recording the eyes and performing an analysis called fundoscopy. Microphone-related applications work by monitoring the flow of exhaled air (lung volume) or by monitoring sounds (cough and nasal symptoms).
Smartphones are also equipped with a microphone to record environmental noise and suppress it. This improves the quality of the acquired signal and therefore the reliability of the monitoring. These characteristics make the smartphone suitable for spirometry, cough analysis and noise-related symptoms recognition.
Plaza et al. (2011) use a list of specific needs of older people addressed by mobile apps as a starting point to introduce different types of mobile apps:
The second group is camera-based applications. Blood pressure can be estimated from a photoplethysmographic signal or by measuring the pulse wave velocity of a viewfinder placed on the camera by the user. By varying the blood flow over time, the phone determines the shape of the signal and the blood pressure. Heart rate is determined by recording the face, and eye examination is performed by recording the eyes and performing an analysis called fundoscopy. Microphone-related applications work by monitoring the flow of exhaled air (lung volume) or by monitoring sounds (cough and nasal symptoms).
Smartphones are also equipped with a microphone to record environmental noise and suppress it. This improves the quality of the acquired signal and therefore the reliability of the monitoring. These characteristics make the smartphone suitable for spirometry, cough analysis and noise-related symptoms recognition.
Plaza et al. (2011) use a list of specific needs of older people addressed by mobile apps as a starting point to introduce different types of mobile apps:
- Health, wellbeing and home care - wellbeing and healthcare are closely linked, and wellbeing support can make a positive contribution to a person's physical wellbeing. Activity planning, recording, feedback and linking to health determinants can support wellbeing. Typically this area involves a combination of conventional care and assistive technologies.
- Safety and mobility - the most common devices used in this area are location tracking devices, telemonitoring systems and alarm systems. Smartphones can be combined with other devices, such as accelerometers, to provide these functions.
- Tasks and supplies - a smartphone can be used to monitor calories as part of healthy weight management.
- Information, learning and education - devices like a smartphone help older people stay informed. Being informed is important for personal development, staying in touch with the outside world and exercising mental skills.
- Religion, spirituality - there are mobile apps that contribute to a person's religious experience, but they are usually not specifically aimed at older users.
- Social interaction - the essential social needs of older people are: staying in touch with the social networks and spaces they have built up over their lifetime; spending time with family, friends and significant others; physical contact with people in the neighbourhood; and being active in different communities.
- Hobbies - Hobbies are an important element of social interaction, personal development, and recreation. Smartphone games are one way that older people can keep socially connected.
- Work - Work can be divided into physical and mental work, which can be done by people with physical disabilities. One of the challenges in this area is how to fill the gap left by older people at the end of their active working lives.
Figure 17: Exercise Plan for Seniors application
Retrieved from: Google Play 2021)
Figure 18: Medication Reminder & Pill Tracker application
(Retrieved from: Google Play 2021)
At the same time, more and more smartphone apps are appearing to make it easier for older people to use what may be too complex device for them. These applications turn the usual smartphone interface with its many icons and functions into a simple and clear interface with basic buttons. An example of such application is BIG Launcher (Google Play).
Figure 19: Big Launcher
(Retrieved from: Google Play store)
Check out how active you are in reading and how much you have taken away from the content presented above in this way to solve this QUIZ (click on the word "QUIZ" with the mouse). We also invite you to help us improve the presented content and take an additional 5 to 10 minutes to answer the QUESTIONS (click on the word "QUESTIONS" with the mouse).
REFERENCES:
Astell, A. (2013). Technology and Fun for Happy Old Age. In A. Sixsmith and G. Gutman (Eds.), Technologies for Active Aging (pp.169–188). New York: Springer.
Cook, D. J., Augusto, J. C., & Vikramaditya, R. J. (2009). Ambient intelligence: tecnhologies, applications, and opportunities. Pervasive and Mobile Computing 5(4), 277–298.
Cullen, K., McAnaney, D., Dolphin, C., Delaney, S., & Stapleton, P. (2012) Research on the provision of Assistive Technology in Ireland and other countries to support independent living across the life cycle. Retrieved from: http://nda.ie/File-upload/Research-on-the-provision-of-Assistive-Technology1.pdf
Dolničar, V. (2009). Podporne tehnologije – podpora ali ovira medgeneracijske solidarnosti. In V. Tašner (Ed.), Brez spopada: kultur, spolov, generacij (pp.275–290). Ljubljana: Pedagoška fakulteta.
Dom IRIS. (2015). Retrieved from: http://www.dom-iris.si/index.php
Doughty, K. (2011). SPAs (smart phone applications) – a new form of assistive technology. Journal of Assistive Technologies 5(2): 88–94.
Doughty, K., Monk, A., Bayliss, C., Brown, S., Dewsbury, L., Dunk, B., … Ward, D. (2007). Telecare, telehealth and assistive technologies – do we know what we're talking about? Journal of Assistive Technologies 1(2): 6–10.
European Commission. 2010. ICT & Ageing – European study on users, markets and technologies. Retrieved from: http://www.ict-ageing.eu/ict-ageing-website/wp-content/uploads/2010/D18_final_report.pdf
Guerrete, P. & Anthony, P. (1999). Assistive technology for older adults: opportunities for advocacy. Home Health Care Management Practice 11(3): 17–24.
Hojnik Zupanc, I. (1999). Samostojnost starega človeka v družbeno-prostorskem kontekstu. Ljubljana: Faculty of Social Sciences.
Joe, J. & Demiris, G. (2013). Older adults and mobile phones for health. Journal of biomedical informatics 46(5): 947–954.
Lamonaca, F., Poliemeni, G., Barbé, K. & Grimaldi, D. 2015. Health parameteres monitoring by smartphone for quality of life improvement. Measurement 73: 82–94.
Merz, E. M., Schuengel, C., & Schulze, H. J. (2007). Intergenerational solidarity: An attachment perspective. Journal of Aging Studies 21(2): 175–186.
MKS Elektronski sistemi d.o.o. Retrieved from: http://www.mks.si/index.htm
National Disability Authority. (2018). Effective implementation and monitoring of telehealth and telecare in Ireland: learning from international best practice. Dublin: National Disability Authority.
Piper, A. M., & Hollan, J. D. (2013). Supporting medical communication for older patients with a shared touch-screen computer. Internaional journal of medical informatics 82: 242–250.
Plaza, I., Martin, L., Martin, S., & Medrano, C. (2011). Mobile applications in an aging society: status and trends. The Journal of Systems and Software 84(11): 1977–1988.
Raij, K., & Lehto, P. (2008). Caring TV as a service design with and for elderly people. In G. A. Tsihrintzis, M. Virvou, R. J. Howlett & L. C. Jain (Eds.), New directions in intelligent interactive multimedia, (pp.481–488). Berlin: Springer.
Robitaille, S. (2010). The Illustrated Guide to Assisitve Technology and Devices: tools and gadgets for living independently. New York: Demos Medical Publishing.
Rudel, D. (2008). Zdravje na domu na daljavo za stare osebe. Informatica Medica Slovenica 13(2): 19–29.
Sorell, T. & Draper H. (2012). Telecare, surveillance, and the welfare state. The American Journal of Bioethics 12(9): 36–44.
Stowe, S. & Harding, S. (2010). Telecare, telehealth in telemedicine. European geriatric medicine 1: 193–197.
Timonen, V., Conlon, C., Scharf, T., and Carney, G. (2013). Family, state, class and solidarity: re-conceptualizing intergenerational solidarity through the grounded theory approach. European Journal of Ageing 10(3): 171–179.
Sixsmith, A. (2013). Technology and the Challenge of Aging. In A. Sixsmith & G. Gutman (Eds.), Technologies for Active Aging, 7–25. New York: Springer.
Szydlik, M. (2008). Intergenerational solidarity and conflict. Journal of Comparative Family Studies 39(1): 97–114.
Šircelj, M. (2009). Staranje prebivalstva v Sloveniji. V Starejši ljudje v družbi sprememb, ur. Valentina Hlebec, 15–44. Maribor: Aristej.
Vertot, Nelka. (2010). Starejše prebivalstvo v Sloveniji. Ljubljana: Statistični urad Republike Slovenije. Retreived from: http://www.stat.si/doc/StarejsePrebivalstvo.pdf
Penger, S. and Dimovski, V. (2007). Strategija aktivnega staranje prebivalstva Slovenije s poudarkom na kakovostnem staranju in medgeneracijskem sožitju. IB revija 41(1): 42–55.
Zupan, A., Cugelj, R., & Hočevar, F. (2007). Dom IRIS – nova priložnost za invalide, starejše in razvoj rehabilitacije. Bilten: ekonomika, organizacija, informatika v zdravstvu 23(4): 146–148.
Astell, A. (2013). Technology and Fun for Happy Old Age. In A. Sixsmith and G. Gutman (Eds.), Technologies for Active Aging (pp.169–188). New York: Springer.
Cook, D. J., Augusto, J. C., & Vikramaditya, R. J. (2009). Ambient intelligence: tecnhologies, applications, and opportunities. Pervasive and Mobile Computing 5(4), 277–298.
Cullen, K., McAnaney, D., Dolphin, C., Delaney, S., & Stapleton, P. (2012) Research on the provision of Assistive Technology in Ireland and other countries to support independent living across the life cycle. Retrieved from: http://nda.ie/File-upload/Research-on-the-provision-of-Assistive-Technology1.pdf
Dolničar, V. (2009). Podporne tehnologije – podpora ali ovira medgeneracijske solidarnosti. In V. Tašner (Ed.), Brez spopada: kultur, spolov, generacij (pp.275–290). Ljubljana: Pedagoška fakulteta.
Dom IRIS. (2015). Retrieved from: http://www.dom-iris.si/index.php
Doughty, K. (2011). SPAs (smart phone applications) – a new form of assistive technology. Journal of Assistive Technologies 5(2): 88–94.
Doughty, K., Monk, A., Bayliss, C., Brown, S., Dewsbury, L., Dunk, B., … Ward, D. (2007). Telecare, telehealth and assistive technologies – do we know what we're talking about? Journal of Assistive Technologies 1(2): 6–10.
European Commission. 2010. ICT & Ageing – European study on users, markets and technologies. Retrieved from: http://www.ict-ageing.eu/ict-ageing-website/wp-content/uploads/2010/D18_final_report.pdf
Guerrete, P. & Anthony, P. (1999). Assistive technology for older adults: opportunities for advocacy. Home Health Care Management Practice 11(3): 17–24.
Hojnik Zupanc, I. (1999). Samostojnost starega človeka v družbeno-prostorskem kontekstu. Ljubljana: Faculty of Social Sciences.
Joe, J. & Demiris, G. (2013). Older adults and mobile phones for health. Journal of biomedical informatics 46(5): 947–954.
Lamonaca, F., Poliemeni, G., Barbé, K. & Grimaldi, D. 2015. Health parameteres monitoring by smartphone for quality of life improvement. Measurement 73: 82–94.
Merz, E. M., Schuengel, C., & Schulze, H. J. (2007). Intergenerational solidarity: An attachment perspective. Journal of Aging Studies 21(2): 175–186.
MKS Elektronski sistemi d.o.o. Retrieved from: http://www.mks.si/index.htm
National Disability Authority. (2018). Effective implementation and monitoring of telehealth and telecare in Ireland: learning from international best practice. Dublin: National Disability Authority.
Piper, A. M., & Hollan, J. D. (2013). Supporting medical communication for older patients with a shared touch-screen computer. Internaional journal of medical informatics 82: 242–250.
Plaza, I., Martin, L., Martin, S., & Medrano, C. (2011). Mobile applications in an aging society: status and trends. The Journal of Systems and Software 84(11): 1977–1988.
Raij, K., & Lehto, P. (2008). Caring TV as a service design with and for elderly people. In G. A. Tsihrintzis, M. Virvou, R. J. Howlett & L. C. Jain (Eds.), New directions in intelligent interactive multimedia, (pp.481–488). Berlin: Springer.
Robitaille, S. (2010). The Illustrated Guide to Assisitve Technology and Devices: tools and gadgets for living independently. New York: Demos Medical Publishing.
Rudel, D. (2008). Zdravje na domu na daljavo za stare osebe. Informatica Medica Slovenica 13(2): 19–29.
Sorell, T. & Draper H. (2012). Telecare, surveillance, and the welfare state. The American Journal of Bioethics 12(9): 36–44.
Stowe, S. & Harding, S. (2010). Telecare, telehealth in telemedicine. European geriatric medicine 1: 193–197.
Timonen, V., Conlon, C., Scharf, T., and Carney, G. (2013). Family, state, class and solidarity: re-conceptualizing intergenerational solidarity through the grounded theory approach. European Journal of Ageing 10(3): 171–179.
Sixsmith, A. (2013). Technology and the Challenge of Aging. In A. Sixsmith & G. Gutman (Eds.), Technologies for Active Aging, 7–25. New York: Springer.
Szydlik, M. (2008). Intergenerational solidarity and conflict. Journal of Comparative Family Studies 39(1): 97–114.
Šircelj, M. (2009). Staranje prebivalstva v Sloveniji. V Starejši ljudje v družbi sprememb, ur. Valentina Hlebec, 15–44. Maribor: Aristej.
Vertot, Nelka. (2010). Starejše prebivalstvo v Sloveniji. Ljubljana: Statistični urad Republike Slovenije. Retreived from: http://www.stat.si/doc/StarejsePrebivalstvo.pdf
Penger, S. and Dimovski, V. (2007). Strategija aktivnega staranje prebivalstva Slovenije s poudarkom na kakovostnem staranju in medgeneracijskem sožitju. IB revija 41(1): 42–55.
Zupan, A., Cugelj, R., & Hočevar, F. (2007). Dom IRIS – nova priložnost za invalide, starejše in razvoj rehabilitacije. Bilten: ekonomika, organizacija, informatika v zdravstvu 23(4): 146–148.