Usingggypp Technology to Support Wellness and Aging …ashra.msvu.ca/documents/Conference Presentations... · Number of older adults ... To develop intelligent assistive technology

Using Technology to Support g gy ppWellness and Aging-in-place

Jennifer Boger, M.A.Sc., P.Eng.g , , g

May 27, 2009

Changing Demographics (US Census Dept, 2005)g g g p

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The Problem

Number of older adults

Health challenges with ageg g

Number of caregiversg

Environmental supportpp

This true in terms of both the built

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environment and medical care7

The Need

Support for aging needs new and different pp g gapproaches

These solutions need to:• enable aging-in-placeg g p

• be easy to use

be robust yet sensitive to the changing needs• be robust, yet sensitive to the changing needs of all users

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Technology as a Solutiongy

Researchers have been looking atResearchers have been looking at the use of technology as part of the solutionsolution

Once installed technology canOnce installed, technology can provide affordable, dynamic, customisable 24/7 supportcustomisable, 24/7 support…

if it’s appropriate that is!…if it s appropriate, that is!9

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


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Some Definitions…

Wellness and aging-in-place: g g p

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: g g p• “…means growing older without having to move.”

BCACLBCACL

• “…is not having to move from one's present residence in order to secure necessary supportresidence 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 g g yand comfortably possible.” Wikipedia

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Some Definitions…

Wellness and aging-in-place: g g p

…is growing older in the home of ones’ choice.

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Some Definitions…

Wellness and aging-in-place:g g p

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 technologythat can promote wellness and aging-in-place, without extra burden to the users

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Assistive Technologygy

“Any item, piece of equipment, or product y , p q p , psystem, whether acquired commercially or off the shelf, modified, or customized, that , , ,is used to increase, maintain, or improve functional capabilities of individuals with pdisabilities”

C k & H (2000)Cook & Hussey (2000)

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Some Examplesp

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Some Examplesp

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Some Examplesp

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Some Examplesp

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Our Goal


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Our Design Philosophyg p y

Develop for real-world contexts, to solveDevelop for real world contexts, to solve problems encountered in real-life

Involve the user from the start to theInvolve 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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p

Zero-Effort Technologiesg

Technology should operate without any effort from the users

This means the systems must autonomously:This means the systems must autonomously: • Interact with users and their environment• Continuously collect and redistribute dataContinuously 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 Technologiesp g

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Courtesy of BIME (http://www.bath.ac.uk/bime/)


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Our Goal


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Smart vs. Intelligentg

Smart: Performing actions based on direct ginput 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 Systemsg y

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 ho best to reacthow 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.

It’s time for your

medication.

Y hYou have fallen. Do you need

help?

Are you feeling okay?

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Our Goal


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Examples of Our Researchp

HELPER(ERS)

Anti-collisionWheelchair

HELPER(ERS)

DataSharing

ArtsTh

BalanceA t Sharing TherapyAssessment

Robotic StrokeRehabilitation

The COACH(ADL Cueing)

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The Problem

With age events such as heart attacksWith age, events such as heart attacks and falls become more likely

A fast and appropriate response drastically increases a person’s y pprobability of recovery (and survival!)

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Existing Solutionsg

Call Buttons & Communicator Fall Detector

http://www.lifelinesys.com/howworks/index.php http://ntec.org.uk/gm2.doc

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Existing Solutionsg

Need Help Assistance Need HelpArrives

Hands On

Panic buttonTelephone

Friends Family24 hr Friends, Family, or Emergency

Services contacted

24 hr Emergency Call Centre live operator

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contactedlive operator

Example Scenariop

You are a 86 year old female, living aloneYou are a 86 year old female, living alone

High BP – Asthma – Coronary Vascular Disease

O d f b d l l t d h t b tOn edge of bed – clammy, accelerated heart beat, sweating, light headed, trouble breathing

G t Use ‘Lifeline’

Choices:

Get Neighbour

Use Lifeline(push button personal

emergency response system)Phone 911

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Example Scenariop

Breathe and stand up to grab for itBreathe 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 painCan 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…y

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HELPER: A New Solution

Need Help Assistance Need HelpArrives

Hands On Hands Free

Panic buttonTelephone

Health/Fall MonitoringSpoken Dialogue

Friends Family24 hr Friends, Family, or Emergency

Services contacted

24 hr Emergency Call Centre live operator

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contactedlive operator

HELPER: System Overviewy

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Speaker

Microphone

Camera

Microphone

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Patent Pending


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Patent Pending

HELPER: Trackingg

Original Background Blob withOriginalImage

BackgroundSubtraction

Blob withshadow

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HELPER: Planningg

Short-term health:

• Decide if there is an acute (emergency) event

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HELPER: Planningg

Long term health:g

• Learn the occupant’s normal patterns of ti itactivity

• Detect abnormal, non-emergency events that , g ymight signal a health change

Abilit to share trends ith ser famil and• Ability to share trends with user, family, and care professionals

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HELPER: Responsep

Adverse event actions the system can ytake include:• Call a neighborg• Call a family member• Call an operator (e g Lifeline)Call an operator (e.g. Lifeline)• Call an emergency service (e.g. ambulance)• Share data with family and health• Share data with family and health

professionals

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HELPER: Examplep

A video of the fall detection system was shown here

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HELPER: Pilot Study Resultsy

Twenty-one subjects simulated various y jpostures and falls within a mock-up of a home environment

Total of 315 postures (126 “falls”)

100% correct assistance decision (88% correct recognition)correct recognition)

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HELPER: Current/Future work

Build an older adult speech databasep

Test system with older adult actors

Test system in community

Make system available to consumers

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Examples of Our Researchp

HELPER(ERS)

Anti-collisionWheelchair

DataSharing

ArtsTh

BalanceA t Sharing TherapyAssessment

Robotic StrokeRehabilitation

The COACH(ADL Cueing)The COACH(ADL Cueing)

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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!y

70% of people with Alzheimer’s and other dementias live at homedementias 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 withCurrently, a caregiver must always be with the person to provide prompts, support, and monitoringg

This is a very difficult and frustrating experience for everyoneexperience for everyone

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However…

Procedural memory is generally relatively y g y yspared

Whil l ti f t k b diffi ltWhile completion of a task can be difficult, completion of a step is much easier

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The COACH

An intelligent cognitive g gdevice that tracks a user through an ADL, providing cues when necessarycues when necessary

The

Cognitive Orthosis for Assisting Activities in the Home

COACH

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The COACH

Digital VidVideo Camera

Flat Screen Monitor & SpeakersSpeakers

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COACH: System Overviewy

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COACH: Trackingg

A video hand tracking was shown here

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COACH: Planningg

System chooses the best action to take based yon 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: Responsep

Do nothingg

Give a prompt“D ’ d i t T t i th• e.g. “Dawn, you’re doing great. Try turning on the

water” • 3 levels of specificity (minimal moderate maximum)• 3 levels of specificity (minimal, moderate, maximum)

Call the caregiver

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Putting it all together…g g

STARTHands = ?Usesoap

Weth d

Turn onwaterWater = ?

Turn onwater

handsUsesoap

Rinse

Turn offwater

Dryhands

hands

Dryhands

Turn offwater

FINISH

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Hands = sink START

Water = off Usesoap

Weth d

Turn onTurn onwater

Turn onwater

handsUsesoap

Rinse

Turn offwater

Dryhands

hands

Dryhands

Turn offwater

FINISH

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Hands = tap STARTp

Water = on Usesoap

Weth d

Turn onwater

Turn onwater

handshandsUsesoap

Rinse

Turn offwater

Dryhands

hands

Dryhands

Turn offwater

FINISH

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Hands = water START

Water = on Usesoap

Weth d

Turn onTurn onwater

Turn onwater

handsUsesoap

Rinse

Turn offwater

Dryhands

hands

Dryhands

Turn offwater

FINISH

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Hands = towel START

Water = on Usesoap

Weth d

Turn onTurn onwater

Turn onwater

handsUsesoap

Rinse

That’s not the next step….

Turn offwater

Dryhands

hands

Dryhands

Turn offwater

FINISH

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Hands = towel START

Water = on Usesoap

Weth d

Turn onTurn onwater

Turn onwater

handsUsesoap

Rinse

Dawn, try using the soap

Turn offwater

Dryhands

hands

Dryhands

Turn offwater

FINISH

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Hands = soap STARTp

Water = on Usesoap

Weth d

Turn onTurn onwater

Turn onwater

handshandsUsesoap

Rinse

Turn offwater

Dryhands

handshands

Dryhands

Turn offwater

FINISH

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Hands = water START

Water = on Usesoap

Weth d

Turn onTurn onwater

Turn onwater

handshandsUsesoap

Rinse

Turn offTurn offwater

Dryhands

hands

Dryhands

Turn offwater

FINISH

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Hands = tap STARTp

Water = off Usesoap

Weth d

Turn onTurn onwater

Turn onwater

handshandsUsesoap

Rinse

Turn offwater

Dryhands

handshands

Dryhands

Turn offwater

FINISH

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Hands = towel START

Water = off Usesoap

Weth d

Turn onTurn onwater

Turn onwater

handshandsUsesoap

Rinse


Dryhands

handshands

Dryhands

Turn offwater

FINISH

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Hands = away STARTy

Water = off Usesoap

Weth d

Turn onTurn onwater

Turn onwater

handshandsUsesoap

Rinse


Dryhands

handshands

Dryhands

Turn offwater

FINISH

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Examples of Usep

Two videos of clinical trials were shown here

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Does it work?

Number of steps completed without human assistance for S4

5

3

4

of S

teps

2

Num

ber o

0

1

0 10 20 30 40

7474

0 10 20 30 40

Trial

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 implicationsethical implications

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Conclusions

In a nutshell:

“Can technology help us age in place?”

YES!

We think high-tech technologies can, too B tBut…

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ConsiderationsWhen and where is this type of technology appropriate?appropriate?What funding programs are required?Who chooses when this technology is used?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?systems?How will these issues be affected in the future when new user populations exist (e.g. baby

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when new user populations exist (e.g. baby boomers)?

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)Jasper Snoek, Tony Tam, Vicky Young (IATSL)

Craig Boutilier (University of Toronto)

Jesse Hoey (University of Dundee)

P l P (U i i f W l )Pascal Poupart (University of Waterloo)

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Acknowledgementsg

Research has been supported through generous research grants and industrial support from:

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Contact

Tel: (416) 946-8573Email: [email protected]

Web: www.iatsl.org

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Usingggypp Technology to Support Wellness and Aging …ashra.msvu.ca/documents/Conference Presentations... · Number of older adults ... To develop intelligent assistive technology

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