This is the abstract submission system for ISG2026,┬á16th World Conference of Gerontechnology.
Addressing Accessibility Crisis: A Gerontechnology Education Project among Patients in a Hong Kong Hospital Setting
Purpose Gerontechnology is an innovative solution that plays an important role in promoting patientsΓÇÖ independent living, reducing institutional care, and alleviating caregiver burden. However, one of the major crises hindering its wide acceptance and utilization in Hong Kong is poor accessibility, preventing end-users from acquiring knowledge about gerontechnology products and purchase methods (Our Hong Kong Foundation, 2021). Our project aims to address this gap by promoting patients' gerontechnology knowledge and acceptance through education while identifying their needs to maximize utilization. Method Patients with physical or mental illnesses, at Tai Po Hospital, Hong Kong, who had an assessed need for gerontechnology, were recruited in the project. Occupational therapists provided single 20ΓÇô30-minute face-to-face education sessions, individually or in groups, with multimedia support to introduce gerontechnology and its products, including selection and purchase methods. Pre- and post-education surveys were conducted using a 0ΓÇô10-point rating scale to assess changes in knowledge and acceptance. Patients' keenness towards product trial use services and their preferred products were also investigated. Results and Discussion 70 patients (Age <70, n=45; Female, n=49) with physical (n=34) or mental illnesses (n=36) were recruited from August to November 2023. Regarding knowledge changes, participants overall showed significant improvement in self-perceived knowledge of gerontechnology, F (1,66) =186.61, p<.001, product features, F (1,66) =78.39, p<.001, and purchase methods, F (1,66) =51.43, p<.001. There is significant interaction effect of age group on knowledge changes which the younger age group (<70) showed significantly greater improvement than the older age group (ΓëÑ70) across the same knowledge categories: gerontechnology, F (1,66) =9.72, p<.003, product features, F (1,66) =5.47, p<.022, and purchase methods, F (1,66) =5.53, p<.022. This suggested future education focusing on younger patients and caregivers who displayed better knowledge acquisition. Regarding acceptance changes, participants showed significantly enhanced acceptance of gerontechnology, as evidenced by their increased readiness to use, F (1,66) =13.99, p<.001 and purchase, F (1,66) =22.80, p<.001, the products. These changes were not significantly different between age groups (<70 vs ΓëÑ70) or disease groups (physical vs mental), indicating the project's comparable effectiveness in enhancing gerontechnology acceptance among patients of various ages and illnesses. Furthermore, 50% of participants expressed positive attitudes (rating ΓëÑ6) towards product trial use services to enhance purchase readiness. Similar popular products including smartwatches, sensor lights, and smart pill boxes were identified in both patients with physical and mental illnesses, highlighting the potential benefits of incorporating trial use services for these products to facilitate widespread utilization. In conclusion, gerontechnology education is crucial for addressing the accessibility crisis and enhancing knowledge and acceptance among end-users. Introducing new targeted promotion initiatives and focusing on specific products can maximize utilization and contribute to the sustainability of the gerontech ecosystem. References Our Hong Kong Foundation. (2021). Healthcare and Ageing Policy Research Report: Building an Age-Friendly City Embedding Gerontechnology Into Everyday Life. https://ourhkfoundation.org.hk/sites/default/files/media/pdf/OHKF_Gerontech_report_en.pdf Keywords: gerontechnology education, patient empowerment Affiliation: Occupational Therapy Department, Tai Po Hospital, Hospital Authority, Hong Kong Corresponding Author Email: jch822@ha.org.hk
Copyright (c) 2025 International Society for Gerontechnology
Climate Change in the Context of Informal Care ΓÇô The Development of an App for Caregivers
PURPOSE We will present the conceptual and methodological foundations of the project "Climate Change and Health in the Context of Informal Care," sponsored by the FFG Austrian Research Promotion Agency. This Austrian project aims to improve digital health literacy among informal caregivers (e.g. family caregivers and 24h caregivers) through the development of an app designed to support them during heat waves, providing essential information to minimize health risks and ensuring climate-sensitive care. (Research) Projects can be found in developing apps for professional and informal caregivers to support them in their daily caring activities (e. g. Hudelmayer et al., 2023; Sala-Gonz├ílez et al., 2021; Vandersman et al., 2021). However, there is little scientific information about apps specifically for informing and educating informal caregivers on the health effects of climate change, on explaining and showing them how to protect themselves and their patients from health-worsening consequences METHOD This project contains an interdisciplinary approach with a mixed-model longitudinal study design and a participatory focus . (von Unger, 2014). It is coordinated by the ├ûSB Consulting GmbH as technical partner, supported by the Arbeitsgemeinschaft Pflegegruppe (a consortium for 24h caregivers) as networking partner, and scientifically led by the IMC Krems. In workshops shortly before summer in 2024 and 2025, informal caregivers, firstly, will be generally informed about health effects of climate change. Secondly, they will get instructions on how to use the first prototype of the app and will be asked to use it during summertime while they are caring for their patients. Qualitative Interviews and assessments of digital health literacy will be conducted in order to understand the attitudes of the caregivers towards climate change, their knowledge on the health effects on their patients and on themselves, as well as to measure the effects on their digital health literacy (Griebler et al., 2021). RESULTS AND DISCUSSION In September 2024, the first empirical phase has been performed. Therefore, we will focus on the conceptual and methodological setup of the research project. First insights will be shown on the suitability of the participating approach, as well as first preliminary results from the health literacy assessment and the qualitative interviews with the informal caregivers. Moreover, we will discuss the possible adaptions of the approach for the second empirical phase in 2025. KEYWORDS Digital Health Literacy, Climate Change, Health App, Informal Care, Participatory Research MAIN AFFILIATION AND COUNTRY OF FIRST AUTHOR Institute of Nursing Science at the IMC Krems/Austria jette.lange@fh-krems.ac.at REFERENCES Griebler, R., Stra├ƒmayr, C., Mik┼íov├í, D., Link, T., Nowak, P., & und die Arbeitsgruppe Gesundheitskompetenz-Messung der ├ûPGK. (2021). Gesundheitskompetenz in ├ûsterreich: Ergebnisse der ├╢sterreichischen Gesundheitskompetenzerhebung HLS19-AT. G. Bundesministerium f├╝r Soziales, Pflege und Konsumentenschutz & G. d. Bundesgesundheitsagentur. Hudelmayer, A., zur Kammer, K., & Sch├╝tz, J. (2023). Eine App f├╝r die informelle Pflege. Zeitschrift f├╝r Gerontologie und Geriatrie, 56(8), 623-629. https://doi.org/10.1007/s00391-023-02249-1 Sala-Gonz├ílez, M., P├⌐rez-Jover, V., Guilabert, M., & Mira, J. J. (2021). Mobile Apps for Helping Informal Caregivers: A Systematic Review. International Journal of Environmental Research and Public Health, 18(4), 1702. https://www.mdpi.com/1660-4601/18/4/1702 Vandersman, P., Perimal-Lewis, L., & Tieman, J. (2021). Is There an App for That? A Scoping Review of Apps for Care Workers in the Aged Care Sector. Studies in Health Technology & Informatics(277), 124-134. https://doi.org/10.3233/shti210035 (Studies in Health Technology and Informatics) von Unger, H. (2014). Partizipative Forschung. Einf├╝hrung in die Forschungspraxis. Springer VS.
An MDE approach for the generation of Smart Contracts for elderly care
The use of technology applied to the care of ageing adults is a key strategy to increase the effectiveness of health care delivery, thus contributing to a higher quality of life for ageing people. However, a general and important concern is data security and privacy. Given the security provided by Blockchain (BC), the interest in this technology is growing at an accelerated pace in different contexts, and support for aging is no exception. Security in this type of technologies rests, among other things, on Smart Contracts (SC), immutable decentralized programs for BC platforms that enforce, monitor and execute agreements, without the intervention of a trusted third party. Due to the variety of technologies and their particularities, the development of SCs is a complex process, since the architectural constraints of each platform must be considered. This paper presents a Model Driven Engineering (MDE) tool that automatically generates SCs using the Solidity programming language, in the context of a senior care process, for deployment on the Ethereum platform.
Attitudes of Older Turkish Adults toward Incorporating Radar Technologies into Geriatric Bathroom Design
Attitudes of Older Turkish Adults toward Incorporating Radar Technologies into Geriatric Bathroom Design Y. Afacan*, B. Barshan** ┬á Purpose┬áHome bathrooms are among older Turkish adults' most common fall areas. Technology integration and geriatric bathroom adjustments are challenging, causing major user acceptance problems, construction costs, and burdening social facilities' architectural and engineering services. Although there is an increasing amount of research on geriatric bathrooms and fall-detection technologies, it should be noted that there are significant differences among simulated falls, design guidelines, bathroom standards, and real-world experiences of older adults.┬áΓÇ£Annually, around 424,000 deaths occur due to falls, 80% of which happen in medium and low-income countriesΓÇ¥ (Kimiafar et al., 2021, p.116).┬áCompliance with accessibility standards does not guarantee a fall-free environment and a perception of quality for older adults. This study investigates older Turkish adults' attitudes toward using┬ánear-field radar technology to detect actual hazard situations.┬áMethod┬áFifty-nine interviews were conducted with older adults aged between 65 and 95. ParticipantsΓÇÖ problems with their home bathroom area were asked and their suggestions were collected. Photographs of their bathroom were taken. The study focused on the bathroom's bathing area in the form of a shower unit. The data were analyzed using thematic analysis.┬áResults and Discussion┬áThree themes emerged from the findings: Safety, privacy, and independence.┬áThe study highlighted the perceived importance of fall-detection technologies based on the participantΓÇÖs performance in the bathroom.┬áThe real-time radar-based fall-detection system represents a cutting-edge technological solution designed to address the critical issue of these three themes on detecting and responding to falls. Figure 1 illustrates the overview of an exemplary real-time radar-based fall-detection system used in a related study by the authors (├ûlmez et al., 2024).┬áOne problem that exists with radar-based fall-detection modules is the existence of false positives. Thus, future studies could focus on the simulation of different emergency scenarios and the implementation of radar systems in bathrooms through machine/deep learning techniques to identify falls and differentiate them from other activities. ┬á References Jabiyev R., ├ûzsoy, M. O., Akt├╝rk, U. E., Oral, E. B., ├ûlmez, E., Ansen, B. (2023). RF/Microwave Safety Sensor System, Senior┬á┬á┬á┬á┬á┬á┬á┬á┬á┬áProject with Industrial Focus, Final Report, Dept. of Electrical and Electronics Eng., Bilkent University, Ankara, T├╝rkiye. Kimiafar, K., Farrokhi, M., Manouchehri Monazah, F., Khadem-Rezaiyan, M., Sarbaz, M. (2021). Fall-related hospitalization of patients┬á┬á┬á┬á┬á┬á┬á┬á┬á┬á┬á┬áin Iran.┬áChinese Journal of Traumatology, 24(2), 115ΓÇô119.┬áhttps://doi.org/10.1016/j.cjtee.2021.01.001 ├ûlmez, E. et al., Safety tracking system for bathroom shower environment,┬áProceedings of the IEEE 32nd Conference on Signal Processing andCommunications┬áApplications,┬áin Turkish, 15ΓÇô18 May 2024, Tarsus,┬áMersin, T├╝rkiye. Keywords:┬áfall-detection technologies, near-field radar, bathroom,┬ásafety, privacy, and independence Affiliation:┬á*Interior Architecture and Environmental Design/Faculty┬áof Art, Design, and Architecture,┬á**Electrical and Electronics Engineering/Faculty of Engineering, Bilkent University, Ankara, T├╝rkiye. Corresponding Author Email:┬áyasemine@bilkent.edu.tr;┬áAuthorsΓÇÖ ORCID┬áIDs:┬á*0000-0002-0148-5033, **0000-0001-6783-6572 ┬á
Sustainable Solutions for Aging Populations: Navigating Technological Progress
As technological progress accelerates, it brings both opportunities and challenges for aging populations. This text hints at a discussion on how gerontechnology can adapt to incorporate sustainable practices while leveraging advancements like AI and mixed reality to enhance quality of life for the elderly.
Could Healing Architecture Help in Acquiring a Healthy Inclusive Environment? S.M. Issa Abdou
Purpose This study is a trial to review whether Healing Architecture could be an important dimension of the aimed at Healthy Inclusive Environment. The present study will focus on explaining the meanings of Healthy Inclusive Environment and Healing Architecture and their main characteristics and their relation to each other. Method A review of literature will be used to collect definitions, characteristics as well as various opinions of the proposed point of study ΓÇ£Healthy Inclusive Environments and Healing ArchiectureΓÇ¥. Results and Discussion According to the World Health Organization A Healthy Environment is the one that ΓÇ£could prevent one quarter of the Global burden of diseaseΓÇ¥ (World Health organization, ). Such environment would provide its users with clean air, stable climate, adequate water, sanitation and hygiene, safe use of chemicals, protection from radiation, healthy and safe workplaces, secure agriculture practices, health supporting cities and built environment, as well as preserved nature. In this definition it was found that it includes a lot of exaggeration in regard to the protection from radiation and preserved nature. This definition neglects the fact that difference of opinions and conflict of interests lead to wars and army confrontations where the used weapons pollute the atmosphere by producing energy travelling in the form of waves, to which people as well as soil, water and food are exposed. This leads to the spread of diseases affecting millions of individuals around the world (World Health assembly. 2020). ΓÇ£Radiological weapons are generally suitable of terrorΓÇª.The radioactive material acts as a toxic chemical to which exposure eventually proves harmful or fatalΓÇ¥ (Cordsmann, A.H., 2024). For an Environment to be Inclusive, there is a need to spread the culture of mutual respect, effective relationships, clear communication as well as explicit understanding of expectations. Inclusive Environment is where there are values of diversity acceptance and respect of differences. In an inclusive community everyone - regardless of their origin, ethnicity or ability- can collaborate in a constructive way. There is a need, then, to address existing barriers whether physical or discriminatory to allow all community members to access opportunities and resources.┬á .ΓÇ¥ Healing Architecture minimizes health hazards through the design strategies that increase industrial┬á hygiene, air filtration with sanitationΓÇ¥ (┬á┬á┬á ). When one designs for healing and well being. it creates peace with nature, specially designed places that are healthily balanced in order to promote wellness, stimulate creativity and healing within the built environment. There is a need, then, to address existing barriers whether physical or discriminatory to allow all community members to access opportunities and resources. ┬áThe design strategies used by┬á architecture could integrate light and color, space organization, form and building systems as well as building envelope to promote good health and help in the recovery of users whether physically, emotionally or psychologically. Recommendations that should be taken into consideration on various levels include: Teaching new generations the meaning of Healthy Inclusive Environments and their characteristics and impact on society members. Architects should be taught these concepts and how to apply them to their designs. Above all Leaders, Politicians and Decision Makers should have more awareness of the importance of the characteristics of Healthy Inclusive Environments before taking any crucial decisions. ┬á References WHO seventy seventh World Health assembly, Daily update 27 May-1 June 2024 Cordesmann ,A.H, ΓÇ£Radiological Weapons as means of Attack, available online at site-prod.s3.amazonan.com 28-5-2024. . ┬á Keywords: Healthy Environments, Inclusiveness, Healing architecture. Affiliation: Department of Architecture/Faculty of Engineering, Menoufia University, Egypt Corresponding Author Email: safaai21@yahoo.com ┬á┬áAuthorsΓÇÖ ORCID iDs ┬á ┬á ┬á ┬á Figure 1. New Gorna village in Luxor Designed by the Father of the Egyptian sustainability ┬áarchitecture. Architect Hassan Fathy the architect who designed for the poor He favored the use of economic building materials. And Ethnic Designs.
Empowering Family Carers: Discovering and Sharing Creative Ideas to Navigate Daily Life
Purpose The majority of individuals requiring care in Germany are looked after by family members (Statistisches Bundesamt [Destatis], 2022). Especially, at the beginning of the caregiving period, family caregivers experiences a lack of experience and routines, which leads to stress (Koch et al., 2021). However, long-term carers have often developed creative practices or self-made products to manage not only the challenging caregiving tasks but also to navigate daily life, employment, family life and social participation to enhance their quality of life. These creative ideas have not yet been systematically documented nor made accessible. It could be assumed that these grassroots ideas and products could enhance nursing familiesΓÇÖ lives (Duncan et al 2019) as many use online support communities (Friedman et al 2018) and rely on peer support (Lancaster 2023), mostly for emotional relief (Chi & Demiris 2015). Structured peer know how was not mentioned in reviews we researched: How can digital technological networks support the creation of know how on quality of life for all those involved, so that families who take on the main burden of care in Germany can meet the requirements in the long term? How can creative ideas for a better management of everyday life be identified, presented and shared through a digital platform? Method An interactive digital platform ΓÇ£PflegeschaetzeΓÇ¥ will document such practices. The design and accessibility of the platform and the information to be displayed need thorough planning: Through a qualitative study the creative ideas of family carers are surveyed through semi-structured interviews, elements of diary and photovoice methods, as well as solution-focused and co-creative design thinking workshops. Solutions identified are described and visualized to be presented on an ΓÇ£exhibitionΓÇ¥ on an interactive platform with regard to accessibility and plain language and visualization. Based on the collected ideas, a scientifically grounded categorization system for structuring and finding the creative ideas on the platform is developed. Results and Discussion Often carers are not even aware of how much knowledge they have, which is why the data collection process itself has the potential to empower research participants. Even new ideas are generated during the identification process. With regard to work, leisure and social participation, creative ideas were identified in categories such as: time management; communication; DIY; self-care. Examples of identified creative ideas include the use of (digital) collaborative charts for communication; strategies for organizing necessary care aids at vacation destinations; cork panelling to protect walls when using a wheelchair. In contrast to exchange in self-help associations or exchanges through social media, the design of the digital content will not be volatile but solution-oriented and searchable in a structured manner. Key requirements for presenting these on the digital platform include the use of concise, understandable descriptions and images/videos to enable the quick comprehension of content without demanding high levels of reading, language and text comprehension (unlike online forums) or knowledge of medical terms and designing for family carers as a highly diverse target group. ┬á References Chi, N.-C, Demiris, G. (2015). A systematic review of telehealth tools and interventions to support family caregivers. Journal of Telemedicine and Telecare, 21: 37ΓÇô44. Duncan, T. S., S. Riggare, S. Koch, L. Sharp and M. H├ñgglund (2019) ΓÇÿFrom Information Seekers to Innovators: Qualitative Analysis Describing Experiences of the Second Generation of E-PatientsΓÇÖ. Journal of Medical Internet Research, 21(8): e13022. DOI: 10.2196/13022. Friedman, E. M., T. E. Trail, C. A. Vaughan and T. Tanielian (2018) ΓÇÿOnline peer support groups for family caregivers: are they reaching the caregivers with the greatest needs?ΓÇÖ, Journal of the American Medical Informatics Association, JAMIA, 25(9): 1130ΓÇô1136. DOI: 10.1093/jamia/ocy086. Koch,┬áA., Kozhumam,┬áA.┬áS., Seeler,┬áE., Docherty,┬áS.┬áL., & Brandon,┬áD. (2021). Multiple Roles of Parental Caregivers of Children with Complex Life-Threatening Conditions: A Qualitative Descriptive Analysis. Journal of Pediatric Nursing, 61, 67ΓÇô74. https://doi.org/10.1016/j.pedn.2021.03.017 Statistisches Bundesamt. (2022). 5 Millionen Pflegebed├╝rftige zum Jahresende 2021. https://www.destatis.de/DE/Presse/Pressemitteilungen/2022/12/PD22_554_224.html Lancaster, K., A. Bhopti, M. L. Kern, R. Taylor, A. Janson, and K. Harding (2023) ΓÇÿEffectiveness of peer support programmes for improving well-being and quality of life in parents/carers of children with disability or chronic illness: A systematic reviewΓÇÖ, Child: Care, Health and Development, 49(3): 485ΓÇô496. DOI: 10.1111/cch.13063.
Active ageing in a community-based living environment
Purpose: The purpose of this project was to explore a community-based living environment for older adults, located in rural surroundings in Norway called Helgetun. It aims to promote active ageing by facilitating social, mental and physical participation and consists of 31 rental apartments, in addition to several shared facilities and common areas. Residents can partake in arranged activities including gardening, choir, workout groups, hiking, dance and a book club. Additionally, a chef comes ones a week to prepare a shared meal, and a personal trainer organizes a weekly workout session. The environment is highly independent, with no external health personal connected, and the residents choose their own house board, and arrange and organize most activities themselves. The aim of our research was to investigate how this living environment functioned compared to theory, by looking at how it has affected residentsΓÇÖ activity levels and social engagement and identify factors important for facilitating active ageing. During data collection, the COVID-19 pandemic occurred, allowing us to investigate how the participants experienced this crisis. ┬á Method: This was a qualitative research project using an ethnographic approach. Data consisted of observation, informal conversations, and in-depth semi-structured interviews with 15 residents (11 female, 4 male, ages 62-84), and were analysed using reflexive thematic analysis.┬á┬á┬á ┬á Results and discussion: Most participants experienced an increase in both physical activity levels and social engagement after moving to the residency. According to our analysis, this increase was related to having three fundamental needs covered: maintaining self-identity, experiencing growth and development, and feeling a sense of belonging (F├╕rsund et al., 2024). These themes draw close resemblance to the self-determination theory, concerning three psychological needs that must be satisfied to foster well-being and enable optimal function and growth (Ryan & Deci, 2017). Another finding was the synergy effect occurred in the residency, in which the residents themselves became the resource: they created the learning arena by exchanging knowledge, inspired and motivated each other to be active and social, and helped each other. Consequently, resulting in a self-sustaining environment in which the participants experienced both contribution and mastery whilst potentially reducing the need for external resources. Most were minimally affected by the COVID-19 pandemic, partly due to clear information about infection-prevention rules and disease status within the community, as well as the feeling of always having people around, thus preventing isolation and loneliness. This finding suggest that community-based environments can increase resilience among this age group and could account for other potential crises. ┬á In conclusion, our results indicate that having a flexible structure, adapting to the core needs and individual resources of the residents, can facilitate active ageing in community-based living environments and reduce the need for external resources. These findings are meant as grounding points for policymakers to reflect upon designing future senior living and may be particularly relevant in the years to come, and in countries where older adults are less dependent on family for care.
Purpose Vulnerable people such as older people or people with disabilities experience the greatest proportion of casualities during and after natural disasters compared to the younger population (cf. American Red Cross, American Academy of Nursing, 2020). Their needs should be taken into account in prevention and in the actual crisis situation. The rescue service is breaking new ground with the non-profit association German Centre of Rescue Robotics (Deutsches Rettungsrobotik-Zentrum e.V. (DRZ e.V.)) which was founded in 2018. Its aims are to promote the development of robotic systems to assist in the rescue and protection of people and property. Method In order to achieve its goals the DRZ e.V. which is a non-profit organisation made up of various interest groups from research to industry and users, has developed and implemented a variety of activities, such as piloting and testing of robotic technologies for disaster management and developing vocational training to use the technology efficiently in disasters, considering the overall disaster situation. Unlike industrial applications, disasters are not standardized and are always specific. Therefore, the technology must be adaptable to the different hazards such as fire, floods, etc. Robots and drones are remotely controlled and can provide an insight into the danger zones. Results and Discussion Although DRZ e.v. focusses on testing and trials, the city of Dortmund can request the support. Initial experiences show that the request comes in the second wave, in order to gain a detailed insight into the hazardous situation. For example, the rescue services can send the robot directly into a burning building. 3D images make it possible to identify whether and where people are inside the building, or even to deploy fire hoses using sensor. Robots are always co-bots providing the task force with detailed information of the hazardous area and automatic analysis of hazardous substances, thus enabling more informed and targeted decision making about next steps. The challenges are to consider the socio-technical system which includes the training of rescue forces in these new technologies, and to develop an understanding of the implications and potential in a hazardous situation, but also an understanding of the needs of vulnerable groups in hazardous situations.
Challenges with Safety, Security, and Emergency Preparedness for those Aging with Long-Term Disabilities
Purpose Worldwide, people with disabilities acquired in early to mid-life are living longer, contributing to growing numbers of older adults aging with disability. Older adults with long-term sensory and mobility disabilities are likely to experience challenges performing everyday activities and have high support needs due to the combination of co-morbid conditions, age-related declines, and long-term disabilities (Mitzner, et al., 2018). They may experience barriers that impact their safety and security in the home and community, which can ultimately inhibit their ability to age-in-place. Technology holds great potential to support people aging with disabilities in preventing and responding to emergency situations. However, effective technology solutions must respond to real-world issues experienced by these individuals and engage target users in research and development. Method The Aging Concerns, Challenges and Everyday Solution Strategies (ACCESS) study is a mixed-method investigation of everyday challenges among people aging with disabilities that explores user support needs to guide technology innovation (Koon et al, 2020; Remillard et al., In Press). We conducted an archival analysis of the ACCESS data regarding reported challenges related to safety and security (e.g., getting help in case of an emergency). Participants were 180 older adults (ages 60-80) with long-term disabilities (i.e., at least 10 years) representing 3 subsamples (n=60 in each group) including: vision impairment (due to macular degeneration or glaucoma), multiple sclerosis (MS), and late-deafened. We conducted a thematic analysis to assess types of concerns (e.g., crime, fire, health episode), challenges, and response strategies, which were further categorized using the Selection, Optimization, and Compensation model of aging to understand adaptation to losses. Results and Discussion For the vision impairment group, key concerns included navigating unfamiliar places (i.e., unsafe part of town, getting lost) and having to trust others without being able to see what they are doing (e.g., taxi driver not going to intended location, potential theft among home service providers). Participants with MS reported concerns about falling as well as mobility challenges that could hinder their ability to respond to an emergency (e.g., evacuating in a wheelchair, inability to move quickly, poor reflexes). For late-deafened participants, concerns were primarily related to missing important sound-based alerts or alarms (e.g., fire alarm) or not having access to essential information in the event of an emergency. Across groups, challenges were primarily related to their disabilities, but were also attributed to other factors such as memory issues, falls, and other health conditions. Participants reported various solutions including technologies (e.g., emergency response devices, smart watches, phone apps); getting assistance from others; personal strategies (i.e., advanced planning and communication); as well as avoiding certain situations. Some participants shared they simply would not know what to do in an emergency. These examples of safety and security concerns from the lived experiences of people aging with long-term disabilities illuminate critical unmet needs and opportunities for technology innovation. Findings reinforce the need for emergency response technologies to provide multi-modal alerts (i.e., sound, vibration, lights) that can be customized to usersΓÇÖ needs and preferences. Emergency response plans must also consider how to be inclusive of those with limited mobility and accommodate mobility aids.
Older Adults Everyday Technology Use During COVID-19: Three-Dimensional Perspective
Purpose: To examine older adults' experiences of using technology for daily activities during COVID-19, from a three-dimensional perspective. Method: Nine virtual focus groups, comprising six to seven participants each, were conducted with older adults, family members, and health professionals (N=59). Data was analyzed using constant comparative methods and thematic analysis. Results and Discussion: Participants of all three focus groups depict technology as an integral part of older adults' daily lives. Yet, in some circumstances, older adults prefer to physically go out and conduct activities in the traditional ΓÇ£face-to-faceΓÇ¥ way in the community. This sentiment was notably highlighted in the context of the COVID-19 pandemic, where older adults emphasized their deep yearning for human connections, underscoring the importance of social activities in their lives. When it came to high-meaning activities, older adults found ways to conduct them using technology, despite the challenges. Health professionals acknowledge the various functions of technology in older adults' daily activities, determining their willingness to use it. In accordance they categorize activities into 3 domains: (1) health-related tasks (e.g. utilizing health insurance applications); (2) routine errands (e.g. shopping and managing bank accounts); (3) activities geared towards addressing loneliness or social- leisure activities (e.g. video conferencing and online games). This differentiation enables a deeper understanding of the unique contribution of technology to older adultΓÇÖs lives. Conclusions: Study findings bring a broad three-perspective view of older adultsΓÇÖ motives of using technologies. Older adults choose to use technology especially in meaningful activities and in ways that support their weekly routine as a whole. In the design of effective interventions for the aging population it is essential to address the complex interplay between older adults, the technology they use, and their daily routines. These findings may be relevant to other stressful situations, wherein technology plays a crucial role in facilitating daily activities, such as war or various health conditions.
Digital Acceleration: Exploration of Gerontechnological Research Needs Towards the Promotion of Successful Ageing
Purpose In a rapidly ageing climate, a culturally shifting society and a consistently evolving world, the advancement of technology has become a necessary evil (Zaid et al., 2023). Although there is a plethora of challenges associated with ageing (Bambeni, 2022), the expansion of the concept of gerontechnology over the years has unveiled many possibilities when it comes to successful ageing. Historically, in Sub-Saharan Africa (SSA), the primary source of support for senior citizens has been the household and family, due to its predominance and lack of patronage of other care options (Dovie, 2019). However, due to an increase in the elderly population, and a shift in cultural and socio-economic dynamics, traditional arrangements are no longer sustainable in today's environment (Essuman and Mate-Cole, 2021). This has paved way for the reliance on technology to bridge the gap left by this transition. Despite the foregoing, there has been a slow increase in scholarly research on the subject throughout the SSA region (Kalu et al., 2021) making it challenging to employ gerontechnological solutions. This study therefore examined the possible marriage of three important concepts: advances in technology, ageing in place, and the socio-cultural landscape as a firsthand approach at identifying the problems associated with gerontechnological adoption to minimize age-related difficulties and serve as a catalyst for successful ageing. Method The study adopted a systematic literature review approach using Harzings Publish or Perish to critically review 127 publications from 2018 to 2024 with key terms ΓÇÿAgeingΓÇÖ, ΓÇÿSub-Saharan AfricaΓÇÖ, ΓÇÿGerontechnologyΓÇÖ, ΓÇÿBarriersΓÇÖ, ΓÇÿAdoptionΓÇÖ, ΓÇÿTechnologyΓÇÖ, ΓÇÿElderlyΓÇÖ, ΓÇÿAccessΓÇÖ, ΓÇÿAgeing in PlaceΓÇÖ, and ΓÇÿDeveloping CountriesΓÇÖ. The review examined the research direction over the past five years to identify barriers to gerontechnological access, and the possibilities of its uptake. Results and Discussion Findings indicate that research on gerontechnology in SSA is severely lacking. Only 11 out of 127 papers covered gerontechnology relating to SSA with majority focusing on challenges with ageing (Nkansah et al., 2021; Skinner et al., 2021), specifically social isolation and internet use (Byaro et al., 2023; Oyinlola 2022; Ojembe and Kalu, 2019). Other research areas included assistive devices (WHO, 2022; Ngaruiya et al., 2019) and geriatric care (Maharaj, 2020). Consequently, it is evident that there is an imminent understudying of these technologies in the global south leading to uncertainty surrounding the topic, both with experts and users. However, there is a complex interplay of factors influencing the exploration of gerontechnological solutions in SSA including technological illiteracy, infrastructure challenges, and debilitating perceptions on ageing. By widening the research scope in SSA, culturally appropriate technological interventions can be developed. It is imperative to prioritize gerontechnological research in SSA to help balance out the distribution of its benefits globally. With approaches that focus on appropriate technology and unique challenges facing the global south, sustainable and contextually relevant methods of integrating these technologies within SSA will be promoted, ultimately contributing to the well-being and independence of older adults.
Bridging Disaster Risk Reduction, Community Work, and Gerontechnology. Potentials, Ambivalences, Challenges
PURPOSE The Round Table brings together discussions on disaster risk reduction, community work, and gerontechnology. The participants work in diverse yet overlapping areas, with expertise in assistive and digital technologies in social and healthcare, social work as disaster relief and community work, rescue robotics, and global disaster risk reduction. Within a co-creative discussion format, the participants engage in the exchange and creation of future knowledge related to the role of communities, technologies, and robotics in disaster risk reduction with a special emphasis on the situation of elderly people. The goal is to facilitate a dialogue between previously separate discussions on social, community-based disaster relief on one hand, and gerontechnology and robotics on the other. This dialogue aims to develop practical approaches and new visions for community-centered disaster relief together with and for people in need, as well as to explore the possibilities of gerontechnology based on best practice examples and exchange of experiences. ISSUE According to the United Nations International Strategy for Disaster Reduction definition, a disaster is "a serious disruption of the functioning of a community or society causing widespread human, material, economic, or environmental losses which exceed the ability of the affected community or society to cope using its own resources" (UNISDR, 2004, 1). Disasters result from the combination of hazards, vulnerabilities, and insufficient capacity to reduce potential negative consequences. They can be natural (e.g., floods), human-made (e.g., terrorist attacks), or a combination of both. The international community responded to the increase in disasters by adopting the Sendai Framework for Disaster Risk Reduction (SFDRR 2015-2030) in 2015, emphasizing focused actions at local, national, regional, and global levels (De Silva et al., 2023). On the one hand, it is particularly vulnerable groups and recipients of social and health care services that are especially affected by disasters and need specific emphasis in this context (Alston, Hazeleger, Hargreaves, 2019; Dominelli, 2012). This includes the elderly, individuals in care and senior facilities, people with disabilities and individuals who depend e.g. on the continuous functioning of ventilators or other technical devices. On the other hand, the question arises as to what possibilities digital innovations, such as rescue robots, can offer for the retrieval and assistance of people before, during and after a disaster (Habib, Baudoin, 2010). The participants of the Round Table take the particular vulnerability of older individuals and addressees of social work and healthcare in the event of a disaster as the starting point. They bring together experiences and research from Austria, Germany and other countries and discuss the role of communities, of robotics and assistive technologies in disasters, considering their potential usefulness for communities in need, as well as ambivalences and challenges. GUDING QUESTIONS How are communities and addressees of health care and social work, especially older adults, affected by disasters? How do communities and local, regional, national, and international support structures handle disasters? What role can assistive and digital technologies, robotics, and AI play in disasters? What potentials do they have, and where do ambivalences and challenges arise? How can digital tools be orchestrated and embedded in a community-centric, participative and needs driven manner within affected communities?
Auto-REBA: Improving Postural Ergonomics Using an Automatic Real-Time REBA Score in Virtual Reality
Purpose: This pilot system explores the integration of advanced technologies, including Virtual Reality (VR) and wearable devices, with the REBA (Rapid Entire Body Assessment) [1] technique for real-time posture correction and ergonomic assessment. Aimed at mitigating musculoskeletal strain and enhancing ergonomic practices, the research investigates the effectiveness of immediate feedback mechanisms in dynamic and simulated work environments. The ultimate goal is to enable elderly individuals to remain in the workplace longer [3]. Method: Utilizing a digital adaptation of the REBA method, we combined motion capture technology, VR, and wearable feedback systems to provide participants with real-time evaluations of their postural ergonomics in an exploratory study (N=5). To create a synchronized ergonomic assessment from physical to virtual, an innovative plane method for Rapid Entire Body Assessment (REBA) scoring in VR was developed to measure body angles accurately, aiming to replicate traditional ergonomic assessments within a virtual context. Participants were subjected to tasks within a VR simulation designed to induce poor posture, with the study varying the feedback modalities (visual cues represented through a color-coded REBA score within the VR environment via HUD and tactile feedback via wearables) to assess their impact on posture correction. Quantitative measures, including task completion times, REBA scores, and perceived workload (NASA TLX), were employed to gauge the system's efficacy across different feedback conditions. Results and Discussion: In the formative testing phase we found┬áthat real-time feedback aids participants in adjusting their posture towards safer ergonomics. The project demonstrated the potential of VR in ergonomic research, particularly through the successful integration of advanced technologies and the development of the plane method for REBA scoring. The study demonstrates the potential of combining VR and wearable technologies for a proactive approach to correcting postural habits and reducing ergonomic stress, thereby lowering the risk of long-term musculoskeletal disorders. The fusion of REBA with VR and wearable technologies offers a novel pathway for ergonomic intervention and education. We are currently enhancing our system by integrating tactile feedback at various body locations for a comprehensive prototype. Oagaz et al. [2] highlighted VR and wearable technology's benefits for sports learning through real-time ergonomic feedback, indicating their potential to address workplace musculoskeletal disorders. Showcasing the effectiveness of such technologies in improving postural ergonomics offers valuable insights into their potential application in occupational health and safety.
Video-based patient monitoring in long-term inpatient care
Purpose Video-based monitoring systems in long-term inpatient care represent an opportunity to increase patient safety. Technologies using infrared technology, as well as video and sound transmission are used to recognize movement to prevent falls and enable the continuous recording of vital parameters. Individual assessment of the necessity and limits of application from a nursing care perspective is essential due to the restriction on the patientΓÇÖs privacy and autonomy. Care professionals as well as the public were asked about the potentials and risk factors of video-based monitoring systems using semi-structured interviews and an online survey. This paper intends to provide a basis for discussion for the use of video-based monitoring systems in long-term inpatient care facilities. The aim is to conduct qualitative and quantitative fostering a critical analysis of the topic. In addition to displaying the opinion of the general public, the limitations and potential benefits of these technologies are illustrated and ethical aspects are discussed. Method The research was conducted in a mixed-method design by a student research group. Interviews were conducted with nursing care professionals (n=4) and people from the public (n=244) were surveyed on the topic of video-based monitoring systems via an online survey. The interviews were analysed using inductive, structured content analysis methods as Mayring describes to be a suitable analysis method. The online survey was analysed using statistical methods to draw credible quantitative results. Results and Discussion The results clearly show that video-based monitoring systems have both advantages and disadvantages as well as ethical aspects and factors that influence the acceptance of video-based monitoring which must be weighed up individually. A total of 47,1% (n=115) of survey participants are in favor of the use of monitoring systems in nursing, while 40,1% (n=98) are undecided.┬á In contrast, 185 people (75,8%) of the survey participants are of the opinion that video monitoring systems should not be used across the board and that specific groups of people should be considered differentially. Frequently cited reasons for this are data protection, restriction of privacy and self-determination, as well as the fear of data abuse. The most frequently mentioned advantages from the interviews included continual vital sign monitoring, faster reactions in emergencies, a reduction in the workload of nursing staff and an increase in patient safety, for example through improved fall prevention for patients.The hereby collected data suggests that a general interest in the implementation of video-based monitoring systems is apparent among the population. In order to increase acceptance, of aspects such as data protection, privacy and possible abuse of data, further research is needed to establish a reliable conclusion to this matter.
AI for Quality Enhancement of Video Streaming for Ageing AdultsΓÇÖ Entertainment in Rural Areas
Purpose Video streaming has emerged as a leading main multimedia trend, offering entertainment to the ageing adult population (Cui, K. et al.). This technology serves as a valuable tool for alleviating feelings of loneliness, allowing for the enjoyment of both recorded and live content, including films and video calls. Such services necessitate high Quality of Service (QoS), dependent on the availability of technologies such as 4G, 5G, and cloud computing. However, many isolated rural areas suffer from a lack of communication infrastructure, attributed to either the necessary financial investment or geographical challenges. In these contexts, the deployment of streaming-based applications becomes a challenge, adversely affecting the quality of life for the rural populace. Mobile Adhoc Networks (MANETs) present an alternative solution for these scenarios, supporting data transmission between devices without the need for a centralized control unit and utilizing wireless interfaces such as WiFi or Bluetooth. Thus, these devices can move around, changing networkΓÇÖs structure and leading to varying connections. Yet, this dynamic nature poses its own set of challenges, introducing instabilities in the links and complicating the consistency of the network (Goyal P. et al.). This abstract outline a communication architecture designed for video streaming over MANETs in remote rural regions. Utilizing a Machine Learning (ML) model, it classifies connections by their stability to optimize video frame compression.┬áMethod Referencing Figure 1, the architecture differences two key node types: senders and receivers. The first one is responsible for broadcasting video, both live-streamed or stored. To adjust video quality based on the current stability of ad-hoc links, sender node periodically pings nearby devices to evaluate communication metrics (1 and 2) and predict stability with the ML-trained model (3). Variables such as latency, bitrate, connection attempts, and bit error rate are considered to classify links into three distinct reachability levels: stable; semi-stable, and unstable. Accordingly, video frames are compressed based on the prevailing communication conditions (4). Furthermore, some unstable links may become unreached by the sender, requiring receiver nodes to route streaming towards these devices, pinging nearby nodes, classifying new links, and adapting compression to the stability (5). This strategy enables video broadcasting to devices beyond the range of the wireless interface. Results and Discussion A proof-of-concept was developed to assess the ML classification's effectiveness and the QoS improvement. Utilizing a boosted decision tree algorithm, the model was trained with actual MANET communication data. Subsequently, the model was integrated into a smartphone application, implemented to broadcast live-video. Four laboratory tests were conducted with three real smartphones: one acting as sender; another as a stable receiver node, close to the sender; and another smartphone situated beyond the senderΓÇÖs range. In this arrangement, latency was recorded and compared to results from non-adaptive streaming scenarios. As depicted in Figure 2, latency is significantly reduced with the proposed architecture, enhancing QoS and offering a viable option for video streaming in disconnected rural areas.
Game-based learning to enhance clinical reasoning skills in health professions education
Purpose: In today's healthcare environment, shaped by an aging population, health professionals frequently face complex clinical reasoning (CR) scenarios. Influences such as multimorbidity, technological advancements, and time constraints significantly impact their daily practice (Aud├⌐tat et al., 2019; Scott, 2009). This emphasizes the need for adequate CR instruction in health professions education to prepare them for these challenges and reduce potential patient safety risks. Moreover, the increasing shortage of nurses, potentially leading to inadequate guidance for future nurses, highlights the urgency for innovative solutions to enhance exposure to CR scenarios. Game-based learning (GBL) emerges as a promising approach to support CR instruction in an immersive and safe environment (Koivisto et al., 2017). However, clarity regarding available games and the associated educational strategies for teaching CR remains lacking. Recognizing the pivotal role of reflection in education for effective learning, a similar role is expected in GBL. This study aims to explore available games to support the teaching of CR among future healthcare professionals and to understand how to incorporate reflection within or around these gaming experiences. Method: First, a scoping review was conducted following PRISMA-ScR guidelines. We systematically searched 'Scopus', 'PubMed', 'CINAHL', and 'ERIC' databases using the search terms ΓÇÿgame-based learningΓÇÖ, ΓÇÿhealth professions educationΓÇÖ, ΓÇÿclinical reasoningΓÇÖ. Three reviewers independently screened titles and abstracts based on preset criteria. Secondly, qualitative semi-structured interviews were then conducted with health professions educators using GBL in teaching CR. Thematic analysis of data was performed by two researchers. Results: GBL tools to teach CR in health professions education could be divided into two categories: computer-based (n=10) and real-life games (n=9), with one computer-based game featuring added virtual reality functionality. Computer-based games mainly comprised simulation games, while real-life games included escape rooms and board games. Additionally, only six games integrated reflection as a CR step, with only four describing an educational model. Educators can facilitate learnersΓÇÖ reflection before, during and after game-based experiences to support CR, with options including self-reflection, peer-reflection, and instructor-led reflection. Discussion: In our initial research, we identified a broad application of GBL to support the teaching of CR in health professions education, particularly involving older adults. Further research is necessary to understand the current practices and perspectives of health professions educators regarding the facilitation of learnersΓÇÖ reflective practices, both before, during, and after engaging with game-based experiences. This forthcoming research, aimed at exploring the role of reflection in GBL for teaching CR, will be initiated in the coming months and subsequently discussed. References Aud├⌐tat, M.-C., Sader, J., Notari, S. C., Ritz, C., Fon, N. C., Maisonneuve, H., Blondon, K., & Nendaz, M. (2019). Understanding and promoting clinical reasoning in chronic and multimorbid conditions: a call for GPs and healthcare professionals. Health, 11(10), 1338ΓÇô1346. https://doi.org/10.4236/health.2019.1110103 Koivisto, J.-M., Niemi, H., Multisilta, J., & Eriksson, E. (2017). Nursing studentsΓÇÖ experiential learning processes using an online 3D simulation game. Education and Information Technologies, 22(1), 383ΓÇô398. https://doi.org/10.1007/s10639-015-9453-x Scott, I. A. (2009). Errors in clinical reasoning: causes and remedial strategies. BMJ, 339(7711), 22ΓÇô25. https://doi.org/10.1136/bmj.b1860
The impact of utilizing care robots on sustainability.
Purpose The recent increase in the elderly population has led to a growing demand for nursing services. In response, new care robots, utilizing digital technologies, have been developed, offering delicate and precise caregiving services that were previously impossible. However, stakeholders such as the elderly, their families, and caregivers, have low awareness of digital technologies and face difficulties accessing them due to factors such as prices. In this study, the user experience of care robots becomes crucial. The user experience of care robots refers to various factors such as emotions, perceptions, cognitive outcomes, and frequency of use gained while using the product (Turja et al., 2020). Aforementioned, it is important to investigate how the user's experience of using care robots directly influences satisfaction and sustainability. Method This study, a survey was administered to caregivers in three nursing facilities after the caregivers used care robots for one week. The survey aimed to assess satisfaction and sustainability. Data acquisition took place from October 1st, 2023, to November 30th, 2023. Researchers collected a total of 80 surveys through direct visits. Pearson's correlation analysis was conducted to examine the relationship between variables. Cronbach's ╬▒ coefficient and exploratory factor analysis were employed to analyze the reliability and validity of the survey instrument. Additionally, to verify the impact of caregiving robot user experience on sustainability, regression analysis was performed using Process Macro Model 4. Results and Discussion The demographic characteristics of the caregivers, 42 people had less than 4 years of experience as caregivers in nursing and 38 people had more than 5 years of experience. The Pearson's correlation analysis, significant correlations between variables were confirmed. Exploratory factor analysis yielded a total of 6 factors. The Kaiser-Meyer-Olkin (KMO) measure of sampling adequacy was .783, indicating an acceptable level, and Bartlett's test of sphericity showed a significance level of .000. Furthermore, Cronbach's ╬▒ coefficient values of .734, indicate satisfactory reliability. Regression analysis revealed that caregiving robot usage experience significantly influenced satisfaction (t=4.3182, p=.0000) and sustainability (t=6.4187, p=.0000). However, satisfaction did not significantly affect sustainability (t=-.2954, p=.7685). The study findings suggest that the advancement of care robots technology will play a crucial role in the future of elderly care and caregiving services. But, lack of significant association between satisfaction and sustainability can be attributed to the several following reasons. The first, limited utilization of various functional aspects of care robots may have hindered the acquisition of sufficient benefits in terms of sustainability. Secondly, the pursuit of short-term satisfaction without considering long-term impacts due to insufficient usage experience of care robots might have contributed to the lack of significant sustainability. Finally, prioritization of economic benefits due to the high purchase cost of care robots may have overshadowed considerations of sustainability. In conclusion, extensive research is needed to explore the long-term impacts of care robot usage experience on caregivers.
Evaluating robot effectiveness for older adults and their care partners
Effectiveness generally refers to the attribute of a system, process, or product to support its users in completing actions accurately (adapted from ISO 9241-11 usability definition (ISO,1998)). The effectiveness of a robot to support an older adult therefore refers to the degree of accuracy and completeness with which older adults can accomplish their goals using the robot. The satisfaction of the older adults in this process is vital because it impacts their comfort, willingness to use, actual use, and eventual acceptance of the robot (Boot et al., 2020). Older adults and their care partners have been reported to be open to robots as a care tool (Shishehgar et al., 2019). However, a critical question emerges - are robots ready? Is the task completion process satisfying to the users? These are the questions motivating this research wherein we examined the effectiveness of robots to support older adults and their care partners.┬áMethod┬áWe examined literature in the past 5 years to identify relevant studies that focused on assistive robots for the care of older adults and to support their care partners. We focused on four stakeholder groups: older adults with mobility impairments, older adults with cognitive impairments, professional caregivers, and family care partners. We identified a total of 44 papers that focused on these areas. We evaluated the robot effectiveness using a Likert scale (1-poor to 5-excellent) based on measures reported in the articles related to overall effectiveness such as accuracy or completion of the task by the robot. We evaluated user satisfaction using a Likert scale (1-very dissatisfied to 5-very satisfied) based on measures in the articles related to the usersΓÇÖ acceptance of the work completed by the robot and the manner in which it completed the task. We identified emerging themes and gaps that could influence effectiveness and user satisfaction.┬áResults and Discussion┬áOur ratings of documented robot effectiveness┬á┬á(M=3.55, SD=0.41)and user satisfaction (M=3.49, SD=0.11) were both in the positive direction above the mid-point fo the scale. The themes and gaps observed centered around:┬á(i)┬áutility┬áΓÇô robot interventions show potential to support older adults with mobility and cognitive impairments with various tasks of daily living;┬á(ii) learning support┬áΓÇô adequate training along with instructional support materials are needed to operate these robots; (iii)┬áease of use and personalization┬áΓÇô older adults and professional caregivers had similar viewpoints on ease of communication, control, behavior, appearance and ability to be tailored to their personal preferences; and. (iv)┬áerror recovery modalities┬áΓÇô recurring robot failures were mentioned in several studies without much discussion on design intended to support the userΓÇÖs handling of the robot in these situations. Overall, our review revealed a positive trend in the effectiveness of the current state of assistive robots to support older adults and their care partners. It also highlighted areas of improvements that could bridge the gap between development and actual use of the robots by the care recipients and care partners to improve their quality of life.┬á
Combining daytime structure, lifestyle-monitoring and social companionship in socially assistive robots for gerontechnology
Purpose┬áIn recent years, robots have more frequently beenimplemented in carefor older adults (Na et al., 2023). Care robots can serve different purposes, for example providing social, physical, or medical assistance (Bouwhuis, 2016). Socially assistive robots (SARs) support in activities of daily living and/or providing social companionship(Abdi et al., 2018). In practice many SARs also have a physical or medical assistive function. However, as noted by Vercelli et al. (2018), the majority of SARs aid users in maintaining daytime structure, such as reminding them to take medication or suggesting activities for a healthy lifestyle.Furthermore, the research of Casaccia et al. (2019) showed promising results for integrating SARs with lifestyle monitoring devices, resulting in better aligned advices by the robot and more accurate measurement of ADL of older adults. In addition, the review of Vercelli et al. (2018) showedthat robotpets and dolls are, in healthcare, often used aspsychotherapeutic tools to improve the emotional state of users, acting as a form of social companionship.Lifestyle-monitoring devices, robot pets and devices for daytime structure have their specific stage in the dementia process in which they can be best implemented (Ipakchian Askari et al., 2024).The earlier stages are suggested for daytime structure and lifestyle monitoring, while robot pets are suggested to be used in later stages.By integrating the three components, a SAR can be used for a longer┬áprogression of the disease. Furthermore, whenSARs are used for alongerperiod of time end-users tend to build a social connection with them(Reeves and Nass, 1996). Hence, a SAR that integrates the three components can improve the potential of SARs. An example of such an integration is the Hyodol robot, developed in South Korea. In this study, we assess Hyodol's potential in Dutch care context. The results can be used in future development of SARs that integratedaytime structure, lifestyle monitoring and social companionship in one SAR. We introduce this new type of care robots ascuddly and socially assistive robots (CSARs). Method This study was an explorative study involving22 healthcare professionals and 15 older adults with dementia, spreadover three research activities. The first activityentailed mapping the care processeswhen delivering daytime structure, in which a comparison was drawn between the care processes without and withhypothetical implementation of┬áHyodol. The subsequent two research activities comprised focus groups, one including healthcare professionals and one involvingolder adults with dementia.During these focus groups the potential effects of┬áHyodol were assessed and discussed.┬áResults and Discussion┬áWe have explored the potential of integrating social companionship, lifestyle monitoring and daytime structure in CSARs for older adults. Results indicate that the use of a robot with these integrations can have potential benefits for both extramural and intramural care. Moreover, it was discussed that the target group that could benefit from the CSARsis not merely people with dementia. For clients in somatic or psychogeratric departments the device could also be promising.Additionally, healthcare workers expressed to see potential in using Hyodolfor people with (cognitive) disabilities or fordaytime activity centers. To conclude, thecombination ofdaytime structure, lifestyle monitoring and social companionship in CSARs can have potentialbenefits in long-term care and is worth further research.┬á
Telepresence robots in mental health care to enable digital participation: a qualitative exploratory pilot study
Purpose The rapid increase in technological development over the last years (Birkner 2021, 629) has highlighted the need for action to ensure equal digital participation for all individuals. This includes people with mental health disorder (clients), who can achieve a higher level of independence if the technologies are designed for their benefit (Garcia & Filatr 2022, 189). Therefore, the Distr@l research study 'EmpowermentAssistant' focused on identifying the conditions for the successful use of a telepresence robot for the target group. The primary objective was to enable the clients to acquire and strengthen their digital skills and to benefit from digital participation. Assisted living facilities in various settings were chosen as the deployment location. The telepresence robots were used in two one-person apartments and in an assisted living group with 15 clients. The medical diagnoses of the clients included endogenous psychoses, such as schizophrenia and affective disorders, such as depression or mania. The different support needs of the clients were addressed through individual support planning from a person-centered perspective (Schreiber 2010, 15). Method. As part of an exploratory study, clients in shared and individual assisted living settings received a telepresence robot for eight months. In advance, the software of the telepresence robots was specifically programmed based on the results of a participatory requirement analysis. During the trial period, 28 qualitative semi-structured observations of the users were conducted with focus on technology use and acceptance (D├╢ring & Bortz 2016). In addition, 11 qualitative interviews were conducted with a total of 15 participants. The interviews focused on human-robot interaction, usability, technology acceptance and the overall conditions. The data collected from the field observations and interviews was subjected to a qualitative content analysis (Kuckartz 2018). Results and Discussion During the trial period, the telepresence robots were regularly used by clients and professionals, especially for applications related to structuring everyday life for instance as daily reminders (medication intake, meal times), entertainment functions (music videos, individualized quizzes) as well as physical and cognitive health enhancement (relaxation and sports videos, brain jogging app). Functions that conveyed a feeling of safety, e. g. video telephony and emergency call function or entertainment options, for example to distract from symptoms of mental health disorder, were rated positively. Applications that were individually designed for the target group were perceived as beneficial. The main aspects that influenced user behavior were previous experience with digital devices, support provided by the professionals during the human robot interaction, overcoming fears regarding the use of the robot and the motivation of the clients. Potential for improvement can be identified in the screen display which does not fully meet the criteria of the Web Content Accessibility Guidelines, and the language model. Furthermore, the use of a telepresence robot with a vulnerable target group requires complex consideration of ethical and data protection aspects. Overall, our findings suggest that the use of telepresence robots in mental health care can improve the care situation for clients and professionals, create new digital opportunities and enable digital participation.
Self-learning AI method for anomaly detection in ambient assisted living environments
The demographic shift in Germany, coupled with an aging population and a shortage of skilled caregivers, underscores the need for innovative solutions to address the challenges of eldercare.┬áThis paper explores the potential of digitalization to support independent living for the elderly through the use of sensor technologies. By detecting subtle changes in daily routines and behaviors┬áthese technologies enable early intervention to prevent accidents and maintain health.┬áA self-learning system is proposed, leveraging AI methods to continuously adapt to individual users' needs while ensuring privacy.
Co-construction of a Canadian virtual reality technology to manage pain and anxiety in palliative care units in the province of Quebec
Purpose┬áStudies have demonstrated the usability, feasibility, and acceptability of virtual reality in palliative care (Martin et al., 2022). Virtual reality has proven efficacy with positive effects in the reduction of pain, tiredness, drowsiness, shortness of breath, depression, and improvement in psychological well-being (Mo et al., 2023; Moloney et al., 2023). This consultation process aims to conduct the first iteration of a virtual reality technology to be tested in palliative care. The intervention called ΓÇ£Come with me" uses high-quality 360-degree (5K) video content and ambisonic sound developed by a Canadian start-up in Montreal, Quebec (Nipper Media).┬áMethod┬áThe virtual reality intervention ΓÇ£Come with me" consists of a ten-minute session in which participants use a virtual reality headset to visit a pre-established passive scenario (e.g., beach, city). A steering committee formed by healthcare professionals working in palliative care, volunteers of a palliative care foundation, graduate students in psychology, and researchers tested the virtual reality technology ΓÇ£Come with me" (n = 7). Following the test, participants expressed their opinions regarding different aspects of its potential use in the context of palliative care (e.g., duration, content, appropriateness for palliative care).┬áResults and Discussion┬áMost participants expressed having experienced feelings of relaxation after having tested this virtual reality technology (71%), indicating a positive perception following the experience. However, a person reported dizziness during a visual transition. The volume and quality of the sound were judged as excellent (29%) or good (57%). Most participants found the duration of the experience to be adequate for palliative care. The majority also considered the equipment comfortable for individuals in palliative care (86%). Participants expressed a preference for less music or narration during the intervention according to the individual needs of the person in palliative care (29%). They also recommended favoring both the exploration of public places and nature (86%), with 71% expressing the desire to visit places outside the province of Quebec, Canada. In addition, they highlight the importance of being able to adapt the intervention to the needs of the person in palliative care. Finally, 37% recommended individual sessions, 63% suggested including a significant other simultaneously and 25% mentioned the possibility of including several significant others at the same time. The preliminary results of this consultation process suggest that this virtual reality technology is judged as being positive and suitable for individuals in palliative care. These results will guide the necessary adjustments to optimize this virtual reality technology to the specific needs of this population. Additional consultation sessions will be conducted to adjust and refine the current prototype using an iterative process of cross-validation and co-construction.┬á ┬á References Martin, J. L., Saredakis, D., Hutchinson, A. D., Crawford, G. B., & Loetscher, T. (2022). Virtual reality in palliative care: A systematic review.┬áHealthcare, 10(7), 1222. https://doi.org/10.3390/healthcare10071222┬á Mo, J., Vickerstaff, V., Minton, O., Tavabie, S., Taubert, M., Stone, P., & White, N. (2022). How effective is virtual reality technology in palliative care? A systematic review and meta-analysis.┬áPalliative Medicine, 36(7), 1047ΓÇô1058. https://doi.org/10.1177/02692163221099584 Moloney, M., Doody, O., O'Reilly, M., Lucey, M., Callinan, J., Exton, C., Colreavy, S., O'Mahony, F., Meskell, P., & Coffey, A. (2023). Virtual reality use and patient outcomes in palliative care: A scoping review.┬áDigital Health, 9,┬á20552076231207574. https://doi.org/10.1177/20552076231207574 ┬á Keywords:┬áGerontechnology, AgeTech, Palliative care, Virtual reality, End-of-life, Family Caregivers, Older adult, Aging. Affiliation:┬á1Department of Psychology, Universit├⌐ de Montr├⌐al, Montreal, Quebec, Canada ;┬á2Centre de recherche de lΓÇÖinstitut universitaire de g├⌐riatrie de Montr├⌐al,┬áCentre int├⌐gr├⌐ universitaire de sant├⌐ et de services sociaux du Centre-Sud-de-lΓÇÖ├Äle-de-Montr├⌐al, Montreal, Quebec, Canada;┬á3Notre-Dame Hospital,┬áCentre int├⌐gr├⌐ universitaire de sant├⌐ et de services sociaux du Centre-Sud-de-lΓÇÖ├Äle-de-Montr├⌐al (CCSMTL), Montreal, Quebec, Canada;┬á4Universit├⌐ C├┤te dΓÇÖAzur. Corresponding Author Email:┬ájhon.alexander.moreno.1@umontreal.ca;┬áAuthorsΓÇÖ ORCID iDs:┬á0000-0003-3651-3222 Acknowledgement┬áWith financial assistance provided by the Gouvernement du Qu├⌐bec (Minist├¿re de lΓÇÖ├ëconomie, de lΓÇÖInnovation et de lΓÇÖ├ënergie┬áin Quebec, Canada) and Inven_T (Universit├⌐ de Montr├⌐al). ┬á ┬á
Minimal toe clearance in older adults when walking on level, uphill and downhill conditions
Purpose As people age, changes in gait parameters are commonly observed, and have been shown to increase the risk of mobility decline and falls. Minimal toe clearance (MTC) is a key gait parameter indicative of tripping. However, research on MTC is limited to walking on level surfaces, which do not reflect normal daily activities (Al Bochi et al., 2021; Avalos et al., 2024). We aimed to evaluate how MTC and its variation differ among level, uphill, and downhill walking conditions in older adults. Method This study is part of a larger cross-sectional research project, Gait features in different environments contributing to participation in outdoor activities in old age (GaitAge) (Rantakokko et al., 2023). A volunteer sample of 40 individuals was recruited via senior organizations and a university of third age. The inclusion criteria were community-dwelling, aged 70 years or over, able to walk 1 km without assistive devices, able to communicate, and living in a local area. The exclusion criteria were the use of a walking aid, severe sensory deficit (vision, hearing), memory impairment (MMSE score Γëñ23), or neurological condition. The participants walked on a level, five degrees uphill and five degrees downhill motor-driven treadmill (Gymstick Walking Pad Pro) at a self-selected constant speed. On the level surface, the participant walked for three minutes and on the uphill and downhill surfaces for two minutes. The uphill and downhill tests were performed in random order. Body movement was recorded using a 3D motion capture system (Vicon Motion Systems, Oxford, UK) with 16 cameras at a 200 Hz sample rate. Six of the 26 reflective markers (heels, proximal heads of the second metatarsals, and anterior superior iliac spines) were used in the MTC algorithm. A PlugInGait pipeline (MATLAB, b2022, The MathWorks, Inc.) was used for the analysis. For each gait cycle, the MTC was computed as the minimum vertical distance from the toe marker to the ground, which occurred between two local maximas of the trajectory during the swing phase. The values of the right and left legs were combined for the analysis. The gait variability (within-person differences in steps) was calculated as the coefficient of variation (CoV%) (standard deviation/mean ├ù 100%) of the MTC (%) in the level, uphill, and downhill conditions. Data were analyzed using repeated measures analysis of variance. Results and Discussion Thirty-seven community-dwelling older adults (mean age 76 (SD 5.2) years, 62% female) had a complete dataset and were included in the analyses. Mean MTC was 21.3 mm (SD 10.7) on level, 21.9 mm (SD 9.5) on uphill, and 20.8 mm (SD 11.3) on downhill walking. The mean MTC did not differ between the conditions. CoV% for MTC was 26.0% (SD 12.0) for level walking, 25.0% (SD 12) for uphill walking, and 29.9% (SD 9.6) for downhill walking. Downhill walking resulted in greater variation (p=0.023) than uphill walking did. In conclusion, our results suggest that older adults have increased variation in minimal toe clearance in downhill conditions and that walking modifications are likely to increase with increasing environmental challenges. Real-life measurements of the variation in the spatiotemporal characteristics of walking in various outdoor environments are required to better understand the risks of mobility limitations and falls in the daily activities of older adults.
Enhancing Eye-Hand Coordination in Older Adults: A Nature-Inspired Drone Training Approach
Purpose Aging society has become an unavoidable issue globally. Therefore, healthy aging emerges as an effective long-term solution that can help older adults maintain their abilities to perform daily activities, particularly requiring good eye-hand coordination (EHC). While various innovative EHC training tools have been developed, most are computerized, either in a 2D platform involving tapping a rapidly appearing object on the screen or a 3D platform simulating immersive experiences in a virtual reality headset. From the authors' perspective, the existing EHC training tools still lack essential information for users, such as depth perception and realism, which might enhance their training. In our study, we designed and implemented a nature-inspired system for EHC training using a palm-size drone as a medium for users to practice their EHC skills. Participants engaged with the drone as if catching insects like a fly or butterfly. The drone featured a ball-shaped object hanging beneath it for participants to catch as it flew away. We set three simple drone leaving directions (forward, rightward, and upward) to observe participants' responses to a rapidly moving object in different directions. Additionally, we varied the drone's leaving speeds (0.8 m/s and 1.0 m/s) to challenge participants and validate the impact of direction on their performance. Since participants were unaware of the drone's fly-out direction and speed beforehand, this would challenge their cognitive-motor coordination and EHC throughout the experiment. We believe that this training system can assist older adults in developing their EHC skills, upper limb movement, and balance control abilities. Method Eight healthy individuals, comprising five females and three males with an age range of 71.75┬▒4.17 years, were recruited for this study. Data were recorded using a motion capture system to track the subjects' hand and drone movements. The study received approval from the NCKU Hospital Institutional Review Board. During each trial, the drone was positioned in front of the subject at a distance equal to one arm's length. Subsequently, the drone flew up to eye level and hovered for 2 seconds before flying out, prompting subjects to grab the ball beneath it. The drone's leaving directions and speeds were randomized across trials, totaling six conditions (three directions and two speeds), each repeated five times. The study focused on analyzing reaction time (RT) and movement time (MT) from successful trials where subjects caught the drone without losing balance. Statistical analysis involved non-parametric Friedman and post-hoc Wilcoxon signed rank tests. Results and Discussion Statistical analysis revealed significant differences in reaction time (RT) and movement time (MT) among the three directions (Table 1). The RT results showed that catching the drone in the upward direction took significantly more time compared to the other directions. It suggests that the narrower field of view in vertical-up planar may have contributed to the longer RT. Meanwhile, the MT results showed significant differences at the drone's fly-out speed of 0.8 m/s among the three directions. The MT result was significantly prolonged in the rightward and upward directions compared to the forward one. For the MT results, the drone's path was more obvious in the rightward and upward directions, which likely influenced the subjects to slow down their movement as the droneΓÇÖs speed. However, when the drone flew out in the forward direction, the target was moving away at eye level, making it difficult to estimate how far the target was. As a result, the subjects tried their best to grab the target immediately once they knew the target was about to move.
User Perceptions of Emotion for Robot Digital Faces Across Ages
A natural way to observe and analyze emotions is through facial expressions.┬á As such we wanted to understand differences in ages in labeling robot faces specific emotions.┬áThe present study was conducted online via the platform Prolific, where each participant was compensated $3 for time and effort. The sample distribution was n=95 (older 65+; M = 70.27 ,SD = 4.66), n=103 (middle aged┬á 36-64; M = 47.12,SD =8.08), and n=101 (young 18-35; M = 28.37,SD =4.44).┬áA series of chi-square analyses were run on the data to understand differences between the age groups. 62 chi-square analyses were run on the data (31 for emotions displayed perceptions per face and 31 for emoji classification perceptions per face).┬áResults suggest that digital faces that elicit strong emotions are easier to classify, aiding in congruent perceptions across the age groups.
Unveiling the Digital Horizon: Perspectives and Progress in Digital Adoption among German Geriatric Care Facilities
Purpose The emergence of digital transformation in the care sector signifies a noteworthy and crucial change in how we approach the requirements and difficulties faced by an aging demographic. Amidst global challenges posed by aging populations and rising healthcare needs, the use of digital technologies presents novel approaches to improve and reshape the standard of the healthcare system and promote sustainability during times of crisis like the corona pandemic. Fundamentally, digital transformation in the healthcare field refers to the use of diverse technology instruments and platforms to optimize patient outcomes, simplify healthcare delivery, and empower both seniors and caregivers, as they, alongside family caregivers, have the primary responsibility for caring for these people. These technologies are categorized as gerontechnologies and include telemedicine, remote monitoring and security systems, documentation systems, as well as care and service robots for outpatient, inpatient, and home care. However, the adoption and utilization of assistive technological solutions and services in the care sector is often hindered by inadequate access or insufficient information base or knowledge regarding procurement and deployment options, which is why uptake of gerontechnologies in the healthcare sector is taking longer than in other sectors (Lee, 2022). The primary goal of our study is to (a) assess the degree of dissemination, meaning the extent to which digital technologies are used in care facilities. To this end, (b) the perspectives of nursing staff were analyzed with regard to their attitudes towards digital and supporting technologies, and possible opportunities and risks were identified. In addition, (c) significant factors that influence the digital transformation in nursing care were to be determined. Method Three questionnaire studies were conducted in the form of quantitative online and paper surveys, in which employees from the nursing and healthcare sectors across four different federal states in Germany (Saxony (n┬á=┬á97), Berlin and Brandenburg (n┬á=┬á64), and Saxony-Anhalt (n┬á=┬á71) ) took part over the last three years. Participants from outpatient and inpatient care took part in the studies in 2021 and 2023, while participants from both the care and healthcare sectors were involved in the 2022 study. The questions were focused on information about the care facilities, use and frequency of digital technologies, expected effort for the use of these technologies, arguments about advantages and disadvantages, as well as socio-demographic variables such as age, gender, education/degree, and occupational groups. The purpose of these studies was to gain a comprehensive understanding of the implementation and utilization of digital support systems in care and health. The questionnaires were therefore continuously developed and adapted to include new influencing factors. Results and discussion Our preliminary study results indicate widespread use and high intensity of documentation systems, underscoring their role in enhancing efficiency in the care field. Nevertheless, there are critical gaps, e.g., in monitoring and safety systems, which emphasize the difficulties in providing digitally supported care. Furthermore, positive attitudes toward assistive systems and technologies contrast with low implementation intensity, suggesting barriers to adoption that warrant further investigation. Challenges such as cost considerations and user acceptance issues emerge as significant hurdles in implementation endeavors. Despite assistive digital technologies offer potential benefits, concerns surrounding safety and staff reductions underscore the complexities of integrating technology into elderly care settings. Overall, these findings underscore the significance of comprehensive strategies for digital transformation in the healthcare sector. To achieve successful integration of technology, it is necessary to overcome obstacles to its adoption, encourage active participation from users, and ensure that technological solutions are tailored to the specific requirements and difficulties encountered while providing care for seniors.
Implementing Socratic Questioning Techniques and the PIRLS framework in a gamified learning activity to enhance Cognitive Functioning and Psychological Well-being in Older Adults
Abstract Purpose The population of older adults is expected to double by 2050, with the elderly projected to make up more than a third of Hong Kong's total population by 2046. Cognitive decline and loneliness are on the rise among older adults, which can have a negative impact on their health. According to Samaritan Befrienders Hong Kong, 44% of 1,080 suicides involved people aged 60 or older. This may be due to feelings of loneliness exacerbated by the recent wave of emigration leaving older family members behind. Added to this are the increasing mental health issues in young people and the older generation in Hong Kong. In light of these problems, we have developed an intergenerational reading program to reconnect older adults and young people, aiming to strengthen bonding and understanding between the two generations. Based on this idea, we have created an intergenerational reading program involving older adults to participate in children book questions creation project using Socratic questioning. This is an active learning pedagogy that allows the learner to develop higher order thinking skills such as analysis, synthesis, and evaluation (Gouges, 2012). Method Before designing questions in our reading program, older adults have attended workshops to learn about The Progress in International Reading Literacy Study reading assessment framework (PIRLS) with four levels (Information Retrieval, Inferences, Interpretation & Evaluation). The questions generated were published and participants entered a competition ΓÇ£Compete with SocratesΓÇ¥ to assess the quality of questions. 15 semi-structured interviews were conducted with older adult participants aged 60-70 individually to collect their feedback on the overall experience and the ways this program has affected them. Results and Discussion Almost all participants reported a positive experience following the question generation activity. The impacts of this program on older participants were categorized into cognitive abilities, psychological well-being, and social connection. The majority of participants have expressed a high level of satisfaction with the structure and influence of this question generation activity. The program has been noted to have a positive impact on enhancing the cognitive abilities (e.g. to think more critically, solve problems creatively, and regulate their own learning). Although the program has brought about significant impact in improving the cognitive abilities and psychological well-being of participants, improvement may focus in building the social connection of participants. Afterall, social engagement is vital for combating loneliness and depression in older adults, promoting social support networks and interpersonal relationships. (396 words) ┬á Keywords: ┬ácognitive abilities, psychological well-being, Intergenerational, Socratic questioning, PIRLS, Affiliation: Professor in Health Sciences (focusing on Gerontechnology), School of Nursing and Health Studies, Hong Kong Metropolitan University Author Email: Prof. Samuel Kai Wah Chu skwchu@hkmu.edu.hk AuthorsΓÇÖ ORCID iDs: 0000-0003-1557-2776
INNOVATIVE TECHNOLOGIES FOR HEALTH EQUITY IN MARGINALIZED GROUPS AND UNDERSERVED COMMUNITIES
ISSUE: Technology is a tool that can bring benefits, but may increase disparities between people due to limited accessibility or relevance. Health innovations should be more accessible for marginalized and underserved communities, including people with limited digital literacy. Co-creation is a strategy to reduce inequities by involving end users, such as patients, clients, residents, professionals, in the health innovation development and implementation. CONTENT: This symposium focuses on technology acceptance, usability, and adoption in marginalized groups and underserved communities. We use the GATEΓÇÖs 5P framework (WHO, 2022) to describe aspects of innovative technologies: people, policy, products, provision and personnel. First, Van Waterschoot and Gramberg will talk about innovative technologies to support professionals in the communication with older adults living independently at home. A virtual assistant has been developed to increase the awareness of seniors regarding their living conditions at home. Bults, Zuidhof, van den Berg, Liu, and den Ouden will discuss barriers and opportunities for wide-scale implementation of innovative technology in healthcare. Morita, Istrate, Zalc, Rumeau, Vigouroux, and Campo will focus on sustainable AAL technology for supporting seniors in independent living shared homes. Finally, R├¡os Rinc├│n, Miguel Cruz, Daum, and Liu will challenge assumptions about digital technology acceptance among older adults. STRUCTURE: Presenters from the Netherlands, Canada, and France will give a brief presentation summarizing their papers. This will be followed by round table discussions based on the GATEΓÇÖs 5P Framework. CONCLUSION: The symposium will provide participants with an opportunity to apply the GATEΓÇÖs 5P framework to their work, and exchange international perspectives. References World Health Organization. (2022). Global report on assistive technology. Retrieved from: https://www.who.int/publications/i/item/9789240049451
User Acceptance As Key Factor For Development And Risk Management Of An AI-based Robot Arm Control
Purpose User acceptance plays an important role in the risk management of medical products, as it can have a significant impact on the safety and effectiveness of a product. Usability issues in accordance with the requirements of IEC 62366 must be carefully considered in risk management (Questions Catalog 2023). This is even more important for medical products using artificial Intelligence (AI) and the development of such products. This paper aims to show how user acceptance had a meaningful impact on the development process and risk management towards the development of an AI-based Control for a robot arm in the research project DoF-Adaptiv. Currently, three robot arms are available for people with severe physical impairments in Germany. These robotic arms, such as the Jaco from Kinova, are mounted on an electric wheelchair, and users control them in the same way they control their wheelchair, typically with a joystick. To make the robot arm more accessible an AI-based Control using smart glases could be a solution (Baumeister et al. 2022). However, using AI leads to new ethical and social implications that could influence the userΓÇÖs acceptance of the new control. Method In the DOF-Adaptiv project, future users were involved in the development and evaluation through workshops and interviews. This included qualitative interviews with the target groups to gain a deeper understanding of their needs and activities. Additionally, ethics workshops were conducted. The project also employed "personasΓÇ¥ creating them initially together with future users and later discussing them in the context of the risk management workshops. The internal risk management workshops were significantly influenced by insights from previous studies involving future users within the DOF-Adaptiv project. This participatory approach resulted in important insights towards the development and evaluation of AI applications in healthcare. Results and Discussion While AI gains more significance in medicine, the current legal framework for AI medical products is not yet sufficiently established. The risk management workshop and the ethical workshops with future users provided valuable insights, including the identification of acceptance issues as a specific risk associated with AI medical products. Particularly relevant was the acceptance issue with AI medical products during the risk management workshops, as they are new to the users. In particular, the comprehensibility of the instructions for use, users' trust, and the correct perception and interpretation of the results were the focus of attention. There was a deep discussion about the importance of clarity regarding what is behind the term AI, the types of AI that exist, and what this means in each specific case. It was concluded that clearly defining the term AI is of great importance to avoid misunderstandings and promote user acceptance. Precise communication among manufacturers, regulatory authorities, and other stakeholders is necessary to ensure effective and transparent risk assessment of AI medical products. The use of developed personas proved to be a suitable method for evaluating user acceptance from a risk management perspective. This insight could make a significant contribution to risk management in the context of AI medical products. ┬á ┬á References Baumeister, A., Pascher, M., Shivashankar, Y., Goldau, F., Frese, U., Gerken, J., Gard├│, E., Klein, B., Tolle, B. (2022): AI for Simplifying the Use of an Assistive Robotic Arm for People with severe Body Impairments. Conference: 13th World Conference of Gerontechnology (ISG 2022); At: Daegu, Korea DOI: 10.13140/RG.2.2.13860.35208/3 Baumeister, A., Kozlova, O., Gardo, E., Tolle, P. (2024): Nutzer*innen Akzeptanz als Erfolgsfaktor und Risiko bei KI-Anwendungen im Bereich Healthcare. In: Klein, B., R├ñgle, S., & Kl├╝ber, S. (Hrsg.), K├╝nstliche Intelligenz im Healthcare-Sektor. Questions Catalog 2023. "Artificial Intelligence in Medical Devices: Question Catalog." Online: https://www.ig-nb.de/?tx_epxelo_file[id]=861877&cHash=5c3e1b0889ef5e017c2ff309f4ea82a8 (accessed on February 18, 2024). ┬á ┬á Keywords: user acceptance, user involvement, medical device regulation, risk management, AI medical product Affiliation: Sciencenter FUTURE AGING, Frankfurt University of Applied Sciences, Germany Corresponding Author Email: olga.kozlova@fb4.fra-uas.de AuthorsΓÇÖ ORCID IDs: 0009-0008-7426-3002 (Kozlova), 0009-0002-1007-7549 (Baumeister)
Advancing Healthy Aging in Times of Sustainability: The Role of Lower-Limb Exoskeletons in Gerontechnology.
Purpose Anchored in the World Health Organization's perspective on agingΓÇöwhich advocates for the preservation of functional abilities essential for well-being in later lifeΓÇöthis review scrutinizes the role of intrinsic capacity (IC), spanning cognitive, psychological, locomotor, sensory, and vitality dimensions. Moreover, it considers the environmental dynamics that shape older adults' operational capabilities. Amidst global challenges, such as demographic shifts and healthcare crises, the mobility of older adults emerges as a pivotal concern. This review seeks to fill the research void on the comprehensive effects of LLE on IC and functional abilities, evaluating how LLE technology can support active aging, mitigate injury risks, and foster a more autonomous community of older adults in the face of sustainability and crisis challenges. It aims to unfold the capacities of LLE interventions to revitalize IC, enhance functional abilities, and navigate the complexities of aging, thereby offering insights into the expansive utility of LLE beyond conventional rehabilitative and assistive scopes. Method This systematic review, registered in PROSPERO (CRD42023434655) and adhering to PRISMA 2020 and the Cochrane Handbook, employed a comprehensive search across PubMed, EMBASE, Web of Science, and other databases in June 2023, targeting studies on the use of lower-limb exoskeletons (LLE) in older adults to enhance functional ability and intrinsic capacity (IC). The search included a wide range of study designs, settings, and populations, focusing on individuals aged ΓëÑ50 years, with a mean age of ΓëÑ65 years, without limiting health conditions, exoskeleton types, or intervention specifics. Studies were screened and data extracted using EndNote X9 and Rayyan QCRI, with inclusion determined by two independent researchers and disputes resolved by a third. Data on study design, outcomes, and participant demographics were systematically collected. The extracted information was categorized based on the WHOΓÇÖs vision on healthy aging into IC and functional ability, with a further subdivision for performance indicators within the IC domain. The methodological quality of included studies was evaluated using the Downs and Black Scale, classifying studies from excellent to poor. Results The systematic review analyzed 36 articles, highlighting the diverse application of lower-limb exoskeletons (LLE) in enhancing functional abilities, intrinsic capacities (IC), and performance indicators in older adults across various health conditions. Methodological quality varied, with 22.2% rated as poor, 55.5% as fair, and the remaining 22.2% as good. Studies spanned multiple conditions, including stroke, ParkinsonΓÇÖs Disease, osteoarthritis, and more, with significant positive outcomes in mobility, functional abilities, and various performance measures. Specifically, improvements were noted in mobility measures across different conditions, with varied efficacy depending on the health issue and the type of LLE used. Additionally, the review revealed enhancements in IC through LLE interventions, demonstrating improvements in locomotor capacity and vitality, among others. The analysis also underscored significant gains in performance indicators, such as walking speed and endurance, underlining the potential of LLE to support healthy aging and rehabilitative efforts across a broad spectrum of older adults. Keywords Healthy ageing, lower-limb exoskeletons Affiliation Rehabilitation Research group (part of BruBotics) Corresponding Author Email: David.beckwee@vub.be
AI in ambulatory care: stakeholder needs, challenges and anticipations towards a hybrid, multimodal interaction AI-system
Purpose As the global population ages, there is a growing need to provide personalized, sustainable and effective care for elderly individuals, particularly during pandemics. The challenges of a pandemic disproportionately affect older people with care needs and their families. Due to contact restrictions, many voluntary and semi-professional support services (e.g. everyday support) cannot be provided (Horn V. & Schweppe C., 2020). This creates an additional barrier to often already fragile care arrangements. Limited contact can lead to an increased risk of social isolation and loneliness for those in need of care and their relatives, which can be associated with considerable physical, cognitive and psychological health problems (Naito, R., McKee, M. et al., 2023). One potential solution to address this issue is the use of systems using artificial intelligence (AI) to support their daily living. The digital care assistant KARE, as a hybrid multimodal interaction system, helps to support contact-reduced healthcare on site and enable interpersonal interaction that is conducive to maintaining health. AI-systems like KARE provide personalized care and support to elderly individuals and their caregivers, even during times of limited contact. Method The study aimed to gain insights into the requirements for an effective AI system that supports the elderly in their daily lives while providing valuable assistance to their caregivers. To understand the specific needs of elderly recipients and other stakeholders in ambulatory care in relation to AI systems, stakeholders were invited to participate in various activities. The study involved conducting interviews to explore the potential benefits and challenges of integrating AI systems into the day-to-day business of providing outpatient care. Participants were asked about their daily routines, the challenges they face when giving or receiving care, and how AI systems could help address these issues. Workshops were also held to discuss the differences between telepresence and telecare, as well as to assess and design interactions in ambulatory care (Roos, T.; Purps, C. F. et al., 2023). Results and Discussion The study's results identified important considerations for AI systems that support the daily lives of elderly recipients of ambulatory care and their caregivers. The development and implementation of AI systems should prioritize the relational values and moral commitments of Care-About-Relationship. This means that the AI systems should prioritize the human connection and treat stakeholders in the care process as active agents rather than passive objects. The study emphasized the importance of supporting independence in elderly recipients through AI-systems. This includes empowering older adults to maintain control over their daily activities and decision-making processes. Additionally, AI-systems should provide personalized and tailored care to meet the specific needs and preferences of elderly recipients. This input was important in refining the functionalities of the KARE system to ensure it meets the specific needs and preferences of elderly individuals and their caregivers. By taking this user-focused approach, the system aims to not only attend to practical needs but also promote companionship and social interaction to alleviate negative impacts such as social isolation and loneliness. ┬á References Horn V., Schweppe C. (2020). H├ñusliche Pflege in Zeiten von Covid-19. Nachrichtendienst des Deutschen Vereins f├╝r ├╢ffentlichen und private F├╝rsorge e.V.. Naito, R., McKee, M., Leong, D., Bangdiwala, S., Rangarajan, S., Islam, S., & Yusuf, S. (2023). Social isolation as a risk factor for all-cause mortality: Systematic review and meta-analysis of cohort studies. PloS one, 18(1), e0280308. Roos, T.; Purps, C. F.; Kunze, C.; Woelfel, M. (2023): Transitioning from Conventional Emergency Devices to Interaction and Voice Assistance - A Case Study on Co-Creating an AI-based Care Assistance and Multimodal Interaction System for Outpatient Care. Mensch und Computer 2023 - Workshopband. DOI: 10.18420/muc2023-mci-ws06-368. GI. MCI-WS06: First International Workshop on Co-Creation of Hybrid Interactive Systems for Healthcare. Rapperswil. 3.-6. September 2023
Understanding digital technology usability in home-based neurorehabilitation: a realist review
Purpose In the realm of gerontechnology, the integration of digital technology into the management of neurological disorders holds promise, especially for the aging population requiring intensive rehabilitative care in both clinical and home settings. While prior research has informed the advantages of digital rehabilitation platforms for specific populations such as stroke survivors and children with disabilities, the current underutilization of these technologies at home indicates barriers related to their usability in terms of effectiveness, efficiency, and satisfaction (ISO 9241-11, 2018). Our study aims to understand the usability of digital technologies for home-based rehabilitation in older adults with neurological conditions, thus determining essential factors that could influence their implementation. Method We conducted a realist review complemented by expert consultations, adhering to realist review principles (Pawson & al., 2005) and the RAMESES I publication standards (Wong & al., 2013). An initial program theory (figure 1) was developed based on multiple frameworks and established theories to explain the extent of which certain technologies are usable for home neurorehabilitation for older adults. This program theory was reviewed and refined through focus group discussions with five research experts in gerontechnology or realist review methodologies. Their insights were crucial for validating the framework and recommending enhancements. We are currently examining literature from 2015 to 2023 across various databases and grey literature, using the Context-Mechanism-Outcome configuration analysis (CMOC) (Pawson et al., 2005) to further test this program theory. We focus on understanding how the home setting activates mechanisms that influence technology's usability for older adults with neurological conditions. Each CMOC extracted could reinforce or challenge aspects of our program theory, thereby testing and adjusting it to better reflect the reality of technology usability. A second consultation with users, clinicians, and researchers is planned to validate the updated theory based on their experiences. This process aims to lead to a middle-range theory that is specific enough to guide the usability of certain technologies at home and general enough to apply across different situations, such as various technologies or neurological conditions. Results and Discussion An initial program theory explaining the usability of digital technologies for home neurorehabilitation of older adults was developed and validated by field experts. The literature review stage is ongoing, with an initial screening of 4,708 titles and abstracts leading to 332 articles selected for full-text review. The latest update of our program theory will be presented, aiming to enhance the usability of new digital technologies for rehabilitation at home. The findings underscore the critical role of technology in improving quality of life for older adults by facilitating effective, efficient, and satisfying home-based rehabilitation solutions. ┬á
Older adults as users of conversational agents in health and social care: designers' and developers' motivations and images of ageing.
Purpose┬áThe term conversational agents (CA) encompasses various other terms and is often used interchangeably with chatbots, virtual assistants (such as Apple's Siri, Microsoft's Cortana, or Amazon's Alexa), smart agents, and more. CA are used in various fields today, including healthcare and social care. While older adults are often considered as late adopters of digital technologies, they have been identified as a central user group of CA in in these fields (Merkel & Schorr, submitted) as CA are believed to offer "more advantages than challenges." (Even et al., 2022). On one hand, the technology offers a seemingly perfect match between the purportedly low digital skills and competencies of older adults and the ease of use provided by natural language processing, which requires no knowledge of graphical interfaces. On the other hand, there is evidence that the CA and AI are seen as a ΓÇ£techno-fixΓÇ¥ for ageing societies (Higgs & Gilleard, 2021). The design and the use cases of CA are influenced by images of ageing (e.g. Neven, 2010; Endter, 2017; Merkel, Kucharski & Schorr, 2022). Against this background, this article aims to analyse the motivations of designers and developers of CA. The focus is on two questions: how the development of the devices is framed and what the underlying images of ageing are. Method┬á┬á┬áIn February and March 2023, a scoping review was conducted on smart speakers as a type of CA. Three databases (PubMed/Medline, Scopus, and Sociological Abstracts) were searched, along with the first 20 pages of Google Scholar. The search was conducted using a combination of multiple keywords, including the technology used, the brand, and the setting. Only publications that met the inclusion criteria were included. Two reviewers screened the title and abstract, and if they matched the criteria, the full text was also screened. To extract information from the publications, we used a data extraction template that includes general information such as the title and year of publication, as well as specific details like the setting and target group.┬á Results and Discussion┬áA total of 28 publications were included in the scoping review, twelve of which addressed older adults as a user group, mostly in the setting of their private households. This makes older adults the main user group identified, whether directly or indirectly e.g. through their relatives and family members. Our analysis shows that the ease of use and the distribution of the devices among private households are the main motivations cited. Furthermore, evidence suggests that designers and developers draw on negative stereotypes of ageing to identify use cases and justify their development. This supports the observations of previous research on other technologies such as robots (e.g. Neven, 2010) or Ambient Assisted Living (e.g. Endter, 2017).┬á References Endter, C. (2017): Assistiert altern. Die Entwicklung eines Sturzsensors im Kontext von Ambient Assisted Living [Assisted ageing. The development of a fall sensor in the context of Ambient Assisted Living]. In: Biniok, P., Lettkemann, E. (eds) Assistive Gesellschaft. ├ûffentliche Wissenschaft und gesellschaftlicher Wandel [Assistive Society. Public science and social change]. Springer VS, Wiesbaden, 167ΓÇô181. https://doi.org/10.1007/978-3-658-13720-5_8. Even, C., Hammann, T., Heyl, V., Rietz, C., Wahl, H.-W., Zentel, P., & Schlomann, A. (2022): Nutzen und Herausforderungen konversationeller Agenten f├╝r ├ñltere Menschen: Ein Scoping-Review [Benefits and challenges of conversational agents in older adults: A scoping review].┬áZeitschrift F├╝r Gerontologie Und Geriatrie, 55(5),┬á381ΓÇô387.┬áhttps://doi.org/10.1007/s00391-022-02085-9. Higgs, P., Gilleard, C.┬á(2022):┬áTechno-fixes for an ageing society,┬áAging & Mental Health,┬á26:7,┬á1303-1305. doi:┬á10.1080/13607863.2021.2008308 Merkel, S.,┬áKucharski, A.,┬áSchorr, S.┬á(2022):┬áΓÇ£Computer, how do smart speakers support aging in place?ΓÇ¥┬áΓÇô A feature analysis focusing on smart speaker applications in┬áAmazonΓÇÖs skill store for older persons.┬áGerontechnology, 21(1), 1-11.┬áhttps://doi.org/10.4017/gt.2022.21.1.592.12 Merkel, S., Schorr, S. (submitted): Smart speakers in healthcare and social care. A scoping review.┬áJMIR. Neven L. 'But obviously not for me' (2010): robots, laboratories and the defiant identity of elder test users.┬áSociology of Health and Illness┬á1;32(2), 335-47. doi: 10.1111/j.1467-9566.2009.01218.x. Keywords:┬áConversation agents, healthcare, social care, images of ageing Address: Ruhr-University, Bochum Email:┬ásebastian.merkel@rub.de
Walking Aid with Haptic Feedback for Combined Use with a Smart Foot Orthosis
Purpose Elderly people often face the risk of falls, which increases the need for walking aids to ensure mobility and safety. The occurrence of further injuries requires the use of additional orthopedic aids (e.g., foot orthoses). Wearing such an orthopedic aid also impairs the natural gait pattern, which leads to increased instability in older patients. This highlights the need for innovative solutions for assistive smart walking aids. Doan et al., for example, presented a smart walking aid for fall detection that can detect falls based on machine learning with an accuracy of 99.62% (Doan et al., 2024). This development can lead to improvements in home care and remote health monitoring technologies. However, a solution that allows the combined use of an intelligent walking aid with a smart foot orthosis to provide patients with active feedback does not exist. Based on the identified research gap, we propose the technical development of an augmented walking aid with haptic feedback that enables direct communication of sensor data with a smart foot orthosis. Providing additional feedback in case of problems with the foot orthosis is particularly important for patients with neuropathy in the feet (such as diabetic foot syndrome), for which neural feedback is not possible. Our approach enables direct haptic feedback through vibrations on the handle of the walking aid when acute problems are detected by the smart foot orthosis. The system achieves this by continuously monitoring relevant gait parameters and pressure distributions in the foot orthosis. This should support the proactive adaptation of gait problems and increase safety when using assistive technologies for older people. Method The concept development is based on a comprehensive literature analysis of existing walking aids, as well as the identification of patient needs for the use of augmented feedback and wearable technologies. Based on these findings, we have developed an initial concept for a feedback-enabled walking aid designed for combined use with a smart foot orthosis, which provides real-time feedback on the patient's gait behavior. Figure 1 shows the proposed conceptual design of the intelligent walking aid with an integrated vibration motor on the handle and an inertial measurement unit to determine the spatial parameters. Wireless communication of recorded data occurs via Bluetooth. Results and Discussion We propose to investigate the system in an experimental within-subject study to evaluate the effectiveness of gait improvement, as well as usability and social acceptance, with a sample size of 20 participants. In this context, we intend to use the think-aloud protocol to gain deeper insights into the participants' thought processes during interaction with the system. By combining the proposed concept with a smart foot wearable device that provides specific data on foot positioning and movement, we expect a more reliable gait analysis and better tailored corrective suggestions. Additionally, the application of machine learning allows the identification of gait patterns and the initiation of preventive measures against potential fall risks. In future applications, the system can be modularly expanded to include additional walking aids, such as walking sticks, crutches, or walkers.
Addressing Social Isolation and Cognitive Decline in Care Homes with Virtual Reality: Challenges and Early Benefits in Germany and Czechia
Purpose The immersivity and versatility of virtual reality (VR) offers vast potential for providing older adults in care homes with stimuli from the outside world, thus helping them to maintain their physical, psychological, and cognitive health. However, similarly to many assistive technologies and other digital innovations in the senior care sector, the adoption rate of VR-based tools remains rather low. The purpose of this paper presentation is to shed more light on the benefits of such applications as experienced by care staff and older adults themselves, as well as on the barriers preventing large scale integration of VR in care home routines. Research preceding the COVID-19 pandemic, which only boosted the widespread issue of social isolation in nursing homes, delivered promising evidence of the numerous benefits VR content may bring to the ageing population. An RCT in Korea (Thapa et al., 2020) supported the potential of virtual experiences in decelerating or stopping cognitive decline which was in line with the finding of DΓÇÖCunha et al. (2019) that VR content may strengthen overall mental wellness in the long term. Other studies highlighted that in order to produce positive health outcomes (especially in the case of older adults with dementia), VR content must be tailored to their specific needs, ideally by being only semi-interactive (Kim, Pang, & Kim, 2019) and providing 360-degree film-based sceneries instead of truly virtual environments (Appel et al., 2020). The great majority of such research-based insights comes from non-European countries, hence the aim of this paper to explore the acceptability and effectiveness of virtual experiences as a tool for occupational therapy and cognitive training in Czech and German social care practice. Additionally, this paper strived to contribute to both research and practical advancements by investigating the usability of VR by caregivers who function as gatekeepers of such assistive technologies and play a vital role in the process of capitalizing on the potential of VR for senior care home clients. Method This paper showcases two research studies conducted in real-world conditions in 2020 in Czechia and in 2022 in Germany. Both studies followed the same design of providing caregivers in selected nursing homes with VR headsets featuring a set of multiple virtual experiences (10-minute 360-degree films with voiceover narration, categories spanning from travelling to cultural and relaxation experiences and animation-enhanced cognitive training movies) tailor-made for the purpose of boosting older adultsΓÇÖ mental, physical, and cognitive wellbeing. The Czech study involved 40 care facilities and data collection lasted for four months. The subsequent German study was conducted over the course of two months with 13 care homes. Both studies adopted a mixed method involving quantitative data collection through online surveys after occupational therapy sessions completed by the caregiver-client pair (N = 212 in 2020, N = 70 in 2022) and qualitative data collection through phone-based semi-structured interviews conducted with the involved care home staff in the middle and at the end of the study period. Thematic analysis was employed to study the interview data while a combination of various descriptive and inferential statistical methods was applied to analyze the survey data. Participation was completely voluntary, and the care home clients were always reminded that they could end a therapy session with the VR headset at any moment. Results and Discussion Both studies yielded supportive evidence for the many health prevention benefits VR content may bring to older adults in care homes. The Czech study highlighted the client-caregiver bonding effect of VR-enabled occupational therapy and showed that VR tools can also effectively facilitate physical activation even in bed- and chair-bound clients, however, the German study showed this activation effect might be diminished in physically disabled clients. Neither study found any significant relationship between the level of cognitive deficit and the acceptability or effectiveness of virtual experiences which highlights the potential of VR-based tools for therapeutic work with clients suffering from AlzheimerΓÇÖs disease and other types of dementia. While both studies showed that VR headsets and software may be well-accepted by care home staff and support overall positive atmosphere in care facilities, they also generated anecdotal evidence with strong practical implications on the negative myths about VR circulating among caregivers and several practical hurdles VR tools will encounter in their journey towards mass-scale adoption in social care, such as the weight of the headsets, the challenging disinfection workflow during a respiratory disease epidemic, or the surprisingly high demands on both hardware and content quality expressed by both caregivers and clients. In sum, the two studies presented in this paper provide original evidence grounded in practice and crucial learnings for both practical projects and further research utilizing virtual reality content for the health and social benefit of older adults.
Holistic Care System based on Affective and Proactive Robots For Older Adults
Purpose Socially Assistive Robots (SARs) are interactive, intelligent systems that employ social interaction strategies to assist in a specific healthcare context (Feil Seifer et al, 2005). This work contribute to the improvement of the quality of life of elderly people at home through assistants based on proactive and affective robotic platforms, and the study of their proactive intervention, according to the needs of the user and their context. The main contribution of this work is to model and implement proactive behaviors, where the robot intervenes and collaborates with the elderly person by its own initiative, based on the context, and always ensuring non-intrusiveness and privacy (Figure 1) (Villa et al, 2022). Method The hardware design includes a 3D printable model and components such as Jetson Nano with 4GB RAM, a 7-inch display, a ReSpeaker microphone array to capture 360┬░ sound, and servo motors for fluid head movement. For voice interaction it uses cognitive cloud services and a communication system based on fine-tuned LLMs (Villa et al, 2023). A proactivity model has been designed at different levels to interact with the elderly on their own initiative, suggest activities or intervene autonomously for the well-being of the user (Johnson et al, 2023). Results and Discussion The assistive robot has been evaluated in functional tests, including the cognitive services for voice interaction, the conversational system based on LLMs, as well as heuristics and algorithms, based on computer vision, to distinguish users and detect their presence in front of the robot and activation by looking directly at the robot. The proactivity model is being evaluated to determine what levels of autonomy and decision-making are accepted by end-users and their caregivers.
AI-Powered Mobile App with AR Glasses for Remote Chronic Wound Management and Expert Consultation
┬á ┬á Purpose: Chronic wounds pose a significant healthcare challenge due to their resistance to healing. This study tackles this challenge by developing a mobile application powered by AI, aiming to identify and measure wounds using augmented reality (AR) glasses. The user-friendly application seamlessly integrates with Vuzix Shield Model 492 smart glasses running Android 11, embedding the AI model within its framework. This empowers nurses visiting patients with chronic wounds at home to conduct real-time video calls with wound care experts through the smart glasses. This enables remote expert assessment of the wounds and immediate guidance on treatment, potentially improving patient outcomes and reducing the healthcare burden. Methods: This study presents the development of a novel application leveraging Vuzix Glasses and Android Studio to enhance remote wound care management. The application serves as a conduit between the Vuzix Glasses and Telko Live software, a web-based platform facilitating video calls. By enabling seamless connectivity, our solution enables real-time video transmission from the Vuzix Glasses worn by nurses at the patient's location to wound care experts at their desktops via Telko Live. Results and discussion: our approach leverages machine learning (ML) algorithms for precise chronic wound segmentation. We initially employ YOLOv4 for detection and then transition to TensorFlow for streamlined integration into the Android application. A dataset of 322 chronic wound images, augmented for enhanced performance, is utilized for training. While TensorFlow yields strong results in detecting a calibration panel (90.79%), chronic wound detection currently achieves a modest rate (38.46%) due to limited and diverse image data. However, segmentation achieves promising metrics (dice coefficient = 85%, precision = 94%, recall score = 86%, accuracy = 95%). This setup empowers remote experts to observe and provide guidance based on the nurse's perspective, thereby enhancing the quality and efficiency of wound care delivery. Our work exemplifies the fusion of wearable technology and telehealth solutions to address critical healthcare challenges, particularly in remote patient monitoring and specialized care delivery. ┬á
Robot Voice Calls Asking Older Adults Daily Life Difficulties for the Prevention of Early Dementia
For early dementia prevention, we are building a system that allows robots to ask older adults about difficulties needing help in daily life. To get answers from older adults about negative topics such as things they cannot do or difficult to achieve, we designed the robot's voice-call to include comments regarding things they cannot do in a positive light. Participants in their late 60s took part in an experiment where their responses to a questionnaire differed from those given to a robot.πÇÇFuture steps involve larger participant pools and analyzing responses to improve methods for gathering information on older adultsΓÇÖ daily challenges, considering cognitive function differences.
Augmented Health Education for older adults
Purpose The global number of people aged 65 and over is expected to more than double in the next three decades, and the World Health Organization has declared that "ageing well must be a global priority." (United Nations, 2020) In this context, health education can be a powerful tool to help people age well as it informs them of health risks and promotes healthy lifestyles. Access to and the understanding of health information can lead to better health and social care outcomes. Digital channels have increased the volume of health information available but can also alarm, confuse or overwhelm people. This study was conducted to examine how paper and screen-based media are used in current forms of health promotion, and to collect feedback on the usability and value of a new technology for combining paper and screen reading through augmented print. This involved the use of a new platform for ΓÇÿ Next Generation PaperΓÇÖ ┬á(NGP) developed at the University of Surrey for linking digital content on a smartphone with printed hotlinks on a document (Frohlich et al 2019). This kind of Augmented Reality paper was demonstrated through an NGP ΓÇÿa-book PlayerΓÇÖ app and an augmented booklet on healthy ageing containing hotlinks to video clips, animations, voiceovers and web links (see Figure 1 below). A video demo of this booklet can be found here: https://vimeo.com/926936499?share=copy Methods We conducted two focus groups with older adults 60 years or older that had a smartphone or tablet, consecutively with 4 and 5 participants (n=9). The first hour of the group discussion was used to explore their experience receiving and seeking health information. The second hour of the session involved demonstrating a health education a-book prototype and collecting their feedback. The sessions were recorded and all the discussion is being transcribed. Results and Discussion Our early findings revealed that the participants do not tend to seek health information when they are healthy, and all of them used online search engines to find health information when they are sick. Most of their current health information comes through digital media, and just a few of them received some kind of health education through paper delivered by health professionals or the UK National Health Service (NHS). The use of paper was mentioned as a way of ΓÇÿprinting to rememberΓÇÖ, when they wanted to save very relevant information that they found online. Participants also liked the idea that all public health leaflets could have links to additional explanatory information available on their phones. For example, printed diagrams for physiotherapy exercises could have video demonstrations with them, or printed breathing exercises with guiding videos. ┬áThere was also a discussion about what they would change in the app to improve the user experience of the a-book on their devices. For example, more intuitive layout and different sizes of buttons and images. In general, the study confirms a migration from paper to screen media in the reading of health information (Ferraz, et. al, 2024), but a residual role for paper as a tangible reminder and bridge to screen media. This shows an opportunity to improve the link between paper and screen media in the use of health education for older adults.┬á
Low power activity monitoring using accelerometer data from an inertial measurement unit (IMU)
A custom-made device equipped with a low-power IMU sensor and BLE functionality was developed for comprehensive activity monitoring of elderly individuals and geriatric patients. The device automatically recognizes various types of movements and orientations, storing data on a microcontroller for up to a week before transferring it to a Raspberry Pi and then to a database for visualization and evaluation. Unlike similar approaches, this method doesn't rely on machine learning, resulting in lower computing power requirements, decreased energy consumption, longer battery life, and improved user acceptance due to a smaller device size and less frequent need for recharging.
Enhancing the Aging Experience with VR360 Technology
Purpose This study explores the use of VR360 technology to improve the lives of elderly individuals in both home and nursing home settings. We aimed to stimulate memory and provide virtual experiences of physically challenging activities, including a novel application of the AutoVR360 app for virtual driving experiences. Method We utilized immersive VR360 videos to simulate environments for memory stimulation and social activities. For the virtual driving experience, the AutoVR360 app, originally designed for car dealerships, was adapted to allow elderly users to navigate dream cars on various scenic routes. Participants from both home and nursing home settings were introduced to VR sessions, including virtual tours and board games, tailored to their interests and physical capabilities. The application is equipped with advanced hand-tracking capabilities, enabling users to navigate and interact without the need for controllers. The complication with regular VR practices includes controllers. While regular users of VR may find it simple to use others may find it more difficult. Using hand tracking allows users to use their hands which everyone is used to. Users are not required to be sat down but it is always good to have both options available so the users can choose their preference. Users can seamlessly use their hands within the application, with the added feature of seeing their own hands rendered in real-time. This intuitive system allows users to activate functions through natural gestures, enhancing the overall immersive experience. Hands are tracked for movement and gestures are used to control usersΓÇÿ actions (Figure 1). ┬áResults and Discussion Preliminary feedback from participants indicated a positive response to VR360 experiences in terms of emotional well-being and cognitive engagement. The AutoVR360 app, in particular, was highlighted for providing a sense of freedom and adventure, with many elderly expressing joy in virtually driving cars they once dreamed of owning. Driving does not need any controls only hand gestures. This does not mean users could not include controls if preferred. VR allows for many different design iterations. Observations noted improvements in mood, increased social interaction, and enhanced recall abilities during and after VR sessions. The application of VR360 technology presents a versatile tool for addressing the diverse needs of the elderly. The stimulation of memory lanes through virtual tours and the adaptation of the AutoVR360 app for elderly users demonstrate the technology's potential to enrich the aging experience significantly. These findings underscore the importance of technological innovation in elder care, suggesting that VR can offer meaningful, accessible experiences that transcend traditional activity limitations. Future research should explore the long-term impacts of regular VR engagement on cognitive health and social well-being among the elderly. This study illustrates the feasibility and benefits of employing VR360 technology and the AutoVR360 app to enhance the quality of life for the elderly. By repurposing existing technologies for new applications, we can create impactful, enjoyable experiences that cater to the unique needs of aging populations.
Digital Platform for improving Older Adults' Quality of Life in Today's Super-Aging Society
Digital platforms have recently been used in a variety of occasions and are considered an effective way for everyone to stay connected with society. In reality, however, the use of digital technology by older adults has been slow to take off. We discuss the requirements for solving the problems that hinder the use of digital services by older adults due to their inadequate IT literacy and diminished physical abilities, from the perspectives of mental models, experience, and technology. A digital platform that fully considers these factors would expand the use of digital services by older adults, but this alone is not sufficient. Another important factor is their motivation, without which any services might not be used. Therefore, we also examines, through experimental observations, older adultsΓÇÖ motivation for using digital services and shares future prospects of the digital platforms for improving the quality of life of older adults.
During this symposium we will share the findings of the HAAL project. The overall aim of HAAL is to support people with dementia, their loved ones and care professionals during the different stages of dementia through embedding multiple cares and well-being technologies in an AAL bundle. Partners from the Netherlands, Taiwan, and Italy collaborate and share their experiences in the HAAL project, on the topic of supporting dementia care through state-of-the-art AAL bundles. During the project a Decision Support System (DSS) was iteratively developed and evaluated. In this symposium we will discuss the insights gained during the in field evaluation of the DSS, technological development of the DSS, activities conducted with regard to the responsible development of the DSS and there will be an interactive workshop on co-design.
Towards a digital intervention to support older adults with malnutrition: Findings from a design exploration with home care professionals
Purpose Maintaining a healthy diet is vital for overall well-being and quality of life. Older adults face unique challenges in sustaining a nutritious diet, often leading to malnutrition (Leij-Halfwerk et al, 2019). Age-related health conditions, medication interactions, limited mobility, and mental health challenges can contribute to inadequate nutritional intake (Volkert et al, 2019). Older adults frequently receive support from dietitians, GPΓÇÖs, nurses, and their informal care network to improve and/or maintain adequate nutritional intake (Ziylan et al, 2015, Beelen et al., 2017). However, due to for example a lack of time and a lack of insight into the clientΓÇÖs health status, inadequate role division, and limited shared awareness within the care network, the support of older adults is often not optimal. Digital intervention could help address these challenges (ten Cate 2021; Marshall et al., 2018). In this paper, we explore the potential of digital tools to address these challenges, from the perspective of home care professionals. Method This paper is part of a broader research in which the perspectives of dietitians, elderly, formal caregivers and informal caregivers are collected through co-design as input for the design of a digital food companion. This study focuses on the perspective of the home care professionals. Through semi-structured interviews, we aim to gather their views and needs regarding the treatment of older adults with malnutrition, and the potential value of a digital tool to support such treatment. The interviews address the challenges underlying the nutrition process, and the opportunities to improve the process through a digital intervention A total of 7 participants were interviewed (aged 31 to 60 years) based on saturation criteria. The transcribed interviews were analyzed using an inductive thematic analysis┬á We iteratively identified patterns in the data, allowing themes to emerge from the dataset through a bottom-up approach, starting with specific categorizations and then moving to broader generalizations. Results and Discussion Two challenges were identified by the home care professionals, which could be addressed by digital tools: (1) Interdisciplinary collaboration within the care network is sub-optimal, influenced by missing communication, unclear role division, and lack of shared responsibility. Home care professionals experience being kept out of the loop by other professionals (such as dietitians), limiting their ability to support dietetic care. (2) Instrumental nutritional care promoting eating moments care activities such as supporting with the groceries, heating meals, or making a sandwich are not part of the insured care tasks, limiting their ability to step in. Home care professionals improvise by combining nutritional care with other insured care activities, to be able to provide the needed care. The results show that improving interdisciplinary collaboration amongst care network members is considered highest priority. This need could guide development of digital interventions: home care professionals may benefit from a digital intervention functioning as a mediator between network members, addressing the communication gap and improving the shared awareness, mediating in expectations and role division within the network. Further explorations are needed to define the balance between a digital intervention and a social intervention. In addition a digital tool may support in the day to day care of older adults, by functioning as an extension of the repetitive care tasks of home care professionals. Not all care tasks can be supported by a digital tool. As explained by home care professionals, physical contact and a (human) conversation may be as important as the care giving tasks.┬á
Enhancing Elderly Care through Technology Adoption: A Case Study of the ΓÇÿAnders Werken in de ZorgΓÇÖ Project
Purpose The growing aging population, coupled with a shrinking workforce in long-term care, poses a significant challenge. ΓÇÿAnders Werken in de ZorgΓÇÖ (AWIZ) aims to provide better care and a pleasant working environment with reduced time and effort. The program focuses on addressing workforce challenges and enhancing client and employee satisfaction in the long-term care sector by supporting the implementation of technological innovations. In 2019, the Anders Werken in de Zorg project was launched in the West-Brabant region, with twelve elderly care organizations collaborating to collectively adopt and evalaute technological applications. This collaborative approach aims to prevent each organization from individually starting the implementation process, reinventing the wheel. In 2023, the AWIZ project expanded its initiative to 11 regions, all with the intention of collaboratively partnering with elderly care organizations in the region to implement healthcare technology.┬áWithin the AWIZ project, Vilans, the expertise center for long term care, conduct research for the West-Brabant region into those technological solutions that can make healthcare more efficient, effective, and less burdensome for healthcare professionals. Method The AWIZ project adopts a collaborative approach, allowing participating long-term care organizations to select, test and implement several technologies that align with their needs. When organizations are planning to implement a technology it is crucial to reflect on the vision of the organization as well as the technology. The technology is a mean to improve the quality of the patient and improve the care process. Vilans developed a Honeycomb model to support in this reflection process with the aim to implement technologies fitting the organization (Suijkerbuik et al, 2021)). This model supports organizations during the implementation of (new) technologies. Broadly categorized, some technologies represent innovations in the sector, necessitating exploration to determine their feasibility for long term care. Others may be in the adoption phase, requiring attention for further scaling and integration into routine practices.┬áDepending on the TRL level of the technology but also on the needs of the organizations the implementation process will go through the different phases exploring the fit of the technology within the organization. For each technology project within the region, collaborative work sessions are organized. During these sessions, participating organizations exchange experiences regarding the implementation or testing process, fostering a valuable platform for shared learning. The suppliers of the technologies and innovations are also involved in those sessions.┬áSimultaneously, an elaborate research plan is crafted based on Vilans' 'waardewaaier-methodiek' (social-cost benefit methodology) (Bierhoff et al, 2023; van Erp & Schuitemaker, 2022). This involves mapping out care pathways, creating impact maps, establishing measurement plans, and conducting surveys, interviews, observations, and measurements. The outcomes of this comprehensive process typically result in both tangible and intangible cost-benefit matrices.┬áIn the year 2023, the research focused on technologies such as hip airbags, medication dispensers, medical bed sheets, support stocking aids, exoskeletons, virtual reality applications, and bed sensors. This multifaceted approach ensures an understanding of the implementation and impact of diverse care technologies.┬áResults and Discussion The structured program, including workshops, received positive feedback for its efficacy in promoting collaborative learning. The work sessions facilitated extensive experience sharing. Also the collaboration with technology suppliers was highly beneficial, often these suppliers to accelerate their development process leading to improvement of the technology.┬áAdditionally, comprehensive reports and factsheets have been written for each of the researched technologies, offering in-depth insights into their implementation and impact. These resources serve as valuable references for both the participating organizations and external stakeholders such as health insurers.┬áThis iterative approach ensures a continuous adaptation to the evolving landscape of care technology and innovation.┬áIn essence, the Anders Werken project facilitated a quicker understanding of technological possibilities for all organizations involved, emphasizing the supportive role technology can play in long-term care. Ongoing attention is crucial to sustain employee enthusiasm for technology adoption in the long-term care sector.┬áThe success of the research in West-Brabant has gained significant interest, leading to requests for expansion of the research into Midden-Brabant.┬áLooking ahead to 2024, follow-up research initiatives are planned, encompassing a selection of previously examined technologies and introducing new ones. The technologies chosen are based on the specific needs and preferences of the long-term care organizations involved. Whereas in previous years the focus lied on one technology, in 2024 a shift has taken place in which multiple technologies will be evaluated within one fitting theme. For example in the case of remote healthcare different technologies will be evaluated within the same teams
Therapy Laboratory for Activation of Neuromotor Skills through Serious Games in Education and Research
Purpose This abstract provides an overview of the new digital therapy laboratory at Hamm-Lippstadt, University of Applied Sciences, emphasizing its role in shaping future gerontological research. It highlights the lab's potential to facilitate studies on digital cognitive therapies and visual-cognitive training, and their impact on improving the quality of life among the elderly, particularly during challenging times. Method Establishing a therapy laboratory with state-of-the-art therapy equipment for the rehabilitation of neuromotor disorders within a university setting offers several benefits for both teaching and research: Students gain hands-on experience with cutting-edge therapy equipment, allowing them to develop practical skills and deepen their understanding of neuromotor rehabilitation techniques. The laboratory serves as a collaborative space for engineers, psychologists, therapists, and students from various disciplines to work together on research projects, fostering interdisciplinary collaboration and knowledge exchange. They have access to advanced digital therapy devices which are based on serious games: the Tovertafel for individuals with dementia, therapy devices from Neofect (Smart Board, Smart Gloves and Cognition Trainer) for stroke patients and the Skillcourt to improve neuroplasticity by visuomotor training. Although research projects are in the preparatory phase, expectations are high regarding the laboratory's contribution to the field of gerontological research. The unique interdisciplinary setting allows for comprehensive studies into how digital interventions can be optimized to improve cognitive functions and quality of life. This lab not only aims to produce significant scientific knowledge but also to strengthen collaborations across various sectors. The ultimate goal is to translate research findings into practical applications that can be integrated into regular care practices, especially during times of crisis when the elderly are most vulnerable. The digital therapy lab stands as a beacon for future gerontological research, offering a platform for exploring innovative therapeutic methods. The research conducted here will provide crucial insights into the role of technology in enhancing the lives of the elderly, potentially reshaping how care is administered in geriatric settings. Furthermore, the lab is poised to attract new partners, thereby expanding its research scope and improving the overall effectiveness of digital therapies in gerontology. Results and Discussion Overall, the establishment of a therapy laboratory with modern therapy equipment within a university setting enriches both teaching and research endeavors, ultimately contributing to advancements in the field of neuromotor rehabilitation to develop new, cost-effective, digital systems for the therapy at home. The digital therapy laboratory at Hamm-Lippstadt University represents a significant step forward in gerontological research. Collaborative projects with existing partners such as the Alzheimer's Society Hamm, Hamm Telemedicine Center, and Ambulanticum will help to establish comprehensive long-term studies, examining the efficacy of digital interventions in cognitive and physical health of the elderly.
Usage and acceptance of digital health among Dutch physiotherapists: a cross-sectional study
Purpose: To gain a general overview of nowadays usage of different types of digital health, and the acceptance and attitude towards digital health, among Dutch physiotherapists. ┬á Method: For this cross-sectional study, a survey was developed in collaboration with international researchers in the field of technology and physiotherapy. For nine categories of digital health (Technology toΓÇª 1. Record and share data; 2. Communicate asynchronous; 3. Communicate synchronous;4.Make therapy engaging; 5. Inform and socially support?; 6. Measure; 7. Perform physical tasks; 8. Support with AI; 9. Replace (part of) face-to-face guidance of a physiotherapist) physiotherapists were asked whether they used the type of technology and, if yes, for what percentage of their patients. For measurement of the acceptance of digital health, a translated version of the Ehealth Acceptability Scale was used1. Physiotherapists working in all kinds of settings were invited to participate using social media, the newsletter of the professional organization of physiotherapists and the researchers network. Descriptive statistics were used to analyze the data in SPSS. ┬á Results and discussion: Responders (N=160) were mostly female (53%), had a variation in numbers of years working experience (0-5 years N=19 (12%) up to 31-35 years N=20 (12.5%); and worked mostly in a large primary care practice with 6 or more physiotherapists N=81 (52.6%). Almost all (99%) therapists reported to use technology to record patient data or to share patient data using a secured system. 90% make usage of public health webpages and social media, and 80% of therapeutic apps with exercises. Less than half reported to use video consultations (49%) and activity monitors (45%) or motion capturing sensors (40%). Gamification technology was used by 20% of physiotherapists. Overall, physiotherapists reported to use the technologies in 1-33% of their patients. These results provide a general insight in current usage and acceptance of digital health among physiotherapists and are relevant for researchers, policy makers and healthcare professionals. Digital health is seen as one of the solutions for rising healthcare costs in an ageing society2. By repeating this survey each year, the researchers aim to get insight into developments over time. Increased number of participants will facilitate performing subgroup analyses for physiotherapists working with for example older adults. In the near future this survey will be distributed in other countries as well, which will result in an international comparison between countries.
Ethical Considerations in AgeTech: Towards Inclusive and Equitable Solutions
Purpose In the realm of technology-driven solutions for older adults, known as AgeTech, there exists a promising landscape where advancements can significantly enhance the health, autonomy, and overall quality of life for elderly individuals (Sixsmith, 2021).┬áThese innovations not only enable aging individuals to remain independent within their familiar environments but also revolutionize the delivery of essential services. However, within this realm of potential, lies a pressing need to address ethical challenges such as the protection of the fundamental rights, privacy, and well-being of older individuals, particularly in an era marked by rapid technological advancement (Rubeis et al., 2022; Ryan and Gutman, 2023). Methods This study embarked on a comprehensive exploration of these ethical quandaries through a series of six 2-hour workshops (n=3 in Canada; n=3 in Scotland). These workshops convened Canadian and European stakeholders, including academics, healthcare and social work professionals, engineers, and representatives from the older adult community. Through thematic analysis, the discussions delved deep into the ethical dimensions inherent in AgeTech research and development. Results and Discussion Our analysis highlighted the need to integrate perspectives of marginalized groups into the fabric of AgeTech processes. Furthermore, participants advocated for the establishment of inclusive co-creation workshops as a means to nurture ethical awareness and action. Additionally, the analysis emphasized the significance of fostering cultural shifts within the AgeTech landscape, steering it towards a more equitable and ethically-sound trajectory. In essence, this research underscores the indispensable nature of addressing ethical considerations in AgeTech. Doing so not only promises positive outcomes for older adults yet also holds the potential to bridge the digital divide and forestall any unintended negative consequences that may arise in the AgeTech arena. ┬á References Sixsmith, A. (2021). AgeTech: Technology-based solutions for aging societies. Promoting the health of older adults: The Canadian experience, 135. Rubeis, G., Fang, M. L., & Sixsmith, A. (2022, October 27). Equity in AgeTech for Ageing Well in Technology-Driven Places: The Role of Social Determinants in Designing AI-based Assistive Technologies. Science and Engineering Ethics, 28(6), 49. https://doi.org/10.1007/s11948-022-00397-y. Erratum in: Science and Engineering Ethics, 28(6), 67. PMID: 36301408; PMCID: PMC9613787. Ryan, Y., & Gutman, G. (2023). Aging, artificial intelligence, and the built environment in smart cities: Ethical considerations. Gerontechnology, 22(2), 1-5. https://doi.org/10.4017/gt.2023.22.2.rya.08
Social and assistive robotics in hospitals: evaluation of the usability, acceptability and ethical issues associated with the use of these new technologies in geriatric institutions.
Introduction: Older adults suffering from neurocognitive disorders require multimodal support. Social assistant robots, mechanical entities capable of interacting socially with their users in a variety of contexts (informational, recreational, educational), could be used to improve their physical and psychological well-being and maintain their quality of life. Today, however, these robot assistants are not sufficiently advanced to engage in satisfactory social interactions that would lead to their adoption. This project is part of the European SPRING project, which aims to develop a social assistance robot, ARI, capable of interacting with several speakers in hospital environments. ARI is designed to inform, guide and entertain users and support healthcare professionals in their work. Methods: The evaluation of the ARI robotic system was carried out with two stakeholders in a Paris hospital department (France): patients and their carers, who used the ARI robot. The study focused on the usability of the system and the analysis of human-robot interactions in order to identify areas for ergonomic improvement. To assess usability, we used the System Usability Scale. The robotΓÇÖs acceptability in hospital settings was assessed using the French version of the Acceptability E-Scale questionnaire and a semi-directive interview, asking users about the ethical issues involved in implementing social robots in hospital settings. Results: Two waves of experiments have been carried out since March 2023, involving 20 and 49 participants respectively, with an average age of 76.7 and 73.89. The second wave introduced a major innovation: the integration of a Large Language Model (LLM) into interaction with the ARI robot. The results showed an improvement in the acceptability and usability of the social robot during this second phase. Mean scores on the Acceptability Evaluation Scale (AES) rose from 15.4 to 20.8/30, while those on the System Usability Scale (SUS) increased from 47.5 to 57/100. Conclusion: In conclusion, our study within the European SPRING project aimed to evaluate the ARI social assistance robot in hospital settings, focusing on usability and human-robot interaction. The integration of a Large Language Model (LLM) in the second phase marked a significant advancement, leading to improved acceptability and usability scores. These findings highlight the potential of advanced technologies in enhancing social robots' effectiveness in healthcare contexts. As we continue to refine ARI based on user feedback, our research contributes to the ongoing development of assistive technologies tailored to the ┬áneeds of older individuals and their caregivers. Acknowledgements: We would like to thank all the participants and hospital staff for their invaluable collaboration in this study.
GaitKeeper: Revolutionizing Gerontechnology with Artificial Intelligence and Augmented Reality for Enhanced Gait Analysis
Purpose: GaitKeeper is an innovative mobile technology that uses artificial intelligence (AI) and augmented reality (AR) to enhance gait analysis in aging populations. GaitKeeper standardises assessments of gait speed, ensuring that each patient is uniformly evaluated. Standardisation boosts the reliability of data collected whilst also providing a consistent metric for monitoring patients over time. Gait speed is often referred to as the "sixth vital sign" due to its predictive value for functional capacity, mobility, cognitive decline, and overall mortality. (Fritz & Lusardi, 2009) By improving the precision and accessibility of gait speed measurements, GaitKeeper is set to revolutionise health assessments for older adults. ┬á Method: GaitKeeper employs AR to create a standardized virtual gait laboratory that ensures uniform assessment conditions. Concurrently, GaitKeeperΓÇÖs AI components analyse video recordings to capture 25 distinct joint positions. GaitKeeper simulates a 4-meter walkway, as recommended by the global guidelines for falls prevention and management, ensuring consistent assessment conditions across various clinical settings. (Montero-Odasso et al., 2022) This standardised testing environment improves the measurement of variables such as the acceleration phase, which previously lacked consistent measurement in traditional methods of measuring gait speed. GaitKeeper's efficacy and technological rigor were validated against Vicon and GaitRite through comparative analyses in both laboratory and clinical environments. ┬á Results and Discussion: A technical evaluation at Dublin City University (n=30) measured GaitKeeperΓÇÖs ability to capture accurate positional data from video, using the Vicon system as the verification gold standard. Additionally, a clinical evaluation at Tallaght University Hospital involving people with mild cognitive impairment (MCI) (n=30) compared gait speed data with specialist physiotherapist clinical observational studies and GaitRite systems during 4m walking under single and dual task conditions. The technical evaluation provides evidence of GaitKeeperΓÇÖs ability to capture accurate gait data from video (n=30, p<0.001, error<3%). The clinical evaluation supports the accuracy in comparison with the gold standard (n=30, p<0.001, error<6%). These results demonstrate that GaitKeeperΓÇÖs outputs are highly consistent with established gait analysis systems, showing less than 2% variance from Vicon and robust correlation coefficients with GaitRite (Pearson r = 0.72, Spearman ╧ü = 0.918). The integration of AI and AR not only facilitates precise gait measurements but also enhances the scalability and usability of gait analysis, supporting proactive health management in older adults.
Impact of music on wellbeing of older persons and their technology acceptance of IoT Ring as the measuring device
Purpose┬áThe aging of the population is a major challenge facing superageing places around the world. More policies are introduced to support expand the service capacity and provide a community-based, high-quality, universal, affordable, diverse and continuous comprehensive long-term care system. New elderly medical and care service models are designed to create a healthy, energetic, happy and elderly-friendly communities. In addition, providing health promotion and management for healthy and sub-healthy elderly people can slow down aging, improve the quality of life of the elderly, and indirectly reduce medical costs. This is also a strategy adopted by countries around the world to face the challenge of an aging population.The application of science and technology in health promotion and long-term care is a global trend that has emerged in recent years. The longevity industry has unlimited business opportunities for the application of digital technology, artificial intelligence (AI), Internet of Things (IoT) and other technologies in smart hospitals, rehabilitation, remote home care, elderly care, etc. A research study which uses an IoT ring from LeadTek (Taiwan) to closely monitor the impact of music on improving the well-being of the elderly in Singapore and Taiwan and Canada communities. The elderly in the three countries have similar characteristics in the cultural, psychological and social environment. This study will be jointly conducted by National Taiwan Normal University (NTNU), Singapore University of Social Sciences (SUSS) and the University of British Columbia (UBC) in Canada.┬áMethod┬áAn exploratory mixed qualitative and quantitative research method to study the acceptance of the IoT ring by the elderly using Senior Technology Acceptance Model (STAM), QoL, and Subjective Happiness questionnaires. The IoT ring will be collecting the Heart rate variability (HRV) and Autonomous nervous system to calculate the sleep quality and biological age of up to 80 participants.┬áResults and Discussion┬áIn addition, the collaboration between the three universities and Leadtek Technology can contribute valuable research results to the important global challenge of promoting healthy aging. We will also investigate how older peopleΓÇÖs attitudes toward IoT rings, music activities affect various physical and mental functions of individuals, such as sociability, value relatedness, or reduction of cognitive dissonance.┬á
New Ways of Helpcoordination: Results of an Implementation Study on the Digitalization of Neighborhood Assistance for the Elderly
Purpose As a recent study shows, primary caregivers spend an average of 49 hours per week caring for and supporting dependent relatives. At the same time, these caregivers are exposed to high levels of stress, which can lead to impairments in their own life satisfaction and health. Therefore, voluntary assistance for the elderly is gaining increasing importance, as it supports aging in their own homes and assists caregiving relatives in their duties. (Schwinger & Zok, 2024) Given the decreasing and exhausted family care potentials and resources, there are increasing calls for voluntary assistance services. However, the number of volunteers is limited, which, together with rising demands for help, leads to an availability problem. A promising solution to this problem lies in the use of digital platforms, which are intended to improve the organization and coordination of assistance services. Although there are high expectations for these platforms, there is a lack of empirical evidence on how such digital matching platforms may be sustainably implemented and what specific impacts they have on the efficiency and effectiveness of voluntary assistance services in a local area. The┬áIPot project accompanies the implementation process of a digital platform in a rural neighborhood assistance network in southern Germany. The central research question is: What factors and conditions promote the successful implementation of a digital solution for the matching of helpers for the elderly? In addition to evaluating practical and process-related implementation elements, the focus is also on examining the benefits of the digital solution in terms of its engagement-promoting effects. Method The implementation study follows a multiperspective approach within a focused ethnographic research design and accompanies the digitalization process for a year. The data collection was carried out using guided interviews at three data points from the perspective of the organization and the user group (helpers and clients seeking help) as well as through process-accompanying participant observations. The analysis was conducted using qualitative content analysis methods. Results and Discussion The article presents detailed findings on facilitating and inhibiting factors of implementation and engagement-promoting potentials of the digital solution. It shows how digitalization changes the help matching process and what new matching processes emerge. These new processes are compared and analyzed with existing matching models from the literature to identify differences and similarities. Additionally, the diverse benefits associated with the implementation of the digital solution are critically discussed. These effects concern not only the structures and processes within the organization but also impact local engagement. It is examined how the efficiency and flexibility of assistance can be improved and how communication between helpers and help seekers as well as among teammembers of the organization can be facilitated. At the same time, challenges such as technical start-up problems and how to ensure the long-term sustainability of the platform are addressed. In sum, this provides a comprehensive picture of the opportunities and risks of digitalization in the area of local neighborhood assistance for the elderly. ┬á ┬á References Schwinger,┬áA. & Zok,┬áK. (2024). H├ñusliche Pflege im Fokus: Eigenleistungen, Belastungen und finanzielle Aufw├ñnde. WIdOmonitor, 21(1). https://www.wido.de/fileadmin/Dateien/Dokumente/Publikationen_Produkte/WIdOmonitor/wido-monitor_1_2024_pflegehaushalte.pdf
Service Robot for Laundry Transport and Drink Distribution in Nursing Homes
The paper examines the use of service robotics to overcome the challenges in retirement and nursing homes posed by an ageing society and a shortage of manpower. Using the example of the Lio robot, its potential for tasks such as laundry transportation and beverage distribution is being investigated. The two-year project identified challenges for stakeholders through observations and interviews, followed by a phased approach to testing and developing the technology. The results showed that adaptations to the robotic tray and navigation were needed to improve efficiency and reduce the workload of care staff in tasks such as beverage distribution and laundry transportation.
"Measuring Stress Factors: Sensor Technology for Outpatient Nursing Staff and Exoskeleton Development"
PURPOSE: Mobilization of elderly or disabled patients is one of the most stressful tasks within nursing (DNQP 2020, BGW 2024). In particular outpatient nursing care faces special challenges, as there are usually no colleagues on site to provide support and (electro-mechanical) aids are not provided in all cases. Even though modern technologies such as exoskeletons are nowadays available to reduce the weight of the patients during the mobilization procedures (Strube-Lahmann et al. 2023), mobilization remains stressful. In this contribution we will present (1) the conceptual and methodological foundations of a concept for the measurement of stress and strain factors (with the help of sensor technology) for outpatient nursing staff and (2) the derivation of explorative research approaches for the (further) development of exoskeleton solutions to relieve employees in the outpatient field of activity. In recent years, a number of different exoskeleton systems have been developed that are also intended for use in occupational care (Rayssiguie et al, 2022, Vall├⌐e, 2024). However, widespread use has not yet been observed. It is currently unclear whether it is only the framework working conditions that are hindering the use of these weight-reducing systems or whether the systems already available on the market do not yet comprehensively address the needs of professional caregivers at different qualification levels. METHOD: The envisioned concept can be divided into three different tasks: a)┬á┬á A systematic review of biopsychosocial stress factors in outpatient care scenarios. The review will identify factors for comparing stress and strain in relation to physical and psychosocial demands in the day-to-day work of outpatient nursing and support staff. b)┬á┬á Sensor-supported measurement and self-reported outcome measures (PROMs) of biopsychosocial stress in outpatient care. In preparation for the measurement, the factors from task (a) are analysed within the route data of the outpatient services to combine partial surveys with extrapolations if necessary. Recourse to the data from the tour planning and documentation systems is also being considered in order to assign corresponding stresses to individual tasks in the homes of people in need of care, in order to enable extrapolation for more tours than those actually measured. c)┬á┬á Design of an alternative (robotic or mechatronic) systems to relieve the burden on employees in outpatient care. Based on the findings of tasks (a) and b), workshops on the (further) development of future systems to reduce biopsychosocial stress (e.g. during mobilization) will be held together with employees from outpatient care, in which the field of application and technological possibilities are closely interlinked. Based on the results of the research, the event will provide impetus for the (further) development of exoskeletons or similar solutions for the physical and, in some cases, psychosocial relief of employees in outpatient care. RESULTS AND DISCUSSION:In the beginning of 2024, an interdisciplinary working group was formed to advance the concept idea over the course of the year and develop a concrete project proposal. The aim here is to present the reorientation towards specific burdens in outpatient care along different qualification levels and the development of supporting robotic systems based on this. KEYWORDS: Biopsychosocial stress; outpatient care; exoskeletons, stress assessment. ADRESS: Institute for Work and Technology, Westf├ñlische Hochschule Gelsenkirchen, Germany. E-MAIL: wirth@iat.eu┬á REFERENCES Berufsgenossenschaft f├╝r Gesundheitsdienst und Wohlfahrtspflege (BGW) (2024): R├╝ckengerecht arbeiten in der Pflege. Hamburg. URL: https://www.bgw-online.de/resource/blob/18122/f2a96d9de20d29c2209f09efbd480128/bgw07-00-000-starker-ruecken-data.pdf (l.v. 19.05.2024). Deutsches Netzwerk f├╝r Qualit├ñtsentwicklung in der Pflege (DNQP) (2020): Expertenstandard nach ┬º 113a SGB XI ΓÇ₧Erhaltung und F├╢rderung der Mobilit├ñt in der PflegeΓÇ£. Osnabr├╝ck. Strube-Lahmann, Sandra, M├╝ller, Franziska, Naumann, Bj├╢rn, M├╝ller-Werdan, Ursula, Lahmann, Nils (2023): Pilotierung eines aktiven Exoskelettes in der station├ñren Akut- und Langzeitpflege.Zeitschrift f├╝r Neurologie & Rehabilitation. 29(1). S. 56-61. Rayssiguie, Esther, and Mustafa Suphi Erden (2022): A Review of Exoskeletons Considering Nurses. Sensors 22, no. 18: 7035. https://doi.org/10.3390/s22187035. Vall├⌐e, Alexandre ((2024) ┬áExoskeleton technology in nursing practice: assessing effectiveness, usability, and impact on nursesΓÇÖ quality of work life, a narrative review. BMC Nurs 23, 156 https://doi.org/10.1186/s12912-024-01821.
Development of a Training Program to Educate Care Workers Utilizing Digital Transformation in Japan
Purpose Japan, with its rapidly progressing low birth rate and aging population, reached an aging rate of 29.1% in 2023, marking the highest level both in its history and globally. By 2065, approximately one in every 2.6 people is expected to be 65 or older. Simultaneously, the shortage of care workers is expected to reach approximately 690,000 by 2040. To address these challenges, the Japanese government is promoting measures such as improving productivity in care settings by leveraging ICT, utilizing diverse human resources, and creating more conducive working environments. Considering these issues, this study aimed to develop a ΓÇ£Digital Transformation (DX) Care Worker Training ProgramΓÇ¥ to train care workers equipped with ICT skills (Ministry of Health, Labor and Welfare). This program also includes job placement mechanisms to facilitate the smooth transition of trainees to the caregiving profession. Methods The program was designed to enable participants to leverage their existing ΓÇ£skillsΓÇ¥ and ΓÇ£experienceΓÇ¥ to find employment or transition into the caregiving field, not only by imparting specialized knowledge and skills in caregiving but also by fostering ICT-capable care workers. Initially, surveys were conducted among care workers and educators at care worker training schools. Based on the survey results, a program was developed that integrates three courses, namely: the ΓÇ£Care Worker Induction Course,ΓÇ¥ which is an introductory course in caregiving; the ΓÇ£Smart Care Worker Course,ΓÇ¥ which teaches the use of ICT in caregiving settings; and the ΓÇ£Practical Training Program for Care Workers,ΓÇ¥ which aims to develop leadership, career planning skills, and the ability to utilize ICT and robotics. The impact of the developed ΓÇ£DX Care Worker Training ProgramΓÇ¥ on participants was evaluated through questionnaire surveys and interview surveys. This study was approved by the Research Ethics Committee of the Vocational Education Research and Development Center of Keishin Gakuen (Approval No. 22-04). Results and Discussion The questionnaire survey revealed an increase in the average score for ΓÇ£interest in caregiving workΓÇ¥ from 3.75 before the course to 4.00 after the course. The average score for ΓÇ£intention to pursue caregiving workΓÇ¥ increased from 3.00 before the course to 3.50 after the course. The average score for ΓÇ£subjective caregiving practice abilityΓÇ¥ increased from 44 points before the course to 65 points after the course. Post-course interview surveys indicated that the program was accessible even for complete beginners. Furthermore, participants learned about diverse fields and professions related to caregiving through advanced caregiving topics and were constantly encouraged to think about what they learned and their future goals, highlighting the importance of reflective thinking. In addition to enhancing caregiving and ICT skills, the program was found to encourage evidence-based thinking and career considerations. Moving forward, the identified issues will be addressed, and follow-up surveys of the participants will be conducted to further improve the program.
Human-Follower Mobile Robot with High Payload for Cross-Domain Assistance using Shared Autonomy
Purpose Relocating heavy payloads during removals in home settings or in the parking of supermarkets might cause physical stress on the human body and affect health of older adults. Whereas fully autonomous social navigations of robots carrying payloads to assist humans remain a challenge (Navarro, et al., 2024), scripted robot motions fail to adapt to dynamic goals and unpredicted events. We therefore address robotized payload carrying while following a human by leveraging on shared autonomy (Guiffo Kaigom, 2023). Our objective is to combine cognitive human skills and machine intelligence for a smart and decent transportation of a wide range of payloads (up to 70 Kg) in multiple domains with negligible efforts, comfort, and self-fulfillment for humans. This assistance benefits from the ability of upskilled mobile robots to spatially track goal-oriented (e.g., collision-free) and dynamic motions of a human to reach unknown locations while carrying a payload. Conversely, humans can contextualize, supervise, and adjust the robot behavior to accommodate events the robot is not aware of and meet highly personalized objectives. The resulting symbiosis thus supports the self-determination of older adults. Method The robot reacts to the human behavior using three functionalities: perception, reasoning, and self-control. Perception is achieved by using a state-of-the-art stereo camera sensor (Stereolabs ZED 2i). The relative distance and orientation of the target person in the 3D space are estimated from image and depth data. Specifically, a pre-trained YOLOv8 model extracts human features from data to reason. The depth map uses the coordinates of a bounding box to determine distance values related to the nearest person by harnessing camera characteristics. Desired linear and angular velocities enforcing the proximity to the person while preserving a safety zone that depends upon the context are autonomously generated by a proportional, integral, and derivative controller and forwarded to the control unit of the robot. The communication occurs via the robot operating system ROS2. Results and Discussion The mobile robot system endowed with a vision-driven human-follower ability can assist people in several tasks. It also leaves room to cope with future challenges. As shown on pictures below, the robot can help move heavy removal boxes from one room to another in home settings. A physical stress on human body is thereby avoided during navigation. Also, the robot can bring shopping baskets to a car in a parking. Older adults can therefore focus on their needs and no longer on the final total weight.┬á During extensive application validations in practice, we observed that pre-trained neural networks need more robustness to avoid mismeasurements in detection and distance estimation. Enhanced generalization and adaption to changing conditions are investigated. To enhance safety, algorithms for obstacle avoidance based on e.g. LiDAR data (Uguzlar, Cansu, Contarli, & Sezer, 2023) will be implemented. Therefore, redundancy through the fusion of multiple sensor data to improve robustness is pending. All in all, this work forms the basis for follow-up projects with the overarching goal of pervasive and itinerant self-determination fostered by robotics and digitalization (Guiffo Kaigom, 2023).
Ghostly, an electromyography-based serious game to counter muscle mass and strength loss in hospitalized older adults
Purpose: The functional decline experienced by older adults and its interaction with morbidities expose them to an increased vulnerability to stressors (i.e., frailty) and higher risk of hospitalization. Additionally, hospitalization itself also poses risks for functional decline because of the negative effects of prolonged bedrest and restrictions in activity. This bedrest and restriction in activity leads to significant decline in several functional parameters and multiple muscle characteristics (e.g., muscle mass, muscle strength, etc.). Furthermore, strategies to mitigate these effects include targeted physical activity interventions, but these patients are often unable to perform dynamic, more high load functional exercises, further limiting recovery. With this in mind, the implementation of low load blood flow restriction training, in which the blood flow towards the targeted muscle is partially restricted during training. This novel training modality is proven to have beneficial effects on muscle mass and muscle strength compared to regular low load strength training. Moreover, serious games might provide a relevant solution to bridge the gap between exercise in bed and more functional out-of-bed exercises. Based on the principles of user-centered design, the Ghostly game, an electromyography-based serious game was developed as part of a co-creation process between engineers, clinicians and different patient populations. This feasibility study collected relevant data on usability and user experience from hospitalized older adults which in turn will be used to further develop the game and structure future larger randomized pilot studies. Method: Patients were recruited from the geriatric ward of the University Hospital of Brussels and randomized in three groups. All groups received daily conventional therapy provided by the physiotherapist of the ward, as well as different forms of additional therapy based on group allocation. The Ghostly group received the Ghostly game as additional therapy, the Ghostly and blood flow restriction group received the Ghostly game combined with blood flow restriction therapy, and lastly, the control group received dose-matched isometric exercises. User experience and usability was assessed through observations by several different professionals (e.g., researchers, engineers, clinicians, etc.) while the patients were playing the Ghostly game, as well as after one week of intervention using the Usability, Satisfaction and Ease-of-use (USE) questionnaire. Furthermore, clinical outcomes (muscle strength, muscle architecture, segmental body composition, etc.) were measured at baseline and after one week of intervention in preparation of future larger randomized pilot studies. Results and discussion: ┬áIn total 14 patients, ranging from 78 to 94 years old (mean age 84.93┬▒4.43 years), were included in this study. On average participants completed 3 to 5 (mean 3.5┬▒0.73) sessions before being discharged from the hospital. Observations from several professionals while the participants were playing the Ghostly game revealed several facilitators and barriers in usability related to in-game elements (color contrast, reaction speed, respawn checkpoints, etc.) that require adjustments to increase user experience. Nonetheless, the results from the USE questionnaire revealed an overall moderate to high score with regard to usefulness (71.96%), ease of use (74.94%), ease of learning (75.36%) and satisfaction (78.98%). These results further emphasize the need for a user-centered approach not only focusing on user experience data from a patient population, but also observational and qualitative data from professionals involved in the use and development of rehabilitation technology. Additionally, the results indicate that the current research protocol is feasible for future larger randomized controlled trial (RCT) in terms of recruitment, outcome measure assessments, duration of intervention, etc. Finally, the results from the clinical outcomes will be used to calculate sample size for the fully powered RCT to test the effectiveness of the Ghostly game in relation to strength training.
Exploring the Association Between Wearable Device Metrics and Frailty Syndrome in Community-Dwelling Older Adults
PURPOSE Frailty Syndrome (FS) assessment is pivotal for identifying older individuals who would benefit from comprehensive gerontological evaluations (Turner et al. 2014). Wearable devices have emerged as a promising tool for monitoring FS in this population. Our study aims to investigate whether metrics provided by smartwatches are associated with FS among community-dwelling older adults. METHOD We conducted a cross-sectional study involving older adults aged 60 years or older of both sexes. We evaluated their physical frailty phenotype based on the criteria developed by Fried et al. (2001). FS was defined as the presence of at least three of the following criteria: muscle weakness (handgrip strength < 16 kgf for women and < 26 kgf for men), slow gait (adjusted for height and sex), self-reported exhaustion, low physical activity (< 150 minutes/week), and unintentional weight loss (ΓëÑ 5 kg in the last year). Participants wore the Garmin Forerunner 245┬« smartwatch (Garmin, USA) continuously for seven days. We analyzed step counts (steps/day) and light sleep time (minutes/day). Multiple linear regression models were developed, including Model 1 (steps counts) and Model 2 (light sleep time), adjusted for age, chronic conditions, and educational level. RESULTS AND DISCUSSION Ninety-nine older adults participated in the study, with a mean age of 68.7 ┬▒ 15.6 years. Most participants were women (n=61, 80.3%). FS was present in 23 participants (30.26%). Step counts and light sleep time did not significantly differ between frail (5420.4 ┬▒ 2673.8 steps/day; 276.9 ┬▒ 64.8 min/day) and non-frail participants (6839.4 ┬▒ 2296.4 steps/day; 249.5 ┬▒ 78.0 min/day) (p-value > 0.05). Our multiple linear regression analysis revealed that low physical activity (╬▓ = -1945.70; 95%CI: 7027.17 to 11087.06) and muscle weakness (╬▓ = -2680.32; 95%CI: -5315.90 to -44.73) were associated with step counts (Model 1 - R┬▓adjusted = 27.7%). These findings align with prior studies conducted by Watanabe et al. (2020) and Hsueh et al. (2019). Additionally, exhaustion was the sole FS criterion linked to light sleep time (╬▓ = 40.07; 95%CI: 3.06 to 77.08) (Model 2 - R┬▓adjusted = 31.3%), corroborating with Goldman et al. (2008). Our findings suggest that the Garmin Forerunner 245┬« holds significant potential for continuously monitoring critical health aspects in older adults.
Guiding Exoskeleton Development for Healthy Ageing: Co-Design Insights from Older Adults
Purpose: Healthy ageing, as defined by the World Health Organization (WHO), is the process of acquiring and maintaining the functional ability that promotes well-being as people age (WHO, 2015). This functional ability is related to a person's intrinsic capacity as well as the environment in which they live and with which they interact. To promote healthy ageing, lower limb exoskeletons (LLEs) could represent a game-changer, as they may act as (1) an assessment tool (Moeller et al., 2023), able to measure intrinsic capacity, and (2) an augmentation tool (Grimmer et al., 2019), providing additional support for improved functional ability in daily life. According to the importance of including end-users in the development of technology (i.e. user-centred approach), the purpose of this study is to capture the insights of older adults (aged 65 and above) on the needs and requirements of LLEs that can be implemented in a home environment. Methods: Three focus group discussions were organised, implementing the PERCEPT methodology (Bourazeri & Stumpf, 2018). Within this methodology, participants co-create a set of personas that are further used throughout the co-design process, by discussing different topics. All sessions were structured by a pre-designed interview guide with open-ended questions. Data analysis includes verbatim transcription, followed by thematic analysis (NVivo version 14), utilising Brain and Clarke's methodology (Braun & Clarke, 2006). Results and Discussion: This study is part of the interdisciplinary RevalExo project, aimed at developing LLEs for healthy ageing. Four older adults (gender: two male and two female; age: 74-88 years; Montreal Cognitive Assessment: 25-27; Short Physical Performance Battery: 5-11) with mobility problems participated in three two-hour group discussions (6 hours in total). Topics included activities that would benefit from additional assistance (i.e. ASSIST), parameters that need to be assessed by an exoskeleton (i.e. ASSESS), the influence of fatigue on daily life and activities (i.e. FATIGUE), and the optimal design and usability of LLEs (i.e. DESIGN & USABILITY) (Figure 1). The methodological approach and findings of this qualitative study will inspire researchers to develop assistive LLEs to enhance the intrinsic capacity and functional ability of older adults during daily life. Furthermore, the results of this study will also inform future research related to assessing feelings of fatigue, including the use of assistive technology to support when intrinsic capacity is reduced. Indeed, within the field of healthy ageing, vital capacity is considered to be the underlying physiological determinant of intrinsic capacity and fatigue plays an important role within this (Bautmans et al., 2022).
Variants of knowledge-based chatbots in family caregiving ΓÇô human evaluation and comparison
Purpose┬áKnowledge in the family caregiving domain is highly complex and incorporates many conditions and peculiarities. This knowledge poses a challenge for people needing care and their informal caregivers due to the assessment of reliability, credibility, and seriousness of the vast array of available information (Hoffmann et al. 2021).┬áSimultaneously it is essential for effective home care. Although professional care advice exists, it is sometimes difficult to reach and cannot be consulted immediately. Therefore, we develop a Large Language Model (LLM) based, knowledge-integrated chatbot tailored to support this target group with reliable information about rights and entitlement to benefits and how to apply for them. One promising conceptual solution is the Retrieval-Augmented Generation (RAG) (Lewis et al., 2020). RAG connects LLMs to external sources to provide more specific domain knowledge for answering questions (Pan et al., 2024). In light of the increasing dissemination of LLMs and their use cases in sensitive areas such as the family caregiving domain, we provide a rigorous human evaluation of the effectiveness of different variants of knowledge integration into chatbots to reduce factual inaccuracies, the so-called hallucinations.┬áMethod┬áIn this study, we compare five different variants of knowledge graphs (KG) and vector databases (VDB) in RAG systems combined with LLMs like Llama3 and GPT-4.┬áBesides the mathematical evaluation based on RAGAS metrics, we performed a comprehensive human evaluation by experts in family caregiving. For the evaluation of the given answers, we used the following criteria: faithfulness of the content, correct language, factual accuracy and completeness. Furthermore, we allowed free text comments for more detailed remarks, e.g. if the domain terms used were outdated or what content was missing. The study focused on specific questions concerning care benefits-in-kind, especially relevant for informal caregivers. This allowed us to identify the potential and challenges in knowledge representation for such a sensitive area.┬áResults and Discussion┬áThe preliminary results of our study show that for generating highly accurate answers to qualified questions the integration with a knowledge graph is especially advantageous. In contrast, vector databases perform very well in delivering a broader context. However, all of the knowledge-integrated chatbots showed an apparent increase in performance for the answer-generation process. These observations encourage the potential significance of a combination of both techniques. Furthermore, the results suggest the need to tailor the knowledge representation to the specific use case as in home care a huge variety of information needs exists.┬á In light of ever-developing and increasing requirements for the healthcare system, our findings can add to the development of chatbots and AI-based information systems that better suit diverse users' needs and competencies. Future research should strive to combine KG optimally with VDB approaches to enhance the reliability and accuracy of LLM-generated answers. This should also allow the dynamic adaptation to new information.┬á┬á ┬á References Lewis, P.; Perez, E.; Piktus, A.; Petroni, F.; Karpukhin, V.; Goyal, N.; Kuttler, H.; Lewis, M.; Yih, W.-t.; Rockt├ñschel, T.; et al. 2020.┬áRetrieval-augmented generation for knowledge-intensive nlp tasks.┬áAdvances in Neural Information Processing Systems┬á33:9459ΓÇô9474.┬á Hoffmann, M.; Schwarz, C.; Sendlhofer, G. ; 2021. Patienten und Angeh├╢rige richtig informieren. Springer Fachmedien. Wiesbaden.┬áhttps://doi.org/10.1007/978-3-658-35274-5 Pan, S.; Luo, L.; Wang, Y.; Chen, C.; Wang, J.; and Wu, X. 2024.┬áUnifying large language models and knowledge graphs: A roadmap.┬áIEEE Transactions on Knowledge and Data Engineering. ┬á Keywords:┬áLarge Language Models, Retrieval Augmented Generation, family caregiving, Chatbot, Response Accuracy Affiliation: Institute for Media Research and Media Pedagogy; TH Cologne; Germany┬á Corresponding Author Email:┬áisa.nowak@th-koeln.de┬áAuthorΓÇÖs ORCID iD:┬áhttps://orcid.org/0009-0000-4415-734X Acknowledgement┬áThe authors would like to thank the German Federal Ministry of Labour and Social Affairs for supporting the research in the project ΓÇ£BOTschafft Inklusion: Der inklusive Chatbot zur Eingliederung und Teilhabe von pflegenden Angeh├╢rigen in den ArbeitsmarktΓÇ£ (#CIP.00.00012.23). This research is making an essential contribution to the understanding of external knowledge sources for LLMs and their influence on answer accuracy.┬á ┬á
Sensor-based prevention of falls and pressure ulcers: a scoping review
Purpose Global population aging increases the demand for long-term care due to functional and cognitive decline among older adults. Adverse events, particularly falls and pressure ulcers (PUs), are common in long-term care, challenge patient safety and healthcare resources. Both movement-associated phenomena severely affect quality of care (Lampersberger et al., 2022). Falls can cause physical injuries and psychological effects, leading to reduced mobility and quality of life (Cameron et al., 2018). Similarly, PUs are a serious complication with high incidence and prevalence among nursing home residents (Sugathapala et al., 2023). Sensor technologies offer promising solutions for preventing these adverse events by enabling continuous monitoring and early intervention. Given their dependence on nursing care, falls and PUs are key indicators of nursing-sensitive outcomes. Therefore, examining sensor-based strategies for both phenomena together is crucial. We conducted a scoping review to investigate the effects of sensor-based prevention strategies for falls and PUs in long-term care and to explore the experiences of patients and healthcare professionals with these technologies. Method This scoping review was conducted following the JBI Reviewer's Manual and PRISMA-ScR guidelines. A comprehensive literature search was performed in MEDLINE, CINAHL, Web of Science, and Google Scholar for studies published from 2014 to 2023. The MMAT and JBI appraisal tools were applied for quality assessment. Extracted data were synthesized both narratively and descriptively. Results and Discussion Among 31 included studies, 22 focused on fall prevention, 8 on PU prevention, and 1 on both phenomena. Sensor technologies were categorized into user-based and context-based types. User-based sensors in the form of accelerometers showed positive effects for both fall and PU prevention. Regarding fall prevention, a sensitivity of 80% has been reported. For PU prevention, accelerometers improved adherence to repositioning protocols, reducing PU incidence from 5.24% to 0.0% and achieving a 94.0% reduction in facility-acquired PUs. In terms of context-based sensors for fall prevention, Doppler radar achieved 90.0% fall detection but generated up to 49 false alarms per month. Webcams had fewer false alarms but were less reliable than Kinect, which had minimal false alarms within a 4-meter distance. Range sensors demonstrated high accuracy with 94.5% precision and 86.7% recall. For PU prevention, a context-based accelerometer was promising, whereas pressure sensors provided unreliable data. Manual assessments remained crucial for complementing sensor data and improving predictive accuracy. Patients showed higher acceptance for non-obtrusive, user-friendly sensors. Health professionals valued real-time monitoring and alert capabilities, stressing the importance of seamless integration into care routines and documentation. Privacy and data security remained significant concerns. Sensor technologies show positive outcomes for fall and PU prevention in long-term care, pointing to a need for further refinement of context-based sensors regarding PU prevention. The combination of technological advancements and standard care methods can improve patient safety and care quality. Future research should expand randomized controlled trials and explore sensor technologies in various long-term care settings. Addressing privacy and ethical concerns is essential for increasing acceptance of these technologies. ┬á References Cameron, I. D., Dyer, S. M., Panagoda, C. E., Murray, G. R., Hill, K. D., Cumming, R. G., & Kerse, N. (2018). Interventions for preventing falls in older people in care facilities and hospitals. Cochrane Database of Systematic Reviews, 9(9), CD005465. https://doi.org/10.1002/14651858.CD005465.pub4 Lampersberger, L. M., Bauer, S., & Osmancevic, S. (2022). Prevalence of falls, incontinence, malnutrition, pain, pressure injury and restraints in home care: A narrative review. Health & Social Care in the Community, 30(6), e3656-e3669. https://doi.org/10.1111/hsc.14021 Sugathapala, R. D. U. P., Latimer, S., Balasuriya, A., Chaboyer, W., Thalib, L., & Gillespie, B. M. (2023). Prevalence and incidence of pressure injuries among older people living in nursing homes: A systematic review and meta-analysis. International Journal of Nursing Studies, 148, 104605. https://doi.org/10.1016/j.ijnurstu.2023.104605 ┬á Keywords: Long-Term Care, Falls, Pressure Ulcers, Prevention, Sensors
Purpose The Republic of Korea has experienced the world's fastest rate of population aging. This rapid increase in the number of older adults, particularly the oldest oldΓÇöthose aged 85 and aboveΓÇöcoupled with a shrinking caregiver workforce, necessitates innovative solutions. In response, the Korean government launched a major research and development (R&D) initiative in 2019 specifically aimed at developing care robots to assist with transferring, preventing bedsores, toileting, and feeding. Additionally, mass media has widely reported on the promising future of care robots, often depicting them as humanoid. However, little is known about how the general public defines and perceives care robots. This study aims to bridge this gap by exploring public perceptions of care robots. Method Data for this study was collected through an online survey administered to a sample of 1,668 participants in South Korea. The sample was stratified by age group, gender, and region to ensure representativeness. Participants were asked about their knowledge of care robots, with the following response options: (a) I know it well, (b) I have heard the word, and (c) I do not know it at all. Participants were also asked to select the definition of care robots that most closely aligned with their understandings from the following options: (a) a robot that assists with one specific activity (e.g., transferring, eating, toileting) in diverse care environments; (b) a robot capable of assisting with various activities in diverse care environments; (c) a humanoid robot designed to replace care aids; and (d) something else. Participants who chose the last option were invited to provide their own definition of care robots. Results and Discussion The survey results regarding perceived knowledge level showed that over half (52.1%) of participants reported having heard of care robots, while nearly four in ten (39.7%) reported not knowing them at all. Only 8.3% of participants reported being very knowledgeable about care robots. In terms of participantsΓÇÖ definition of care robots, about one out of three (35.6%) study participants reported they are humanoid robots designed to replace care aids. However, 40.5% viewed them as robots capable of assisting with various activities, and 21.9% perceived them as assisting with only one specific activity. Thirty-two participants selected "something else" when defining care robots, and twelve indicated they had no idea. Notably, five participants described care robots as companions for conversation. The distribution of definitions of care robots across perceived knowledge levels showed that the group reporting no knowledge was more likely to view care robots as humanoid robots, while the group that reported being very knowledgeable were more likely to define care robots as robots assisting with only one specific activity. ┬áA chi-square test of independence revealed a statistically significant associated between the two variables: Ω¡ô2, (4, N = 1636) = 49.95, p < .001. Multinomial logistic regression revealed a statistically significant association between education level and perceived knowledge of care robots, even after controlling for age and gender. Participants with higher education were more likely to report being very knowledgeable about care robots or having heard of them, compared to those who reported no knowledge at all. Age also emerged as a significant factor in defining care robots. Younger participants were more likely to view them as robots capable of assisting with various activities, rather than just one specific activity. The findings suggest that the majority of the general population lacks confidence in their knowledge of care robots, and also, they view care robots in a wide spectrum of capabilities. To bridge this gap and ensure human-centered development addressing South Korea's growing caregiving needs, public communication and open discussions are essential. These discussions should focus on defining care robots, outlining the ethical considerations and potential limitations of their development, and fostering responsible implementation.
Perspectives of Older Adults and Their Caregivers on the Development of a Robotic Exercise Coach
Purpose Physical activity through exercise helps to delay, prevent, or reverse functional decline in older adults (Bean et al., 2004). Recently, various technologies, including assistive robot coaches, have been developed to engage older adults in physical activities (Avioz-Sarig et al., 2021). Nevertheless, there is a lack of understanding regarding the specific needs, preferences, and potential barriers faced by older adults and their caregivers when interacting with this technology (Fasola and Mataric, 2012). This study is part of the interdisciplinary AI@WZC project, aimed at developing an AI-driven robotic exercise coach for older adults living in a residential care home. We aim to acquire insights from residents and their caregivers to inform the design of this robotic coach. Method We organized two semi-structured focus group discussions with respectively five and four care home residents (age: 70-90 years old; gender: three females for session 1 and two females for session 2, two males; MMSE: 18-30) and two caregivers (one physical therapist, one nurse), adhering to the participatory design principles of the PERCEPT methodology (Bourazeri and Stumpf, 2018). The first workshop focused on co-creating personas for two caregivers and a care home resident, gaining insights into their technology use, physical challenges, and daily activities. The second workshop addressed the most promising physical exercises and the functionalities the robot should have to facilitate the exercise program, with emphasis on the information that the robot should provide to older adults and caregivers. Results and Discussion We identified two key user requirements based on the data collected during the two sessions. (1) The robotic coach needs to serve as an assessment tool, allowing caregivers to monitor functional decline and ensure the safety of exercise regimens. (2) It needs to enable personalization of exercise regimens according to individual preferences and physical limitations of care home residents, therefore allowing them to maintain agency regarding their exercise routines. At the same time, interaction between the robot and residents should be minimal, with a focus on functional feedback during exercises. In conclusion, this approach and the findings from this study can inspire and guide future researchers in developing assistive physical exercise technologies for use in residential care homes.
The Center for Innovation, Technology and Aging (CITA)
Purpose: USF has awarded $1 million in seed funding to an interdisciplinary team led by Professors Yu Sun (Computer Science and Engineering), William Haley (Aging Studies), Tammy Allen (Psychology), and Hariom Yadav (Neurosurgery & Brain Repair) to establish The Center for Innovation, Technology, and Aging (CITA). This center, which includes 37 faculty members from seven colleges, aims to transform care for individuals with AlzheimerΓÇÖs disease and related dementias (ADRD), and other vulnerable older adults with disabilities due to other conditions such as Parkinson's disease and stroke. Since most older adults with disabilities are cared for in the community by family members, there will be a strong emphasis on using technology to assist family members in effectively providing care, diminishing caregiver burden, and enabling caregivers to continue other important roles in their lives such as employment. As part of a full spectrum approach, CITA also aims to address the needs of the caregiving workforce.┬á Method: CITA uses a Data, Models, Modules, and Solutions Hub to generate personalized solutions for individual caregivers based on patientsΓÇÖ health/medical record, and their home living conditions (Figure 1). The solution is built with modules of three Pillars: monitoring, intervention, and assistive technologies. The monitoring pillar focuses on modules using AI models and unobtrusive sensing technologies to monitor physical and mental conditions, dietary habits, behaviors, etc. to facilitate early detection and intervention, while upholding the highest standards of privacy and data security. The intervention pillar focuses modules that employ reinforcement learning agents and generative models through multi-media, extended reality (XR), robots, and smart devices to provide interventions such as mitigating patientsΓÇÖ agitation and aggression, preventing wandering and handling emergencies. The assistance pillar focuses on modules that use optimization, AI, and robotics technologies to enhance caregiversΓÇÖ physical and cognitive capabilities, assist them in high-demanding activities, and alleviate their burden and stress. Results and Discussion: Previous research often concentrates on a single module within one pillar. CITA will adopt a holistic and systems-based strategy to develop innovative monitoring, intervention, and assistive technologies, enabling safe and cost-effective at-home care and high-quality personalized care for people with ADRD and other disabilities. By bringing together expertise from multiple disciplines, the initiative addresses the complex needs of people with ADRD and their caregivers, integrating diverse perspectives and methodologies to enhance research outcomes. CITA will advance understanding of ADRD care and push the boundaries of AI and robotics technologies. The centerΓÇÖs innovations are expected to significantly improve the lives of those with ADRD, benefiting caregivers, families, and society at large.
Bridging Experiential Learning and Empathy in Co-Design of Gerontechnology
Purpose There is a growing need for affordable and accessible assistive technologies (ATs) to be developed locally in Singapore for our elderly and disability communities, yet no course exists in local universities that builds talent capacity in design and development of gerontechnology and ATs. Furthermore, most engineering courses involved in technology development are conventionally taught in campus through classes, workshops and laboratories with limited outside community engagement to apply these domain-specific knowledge and skills to relevant people groups that these technologies are designed for. Such integration between learning and community engagement could be a strong learning motivator given our Gen Z studentsΓÇÖ inclination to find meaning and social impact with their learning (Turner, 2015). Method I started an undergraduate course on Gerontechnology in Ageing. Instead of adopting a conventional lecture-tutorial-laboratory strategy, I blended a design-based project with community engagement into a unique experiential community-based learning (CBL) strategy that involves co-design with older adults. CBL is grounded in the notion that learning is more effective if it is not just theoretical but also experiential (Morris, 2020). Such active learning fosters higher order learning (Asok et al., 2016) as knowledge is applied in real-world practice. Learners also develop empathy as they interact with community ΓÇ£need-knowersΓÇ¥ and are more engaged if they observe their learning could impact peopleΓÇÖs lives (Parsons & Taylor, 2011). Here, students worked in groups to partner an older adult from our network of community partners to identify and analyze an unmet need before applying their learning to define technical specifications, create a prototype, and subsequently evaluate it. These higher order learning activities (Krathwohl, 2002) collectively formed the main components of the courses. In place of an examination, this open-ended design-based project where students performed real-world tasks allowed their prototype to be an authentic assessment of their learning (Ashford-Rowe et al., 2014) which is highly relevant in an engineering education (Reynolds et al., 2009). The expectation for students to present their prototype as a gift to their client and the community partners to participate in their assessment ensured sustained engagements throughout the process (Parsons & Taylor, 2011). Results and Discussion Students were able to apply and integrate their learning to create quality prototypes[1] that met the clientΓÇÖs specifications and addressed their unmet needs. The groups eventually passed their prototype to their client as a gift and our community partners affirmed the quality and potential of their prototypes for community deployment. Some project prototypes were adopted by their client for daily use, including an assistive stretcher ΓÇ£Super Stretcher 3000ΓÇ¥ for a wheelchair user and exergames ΓÇ£TACGOΓÇ¥ and ΓÇ£Happy FeetΓÇ¥used by seniors at Active Ageing Centres. Students also gained empathy as they had to place themselves in their clientsΓÇÖ shoes when co-designing the solutions with older adults. These outcomes are evidence of higher order learning in value-creation for users, which is critical in engineering. Selected prototypes arising from the course were then further developed into products, validated by more users within our community network, refined and manufactured for sale or community deployment at-scale. While such an ΓÇ£idea-to-deploymentΓÇ¥ through co-design within an undergraduate course is uncommon, it showcases the potential of studentΓÇÖs work in gerontechnology development towards community translation. [1] Visit our bGood website which showcases all the prototypes developed by students from the undergraduate courses BN4102 Gerontechnology in Ageing and BN4103 Assistive Technology for Persons with Disability over the years. It provides a brief write-up and product video clip produced by the students.
ΓÇ£Navel is like a friend." - Acceptance of a social robot in long-term care
Purpose: Given the rapid development of new technologies, particularly AI (Artificial Intelligence), it is crucial to engage with this progress and explore potential applications of AI in institutional elderly care settings (Janowski et al., 2018). A pilot project involving the social robot "Navel" (Figure 1) is being conducted in two nursing homes of the Evangelische Heimstiftung, a diaconal and non-profit care company in Southern Germany, where Navel is in use since the end of 2023. The project, in collaboration with the developers, tests use cases and evaluates the acceptance and impact of Navel on residents and staff through the internal Institute for Care and Aging. The research questions focus on the extent to which Navel is accepted by individuals and how it can be integrated into resident care. Additionally, it investigates whether Navel can complement the care offerings and enhance positive emotions among residents. Method: During the pilot phase, a total of 26 qualitative resident interviews were conducted using a simple, self-developed interview guide. The respondents were asked about their experiences and attitudes towards Navel. The interviews were transcribed and analysed using a content-structuring approach according to Kuckartz (Kuckartz et al., 2022). In addition to the interviews, respondents were asked to complete an illustrated scale depicting their perception of Navel (n = 22). These responses are presented in a polarity profile using average values. Results and Discussion: Many residents are curious and fascinated by Navel and its appearance, with relatively few fears of contact. Those who agreed to interact with the robot generally desired communication, albeit typically requiring assistance from a daytime companion. The interactions had a positive impact on emotional well-being, as respondents reported feelings of fun, joy, and entertainment, perceiving Navel as a valuable addition to their daily life. In the polarity profile, residents, for example, had difficulty judging whether Navel was a human or a robot or whether he could experience emotions or not. Consequently, Navel is generally perceived as an inanimate figure, a partial anthropomorphization and emotional attachment occur, expressed through actions such as patting his head. Respondents also expressed a desire for technical improvements, such as autonomous mobility and unsupervised visits to residents. Moreover, the robot's speech capabilities need enhancement, as frequent interruptions and lengthy pauses disrupt conversations and confuse individuals. Additionally, the robot occasionally struggles with maintaining eye contact or targeting residents. Implementing these technical enhancements could increase Navel's acceptance among residents, potentially leading to more individuals consenting to interact with the robot. ┬á References: Janowski, K., Ritschel, H., Lugrin, B., Andr├⌐, E. (2018). Sozial interagierende Roboter in der Pflege. In: Bendel, O. (eds) Pflegeroboter. Springer Gabler, Wiesbaden. https://doi.org/10.1007/978-3-658-22698-5_4 Kuckartz, U. (2022). Qualitative Inhaltsanalyse: Methoden, Praxis, Computerunterst├╝tzung (5th ed.). Beltz Juventa ┬á ┬á Keywords: Artificial Intelligence, Social Robot, Nursing Home, Residents Affiliation: Institut f├╝r Pflege und Alter, Evangelische Heimstiftung GmbH, Stuttgart, Germany Corresponding Author Email: diana.moroz@ev-heimstiftung.de
A social robot in long-term care ΓÇô Use Cases, challenges and expectations from the employees' perspective
Purpose: Considering demographic change, the care sector is facing major challenges. While the proportion of elderly people in need of care is increasing, the number of professional caregivers is declining. For some years now, there has been hope of reducing this discrepancy through digitalization and technological developments. Robotic systems have the potential to reduce caregiver burden and to improve the quality of life of people in need of care (Silvera-Tawil, 2024; Ohneberg et al., 2023). In response to the senior residents' need for social interaction and companionship, the German company navel robotics developed the social robot ΓÇ£NavelΓÇ¥. Based on various AI technologies, Navel (Figure 1) supports nonverbal interaction in addition to verbal communication. It detects non-verbal signals such as facial expressions or direction of gaze and responds with facial expressions and gestures. Navel focuses on cognitive and emotional care activities, providing relief in these areas (Toussaint et al., 2023). A pilot project with Navel is being conducted in two nursing homes of the Evangelische Heimstiftung, a diaconal and non-profit care company in Southern Germany, where Navel is in use since the end of 2023. The acceptance and effects of its use on residents and staff are being evaluated by the intern Institute of Care and Aging. Method: Before the robot was introduced into the nursing homes, we conducted a preliminary study. At this time, the staff were informed about the deployment of the social robot in their facility, but they had not yet experienced or tested it in practice. The aim of the study was to explore technology readiness of the staff, attitudes towards the use of a social robot in care as well as hopes, expectations and concerns regarding Navel. For this purpose, a questionnaire survey was carried out with professional caregivers and daytime companions (n=51). The questionnaire included a brief standardized measure of technology commitment (Neyer et al, 2012). To evaluate the attitudes towards social robots a new scale was developed based on a workshop with employees. In addition, expert interviews were conducted with managers (n=6) to explore expectations, opportunities and challenges created by social robots. These interviews also aimed to identify crucial functionalities of a social robot and situations in which it can be useful in a nursing home. Results and Discussion: The results show a general openness and positive expectations among both managers and employees. More than half of the employees are open to new technical developments; 49% believe that social robots will become increasingly important in care. However, 82% do not think that social robots offer a solution to the shortage of professional care givers. The added value of a social robot is seen more in the area of fun and entertainment for the residents and less in terms of supporting employees. The managers see opportunities and possible applications in the context of individual and group activities. They identified characteristics and functions that the robot should have including being empathetic, singing, and providing information. They also reflected on the fears, challenges and limitations of using social robotics with regard to certain situations and target groups (e.g. people with dementia). ┬á References Neyer, F. J., Felber, J., & Gebhardt, C. (2012). Entwicklung und Validierung einer Kurzskala zur Erfassung von Technikbereitschaft. Diagnostica, 58(2), 87ΓÇô99. https://doi.org/10.1026/0012-1924/a000067 Ohneberg, C., St├╢bich, N., Warmbein, A., Rathgeber, I., MehlerΓÇæKlamt, A.-C., Fischer, U., Eberl, I. (2023). Assistive robotic systems in nursing care: a scoping review. BMC Nursing 22(72). https://doi.org/10.1186/s12912-023-01230-y Silvera-Tawil, D. (2024). Robotics in Healthcare: A Survey. SN Computer Science, 5(189) Toussaint, C., Schwarz, P.T., Petermann, M. (2023). Navel ΓÇô a social robot with verbal┬á┬á┬á┬á┬á┬á┬á┬á┬á┬á┬á┬á┬á┬á┬á┬á┬á┬á┬á┬á┬á┬á┬á┬á┬á┬á┬á┬á┬á┬á┬á┬á┬á┬á┬á┬á┬á┬á┬á┬á┬á┬á ┬á┬á┬á┬á┬á┬á┬á┬á┬á┬á┬á┬á┬á┬á┬á┬á┬á┬á┬á┬á┬á┬á┬á┬á┬á┬á┬á┬á┬á┬á┬á┬á┬á┬á┬á┬á┬á┬á┬á┬á┬á┬á┬á┬á┬á┬áand nonverbal communication skills. Extended Abstracts of the 2023 CHI Conference on Human Factors in Computing Systems. ┬á Keywords: Social Robot, Artificial Intelligence, Long-term Care, Nursing Home, Caregivers Affiliation: Institut f├╝r Pflege und Alter, Evangelische Heimstiftung GmbH, Stuttgart, Germany Corresponding Author Email: judith.schoch@ev-heimstiftung.de
Towards an AI-driven selfmanagement app for patients with hip and knee osteoarthritis: development of a theory-driven model as a first step
Purpose: Osteoarthritis (OA) of the hip and knee is among the most common and rapidly increasing chronic diseases. Guidelines recommend a stepped-care strategy: starting with nonsurgical treatments including self-care, education and behavioral and rehabilitative components prior to more expensive joint-replacement. However, there is an underuse of self-care, exercises and weight management and an overuse of surgical treatments1. The SMART app aims to empower people throughout their entire OA journey by using self-administered data and AI-algorithms to provide just-in-time guidance in optimal selfmanagement. Guidance that can be provided by the app consist of selfcare modules on physical activity, weight management or sleep, general information on OA, information on relevant (healthcare) professionals or positive reinforcement. To determine at what time people could benefit from which type of guidance, the (potential) determinants of a worsening in pain, physical functioning and participation were determined with a systematic review2 and a focus group with experts and interviews with patients. As a first step in the development of the AI-algorithm in the SMART app, this study aimed to develop a theory-driven model to predict at what time people might benefit from what guidance. Method: For this developmental study, researchers with a background in the medical field and computer science worked closely together. First, (potential) determinants were screened on feasibility for self-measurement via an app or wearable and listed: age, gender, educational level, alcohol usage, pain medication usage, duration of complaints, BMI, comorbidities, tiredness, support, pain, stiffness, job satisfaction, coping, self-efficacy, anxiety and depression, kinesiophobia and physical functioning. Second, for each determinant the most appropriate measurement instrument was chosen. Third, in a 2-hour pressure cooker with 10 researchers, cut-off points for each measurement instrument were determined using available interpretations and minimal clinical important difference scores. Thereafter, the authors intensively discussed how the combination of determinants that should led to guidance in general. Lastly, based on clinical expertise, criteria were formulated to decide which type of guidance would be the most optimal guidance for which patient. All these decisions together were summarized in a rule-based model. Results and discussion: Input from literature, patients, clinical experts and researchers resulted in theory-based model with rules that describe which patient, at what time (i.e. for what changes in which number of determinants) receives which guidance in the SMART app. Characteristics of the individual patient at baseline will be taken in account to assure that more complex patients will receive their guidance earlier than less complex people. Also, threshold scores for the main OA symptoms were determined, to assure that extreme scores directly result in guidance. Since a lot of choices in this study had to be made based on consensus instead of available theory, this study stresses the need for data-driven decision models. The theory-based model will now be integrated in the SMART-app and used in the SMART e-cOAch cohort to collect continuous data in a large group of patients (n=600) over a period of 1 year. In the next years, a data-driven model will be created based on the cohort data, compared and possibly combined with the theory-based model and, finally, evaluated in an RCT study to compare AI-supported selfmanagement with usual care in patients with hip or knee OA. ┬á┬á┬á ┬á References: 1. ┬á┬á┬á┬á┬á┬á┬á┬á┬á┬á┬á van Zaanen Y, Hoorntje A, Koenraadt KLM, van Bodegom-Vos L, Kerkhoffs GMMJ, Waterval-Witjes S, et al. Non-surgical treatment before hip and knee arthroplasty remains underutilized with low satisfaction regarding performance of work, sports, and leisure activities. Acta Orthop. 2020;91(6):717ΓÇô23. ┬á 2.┬á┬á┬á┬á┬á┬á┬á┬á┬á B. Cijs, R. Stekelenburg, C Veenhof, J. Knoop, T. Boymans, M. de Rooij, C. Kloek. Prognostic factors on changes in pain, physical functioning and participation in patents with hip and/or knee OA: a systematic review. [under review] 2024 ┬á ┬á Keywords: Digital health, artificial intelligence, osteoarthritis, selfmanagement Main affiliation and country of first author: HU University of applied sciences Utrecht, Research Group Innovation of Human Movement Care, The Netherlands Corresponding Author Email: corelien.kloek@hu.nl; ┬á ┬á
Designing of Digital Tool for Hospital-to-Home Transitional Care for Older Adults with Chronic Obstructive Pulmonary Disease
Purpose: Repeated hospitalization in elderly patients with chronic diseases is a risk factor for deteriorated quality of life, functional decline, and mortality. Support for transitional care of hospitalized elderly patients is essential to prevent unnecessary readmission. Transitional care services (TCS) are comprehensive programs designed to enhance the self-care competency of patients discharged from hospitals and help them recover and resume normal daily routines (Naylor et al., 2011). TCS requires comprehensive and systematic activities that identify risk factors for readmission through the initial screening of patients upon admission and provides plans for healthcare, education, and post-discharge care, as well as connection to community resources (Naylor & Sochalski, 2010). TCS is currently not covered by insurance in South Korea but is being implemented as a pilot project at 17 regional and 35 local accountable care hospitals nationwide (Ministry of Health and Welfare, 2018). The key to the success of these programs lies in the expertise and patient management skills of the coordinators in charge of TCS, which depend on the competencies of individual coordinators. TCS can be widely disseminated across multiple hospitals by developing digital tools for patient screening upon admission, items requiring personalized care, and customized services for discharged patient care. This study aimed to develop a digital tool that enabled coordinators to effectively manage TCS in elderly patients hospitalized with Chronic Obstructive Pulmonary Disease (COPD) and make decisions based on necessary information. Method: First, a TCS protocol (screening and establishing care plans for hospitalized COPD patients, providing self-care education, offering post-discharge telephone monitoring, and home visits) was developed to improve the self-care competency of hospitalized elderly patients with COPD (Jo et al., 2023). Second, TCS performance measurement indicators were derived in terms of effectiveness (e.g., readmission rates, emergency room visits), patient safety (e.g., adverse drug events, falls), and patient-centeredness (e.g., patient experience evaluation, caregiving burden) using the Organization for Economic Co-operation and DevelopmentΓÇÖs Health Care Quality and Outcomes Indicators and the UK National Health ServiceΓÇÖs Outcomes Framework (Kim et al., 2023). Third, a digital tool was developed to provide customized TCS for COPD patients that reflected the TCS protocol and performance indicators developed for elderly COPD patients. Results and Discussion: Health indicators for COPD patients screened using a digital tool were linked to care plan forms for coordinators to identify patientsΓÇÖ health risk factors and formulate intervention plans. Moreover, coordinators could connect to screening information when conducting telephone monitoring of discharged patients so that they could provide care for the discharged patientΓÇÖs health status and efficiently provide education. This digital tool is expected to help prevent unnecessary readmission by reducing the workload of coordinators and continuously managing the health status of patients with COPD.
Analyzing Energy Consumption Patterns for Solitary Death in Single-Person Elderly Households
Purpose Solitary death (kodokushi) has emerged as a significant social issue in South Korea, mirroring its prominence in Japan[1]. In South Korea, "solitary death" is legally defined as the passing of individuals who lived in a state of social isolation, disconnected from family members, relatives, and others, and who succumbed to factors such as suicide or illness. In particular, in Seoul, the risk of solitary death is increasing due to the rise in single-person households and the growing number of socially isolated elderly individuals. Preventing solitary death requires extensive efforts from social welfare workers, yet there is a shortage of both budget and personnel. To address this issue, Seoul is utilizing IoT technology to monitor the well-being of socially isolated households, aiming to provide timely assistance and support. However, the monitoring technology utilizing IoT is currently limited to early detection within three days after the occurrence of death. Therefore, there is a need for technology that utilizes artificial intelligence to detect crisis signals before death occurs. In this study, we aim to analyze changes in daily life patterns before death by using time-series data of power consumption and luminosity obtained from smart plugs installed in actual single-person households where solitary deaths occurred. Method The Seoul Metropolitan Government, through the Seoul Welfare Foundation, monitors 3,945 households identified as at risk of solitary death using smart plugs. The study analyzed changes in daily life patterns using the power consumption and luminosity data stored at 10-minute intervals for approximately a month prior to the deaths of 16 solitary individuals and 244 monitored subjects until February 2024. Figure 2 is a flowchart of the study. We analyzed the daily life patterns through the average daily power usage and correlation coefficient over a month. Additionally, we aimed to distinguish between normal and abnormal situations using DBSCAN, an unsupervised learning method. Results and Discussion A total of 260 households at risk of solitary death were analyzed, with the majority of the 16 solitary death victims being men in their 60s. After these individuals passed away alone at home, with no activity recorded by the IoT sensors for 2 to 3 days, welfare checks were conducted and their deaths confirmed. There were more male users than female. IoT sensors were installed on the power supply of TVs in 40.7% of cases. Most users are in their 60s, and the majority of early death detection cases are also in this age group. Figure 3 visualizes the daily power consumption measured by IoT sensors in the month preceding the solitary deaths, with average values displayed, and clustering results using DBSCAN. From the usage patterns observed, it appears that connected devices were predominantly used between 6 PM and 9 PM. In this study, the activity patterns preceding the deaths of individuals who died alone at home were examined. The analysis of daily life patterns before death provides valuable insights into early warning signs and crisis signals, enabling timely intervention and support from healthcare professionals and social welfare workers.
Contextbot: Integration of Smart Home, Robotics and Smartwatches
Purpose: This presentation aims to analyze the current status and future prospects of technological support in residential environments, focusing on stationary systems, wearables, and smartwatches presenting the results of the Contexbot research project. The hypothesis is that integrating advanced technologies in homes can significantly enhance the quality of life and health outcomes, particularly for the elderly people. Method: A review and analysis of current technological advancements and their applications in living spaces were conducted, examining stationary systems, smart homes, wearables, and smartwatches. The emphasis was on their role in health monitoring and support for independent living. Data have been collected from various studies, technological assessments, and case studies. Prototypical applications with smartwatches and robots were designed and partially realized with in the Contextbot project. Results and Discussion: Technological integration in homes has shown significant potential in improving health and quality of life. Smart homes equipped with sensors and actuators can automate and optimize functions such as lighting, heating, and security, enhancing comfort and safety. Wearables and smartwatches offer continuous health monitoring capabilities, detecting vital parameters like heart rate, blood oxygen levels, and sleep patterns, providing early warnings for health issues. These devices are essential in health monitoring. They offer functionalities such as heart rate monitoring, sleep pattern analysis, detection of ADLs (activities of daily living, e.g., drinking), and EDLs (events of daily living, e.g., fall detection). They play a crucial role in preventing health issues through early detection and provide personalized health advice based on the collected data. In combination with care robots and in-house localization, these technologies allow elderly to live longer in their own homes and quickly receive help in emergencies. The Contextbot Project exemplifies the future of technological support in residential settings (see Figure 1). By integrating service robots, wearables, and smart home technologies, Contextbot offers context-aware assistance, enhancing user-friendliness, efficiency, and quality of care. It aims to increase user safety and independence by identifying and responding to critical events like falls or abnormal vital signs. Key Findings of Contextbot: 1. Smart Home Technologies: Provide automation and remote control capabilities using care robots and localization detection and communication with wearables. 2. Wearables and Smartwatches: Monitor health metrics and physical activities, detecting falls, monitoring heart rates, ADLs, and EDLs. 3. Overall advanced monitoring and assistance, particularly for elderly individuals, allow them to live independently while ensuring their safety and well-being.
Assessing VR technology adoption and use among mid-life and older adults
Purpose The Covid-19 pandemic is said to have been a catalyst for virtual reality (VR) adoption (Osterland, 2020). Older adults in the U.S. were among those who adopted technology at an unprecedented rate during the pandemic. Currently, there is research to suggest that VR may have significant social, cognitive, and health benefits for older adults in particular (Huang, 2020; Ball, Huang, & Francis, 2021) but there is still little information on older adultsΓÇÖ adoption and use of VR.┬á Method We conducted a three-wave cross-sectional survey using Amazon Mechanical Turk during Fall 2020, Summer 2021, and Fall 2022. From a total of 902 usable responses across all age groups, the analysis specifically focused on 56 older adults aged 55 and above, spanning the three years. The survey content centered on the acceptance and adoption of VR technology, alongside demographic data. Items were based on Lee et al. (2019), measuring perceived ease of using VR, perceived usefulness of VR, social interactivity, and actual usage. Each construct was assessed using a four-item scale, with responses ranging from 1 (strongly disagree) to 7 (strongly agree). Results and Discussion Our analysis of VR technology acceptance among older adults over three years reveals evolving perceptions and usage patterns. Perceived ease of use showed improvement initially, peaking in 2021, and then declining in 2022, yet it was still better than the baseline year, 2020. This trend suggests that users are becoming more comfortable with VR, though this comfort level may be plateauing. Perceived usefulness, after a dip in 2021, partially rebounded in 2022, indicating variable recognition of VR's benefits among users. Social interactivity experienced a notable increase in 2021 but fell back in 2022, still maintaining higher levels than in 2020, pointing to changing dynamics in how users interact within VR environments. Meanwhile, actual usage of VR, despite a minor increase in 2021, significantly declined in 2022, implying a drop in engagement or satisfaction. The consistent reduction in standard deviations across these metrics in 2022 suggests that user responses are becoming more homogeneous over time. These findings underscore the importance of continuous improvement and adaptation in VR systems to sustain and enhance user engagement, especially among older adults.
Gerontechnology: 30+ Years of Research and Application - Where Do We Stand Today?
Purpose ┬á What does a period of more than 30 years typically mean in interdisciplinary research concerned with human aging? Starting with this general question, this Round Table will make an effort to review the achievements and gaps in gerontechnology, a research area now more than 30 years of age, if we take (pragmatically) the volume ΓÇ£GerontechnologyΓÇ¥, edited by Bouma & Graafmans (1992), as a major starting point. The International Association for Gerontechnology was founded soon after in 1996. New challenges today are the climate crisis and wars and the associated challenges for ageing societies Method We suggest to approach the review effort in several rounds: (1) Current importance of gerontechnology in the context of existing research on aging as an interdisciplinary science; (2) conceptual developments and robustness of theoretical foundations; (3) research standards and comparability in designs, approaches, and measurements used; (4) empirical highlights that may (or have already) gain(ed) a citation classic status; (5) gaps and future investments needed. To discuss these issues, we have gathered two representatives from the Center for Research and Education on Aging and Technology Enhancement (CREATE), which was founded in 1999 (Charness, Rogers), O. von Stryk, among others co-founder and board member of the German Rescue Robotics Center, among 25 most influential computer scientists in the world in 2021 (von Stryck), the President-Elect of the German Society of Gerontology and Geriatrics (Wahl), and an early stage scholar from the University of Applied Sciences, Kempten, Germany (Jokisch). Barbara Klein will take the role of our discussions moderator. ┬á Results and Discussion. We hope to eventually publish an extended version of discussion outcomes in the journal ΓÇ£GerontechnologyΓÇ¥. We look forward to an interactive discussion with the audience to garner their perspectives on these issues. ┬á References --- Bouma, H., & Graafmans, J. (1992).┬á Gerontechnology.┬á IOS Press. ┬á
Emotional Living Spaces - The significance of Emotional Spaces for dwelling and well-being
Purpose Demographic changes will have a profound impact on the healthcare system, housing and infrastructure requirements and social structures (European Union, 2023). According to forecasts, the number of people in need of care in Germany could rise to around 6.78 million by 2055 (Statistisches Bundesamt, 2023). This, together with the low birth rate (VDEK, 2023) will increase the need for new inclusive concepts and barrier-free systems. This project looks at architecture from a different perspective. In this context dwelling is an important issue and a basic human necessity (Hahn, 2008). This applies to the physical requirements of the built environment, but also to its emotional significance. The meaning of dwelling evolves over a person's lifetime and reflects their personal dwelling history. It is shaped by so-called residential breaks, such as relocation or displacement. Dwelling is a process of appropriation of space. The home serves as a shelter, a place for living and acting. It allows relationships to develop and provides a stage for everyday life (G├╝nther-Luckow, 2017). In addition to its functional purpose, dwelling offers a place of identification and self-realization. Dwelling therefore influences the quality of life and human well-being (Hannemann, 2014). The acceptance of a living environment, e.g. in a care facility, depends also on the existing atmosphere, associations and influences resulting from the biography of the residents. Atmosphere should be understood as a sensory perception that is shaped by the sentiment in the spatial coherence. It has an impact on the well-being and social behavior. The reduction of negative feelings and the promotion of positive emotions are important. To achieve this, the causes of stress and anxiety, as well as factors that minimize stress, must be identified and understood (Brichetti, 2019). The research project Emotional Living Spaces (EmotionaLS) investigates the connections between emotions, space and biography. An Emotional Space is an individual phenomenon. It is not a physically perceptible place, but can become bodily observable. Emotional Spaces are characterized by different physical categories such as light, atmosphere, materials, and sensual categories such as smells, sounds and relationships. Important components are affective phenomena such as emotions, feelings and sensations. Method The project is concerned with the study of Emotional Spaces. To begin with, a comprehensive literature review was conducted on topics such as spaces, dwelling, biography, emotions and emotion recognition. Emotional Spaces were identified through extensive interviews (G├╝nther-L├╝ckow, 2017), which is time-consuming. For this a new tool is being developed in order to detect Emotional Spaces in the simplest, quickest and most cost-effective way. This methodology will combine familiar and new working methods. The next steps are the testing of new methods to make the individual Emotional Space visible. Results and Discussion The main challenge is to address the question of how Emotional Spaces of people with advanced dementia, or without the ability to communicate verbally, can be revealed and positively inserted into spatial situations. A new concept is being sought which could be implemented in existing care approaches such as residential care, palliative care and advance directives. References Brichetti, K. (2019). Heilsame Architektur. Raumqualit├ñten erleben, verstehen und entwerfen. Bielefeld, transcript. European Union (Eds.) (2023). The Impact of Demographic Change in a changing environment. https://www.bundestag.de/gg/grundrechte G├╝nther-L├╝ckow, C. (2017). Gef├╝hltes Wohnen. Die Bedeutung der Wohnbiografie f├╝r ein ΓÇ£gutes und gelingendesΓÇ¥ Wohnen im Alter. Dissertation. Dresden, Technische Universit├ñt Dresden. https://nbn-resolving.org/urn:nbn:de:bsz:14-qucosa-230701┬á Hahn, A. (2008). Architekturtheorie. Wohnen, Entwerfen, Bauen. Konstanz/Stuttgart, UVK; UTB GmbH. Hannemann, C. (2014). Zum Wandel des Wohnens. Politik und Zeitgeschichte, 12.05.2014, 36-43. https://www.bpb.de/shop/zeitschriften/apuz/183450/zum-wandel-des-wohnens/ Statistisches Bundesamt (2023). Prognostizierte Anzahl von Pflegebed├╝rftigen in Deutschland nach Bundesl├ñndern im Zeitraum der Jahre 2021 bis 2055 (in 1.000). Statista GmbH. https://de.statista.com/statistik/daten/studie/167654/umfrage/anzahl-pflegebeduerftiger-nach-bundesland-2007-und-2030/#statisticContainer Vdek (2023). Prognostizierte Bev├╢lkerungsentwicklung in Deutschland nach Altersgruppen in den Jahren von 2013 bis 2070 (in Millionen). Statista GmbH. https://de.statista.com/statistik/daten/studie/702412/umfrage/demographie-bevoelkerungsentwicklung-in-deutschland-nach-altersgruppen/
Senior involvement to validate criteria and metrics for assessing the quality of urban space
Purpose The research is a continuation of studies carried out in 2020 at the Faculty of Architecture at Poznan University of Technology in the field of creating architectural spaces that support the ageing process. Assessing the urban quality of life (QoL) and the concept of age-friendly cities is not a new idea, but it requires further development to address new challenges and sociodemographic conditions (Ptak-Wojciechowska et al., 2022). Many publications devoted to the QoL assessment and the role of the built environment have been already published. However, the aspect of the quality of spatial structure concerning the health and well-being of ageing societies has been underestimated. Previous research suggests that there is currently no assessment framework available to measure the spatial structure of a city on a neighbourhood level and its impact on the QoL of older individuals in a comprehensive manner (Gawlak et al., 2021; Ptak-Wojciechowska et al., 2021). Moreover, to the best of the authorsΓÇÖ knowledge, there is no study where architects and seniors are involved as groups of decision-makers in the process of formulating criteria and metrics for a city's spatial structure assessment. The following research questions were formulated: In what way the proposed criteria, sub-criteria and metrics could be validated? What does the validated questionnaire for seniors, measuring their perception of a city's spatial structure, look like? Which aspects of the spatial structure of the city are significant for seniors? Method This study aims to validate the criteria (namely Accessibility of urban area for the ageing population, Age-friendliness of the urban function, Age-friendliness of the urban form, Environmental friendliness of urban area, Urban area legibility for older inhabitants, Adaptability for seniors ageing in place, Affordability of housing for older people, Quality of multisensory experience of the built environment), sub-criteria and metrics for assessing the quality of architectural and urban space, formulated as part of the research for the doctoral thesis (Ptak-Wojciechowska, 2023). The survey is carried out in the form of a workshop among 20 seniors, assisted by the students from the Faculty of Architecture. The first phase of our method includes proposing metrics (for assessing the quality of architectural and urban spaces) by describing them on sticky notes and attaching them to a 100x70 cm board within a specific evaluation sub-criterion. The second phase is the selection of the 3 most important criteria and sub-criteria for the final prioritisation by elderly participants. The last phase is the improvement of the evaluation framework and questionnaire for measuring seniors' perceptions by researchers, based on added/ reformulated sub-criteria and metrics. Results and Discussion The new framework is more precise and pragmatic from the point of view of its use in creating a QoL in the city and shall be used directly by seniors to assess the friendliness of their neighbourhood. Additionally, a method corresponds to the scale of the city and its neighbourhoods. It takes into account the diverse structure of cities and can be used to evaluate smaller areas. The next phase will be to validate the evaluation framework with experts, architects and urban planners, and conduct a questionnaire survey among the elderly.
Identification of universal design elements for the development of inclusive kitchens
Purpose Social developments such as demographic change and the increasing deficit of healthcare professionals (Bundesministerium f├╝r Wirtschaft und Klimaschutz, 2023), together with the desire of many people to live in their own familiar home (Bundesministerium f├╝r Bildung und Forschung, 2023), are fuelling interest in designing the physical environment, and in particular kitchens as an important place for self-care, in such a way that a self-determined life is possible. The aim of this research is to identify inclusive design elements for kitchens based on the analysis of humans, kitchen occupations and the kitchen as an environment. Method Based on a systematic literature research on existing kitchen design solutions that are likely to be inclusive and the criteria derived from them, as well as the definition of the construct of "inclusive kitchen design" (Figure 1), a questionnaire was developed for which ΓÇÿinclusive kitchen design featuresΓÇÖ were operationalised. Finally, an empirical cross-sectional study was conducted using the developed quantitative online questionnaire based on the Kano method (Sauerwein, 2000). The survey analysed (customer) satisfaction with 52 selected kitchen design features and the composition of the sample. Based on the assumption that the positive effect on (customer) satisfaction in a heterogeneous sample is an indicator of 'inclusivity', kitchen design features were considered 'inclusive' if they were rated as 'positive' to 'neutral' in terms of (customer) satisfaction by 100% of the heterogeneous sample in terms of age, gender identity and disability. Using the terminology of the Kano method (Sauerwein, 2000, pp. 28ΓÇô29), the kitchen design feature must be rated by all respondents as ΓÇ£AttractiveΓÇ¥, ΓÇ£One-dimensionalΓÇ¥, ΓÇ£Must-beΓÇ¥ or ΓÇ£IndifferentΓÇ¥ in their answers to the questionnaire to count as inclusive. This means that for none of the sample does the respective feature represent as ΓÇ£ReverseΓÇ¥ or ΓÇ£QuestionableΓÇ¥ according to the criteria of the Kano method. Results and discussion 198 people between the ages of 18 and 88 took part in the study. 23.23% of respondents stated that they had one or more disabilities and/or chronic illnesses (these were physical, sensory, cognitive and mental), 152 (76.76%) stated that they had none. In scope of this study, four kitchen design features met the predefined criteria for an inclusive kitchen design feature and were successfully identified. These were non-slip floor coverings, work surfaces next to hobs and sinks and the quietest possible operating noises from appliances. In addition, it was found that the non-disabled respondents rated only five kitchen design features as positive to neutral in terms of satisfaction, whereas the disabled respondents rated 18 kitchen design features as completely positive to neutral. The results of this study show that the assumption that 'barrier-free' kitchen designs are automatically inclusive should be viewed with caution. Furthermore, it is recommended to conduct an experimental study with a kitchen prototype based on these results. With its holistic approach (Figure 1) and its heterogeneous sample, this research contributes to the development of inclusive kitchens and can help to advance the paradigm shift from the segregating status quo (accessible and non-accessible kitchen design) to inclusive kitchen design.
Influencing Bacharach's quality of life: Inclusive sustainable measures for Bundesgartenschau 2029 integration and enhancement
Purpose The Bundesgartenschau (BUGA) is a national horticultural show held biennially in Germany with the aim of promoting sustainable urban development. In 2029, the BUGA will take place in the Upper Middle Rhine Valley, which covers an area of about 65 km between Koblenz and R├╝desheim. The city of Bacharach forms one of the main locations during this event (BUGA 2029, 2019). Although Bacharach's historic town center is a major tourist attraction, there are several accessibility issues. Regarding the demographic change, an event such as the BUGA needs to address these issues with inclusive constructional measures. As part of a university project, interdisciplinary concepts were developed by us, students of architecture, computer science and social work. Method An examination of the site's accessibility revealed significant deficiencies, such as access to buildings or cobblestone paths. This underlined the need to improve accessibility in Bacharach. We carried out a survey addressing the citizens and tourists of Bacharach (Team BUGA 2029, 2023). The goal of the survey was to increase the participation of citizens and visitors and to capture individual perceptions of the city. The survey allowed for a demand-oriented planning of concepts which can improve BachrachΓÇÖs quality of life. This approach highlights the importance of citizen participation for sustainable and inclusive urban development in the context of major events such as the BUGA 2029. Results and Discussion Based on the identified accessibility issues and the results of the survey, we have developed 11 concepts designed to help tourists and residents navigate and improve access to existing points of interests (Figure 1). The concepts include a guidance system (physical accessible information and smartphone app), the main station, the BUGA entrance, a sports area, a playground, the beach, a campsite as well as the city center and monuments such as the Werner Chapel and Stahleck castle. They include design elements (following the two-senses principle) such as accessible information desks, elements regarding orientation, fully accessible urban space furniture and securely designed pedestrian areas in the city area. The concepts were constrained by the hillside location of Bacharach and by historic preservation. These represent recommendations for cities with similar issues that want to improve accessibility in public spaces in accordance with the DIN 18040 and the applicable law.
Age-related normal limits for visual acuity and contrast sensitivity in different lighting conditions
Purpose: Reduced (low) light levels cause significant changes in visual performance ┬á┬á(Barbur &amp; Stockman, 2010)"}" id="1517657165">(Barbur & Stockman, 2010) which become increasingly noticeable as one ages and also in early-stage, retinal diseases ┬á┬á(Owsley et al., 2016; Puell et al., 2012)"}" id="317699801">(Owsley et al., 2016; Puell et al., 2012). Visual acuity measurements are common in clinical practice, however may not predict accurately visual performance in daily life. Contrast sensitivity is a better predictor of loss of spatial vision when the task involves detection of small spatial details in low contrast, but full, contrast sensitivity tests are rarely used in a clinical setting ┬á(Xiong et al., 2020). The ability to identify individuals with reduced functional vision during the early stages of disease, particularly when loss of spatial vision is more prominent in the mesopic range, may provide the opportunity to equip them with assistive or gerontechnological devices in a more timely manner.┬á As a result, it is of interest to establish normal age-limits for monocular and binocular vision under photopic (daylight) and mesopic (low-light level) conditions so that we can reliably identify individuals with functional vision decline. ┬áMethods: ┬áVisual Acuity (VA) and Functional Contrast Sensitivity (FCS) were measured in two contrast polarities using the Acuity-Plus (AP) test. Mean and ┬▒2.5╧â limits were calculated within each 5-year subgroup for all participants meeting normal sight criteria. Mean values and upper and lower threshold limits for VA and FCS as a function of age were established. Results and Discussions: Of the 382 participants, 285 passed the selection criteria for normal ageing. For each of the 16 stimulus conditions, age-related normal limits were calculated. Mean photopic VA and FCS thresholds and overall variability remain largely invariant below 50 years of age. In mesopic conditions, VA and FCS start with much larger mean values, and both thresholds and inter-subject variability increase more rapidly above 30 years. Age-limits of vision for monocular and binocular viewing under photopic and mesopic conditions were established using a single test. The results can be used to identify subjects that fall outside the normal threshold limits for visual acuity and contrast sensitivity. Additionally, they demonstrate the importance of awareness of the decline in visual performance with ageing. The decline is more pronounced in lower light levels. Therefore, daily activities involving both spatial vision and colour discrimination may be more affected by vision under low-lighting conditions, particularly in seniors. In daily life activities, binocular vision performance is of interest, and therefore, binocular summation in relation to age. Furthermore, monocular normal limits of visual acuity and contrast sensitivity are clinically useful for early detection of retinal abnormalities.┬á
Re-purposing voice assistant technology for use by people living with dementia and their carers
Purpose The use of voice assistants (e.g., Amazon Alexa, Google Home) is being widely advocated as part of supporting people living with dementia at home. The development of this technology is largely driven by industry, and there is little research to determine how people living with dementia, family carers and professionals can use voice assistants, and understand the challenges that this technology presents. In the UK there is an impending digital switch away from analogue systems that is poised to take place by 2025, hence it is essential that alternative technologies are adopted by mainstream health and care services and that acceptance and utilization is high. This paper presents the findings from two studies: Study 1 - a qualitative enquiry aiming to identify the views and barriers of using voice assistants by people living with dementia, family carers and professionals; Study 2 - a pilot case study evaluating a prototype that addresses barriers identified during study 1, entitled IntraVox. Based on processing of smart home sensor data, IntraVox uses a personalised human voice to send prompts and reminders to end-users to conduct daily life activities and to activate smart home processes using voice assistants. Method Study 1 ΓÇô a Community of Practise (CoP members) comprised of 24 membersΓÇötwo people with dementia (1 = F, 85 years; 1 = M, 94 years; both unspecified types of dementia as reported by their family carers), three family carers (live-in daughter of the female participant; live-in daughter and son-in-law of the male participant), four individuals from carer organisations, five Local Authority adult social care professionals, two health integration leads and commissioners, six National Health Service (NHS) older people's service managers, two NHS technology managers focusing on providing digital health care solutions to improve patient care were recruited. Seven group interviews were conducted. We firstly conducted three group interviews with a mix of health, social care, technologist professionals, and carer organisation CoP members, followed by two group interviews comprised of the people with dementia and their family carers. Participants were asked about their personal experience and views of smart technology (e.g., purposes, barriers), with a focus on voice assistants. Following analysis of this data, a technological solution, IntraVox (Cook et al, 2020), was developed to address barriers to use of voice assistants. In keeping with co-production methods a further two on-line interviews, were conducted with nine CoP members to explore their views of the initial IntraVox prototype. Design changes were subsequently made, such as type of voice used to activate the voice assistant. Study 2 ΓÇô┬áwas a pilot study of IntraVox with one person with severe dementia and their family carer. These individuals were identified through discussion with a Local Authority provider that was aware that, although the client was using telecare and smart products, problems persisted. The client was a woman with advanced dementia, who lived alone at home. Her son provided care and stayed with her during evenings and mornings. Several carers (city council employees) visited the mother twice daily to prepare meals and provide medication prompts. The son gave his informed consent to take part in the study and he also acted as a consultee for the involvement of his mother who lacked the capacity to consent. As this was the first deployment of a novel technology in these circumstances the service provider supported the use of the technology, but the use was restricted to one client and their family carer. The pilot study had two phases of data collection. In┬áPhase 1, the pre-deployment of IntraVox, a semi-structured interview was carried out with the son to determine his familiarity with smart home devices, key issues in his caring role and how IntraVox could provide an intervention. Through this interview, it was identified that IntraVox should provide a prompt to alter the mothers behaviour when entering a food storage area. Following this initial interview, IntraVox was installed in the mother's home for use over 7 days. In┬áPhase 2, a post-study semi-structured interview was conducted to explore the son's views and experiences of IntraVox, and his views of the impact that IntraVox had on his mother's situation. Results and Discussion The results of these studies indicate that family carers and professionals use voice assistants in their caring role for home automation, skills maintenance and development, prompts and reminders, behaviour and environment monitoring, and for leisure and social interaction support. The findings also show that family carers and professionals have specific challenges that need to be overcome for them to realise the benefits that may be gained through the use of voice assistants within technology enabled care. The initial study also supported the co-design of a novel solution, IntraVox The pilot case study provided a useful demonstration that interoperability can be achieved to enable exchanges between IntraVox and voice assistants, with the aim of providing customised and personalised technological solutions that address some of the barriers that people with dementia and their carers face in the use of voice assitant technology.
Sleep and indoor environmental quality in homes of people with dementia and informal caregivers: a pilot study
Purpose Worldwide the number of people with dementia is increasing. Most people living with dementia live at home with the support of informal care, provided by family friends, neighbours, and volunteers (Greenwood & Smith, 2019). Most people with dementia eventually experience difficulties with sleep (Petrovsky et al., 2018). This can express itself in different ways, e.g. more naps during the day, difficulties falling asleep, and waking up at night or too early. Problems with sleeping can significantly impact the quality of life and that of their informal caregiver and may increase the burden of care (Byun et al., 2016). It is known that the indoor air quality (IAQ) may influence the quality of sleep of healthy (older) people (Str├╕mΓÇÉTejsen et al., 2016; Van der Veen et al., 2021). There is less known about the effect of IAQ, and other indoor environmental parameters, on the sleep quality of people with dementia. A pilot study was conducted to get more knowledge about the effect of the indoor environmental quality on the sleep quality of people with dementia and their informal caregiver. Method This qualitative study was part of a field study is performed. The study participants were individuals with dementia living at home and their informal caregivers (if available). Two households consisting of two persons with dementia and one informal caregivers participated in the pilot. The study was conducted for a period of three weeks in which measurements were performed. Indoor environmental quality conditions in the bedrooms of the dementia persons were monitored, including light intensity, temperature, humidity and IAQ indicators such as CO2, particulate matter, and total volatile organic compounds (TVOC) concentrations. Measurements were performed using AEther (Hogeschool Utrecht, n.d.) and AirTeq sensors (Zheng et al., 2022). Simultaneously, sleep patterns and sleep quality of the dementia persons and their caregivers were monitored, for this the Qura Ring Gen 3 (Svensson et al., 2024) was employed and collected detailed sleep metrics, including total sleep time, light sleep, deep sleep, REM sleep, wake after sleep onset, sleep efficiency, and sleep onset latency. Additionally, the sleep quality of the informal caregivers was assessed using a modified questionnaire. This tool combined 15 true/false questions of the Groninger Sleep Quality Scale (Mulder et al., 1980) and four questions from the Morning-questionnaire (Mishra et al., 2018), to rate the depth of sleep and restfulness during the night. Results and Discussion The study wants to identify potential correlations between indoor environmental sleeping conditions and the sleep quality of people with dementia and their informal caregivers. The findings propose to raise the awareness of professionals and caregivers about the effect of the indoor environment on dementia and its symptoms. In addition on the results inform potential improvements in the sleeping environment to enhance the well-being of people with dementia which also aim to reduce the burden of care of informal caregivers.
Usability of Remote Digital Interventions: An Analysis from the Perspective of Caregivers of Elderly Individuals with Dementia
Purpose: Identifying the perceptions of caregivers of elderly people regarding the safety and usability of mobile applications, is a factor for improvements in remote digital interventions in order to increase adherence to use. Highlighted the insufficiency of research on online cognitive training for the elderly with dementia, which can be supported by their caregivers, taught through digital remote devices, the objective of this study is to analyze the usability of remote interventions monitored by caregivers of elderly people, aiming at a user-centered experience. Methods: This investigation is part of a pilot feasibility study, with a quantitative-qualitative approach composed of elderly people with dementia and their caregivers, participants of a Gerontology Outpatient Clinic of the University Hospital of S├úo Carlos ΓÇô SP, Brazil. The study was conducted during the period of recess in outpatient activities and consisted of the use of a mobile application by participants during this period. Participants were classified into control group (CG) and intervention group (IG), and each participant formed a pair with their respective caregiver. Participants of the IG were invited to install the application Method of Sampling of Experience and Programmed Intervention (ESPIM) and to participate in the face-to-face training of using the platform. The ESPIM (Figure 1) contained cognitive activities for the elderly, and a questionnaire to monitor the burden of their caregivers. Each pair was followed for four weeks, and the activities and follow-ups were performed twice a week. After remote monitoring, caregivers of IG participants responded online to the System Usability Scale (SUS), which provides a score, enabling the evaluation of the usability of ESPIM. Caregivers also provided feedback on ESPIM through a focus group. In turn, CG participants received the same printed tasks and without the corresponding follow-up through ESPIM and performed the tasks for 4 weeks. Resulted and discussion: Those who were not monitored through the ESPIM platform ΓÇô Control group - during the holidays demonstrated a lower return rate, with only one participant returning and undergoing reevaluation. Four caregivers responded to the SUS and the average score was 76.25, considered very good, given the scores of this questionnaire, which indicate good usability above 68. Caregiver 1 (C1), who takes care of two older people, indicated that he felt overwhelmed using the app, and scored 57.5 on the SUS. Caregivers 2 (C2) and 3 (C3), both older people who care for other older people, despite indicating that they had difficulty using ESPIM, evaluated the system as good, scoring 75 and 70 in the SUS, respectively. Finally, caregiver 4 (C4) reported that monitoring and use were satisfactory, scoring 100 and evaluating the system as the best imaginable. With the SUS results, we realized that usability, measured by effectiveness, efficiency, and satisfaction, is influenced by the particularities of each caregiver, which can be reinforced with feedback from caregivers, such as ΓÇ£It was a good experience. Even though I answered the questionnaire for two people, which was a little tiring, it was good overall, C1.ΓÇ¥ ΓÇ£I thought it was good to be able to participate. It was a period in which we could enjoy and learn about the application. I was unable to send audio, only photos. I think it was a problem with the tablet, C3ΓÇ¥. ΓÇ£For me, the support in the activities was great. I would like it to happen every week, for this activity to be constant. I think everyone should have access to this app. It would be very good for both the caregiver and the older people to exercise, and it improves our mood, C4.ΓÇ¥ Conclusion: Based on the results obtained through the System Usability Scale (SUS) and feedback from caregivers, we can conclude that the usability of ESPIM was considered very good by the participants. References Rodrigues, K. R. et al. Espim system: interface evolution to enable authoring and interaction with multimedia intervention programs. In Proceedings of the 24th Brazilian Symposium on Multimedia and the Web, p 125ΓÇô132, 2018. Frohlich, D. et al. Time matters: Co-design for communication and digital narratives in dementia care. Gerontechnologoy (Valkenswaard. Gedurkt), v. 19, p. 1-1, 2020. Keywords: Mobile Applications. Caregiver. Elderly People. Dementia. Health Education.. Address: Departament of Gerontology, Federal University of S├úo Carlos, Brazil
Enhancing Geriatric Care: Insights from a Mixed Method Study on In-Bed Real-Time Motion Monitoring
Purpose The global rise in emergency hospital admissions among older individuals will likely continue due to ongoing demographic changes. Currently, about two-thirds of hospital patients are elderly, with up to 50% experiencing some form of cognitive impairment, including dementia (George et al., 2013; Jackson et al., 2016; Mudge et al., 2021), which can lead e.g., to falls or accidental removal of intravenous accesses (Choi et al., 2020). There's ongoing debate about using technological innovations to support nurses and caregivers (Astell et al., 2019; Husebo et al., 2020). Bed exit systems, like those studied by Komagata et al. (2019) and Oh-Park et al. (2021), are known in this context. In a previous study, nurses at a university medical center tested a bed exit system placed under patients' mattresses that provided notification when patients moved toward the edge of the bed or left unassisted, which was easy to use but limited in application due to symptom complexity (Walzer et al.). To address this, the research team decided to test a technology with more functionality. Nurses in the geriatric unit of a university hospital piloted a more complex bed sensor system alongside standard care. This system not only provides bed edge and exit information but also real-time monitoring of patient movement patterns in bed. Previous evaluations (Ziegler et al., 2023) found potential benefits for nightly monitoring of patients in general wards and particularly for those with delirium. Method This study employed a parallel mixed methods triangulation design, using a quantitative survey, qualitative focus groups, an interview, and participatory observations (Ingham-Broomfield, 2016). Conducted in a geriatric ward at a university medical center, the study lasted 24 weeks divided into two phases. Phase 0 lasted 6 weeks, following the center's standard care and daily prevalence surveys. Phase 1 lasted 18 weeks, during which the ward was equipped with the system. Nurses used it as an aid in patient care, assessing cognitive status and bed movement tendencies. Nurses had autonomy to select patients, and control over real-time monitoring and bed edge/exit information settings. Results and Discussion Overall, the evaluation of the system was positive across all methods. Nurses benefited mainly from motion monitoring, particularly at night, which increased their sense of security and reduced psychological stress, consistent with Mileski et al.'s systematic review (2019). While the technology's effectiveness in preventing falls couldn't be proven, it reduced nurses' fear of falls and enhanced their ability to respond adequately to such events. However, the focus on preventing falls did not emerge as significantly as other benefits, possibly due to the limited ability to respond in constant circumstances and the general lack of fall events during the study period. Literature suggests that the information system alone isn't effective (Barker et al., 2017; Chu, 2017; Hamm et al., 2016), hence its primary use at night when nurses have more attention for monitoring. Integration of technology into comprehensive care plans is crucial for optimal benefits (Mileski et al., 2019). Ambiguities in the assessment may be related to debates about nursing professionalism in Germany (Roth et al., 2022), with some participants believing that technology isn't necessary for good care but could enhance the profession in general. The findings indicating a lack of serious consideration of patients' concerns by nurses may be related to their diminishing fears of surveillance or invasion of privacy. Integration with documentation standards could alleviate nurses' workload, enhancing the technology's advantages, reinforcing self-determined, knowledge-based nursing practice and professional standing. ┬á References ┬á Astell,┬áA.┬áJ., Bouranis,┬áN., Hoey,┬áJ., Lindauer,┬áA., Mihailidis,┬áA., Nugent,┬áC., & Robillard,┬áJ.┬áM. (2019). Technology and dementia: The future is now. Dementia and Geriatric Cognitive Disorders, 47(3), 131ΓÇô139. Barker,┬áA.┬áL., Morello,┬áR.┬áT., Ayton,┬áD.┬áR., Hill,┬áK.┬áD., Brand,┬áC.┬áA., Livingston,┬áP.┬áM., & Botti,┬áM. (2017). Acceptability of the 6-PACK falls prevention program: A pre-implementation study in hospitals participating in a cluster randomized controlled trial. PloS One, 12(2), e0172005. Chu,┬áR.┬áZ. (2017). Preventing in-patient falls: The nurse's pivotal role. Nursing2022, 47(3), 24ΓÇô30. Hamm,┬áJ., Money,┬áA.┬áG., Atwal,┬áA., & Paraskevopoulos,┬áI. (2016). Fall prevention intervention technologies: A conceptual framework and survey of the state of the art. Journal of Biomedical Informatics, 59, 319ΓÇô345. Husebo,┬áB.┬áS., Heintz,┬áH.┬áL., Berge,┬áL.┬áI., Owoyemi,┬áP., Rahman,┬áA.┬áT., & Vahia,┬áI.┬áV. (2020). Sensing technology to monitor behavioral and psychological symptoms and to assess treatment response in people with dementia. A systematic review. Frontiers in Pharmacology, 10, 1699. George, J., Long, S., & Vincent, C. (2013). How can we keep patients with dementia safe in our acute hospitals? A review of challenges and solutions. Journal of the Royal Society of Medicine, 106(9), 355ΓÇô361. Ingham-Broomfield,┬áR. (2016). A nurses' guide to mixed methods research. Australian Journal of Advanced Nursing, the, 33(4), 46ΓÇô52. Jackson,┬áT.┬áA., MacLullich,┬áA.┬áM.┬áJ., Gladman,┬áJ.┬áR.┬áF., Lord,┬áJ.┬áM., & Sheehan,┬áB. (2016). Undiagnosed long-term cognitive impairment in acutely hospitalised older medical patients with delirium: a prospective cohort study. Age and Ageing, 45(4), 493ΓÇô499. Komagata,┬áH., Hattori,┬áT., Ohshima,┬áR., Kakinuma,┬áE., Ishikawa,┬áM., Shinoda,┬áK., & Kobayashi,┬áN. Development of human behavior monitoring system around bed using infrared depth sensor. In 2019 IEEE 1st Global Conference on Life Sciences and Technologies (LifeTech) (pp.┬á117ΓÇô118). IEEE. Mileski,┬áM., Brooks,┬áM., Topinka,┬áJ.┬áB., Hamilton,┬áG., Land,┬áC., Mitchell,┬áT., Mosley,┬áB., & McClay,┬áR. (2019). Alarming and/or alerting device effectiveness in reducing falls in long-term care (LTC) facilities? A systematic review. In Healthcare (p.┬á51). MDPI. Mudge,┬áA.┬áM., Lee-Steere,┬áK., Treleaven,┬áE., Cahill,┬áM., Finnigan,┬áS., & McRae,┬áP. (2021). Cognitive impairment in older hospital inpatients: prevalence, care needs and carer perceptions. Australian Health Review, 46(2), 244ΓÇô250. Oh-Park,┬áM., Doan,┬áT., Dohle,┬áC., Vermiglio-Kohn,┬áV., & Abdou,┬áA. (2021). Technology utilization in fall prevention. American Journal of Physical Medicine & Rehabilitation, 100(1), 92ΓÇô99. Roth,┬áC., Wensing,┬áM., Breckner,┬áA., Mahler,┬áC., Krug,┬áK., & Berger,┬áS. (2022). Keeping nurses in nursing: a qualitative study of German nursesΓÇÖ perceptions of push and pull factors to leave or stay in the profession. BMC Nursing, 21(1), 48. Walzer, S., Schoen, I., Pfeil, J., Schepputat, S., Ziegler, S., Schgmoor, C., & Kunze, C. Nurses' Perspectives and Experiences of Using a Bed Exit Information System in an Acute Hospital Setting: A Mixed Methods Study: Submitted to NursingOpen for publication. Ziegler,┬áS., Schmoor,┬áC., Sch├╢ler,┬áL.┬áM., Schepputat,┬áS., Takem,┬áE., Grotejohann,┬áB., Steinbrenner,┬áI., & Feuchtinger,┬áJ. (2023). Potential for reducing immobility times of a mobility monitor in-bed sensor systemΓÇôa stepped-wedge cluster-randomised trial. BMC Nursing, 22(1), 478 ┬á ┬á Keywords: geriatric patients, cognitive impairment, technology, fall prevention, hospital Affiliation: Care and Technology Lab, Furtwangen University of Applied Sciences, Furtwangen, Germany Corresponding Author Email: stefan.walzer@hfu.eu ┬á Acknowledgement This study was conducted at the Center of Implementing Nursing Care Innovations, Freiburg, Germany. This joint project on the development and research of new care technologies in Germany is funded by the Federal Ministry of Education and Research.
ARIA index to assess the quality of mobile health apps: A usability and reliability study
Purpose:┬áThe ubiquity of smart devices has precipitated the growth of mobile health applications (mHealth apps), which aim to help users manage health conditions. Persons living with chronic health conditions, especially older adults, can benefit from the use of mHealth apps given their diverse uses. However, challenges persist with regulation of this industry. Thus, the quality of mHealth apps are often unknown. As no tools existed to assess the quality of mHealth apps for persons living with a health condition, care partners, or healthcare practitioners, we developed the Alberta Rating Index of Apps (ARIA), with a paper-based version validated in a previous study (Azad-Khaneghah, Roduta Roberts, & Liu, 2022). ARIA consists of 19 items rated on a Likert scale that ask users to reflect on the usability, trustworthiness, appropriateness, security, and satisfaction of the mHealth app. For example, one item reads ΓÇ£It would be easy for the user to understand the information provided by the app.ΓÇ¥ Subsequently, we developed a web-based version of the index. A web-based version may act to enhance accessibility, broaden the user audience, and improve functionality through computerized features, such as customized font size and automatic saving of progress. Older adults may benefit from these digitized features given the accessibility features available online to accommodate for a range of age-related impairments.┬áMethods:┬áIn this study, the usability and reliability of a web-based version of ARIA was assessed. Eighty-four (84) participants trialed two mHealth apps (Calm and Breathe2Relax) and completed the ARIA Online questionnaire based on their experiences. A retest interval was observed before completing a second round of the questionnaire, in addition to the System Usability Scale (SUS). Frequency distribution described demographics, and statistical analyses included factor analysis, and reliability coefficients (internal consistency, inter-rater, and test-retest); descriptive analysis were applied for SUS scores (mean and standard deviation).┬áResults and Discussion:┬á61 persons living with a health condition, 15 care partners, and 8 healthcare practitioners participated in the study. An exploratory factor analysis identified 11 questionnaire items to be appropriate according to the correlation matrix (coefficients >0.70, KMO 0.838, chi-square 1458.00, 171 df, p<0.001). Reliability analyses show high internal consistency among ARIA items (CronbachΓÇÖs┬áΓì║┬á= 0.819), agreement among raters (ICC = 0.819), and reliability over time (r = 0.590, p<0.01). The SUS scores indicated that ARIA Online was well-accepted (mean = 83.85, SD = 9.85). Our results suggest that ARIA Online is both usable and reliable when assessing the quality of mHealth apps. An established and usable index for mHealth apps could equip app users to accurately assess the quality of mHealth apps. ARIA online can empower users who are considering adopting an application, ultimately enhancing their health management journey.┬á
Evaluating a mobile application to support persons living with dementia at risk of going missing and their care partners
Purpose: With the increasing prevalence of dementia, missing incidents among this population are rising. Consequences include injuries and death, caregiver burden, and high search and rescue costs (Bantry White & Montgomery, 2015).Yet, the ability to move around in oneΓÇÖs community help individuals maintain social, physical, and civic activities, necessary for a good quality of life. Information and communication technologies (ICTs) can support mobility and independence of people with cognitive impairment while providing peace of mind to care partners (Liu, Miguel Cruz, Ruptash, Barnard, & Juzwishin, 2017). ICTs that support wayfinding and community safety typically use global positioning system or GPS. As smart phones have become ubiquitous, mobile applications focused on supporting persons living with dementia in the community and their care partners are emerging. One such mobile application is GuardIO - Family Care, a Health Canada-licensed mobile application. This caregiving tool allows care partners to remotely assess the immediate whereabouts and mobility behaviours of at-risk family members who have cognitive impairment. It captures the mobility behaviour at the time of walking or driving and sends out real-time safety alerts to individuals in the care circle. The goals of this project are to: 1) examine the acceptance and usability of GuardIO; and 2) understand mobility patterns of persons living with dementia. Methods: This study uses a mixed-method pre- and post-test design involving 40 dyads of persons living with dementia and their care partners. Thirty percent of the participants are from an Indigenous community in Canada. Participants use the GuardIO app for one month. They assess the acceptance and usability using a questionnaire based on the Unified Theory of Acceptance and Use of Technology. The questionnaire responses are analyzed using a partial least square regression model. Machine learning-driven analytics characterize the mobility patterns of participants with dementia and without dementia. A focus group discussion with 20 dyads helps us understand user experiences, satisfaction and challenges, and barriers associated with using GuardIO. Results and Discussion: Our poster presentation describes and showcases the GuardIO mobile application and our study protocol. Preliminary findings are presented. This project provides insight into the use of a mobile app to enable persons with dementia and their care partners to manage the risk of going missing. Data collected through the GuardIO application can also be used to identify changes in mobility which may inform decisions about personalized care and support services.
Exploring the Potential of an Interactive Soundscape Tabletop in Dementia Care: Insights from Collaborative Development
Purpose Music is widely recognized for its therapeutic benefits in dementia care, evoking emotional responses, triggering memories and promoting social interaction (Van der Steen 2018). However, the potential of everyday sounds, such as familiar household or natural sounds, remains largely unexplored in care practice. Research suggests that sounds, such as those found in familiar household or natural environments, can elicit positive responses in people living with dementia (Houben et al. 2019). This paper presents the results of a collaborative effort between researchers, caregivers and people living with dementia to develop and propose a sustainable sound-based technological solution for dementia care,focusing on implementation aspects resulting from the collaborative development.Through three years of intensive collaboration, involving practitioners and individuals living with dementia, we developed the 'interactive soundscape tabletop,' designed to offer immersive sound environments for reminiscence care and well-being (Held et al. 2023). Method Following a participatory design methodology and iterative development process, researchers and caregivers from three care facilities worked closely together to co-create an interactive soundscape device tailored to the specific needs of people living with dementia. Key stakeholders, including people living with dementia, caregivers and technology developers, were actively involved in all stages of the project, from initial concept development to final implementation. Through extensive co-design sessions, field testing and a final evaluation within these care facilities, the solution was rigorously tested to assess its potential for long-term viability and effectiveness in supporting sound-based dementia care practices. Results & Discussion The collaborative development process has generated valuable insights into the integration of the soundscape tabletop within dementia care. By combining researchers' expertise with caregivers' practical knowledge, we've crafted an interactive solution to facilitate the use of sounds in care practices. Insights from our ongoing evaluation underscore the importance of continuous collaboration and iterative refinement to maintain the relevance and effectiveness of technological solutions in dementia care. Our study sheds light on practical implications regarding the incorporation of the soundscape tabletop into existing caregiving routines. This encompasses: 1) User interaction aspects, including the potential for autonomous interaction and the importance of respecting individual preferences for specific sounds, 2) sound-based interventions tailored to different engagement levels during both group and individual activities, and 3) the caregiverΓÇÖs pivotal role in facilitating system usage.These findings offer actionable recommendations and practical guidance for researchers, practitioners, and caregivers for optimizing the design and implementation of digital sound-based interventions in dementia care. The digital use of sounds represents a promising approach to complementing existing music-based interventions and providing individuals living with dementia new opportunities for sensory stimulation and engagement. Continuous research and refinement efforts are crucial to ensuring the sustainable integration of this solution into caregiving processes, ultimately aiming to enhance the well-being of individuals affected by dementia. References Held, P., R├╢hrl, F., & Schnell, N. (2023). Interactive Soundscape Tabletop to Promote Immersive Sound Experiences for People Living With Dementia and Their Caregivers. In Mensch und Computer 2023 (MuC '23), September 03ΓÇô06, 2023, Rapperswil, Switzerland (pp. 1-5). ACM, New York, NY, USA. https://doi.org/10.1145/3603555.3609317 Houben, M., Brankaert, R., Bakker, S., Kenning, G., Bongers, I., & Eggen, B. (2019). Foregrounding Everyday Sounds in Dementia. In Proceedings of the 2019 on Designing Interactive Systems Conference - DIS ΓÇÖ19 (pp. 71ΓÇô83). ACM Press. DOI: https://doi.org/10.1145/3322276.3322287 Van der Steen, J. T., Smaling, H. J., van der Wouden, J. C., Bruinsma, M. S., Scholten, R. J., & Vink, A. C. (2018). Music-based therapeutic interventions for people with dementia. The Cochrane Database of Systematic Reviews, 7, CD003477. ┬á
AI for Dementia Prevention and Personalized Care
This symposium invites researchers who are developing systems including AI technology and ICT technology related to preventing dementia and maintaining and improving cognitive function. Speakers are both conducting research in countries where the increasing number of dementia patients is an issue: Japan or Germany. This symposium covers the technologies that can be use at home: the platform for analyzing drawing-based neuropsychological assessments, dialogue system of Virtual Agent (VA) and robot, and applications which allows such the system to be more familiar.
A ten-year systematic review of gerontechnologies tested among community-dwelling older adults living with dementia and their family caregivers
Purpose┬áTo systematically review the literature of gerontechnologies tested in community-dwelling older adults living with dementia and their family caregivers from 2012 to 2022. This information is crucial to help researchers, scientists, clinicians, and the industry to understand the advantages, limitations, and opportunities of their use among dyads of family caregivers and older adults with unimpaired cognition (Moreno et al., 2024a) and individuals with dementia (Moreno et al., 2024b).┬áMethod┬áA systematic literature search was conducted in five different databases (CINAHL, Medline, PsycINFO, AgeLine, and Web of Science) and validated by two independent librarians with backgrounds in Psychology and Geriatrics. Using COVIDENCE software, two independent reviewers screened records available in English, French, and Spanish from 2012 to 2022. We included records addressing the use of technology-assisted home support simultaneously in community-dwelling older adults living with dementia and their family caregivers following a qualitative, quantitative, or mixed methods design.┬áResults and Discussion┬áThere were 1563 references published between 2012 and 2022. After removing the duplicates, 877 titles and abstracts were screened and the full text of 132 studies was assessed for eligibility, with only 20 studies testing 17 different gerontechnologies for home support in community-dwelling older adults living with dementia and their family caregivers. The results of the independent assessment of the quality of the studies using the Mixed Methods Appraisal Tool (MMAT) indicated that most were relatively good studies in terms of quality standards with a mean MMAT score of 4.2 (SD = 0.6). Gerontechnologies with overlapping functionalities included: a) behavioral monitoring, b) health monitoring, c) caregiver education, d) communication, e) tracking devices, and e) reminders, emergency warnings, and solutions for social isolation and daily activities support. Based on the analysis of these studies, we provide recommendations for clinical practice (e.g., education and accessibility early in the disease process), research (e.g., testing with different dementia severities), technological development (e.g., personalization and technical support), and public policy (e.g., privacy policies) to foster the development and implementation of gerontechnologies in the dementia continuum. ┬á References Moreno, A., Scola, M. C., Sun, H., Durce, C., Couve, C., Acevedo-Ben├¡tez, K. & Gutman, G. (2024a). A systematic review of gerontechnologies to support aging in place among community-dwelling older adults with unimpaired cognition and their family caregivers.┬áFrontiers in Psychology,┬á14. DOI: 10.3389/fpsyg.2023.1237694 Moreno, A., Durce, H., Cifuentes, C., M├║nera, M., Acevedo-Ben├¡tez, K., Scola, M. & Gutman, G. (2024b).┬áTechnology-assisted home support of community-dwelling older adults living with dementia and their family caregivers: A ten-year systematic review.┬áNeuropsychological Rehabilitation┬á(Under review). ┬á ┬á Keywords:┬áGerontechnology, AgeTech, Dementia, Major neurocognitive disorder, Older Adults, Aging in place, Home support┬áAffiliation: Department of Psychology, Universit├⌐ de Montr├⌐al, Montreal, Quebec, Canada ;┬áCentre de recherche de lΓÇÖinstitut universitaire de g├⌐riatrie de Montr├⌐al,┬áCentre int├⌐gr├⌐ universitaire de sant├⌐ et de services sociaux du Centre-Sud-de-lΓÇÖ├Äle-de-Montr├⌐al, Montreal, Quebec, Canada; Notre-Dame Hospital,┬áCentre int├⌐gr├⌐ universitaire de sant├⌐ et de services sociaux du Centre-Sud-de-lΓÇÖ├Äle-de-Montr├⌐al (CCSMTL), Montreal, Quebec, Canada Corresponding Author Email:┬ájhon.alexander.moreno.1@umontreal.ca;┬áAuthorsΓÇÖ ORCID iDs:┬á0000-0003-3651-3222 Acknowledgement┬á Purpose┬áTo systematically review the literature of gerontechnologies tested in community-dwelling older adults living with dementia and their family caregivers from 2012 to 2022. This information is crucial to help researchers, scientists, clinicians, and the industry to understand the advantages, limitations, and opportunities of their use among dyads of family caregivers and older adults with unimpaired cognition (Moreno et al., 2024a) and individuals with dementia (Moreno et al., 2024b).┬áMethod┬áA systematic literature search was conducted in five different databases (CINAHL, Medline, PsycINFO, AgeLine, and Web of Science) and validated by two independent librarians with backgrounds in Psychology and Geriatrics. Using COVIDENCE software, two independent reviewers screened records available in English, French, and Spanish from 2012 to 2022. We included records addressing the use of technology-assisted home support simultaneously in community-dwelling older adults living with dementia and their family caregivers following a qualitative, quantitative, or mixed methods design.┬áResults and Discussion┬áThere were 1563 references published between 2012 and 2022. After removing the duplicates, 877 titles and abstracts were screened and the full text of 132 studies was assessed for eligibility, with only 20 studies testing 17 different gerontechnologies for home support in community-dwelling older adults living with dementia and their family caregivers. The results of the independent assessment of the quality of the studies using the Mixed Methods Appraisal Tool (MMAT) indicated that most were relatively good studies in terms of quality standards with a mean MMAT score of 4.2 (SD = 0.6). Gerontechnologies with overlapping functionalities included: a) behavioral monitoring, b) health monitoring, c) caregiver education, d) communication, e) tracking devices, and e) reminders, emergency warnings, and solutions for social isolation and daily activities support. Based on the analysis of these studies, we provide recommendations for clinical practice (e.g., education and accessibility early in the disease process), research (e.g., testing with different dementia severities), technological development (e.g., personalization and technical support), and public policy (e.g., privacy policies) to foster the development and implementation of gerontechnologies in the dementia continuum. ┬á References Moreno, A., Scola, M. C., Sun, H., Durce, C., Couve, C., Acevedo-Ben├¡tez, K. & Gutman, G. (2024a). A systematic review of gerontechnologies to support aging in place among community-dwelling older adults with unimpaired cognition and their family caregivers.┬áFrontiers in Psychology,┬á14. DOI: 10.3389/fpsyg.2023.1237694 Moreno, A., Durce, H., Cifuentes, C., M├║nera, M., Acevedo-Ben├¡tez, K., Scola, M. & Gutman, G. (2024b).┬áTechnology-assisted home support of community-dwelling older adults living with dementia and their family caregivers: A ten-year systematic review.┬áNeuropsychological Rehabilitation┬á(Under review). ┬á ┬á Keywords:┬áGerontechnology, AgeTech, Dementia, Major neurocognitive disorder, Older Adults, Aging in place, Home support┬áAffiliation: Department of Psychology, Universit├⌐ de Montr├⌐al, Montreal, Quebec, Canada ;┬áCentre de recherche de lΓÇÖinstitut universitaire de g├⌐riatrie de Montr├⌐al,┬áCentre int├⌐gr├⌐ universitaire de sant├⌐ et de services sociaux du Centre-Sud-de-lΓÇÖ├Äle-de-Montr├⌐al, Montreal, Quebec, Canada; Notre-Dame Hospital,┬áCentre int├⌐gr├⌐ universitaire de sant├⌐ et de services sociaux du Centre-Sud-de-lΓÇÖ├Äle-de-Montr├⌐al (CCSMTL), Montreal, Quebec, Canada Corresponding Author Email:┬ájhon.alexander.moreno.1@umontreal.ca;┬áAuthorsΓÇÖ ORCID iDs:┬á0000-0003-3651-3222 Acknowledgement┬áThis┬áresearch was supported by┬áMinist├¿re de lΓÇÖ├ëconomie, de lΓÇÖInnovation et de lΓÇÖ├ënergie┬áin Quebec, Canada. Purpose┬áTo systematically review the literature of gerontechnologies tested in community-dwelling older adults living with dementia and their family caregivers from 2012 to 2022. This information is crucial to help researchers, scientists, clinicians, and the industry to understand the advantages, limitations, and opportunities of their use among dyads of family caregivers and older adults with unimpaired cognition (Moreno et al., 2024a) and individuals with dementia (Moreno et al., 2024b).┬áMethod┬áA systematic literature search was conducted in five different databases (CINAHL, Medline, PsycINFO, AgeLine, and Web of Science) and validated by two independent librarians with backgrounds in Psychology and Geriatrics. Using COVIDENCE software, two independent reviewers screened records available in English, French, and Spanish from 2012 to 2022. We included records addressing the use of technology-assisted home support simultaneously in community-dwelling older adults living with dementia and their family caregivers following a qualitative, quantitative, or mixed methods design.┬áResults and Discussion┬áThere were 1563 references published between 2012 and 2022. After removing the duplicates, 877 titles and abstracts were screened and the full text of 132 studies was assessed for eligibility, with only 20 studies testing 17 different gerontechnologies for home support in community-dwelling older adults living with dementia and their family caregivers. The results of the independent assessment of the quality of the studies using the Mixed Methods Appraisal Tool (MMAT) indicated that most were relatively good studies in terms of quality standards with a mean MMAT score of 4.2 (SD = 0.6). Gerontechnologies with overlapping functionalities included: a) behavioral monitoring, b) health monitoring, c) caregiver education, d) communication, e) tracking devices, and e) reminders, emergency warnings, and solutions for social isolation and daily activities support. Based on the analysis of these studies, we provide recommendations for clinical practice (e.g., education and accessibility early in the disease process), research (e.g., testing with different dementia severities), technological development (e.g., personalization and technical support), and public policy (e.g., privacy policies) to foster the development and implementation of gerontechnologies in the dementia continuum. ┬á References Moreno, A., Scola, M. C., Sun, H., Durce, C., Couve, C., Acevedo-Ben├¡tez, K. & Gutman, G. (2024a). A systematic review of gerontechnologies to support aging in place among community-dwelling older adults with unimpaired cognition and their family caregivers.┬áFrontiers in Psychology,┬á14. DOI: 10.3389/fpsyg.2023.1237694 Moreno, A., Durce, H., Cifuentes, C., M├║nera, M., Acevedo-Ben├¡tez, K., Scola, M. & Gutman, G. (2024b).┬áTechnology-assisted home support of community-dwelling older adults living with dementia and their family caregivers: A ten-year systematic review.┬áNeuropsychological Rehabilitation┬á(Under review). ┬á ┬á Keywords:┬áGerontechnology, AgeTech, Dementia, Major neurocognitive disorder, Older Adults, Aging in place, Home support┬áAffiliation: Department of Psychology, Universit├⌐ de Montr├⌐al, Montreal, Quebec, Canada ;┬áCentre de recherche de lΓÇÖinstitut universitaire de g├⌐riatrie de Montr├⌐al,┬áCentre int├⌐gr├⌐ universitaire de sant├⌐ et de services sociaux du Centre-Sud-de-lΓÇÖ├Äle-de-Montr├⌐al, Montreal, Quebec, Canada; Notre-Dame Hospital,┬áCentre int├⌐gr├⌐ universitaire de sant├⌐ et de services sociaux du Centre-Sud-de-lΓÇÖ├Äle-de-Montr├⌐al (CCSMTL), Montreal, Quebec, Canada Corresponding Author Email:┬ájhon.alexander.moreno.1@umontreal.ca;┬áAuthorsΓÇÖ ORCID iDs:┬á0000-0003-3651-3222 ┬á
The relationship between neurocognitive impairment, technology experience, and mobile device proficiency: A cross-sectional exploratory study in older adults
The relationship between neurocognitive impairment, technology experience, and mobile device proficiency: A cross-sectional exploratory study in older adults A. Moreno, CIMA-Q┬á ┬á Purpose┬áTo explore the technological experience and competence with mobile devices in a group of older adults from Quebec, Canada. Understanding current use of technology can help researchers, scientists, clinicians, and the industry to promote their use among dyads of family caregivers and older adults with unimpaired cognition (Moreno et al., 2024a) and individuals with dementia (Moreno et al., 2024b).┬áMethod┬áA total of 194 older adults were recruited from the CIMA-Q study (Consortium for the early identification of Alzheimer's Disease ΓÇô Quebec, Belleville et al., 2019). They were mostly women (62.9%), with university degrees (56,2%), and a mean age of 65.4 (SD=5.9) years. The sample included individuals with different degrees of cognitive functioning with an average Montreal Cognitive Assessment (MoCA) score of 25.7 (SD = 3.5, range = 7-30). The group included people with a confirmed clinical diagnosis of normal cognition or neurocognitive impairment by expert physicians or a memory clinic as follows: a) Unimpaired cognition (n = 12), b) Subjective cognitive decline without dementia (n = 120), c) Mild Cognitive Impairment (n = 59), and d) Major Neurocognitive Disorders (n = 3). Measures included the Technology Experience Profile (TEP) and the Mobile Device Proficiency Questionnaire ΓÇô Short Form (MDPQ).┬áResults and Discussion┬áMoCA scores were inversely associated with age, technological experience, and mobile device proficiency (pΓÇÖs < 0.01). Age was also negatively associated with technological experience and mobile device proficiency (pΓÇÖs < 0.01). Older adults with subjective or objective cognitive impairment report using technologies less frequently and mention more difficulties using mobile devices. AgeTech solutions must adapt technologies to effectively respond to the challenges that older adults may encounter when their cognition is subjectively or objectively affected. As such, flexibility and personalization are key issues when designing technologies for older adults. ┬á References Belleville, S., LeBlanc, A. C., Kergoat, M. J., Calon, F., Gaudreau, P., H├⌐bert, S. S., Hudon, C., Leclerc, N., Mechawar, N., Duchesne, S., Gauthier, S., & Consortium for the Early Identification of Alzheimer's disease-Quebec (CIMA-Q) (2019). The Consortium for the early identification of Alzheimer's disease-Quebec (CIMA-Q).┬áAlzheimer's & Dementia, 11, 787ΓÇô796. https://doi.org/10.1016/j.dadm.2019.07.003┬á Moreno, A., Scola, M. C., Sun, H., Durce, C., Couve, C., Acevedo-Ben├¡tez, K. & Gutman, G. (2024b). A systematic review of gerontechnologies to support aging in place among community-dwelling older adults with unimpaired cognition and their family caregivers.┬áFrontiers in Psychology,┬á14. DOI: 10.3389/fpsyg.2023.1237694 Moreno, A., Durce, H., Cifuentes, C., M├║nera, M., Acevedo-Ben├¡tez, K., Scola, M. & Gutman, G. (2024a). Technology-assisted home support of community-dwelling older adults living with dementia and their family caregivers: A ten-year systematic review.┬áNeuropsychological Rehabilitation┬á(Under review). ┬á ┬á Keywords:┬áGerontechnology, AgeTech, Dementia, Major neurocognitive disorder, Older Adults, Technology Experience, Mobile Devices Affiliation: Department of Psychology, Universit├⌐ de Montr├⌐al, Montreal, Quebec, Canada ;┬áCentre de recherche de lΓÇÖinstitut universitaire de g├⌐riatrie de Montr├⌐al,┬áCentre int├⌐gr├⌐ universitaire de sant├⌐ et de services sociaux du Centre-Sud-de-lΓÇÖ├Äle-de-Montr├⌐al, Montreal, Quebec, Canada; Notre-Dame Hospital,┬áCentre int├⌐gr├⌐ universitaire de sant├⌐ et de services sociaux du Centre-Sud-de-lΓÇÖ├Äle-de-Montr├⌐al (CCSMTL), Montreal, Quebec, Canada Corresponding Author Email:┬ájhon.alexander.moreno.1@umontreal.ca;┬áAuthorsΓÇÖ ORCID iDs:┬á0000-0003-3651-3222
Development of ΓÇ£Maji-Kami AIΓÇ¥: Service for care staff training and care support
Purpose Dementia care, particularly the management of behavioral and psychological symptoms of dementia (BPSD), affects the care burden experienced by facility staff (Kameoka et al., 2020). This has become a major issue, as it affects the retention of care staff. In contrast, expert care staff understand the current difficulties of care recipients and help them move closer to their ideal situation. Based on the experience of our expert care staff in handling BPSD, who are certified as "Maji-Kami" (meaning real god / Oh my god!) in our company, we have developed services to improve the skills of care staff and the quality of life of care recipients using artificial intelligence (AI). Method The expertise of Maji-Kami was obtained through interviews. The Maji-Kami diagnosis was combined with care recording data and provided as learning data for machine learning. Thereafter, the developed Maji-Kami AI was integrated into our care record system "Service Navigation System (sNs)" (Fukuda & Iwaida, 2018). The Maji-Kami AI dashboard was designed following the data analysis and diagnosis method of Maji-Kami. Because Maji-Kami first examines when and how the mental and physical health of an individual has been disturbed by reviewing the changes in data, the ΓÇ£summaryΓÇ¥ screen that was displayed initially provides the data related to comfort and discomfort, along with other quantitative data such as the vital value in calendar format. To identify the factors causing such disturbances and changes, hints regarding the current conditions and problems are available. Links to relevant data and AI-derived care recommendations are provided to consider addressing the problem. Other data screens provide several types of relevant data in timeline bar charts, allowing the care staff to compare and understand changes in the data, including their relationships. For instance, the ΓÇ£physical conditionΓÇ¥ screen shows charts of defecation amount, stool form, urination amount, food and fluid intake amount, body weight, and sleep condition. Timeline bar charts of the related data are displayed on the same screen for comparison. The Maji-Kami AI Dashboard was implemented in 263 nursing homes in our company (as of March 1, 2024). Among them, in 31 nursing homes where the Maji-Kami AI has been in operation for more than one year, its effect was verified. The impact on the care staff was assessed through eye-tracking while collecting information about a selected care recipient, followed by an interview. The effect on care recipients was verified based on care records and data. Results and Discussion Eye-tracking data revealed that care staff using Maji-Kami AI received more diverse data over a longer period. The timeline bar charts of various types of data helped care staff identify when the condition of an individual had changed compared to the conventional sNs screen. In addition, it is highly efficient for information acquisition and several relevant types of data are available on a single screen. Some care staff stated that they required less time to acquire information than before, as the conventional sNs provides different types of data on different screens, not as timeline bar charts, but as raw data. Care staff who identified the key period for the target care recipient from the data could understand their difficulties by reviewing textual information, such as daily reports, during that period. In this way, Maji-Kami AI facilitates care staff in finding and understanding the difficulties of the care recipient more effectively than by reviewing the text of the daily report without checking the data. Various aspects of the impact on care recipients have also been observed. Focusing on the number of incidents, after the implementation of the Maji-Kami AI, the number of falls and wrong room entries decreased in six nursing homes where care staff used the Maji-Kami AI more frequently, whereas in other nursing homes, the number of falls and wrong room entries increased. The results demonstrated that Maji-Kami AI enables care staff to focus on essential information, more accurate assessments, and the provision of appropriate care. It was revealed that Maji-Kami AI has potential as a useful tool for care staff training and care support.
Technology for Enhancing the Wellbeing and Quality of Life for People Living with Dementia
Participants: F. Abujarad (the United States of America), A. Agboji (Canada), S. Freeman (Canada), H. H. Nap (Netherlands), A. Moreno (Canada). ISSUE Dementia is currently the seventh leading cause of death worldwide, and a major contributor to increased vulnerability for adults who require the help of a caregiver for maintaining a daily quality of life prior to condition onset (WHO 2023). In Canada, it is projected that nearly 1 million people will be living with dementia by 2030, and in the United States, trends predict that over 9 million Americans will have dementia by 2030 (Alzheimer Society of Canada 2022, Population Reference Bureau 2021). Additionally, the population in the Netherlands is expected to double by 2050 (Alzheimer Europe 2019). Technology can play a significant role in easing the burden of a myriad of issues related to dementia, such as improving mental health and improving the relationship between the caregiver and person with dementia. CONTENT Our symposium is designed to bring together speakers from Canada, the Netherlands, and the United States of America to highlight the theme of utilizing technology to improve and enhance the wellbeing of people living with dementia. The speakers will discuss topics of 1) a digital elder abuse intervention for use with older adults living with dementia, 2) mitigating apathy using eReader technology for persons with dementia, 3) the use of various AgeTech solutions to enhance both the care and quality of life of persons living with dementia, and 4) a theoretical model for the development and introduction of gerontechnologies for use with older adult-caregiver dyads. STRUCTURE Abujarad will introduce the digital elder abuse project called VOICES, a web-based screening intervention designed for a tablet interface that combines education, screening, and brief psychoeducational interviewing to enhance detection of abuse among older adults living with dementia in the emergency department setting. Agboji will discuss using eReaders to improve apathy symptoms among people with dementia, and the implications for integrating this technology into daily routines. Freeman will present on how AgeTech such as a hydroponic gardening wall, circadian lighting, and a virtual exercise program can benefit persons living with dementia to support their health and wellbeing, as well as the barriers associated with this technology. Moreno will introduce a theoretical model representing the journey of individuals living with dementia, as well as their caregivers, and their relationship with gerontechnologies and how the use of gerontechnology can be beneficial and adapted throughout the progression of an older adultsΓÇÖ dementia. Finally, Nap will discuss a case study on improving acceptance and compatibility with socially assistive robots using co-design methods based on user needs. CONCLUSION Adaptation of technology into the lives and environments of people living with dementia can provide benefits to their quality of life, as well as for their caregivers. Integration of this technology can face certain barriers, but this symposium will encourage people to consider the important role of assistive technology with this critical population.
Association between self-reported and observational pain measured by PainChek app in residents with dementia
Purpose The PainChek application (app) with artificial intelligence is promising in assessing pain in people with dementia (Atee, et al., 2018). It has six domains with 42 items, including facial expressions using automated facial recognition technology, vocalizations, movement, behaviors, activity, and body language observed and documented by assessors (presence = 1, absence = 0, total score 0 - 42), with a score > 6 indicating the presence of pain. While not all individuals with dementia can reliably self-report pain (Hadjistavropoulos, et al., 2014), clinical guidelines advocate individual self-reporting pain (the gold standard of pain assessment) (Herr, et al., 2019). Notably, around 80% of nursing home residents retain the ability to self-report pain (van der Steen, et al., 2021), including some with severe dementia (Pautex, et al., 2006). However, the relationship between self-reported pain and observational pain measured by PainChek remains unclear in people with dementia. Hence, this study aims to explore the potential of PainChek to classify self-reported pain and the association between these two assessments for residents living with dementia in nursing homes who have chronic pain. Method Data was analyzed from a cluster randomized trial conducted between July 2021 and October 2022. Observational pain was initially assessed using PainChek, followed by self-reported pain via the embedded numeric rating scale (NRS) whenever residents were capable of self-reporting. Linear mixed model analyses were conducted to explore the association between the paired PainChek and NRS score, adjusting for age, gender, timing (rest or movement), cognitive impairment (measured by Mini-Mental State Examination, MMSE), and culturally and linguistically diverse backgrounds. Results and Discussion A total of 2149 paired pain assessments from 84 residents (mean age 84.9, 70.2% female, mean MMSE 11.6, Mean PainChek score 3.82) were included for analysis. Residents self-reporting pain and without pain had mean PainChek scores of 4.77 (┬▒2.7) and 3.4 (┬▒2.2), respectively (p < 0.001). A weak correlation was observed between the PainChek and NRS score (r =0.32; p < 0.001). Kwon et al. (2021) reported a similar correlation (r = 0.36) between self-reported NRS and the observational Pain Assessment in Advanced Dementia. Controlling for confounding factors and repeated measures, a significant correlation was still observed (╬▓ = 1.23, 95% Confidence Interval: 0.99 ΓÇô 1.48, p < 0.001). Notably, for residents self-reporting pain, the PainChek with a cut-off of six suggested a potential risk of underestimating pain when solely relying on PainChek observations, a concern previously highlighted as the observational pain assessment scale could underestimate pain severity compared with self-assessment scales (Pautex, et al., 2006). Thus, a combination of self-report and observational pain assessments should be concurrently employed to assess pain in individuals with dementia. Although PainChek might be used as a complementary tool supporting caregivers for pain assessment, more research is warranted to establish a reliable cut-off to minimize the risk of underestimation of pain in people with dementia.
CaregiversΓÇÖ and families role in the implementation of a multi-sensory room in a nursing home.
Purpose This research presents an implementation study of an immersive multi-sensory room for people living with dementia. Nursing homes accommodate increasing numbers of people with dementia and with increasingly severe stages of dementia. With the growing pressure on care, a multi-sensory room may be a solution, by improving the social and emotional wellbeing of people with dementia (Goodall, et al., 2018). In this study a multi-sensory room called Sense-Garden (AAL/Call2016/054-b/2017) was implemented in a Dutch nursing home (Figure 1), focussing on the role of caregivers and family members in the use and adoption of the room. Method Focus groups were organised with family members of people living with dementia in the nursing home with the multi-sensory room. Topics were based on TAM, TAM2 and TAM3 (Venkatesh & Davis, 2008) and included Subjective Norm, Image, Output Quality, Result Demonstrability, Computer Self-Efficacy, Perceptions of External Control, Computer Anxiety, Perceived Enjoyment and Objective Usability. Data was recorded (with consent), transcribed, and analysed by means of thematic analysis (Verhoeven, 2020). Results and Discussion 22 Family members (10 male, 12 female) participated in the focus groups. Six participants were partner of the person with dementia, 13 were a residentΓÇÖs child; three were son- or daughter-in-law. Four participants had visited the multi-sensory room with their loved one. The study revealed three main psychological themes that influence the use of the multi-sensory room, namely: the level of knowledge about the room, how competent one feels to use the room independently and the need to connect with the person with dementia. Three-quarters of participants had no, little or incorrect knowledge of the room. The less knowledge one had the less inclined family members were to use the healthcare innovation. Written messages did not appear to be effective; personal communication by caregivers, however, did, as well as demonstrations. A low sense of competence was caused by anxiety to use the technology, an unclear interface and the effort it takes to visit the room. A higher sense of competence was mainly related to experience with technology, resulting in less anxiety to use the room: "Nothing can go wrong. The only thing is that they might not like itΓÇ¥. The need for connection was only positively effecting the use of the room when family members were already familiar with the room, otherwise they were not aware of the care innovation and its usefulness. Perceived usefulness of the multi-sensory room was evident when family members had attended a demonstration. The perceived usefulness of the interface was considered negative even after a demonstration. Recommendations include: clear, non-written instructions; multiple social meetings; and emphasizing the communication and relational connection that can be strengthened between people with dementia and family members through the multi-sensory room.
Cognitive testings on a touch-screen tablet for older adults: a feasibility study
Purpose Digital tools are currently being developed to help with the diagnosis of neurocognitive disorder (NCD) (Chan 2021). Their use in primary care as screening tools could optimize referral to specialized teams. We aimed to develop a simple, easy-to-use neurocognitive screening tool on a touchscreen tablet to distinguish between people with major NCD, those with mild NCD and those with no NCD. Method We implemented self-questionnaires and tasks for touch-screen tablets self-questionnaires inspired from conventional cognitive tools relevant to screen cognitive impairment.┬á They comprised simple cognitive tasks like immediate and delayed recall of 3 words, temporal orientation questions, categorizations. Response times for tasks were also recorded. The screens have been designed to be used by the participant alone or with the help of a supervisor. Finally, we composed a battery of self-questionnaires and cognitive tasks that can be completed in 10-15 minutes. This battery was offered 77 consecutive patients from a memory clinic and 28 volunteers without cognitive complaints recruited from a citizens' association. Cognitive diagnoses were based on DSM-5 criteria. Results and Discussion Among the 105 participants, there were 79 women (75%) and 26 men (25%) and aged 79.9 +/- 7.5 years; 40 were free from NCD, 40 had a major NCD and 25 a mild NCD. ┬áAll the participants realized the full battery of tests on tablets. Success for each task and response times are shown in Table 1. Four variables were found to be significantly different according to cognitive diagnosis and will be combined in a simplified battery. The feasibility of these tablet-based tests in older adults is excellent, and initial results show promising aspects for the design of a brief tablet-based cognitive screening tool.
Digital cognitive stimulation therapy for people with dementia
Purpose Digital cognitive stimulation therapy (DKST) for people with dementia represents an innovative approach that uses modern technologies to promote cognitive abilities and positively influence the course of dementia. DKST enables personalised and adaptive therapy content that is tailored to the patient's individual interests and current level of ability. Through the use of tablets, stimulating and interactive tasks can be offered to promote memory, attention and executive function, which contribute to cognitive activation. DKST not only offers a flexible and location-independent application, but also enables the automatic adjustment of difficulty levels and the tracking of therapy progress. It also supports social interaction through the possibility of networking with other users. The integration of DKST into the care concept of people with dementia can improve therapy adherence as it is available anytime and anywhere, which is particularly beneficial in rural or underserved areas. Overall, DKST helps to make cognitive stimulation more effective, accessible and engaging, making it a valuable tool in the care of dementia patients. ┬á Method This study investigated the effectiveness of digital cognitive stimulation therapy for people with dementia, which has been offered since 2019 as part of a joint care programme run by the Alzheimer Gesellschaft Hamm and the Telemedizinzentrum Hamm. Nineteen participants received one hour of targeted training per week from specially trained co-therapists. The intervention included digital exercises to strengthen memory, attention and executive functions. Additional auditory training was integrated for those patients who had hearing loss in addition to dementia. The methodology of the study focussed on the use of practical, digital tools for cognitive support and at the same time took sensory impairments into account in order to ensure a holistic care concept. ┬á ┬á Results and Discussion The current study provided significant results regarding the use of digital cognitive stimulation therapy in people with dementia. All 19 participants showed improvements in working memory, attention span and executive functions, although the improvements were minor. One notable aspect, however, is the demonstrably positive impact on social participation and the general quality of life of those affected. In the case of one person with bipolar disorder in particular, it was possible to achieve considerable stabilisation by participating in the therapy within a dementia residential community, which made it possible to avoid an otherwise usual stay in a geriatric psychiatric clinic. These promising, albeit preliminary, results point to the need for further research. A more comprehensive study is already in preparation to evaluate the effectiveness and potential of this therapy method on a broader scale. Keywords: digital cognitive stimulation, Dementia care, social participation, working memory, Quality of life
What has changed in nearly 3 decades of technical developments for persons with dementia?
A study on the use of technology by persons with moderate dementia and their informal caregivers, compared to the requirements in a similar study 30 years earlier.
Scenario-Based Generative AI for Early Detection and Management of Anxiety Attacks in Dementia Care
Purpose: Dementia is linked with various neuropsychiatric challenges, including anxiety attacks. Managing these attacks in individuals with dementia presents unique complexities due to their potential difficulty in communicating emotions or following instructions(Kwak et al., 2017). Expert caregivers possess skills in detecting the early signs of an anxiety episode, removing triggers promptly, accurately predicting the attack's progression, and intervening to comfort the patient. Such expertise is vital in managing the mental health of dementia patients, alleviating the occurrence of anxiety episodes, and controlling their damages. Technological support can enhance early detection of anxiety attacks in individuals with dementia(Tsai et al., 2022). It can also identify potential scenarios and recommend appropriate responses or interventions based on these scenarios. This involves using AI models to analyze patterns and signs indicating the onset of an anxiety attack. This approach aims to prepare caregivers with the right strategies to prevent the attack or lessen its impact, thereby improving the care and support to individuals with dementia. Method: We have developed the outline of a generative AI model that maps out the sequence of events leading from various triggers to the onset of anxiety attacks in patients with dementia (Figure 1). It creates scenarios to forecast the occurrence of anxiety attacks prompted by these triggers. The scenarios are created as time-series of tokens, each representing a specific event or condition. These token sequences can be translated into simple sentences, making them easy to understand. Based on these events, the system provides suggestions for intervention. In its training phase, the model captures time series data of stimuli and anxiety attack incidents. It specifically monitors a combination of daily routine timings and significant sensory stimuli, like loud noises or reports of pain. It also tracks or receives reports on environmental changes or disruptions in daily routines. The model then learns to associate these stimuli with recorded incidents of anxiety attacks, including the attack's delay, duration, and both physical symptoms (like increased heartbeat, sweating, trembling, shortness of breath, reported pains, and nausea) and behavioral responses (such as avoiding specific locations). During the training phase, the model identifies the recurrence patterns of anxiety attack incidents over time in presence of stimuli. In the application phase, the model begins by processing real-time data on the occurrence of stimuli. It then generates a sequence predicting possible upcoming anxiety attack events. Subsequently, this current stream of stimuli data is combined with previously predicted sequences of anxiety events and reintroduced into the model for enhanced prediction follow-up accuracy. These predictions are then communicated to caregivers, who provide feedback based on the actual occurrence of the events. Should the predictions deviate from real events beyond a predetermined threshold, the model resets to a default state, assuming a 'no attack' scenario, and starts anew. A series of early intervention guidelines is established, synchronized with the progression of events. When the model enters an attack-alarm state, it suggests specific interventions. These recommended behavioral interventions are tailored to the most likely scenarios as forecasted by the model, aiming to find the most direct and effective path to restore the individual's anxiety level to its normal baseline. Results and Discussions: We outlined a generative AI model that identifies the timing patterns and associations between various stimuli occurring in the environment or internally to the patient and the onset of anxiety attacks. The model has the ability to simulate and predictively regenerate the sequence of anxiety attack events likely triggered by these stimuli. It is highly adaptable, enabling fine-tuning for individual patients to accommodate personal differences, thus aligning with precision health principles. References Kwak, Y. T., Yang, Y., & Koo, M.-S. (2017). Anxiety in Dementia. Dementia and Neurocognitive Disorders, 16(2), 33ΓÇô39. https://doi.org/10.12779/dnd.2017.16.2.33 Tsai, C.-H., Chen, P.-C., Liu, D.-S., Kuo, Y.-Y., Hsieh, T.-T., Chiang, D.-L., Lai, F., & Wu, C.-T. (2022). Panic Attack Prediction Using Wearable Devices and Machine Learning: Development and Cohort Study. JMIR Medical Informatics, 10(2), e33063. https://doi.org/10.2196/33063
Combatting apathy in long term care facilities with eReaders: A pilot study
Purpose: Research has shown that more than 80% of people living in long term care facilities have apathy (loss of interest or motivation) that can adversely impact their quality of life, cognition, and wellbeing (Zuideima et al. 2009; Nijsten et al., 2017). Despite the availability of simple interventions to improve apathy, health care workers fail to address this issue (Jao et., 2019). The aim of this project was to pilot test the benefits of using Kobo eReaders (a cost-effective handheld device that is meant for reading and storing digital books) to mitigate apathy and improve the wellbeing of residents in long term care facilities across Northern British Columbia, Canada. Method This is a mixed method study. Residents with interest in reading were approached. Cognitively impaired residents who were unable to consent were excluded. All consented participants completed a self-report assessment questionnaire about apathy. Participants were given a Kobo eReader preloaded with books of interest and instructed on the use of the Kobo eReader. All those who enrolled participated in the program for a period of 8 to 12 weeks. After the intervention was completed, a post-intervention assessment was conducted. A logbook was kept to track the participantsΓÇÖ engagement during group reading sessions. We also collected data about the other benefits derived from participating in the program through semi-structured interviews. The interviews were transcribed and analyzed using NVivo software Results and Discussion Out of the 20 participants, 14 were females. Age ranged between 51 and 98 years old. All participants were educated. Eight people reported apathy symptoms at the start of the program, however, at the end of the program, six people had recovered from apathy. The majority of participants were highly engaged in reading activities throughout the program implementation, and all participants expressed that being part of the program had motivated them to engage more in group activities and read more than they would have without the device. The results showed that reading using a simple and cost-effective technology such as the Kobo eReader may improve apathy and contribute to feelings of wellbeing among residents in long term care facilities. In addition, older adults in long term care facilities were open to try out new technologies and were willing to use technologies that support them to continue what they have always enjoy. This research highlights the feasibility and benefits for novel types of activities and actions using technologies, that are easily available, to be integrated into the daily routines to enhance the quality of life and wellbeing of persons residing in long term care facilities. ┬á References Jao, Y.-L., Liu, W., Williams, K., Chaudhury, H., & Parajuli, J. (2019). Association between environmental stimulation and apathy in nursing home residents with dementia. International Psychogeriatrics, 31(8), 1109-1120. Nijsten, J. M. H., Leontjevas, R., Pat-El, R., Smalbrugge, M., Koopmans, R., & Gerritsen, D. L. (2017). Apathy: Risk Factor for Mortality in Nursing Home Patients. Journal of America Geriatric Society, 65(10), 2182-2189. Zuidema, S.U, de Jonghe, J.F, Verhey, F.R, Koopmans, R.T. (2009). Predictors of neuropsychiatric symptoms in nursing home patients: influence of gender and dementia severity. International Journal of Geriatric Psychiatry, 24(10),1079-1086.
Supporting provision of quality of care through sustainable implementation of AgeTech for persons living with dementia in rural areas
Purpose AgeTech can play an important role to support equitable access to high care for persons aging with dementia, especially in rural areas where access to formal care and supports may be limited. To enhance the quality of life and support provided to persons with dementia who wish to age in a rural community, a new facility was designed with AgeTech solutions embedded in their philosophy of care. A mixed methods study, guided by the Theoretical Domains Framework, was conducted to explore the contextual barriers and facilitators to AgeTech implementation in the rural context. Method The Center for Technology Adoption for Aging in the North (CTAAN), worked in partnership with health systems leaders, and community partners, to select multiple AgeTech solutions to enhance both the care and quality of life of persons living with dementia. AgeTech included in this study were a hydroponic gardening wall, circadian lighting, and a virtual exercise program. Semi-structured interviews were held with facility staff, health systems leaders, representatives from the AgeTech companies, and implementation leads including a secondary analysis of existing documentation was conducted. Results and Discussion A range of barriers to AgeTech implementation were identified including geographic context, complexity of dementia symptoms, and limited experiences by older adults with technology. The barriers were countered by community driven mitigation strategies which included establishing collaborative partnerships with AgeTech companies, client interest and motivation, and creation of AgeTech educational resources. Results provide insights to inform planning and policy decisions for rural AgeTech implementation initiatives, highlight considerations for ongoing AgeTech innovation and describe the engagement of community partners in the process of integrating aging technologies. Persons living with dementia can greatly benefit from the use of AgeTech to support their health and wellbeing. Successful and sustainable implementation of AgeTech is possible when the AgeTech enables, empowers, and engages persons to age well.
The role of sex and gender in the adoption of assistive technology in dementia care
The role of sex and gender in the adoption of assistive technology in dementia care ┬á Maren Salzwedel, Sytse Zuidema,Helianthe Kort, Sarah Janus (on behalf of SPREAD+) ┬á Purpose Women are disproportionately affected by dementia on several levels (Derreberry & Holroyd, 2019). At the same time, assistive technology (AT) is expected to alleviate the growing burden of dementia (Gathercole et al., 2021). Notably, the overall use of technology in older populations is affected by individual characteristics such as gender (Chen & Chan, 2014). Furthermore, neglecting sex and gender as an influential factor in dementia care may interfere with progression regarding the detection, treatment, and management of dementia (Nebel et al., 2018). Hence, there is an urgent need to comprehend the role of sex and gender regarding adoption of AT in dementia care in order provide AT tailored to needs of end-users in dementia care. Method We conducted a scoping review following the framework of Arksey and OΓÇÖMalley. Before running the search we consulted with the client council of the university network for elderly care of the University Medical Center Groningen to ensure the alignment of our search strategy with the interests of the dementia care triad. We searched three databases (PubMed, Web of Science, IEEE) and the grey literature (Google Scholar). The included studies were analyzed with thematic inductive analysis to identify emerging topics. Results and discussion Fifteen studies were included. We identified eight topics of sex and gender analysis (compatibility, attitude, usage, acceptance, access, usefulness, well-being, long-term effectiveness), which were all closely linked to AT adoption. Except for usage and long-term effectiveness, all topics revealed sex and gender differences which depended on either type of AT or study. In addition, the relevance of generation, culture, mental health and gender of technology was outlined in relation to sex and gender in the context of AT adoption in dementia care and beyond. Because the majority of studies provided no specifications of the underlying reasons for sex and gender differences, their practical implications remain largely uncertain. ┬á References Chen, K., & Chan, A. H. (2014). Gerontechnology acceptance by elderly Hong Kong Chinese: a senior technology acceptance model (STAM). Ergonomics, 57(5), 635-652. https://doi.org/10.1080/00140139.2014.895855 Derreberry, T. M., & Holroyd, S. (2019). Dementia in Women. Medical Clinics of North America, 103(4), 713-721. https://doi.org/10.1016/j.mcna.2019.02.004 Gathercole, R., Bradley, R., Harper, E., Davies, L., Pank, L., Lam, N., Davies, A., Talbot, E., Hooper, E., Winson, R., Scutt, B., Montano, V. O., Nunn, S., Lavelle, G., Lariviere, M., Hirani, S., Brini, S., Bateman, A., Bentham, P., . . . Howard, R. (2021). Assistive technology and telecare to maintain independent living at home for people with dementia: the ATTILA RCT. Health Technol Assess, 25(19), 1-156. https://doi.org/10.3310/hta25190 Nebel, R. A., Aggarwal, N. T., Barnes, L. L., Gallagher, A., Goldstein, J. M., Kantarci, K., Mallampalli, M. P., Mormino, E. C., Scott, L., Yu, W. H., Maki, P. M., & Mielke, M. M. (2018). Understanding the impact of sex and gender in Alzheimer's disease: A call to action. Alzheimer's & Dementia, 14(9), 1171-1183. https://doi.org/10.1016/j.jalz.2018.04.008 ┬á ┬á Keywords: Keywords: technology, dementia, sex, gender, quality of life ┬á Affiliation: University of Groningen, University Medical Center Groningen,┬á Department of primary and long-term care, Groningen, The Netherlands ┬á Corresponding author Email: m.h.salzwedel@umcg.nl, AuthorΓÇÖs ORCID iD: https://orcid.org/0009-0007-0989-4820 ┬á Acknowledgements: This research is conducted within the SPREAD+ consortium as part of the ZonMW Dementia Research Program, and financially supported by Alzheimer Nederland and Health Holland (WE.32-2022-01). ┬á
Unpaid carers of people living with dementia: ICT-use, non-use and sources of digital support
Purpose Close to a million people are living with dementia in the UK; over 80% of whom are cared for, unremunerated, by a spouse or relative (hereon in referred to as unpaid carers), many of whom are also of an advanced age. Unpaid carers often experience significant problems to their physical and mental wellbeing as a result of their circumstances (AlzheimerΓÇÖs Research UK, 2023; Lindeza et al., 2020). Evidence demonstrates the promise of information and communication technology (ICT) to support dementia care (Hassan, 2020; Caprioli et al., 2023, Lorenz et al., 2019). However, less is known about unpaid carersΓÇÖ current ICT-use and non-use, and how they acquire digital knowledge and skills that could support them to provide care for the progressive needs of a person living with dementia. Method We adopted a mixed-method approach.┬á Descriptive statistics and regression analyses of 167 survey responses on the impact of ICT functions on unpaid carersΓÇÖ wellbeing (ONS4) and quality of life (QOL) (DEMQOL) were complemented by a thematic analysis of 35 one-to-one telephone or videoconference interviews with unpaid carers. Results and Discussion Survey respondents were predominantly female (73%) and a mean age of 68 years (range 32-85 years); 66% reported using mainstream, internet-enabled ICT (e.g., laptop and tablet computers, smartphones, virtual assistants) for information, accessing services, entertainment and reminder purposes; 31% used care-specific ICT such as care management applications (17%), and communication or alarm systems (22%) (e.g., telecare). 32% indicated they did not use any ICT; 7% reported they didnΓÇÖt have sufficient skills or needed help to use ICT. Unpaid carersΓÇÖ use of ICT for entertainment and accessing services was significantly associated better wellbeing (p< 0.01) and QoL (p.<0.05) respectively. Most interview participants reported mostly relying on ICT for information gathering, social networking and administrative support for themselves, as well as for the person they cared for. A small minority discussed their refusal to use - or lack of interest in ΓÇô ICT. Interview participants discussed a range of ways in which they learned about ICT services to help them provide care. Several mentioned that their children, grandchildren and friends directed them to helpful apps and websites. A small number discussed the ICT guidance they received from local dementia and carer services. Some revealed they were self-taught and used ΓÇ£trial-and-errorΓÇ¥ methods to discover how ICT could optimally help them meet their circumstantial needs. Findings demonstrating unpaid carersΓÇÖ reliance on family, friends, and local services for digital support raises concerns about the large number of unpaid carers who are socially isolated (Carers UK, 2023) and/or have low digital self-efficacy (Dale et al, 2018). They also emphasize the need for improved mechanisms to identify the digital needs of vulnerable unpaid carers, and for accessible statutory ICT training and support services.
Caregivers and technology: need assessment to improve digital contents on AlzheimerΓÇÖs disease
Purpose The main objective of this study is to analyze caregiversΓÇÖ opinions regarding digital contents in order to improve a future digital product we are developing. This project is a co-creation process with caregivers, who have contributed the digital content they believe is relevant to include. We have also asked them about the content they believe would be relevant for persons diagnosed with Alzheimer's with the aim of integrating this group in a second phase of the project. Method The research tool of this study is a survey. The survey was self-administered in an online format. In Pasqual Maragall FoundationsΓÇÖs database, we targeted adult caregivers of relatives with Alzheimer's who were participants (2023) and former participants (editions 2021 and 2022) of the online support groups and face-to-face therapeutics groups The survey was provided to an eligible population (N) of 494 caregivers, yielding a sample of 147 individuals with a confidence level of 95% and a margin of error of 8%. A univariate and multivariate descriptive analysis was conducted using RStudio to validate or reject relationships among variables. Two separate databases were utilized based on the language of the survey (Catalan and Spanish). Results and Discussion The tools rated as the most useful were related to the management of time and care tasks, and the contents identified as the most useful were aimed at providing support on communication with the person living with AlzheimerΓÇÖs. In this sense, practical advice and information for resources about the disease stand out. Caregivers believed that the most valuable aspect of a digital community is the ability to share strategies, connect, and exchange experiences with people in similar situations. From the caregiverΓÇÖs perspective, cognitive stimulation is one of the most valued resources and areas of interest for the person with AD, followed by the promotion of autonomy.
Monitoring challenging behaviors in dementia with Sensortechnology
Purpose People with dementia (PwD) often present Behavioral and Psychological Symptoms of Dementia, which include agitation, apathy, and wandering amongst others, also known as challenging behaviors (CBs). These CBs worsen the quality of life (QoL) of the PwD and are a major source/ reason of (increased) caregiver burden. The intricate nature of the symptoms implies that there is no ΓÇ£one size fits all solutionΓÇ¥, and necessitates tailored approaches for both PwDs and caregivers. To timely prevent these behaviors assistive technology can be utilized to guide caregivers by enabling remote monitoring of contextual, environmental, and behavioral parameters, and subsequently alarming nurses on early-stage behavioral changes prior to the presentation of CBs. Eventually, the system should propose an intervention/action to prevent escalation. In turn, improvement in QoL for both caregivers and PwD living in nursing homes (NHs) is expected. In the current project ΓÇ£MOnitoring Onbegrepen Gedrag bij Dementie met sensortechnologieΓÇ¥ (MOOD-Sense), we aim to develop such a monitoring system. The strengths of this new monitoring system lie in its ability to align with the individual needs of the PwD, utilization of a combination of wearables and ambient sensors to obtain contextual data, such as location or sound, and predict or monitor CBs individually rather than in groups, thus facilitating person-centered care, based on ontological reasoning. The project is divided into three parts, Toolbox A, B and C. Toolbox A focuses on obtaining insight in which behaviors are challenging according to nurses and how they are described. Previous studies utilize clinical terminology to describe or classify behavior, we aim to employ concrete descriptions of behavior that are observable and independent of clinical terminology, aligning with nurses who are often the first to notice behavior and can be operationalized such that it can also be aligned with sensor data. As a result, an ontology will be developed based on the data such that sensor data can be integrated into the same conceptual information that standardizes the communication in our monitoring system. Toolbox B focuses on translating data coming from various sensors into the concepts expressed in the ontology, and timely communicate situations of interest to the caregivers. In Toolbox C the focus is exploring interventions/actions employed in practice to prevent CBs. Method In Toolbox A we used a qualitative approach to collect descriptions of CBs. For this purpose, we employed focus groups (FG) with nursing staff who provide daily care to PwD. In Toolbox B pilot studies were conducted. A set of experiments using sensors in NHs were performed. During each pilot, multiple PwD with CBs in NHs were monitored with both ambient and wearables sensors. The pilots were iteratively approached, which means that insights from previous pilot studies were used to improve consecutive pilot studies. Lastly, the elaboration of Toolbox C is ongoing. Results and Discussion Regarding Toolbox A 4 focus groups were conducted, from which we gained insights into behavioral descriptions and the context of CBs. Although data analysis has to be performed yet, there are indications that changes preceding CBs can be observed, such as frowning or clenching fists for agitation or aggression. Further results will be available soon. Regarding Toolbox B a monitoring system, based on sensors, is developed and piloted in three NHs. Analysis of sensor data is ongoing.
A Bibliometric Literature Review on International Trends in Robotic Technology Research in the Field of Dementia
Purpose┬áDementia is one of the seven leading causes of death and a primary factor for requiring long-term care. The number of dementia patients worldwide exceeds 55 million, with approximately 10 million new cases occurring annually. In this context, the utilization of robots is advancing to address the increasing number of dementia patients. This study focuses on the application of robotic technology in dementia care and aims to identify the most influential authors, educational and research institutions, countries, regions, and references internationally through a quantitative literature review. Literature review is a crucial method for analyzing trends in academic development. Investigating published academic literature reveals the current state and trends of a particular field, providing significant insight for future research directions. Bibliometrics, a method for quantitatively analyzing literature, is essential for objectively understanding research trends. Method┬áThis study uses network visualization analysis based on science knowledge mapping in bibliometrics to elucidate international trends in research related to application in the field of dementia. To ensure representative literature, the Web of Science Core Collection (WoSCC) provided by Clarivate Analytics was used. WoSCC. The literature for analysis was selected based on the following inclusion and exclusion criteria. Inclusion criteria: (1) papers related to robotic technology in dementia, (2) peer-reviewed papers published as of May 31, 2024, (3) papers obtained from WoSCC. Exclusion criteria: (1) unpublished papers, (2) conference proceedings and summaries, book chapters, prefaces, (3) duplicate papers, (4) literature unrelated to robotic technology in dementia. The search resulted in 290 papers, with 195 original research papers meeting the criteria for analysis. The search was conducted on May 31, 2024, and the period for the target papers was from 2011, when the first paper was published in WoSCC, to 2024. About ethical considerations, this study performed statistical analysis using bibliographic information from prior literature published as of May 31, 2024. Therefore, ethical review for human subjects was deemed unnecessary. Results and Discussion┬áThe most frequently occurring author in the overall network was Stephen Scott (frequency: 4, centrality: 0.01). Cluster analysis revealed a single cluster primarily related to Transcatheter Aortic Valve Implantation (TAVI). Among educational and research institutions, the highest frequency of four was found in Hospital Universitaire Broca et al. Clustering identified a single cluster mainly related to Socially Assistive Robots. In the analysis of countries and regions, Japan had the highest frequency at eight, while England had the highest centrality at 0.17. Clustering revealed two main clusters: ΓÇ£roboticsΓÇ¥ and ΓÇ£Socially Assistive Robots.ΓÇ¥ Keyword analysis showed that ΓÇ£dementiaΓÇ¥ had the highest frequency at 18. Centrality was highest for ΓÇ£cognitive impairmentΓÇ¥ at 0.44. The largest clusters identified were related to ΓÇ£assistive roboticsΓÇ¥ (size: 26) and ΓÇ£socially assistive robotsΓÇ¥ (size: 26). In the study focused on authors, it was found that TAVI research plays a central role, indicating that research is primarily advancing in the application of robotic technology in cerebrovascular dementia, such as in stroke patients. Additionally, the references indicate that studies on robotic technology for social support are being frequently cited. This suggests that the application of robotic technology is gaining attention in both neuroscientific research on stroke patients and in social support for elderly care.
Portable EEG guided meditation for people with mild to moderate dementia: feasibility exploration
Purpose To explore the feasibility of portable EEG headband-guided meditation for people with mild to moderate dementia and examine the preliminary efficacy in relieving psychological distress among them. Method A Phase II clinical trial with a two-arm experimental pre-post assessments design was conducted. Convenience sampling was used to recruit people with mild to moderate dementia who were able to communicate. Participants were randomly allocated to the intervention or control group. The intervention group received a 10-minute EEG headband-guided meditation session. The control group only received a 10-minute resting test with the EEG headband. Psychological distress was measured with the Depression, Anxiety, and Stress Scale-21 before and after the meditation session. Descriptive statistics and t-test were used to analyze the baseline characteristics. Generalized estimating equations were used to analyze the preliminary efficacy of EEG headband-guided meditation. Results and Discussion Fifty-seven participants consented to participate in this study, with 29 of them randomized to the intervention and 28 to the control group. The average age of participants was 81.65 (8.56). The EEG headband-guided meditation was feasible to be implemented among people with mild to moderate dementia, with all the participants finishing the sessions successfully. No side effect was reported by the participants. The group-by-time interaction effect on improving the depressive symptoms of people with dementia was statistically significant (Wald Chi-square=4.316, p=.038), with the intervention group showing more improvement. However, the efficacy of improving stress and anxiety or the total score of psychological distress was not statistically significant. Our results indicate that EEG headband-guided meditation has the potential to improve depressive symptoms of people with dementia. Longer duration and higher intensity of the intervention are suggested for improvements in stress and anxiety (Li & Bressington, 2019).
Digital phenotyping for changes in activity at the end of life in people with dementia
L.D. Boyle, B.S. Husebo, B. Marty, K. Haugarvoll,O.M. Steihaug, M. Patrascu Purpose: Almost 90% of people with dementia develop behavioral and psychological symptoms (BPSD) such as apathy, agitation, and sleep disturbances.1 Recent research shows that data acquired from mapping the physical, mental, and functional activities of a person can serve as a marker for conditions including BPSD.2-4 The application of digital phenotyping to people with dementia is still mostly unexplored, with issues of ethical nature at the forefront. There is therefore value in investigating whether digital phenotyping can enhance the objectivity of measuring activity and symptom changes during the last period of life. We hypothesize that use of sensing technology will enable better estimation of time of death, facilitating improvement of end-of-life interventions and directives for people with dementia. Method: DIgital PHenotyping in DEMentia (DIPH.DEM), a 3-year prospective cohort study (N=25), will monitor participants living in a nursing home at baseline, and every 6-months (7-days), up to 1-year. The objective of the study is to use sensing-based digital phenotyping (Somnofy and Garmin Vivoactive 5), combined with validated assessment tools, to describe the activity trajectory and associated processes of the end of life in persons with dementia. Presumed consent will be obtained for all participants and traditional outcomes measures completed by proxy. Results & Discussion: The use of digital phenotyping can provide knowledge on living, and dying, with dementia. This can improve directives and provide guidance for timely, appropriate interventions, including referral to palliative services and pharmacological interventions. Preliminary results from the first 11 participants are currently being analyzed (MATLAB and STATA). Analyses will include development of individual models based upon descriptive statistics, traditional outcome measures (proxy-rated), actigraphy (movement) and sleep quality data collected at baseline and at 6-months. ┬á References: Sandvik, R. K., Selbaek, G., Bergh, S., Aarsland, D., & Husebo, B. S. (2016). Signs of imminent dying and change in symptom intensity during pharmacological treatment in dying nursing home patients: A prospective trajectory study. *Journal of the American Medical Directors Association, 17*(9), 821-827. Husebo, B. S., Heintz, H. L., Berge, L. I., Owoyemi, P., Rahman, A. T., & Vahia, I. V. (2019). Sensing technology to monitor behavioral and psychological symptoms and to assess treatment response in people with dementia: A systematic review. *Frontiers in Pharmacology, 10*, Article 1699. Vahia, I. V., & Forester, B. P. (2019). Motion mapping in humans as a biomarker for psychiatric disorders. *Neuropsychopharmacology, 44*(1), 231-232. Au-Yeung, W. M., Miller, L., Beattie, Z., May, R., Cray, H. V., Kabelac, Z., et al. (2022). Monitoring behaviors of patients with late-stage dementia using passive environmental sensing approaches: A case series. *American Journal of Geriatric Psychiatry, 30*(1), 1-11. Keywords: dementia, technology, end-of-life, phenotyping, sensors Affiliation: Centre for Elderly and Nursing Home Medicine, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway Corresponding Author Email: lydia.boyle@uib.no ┬á Ethics: This study was approved by the Regional Committee for Medical and Healthcare Research Ethics (REK) on October 23, 2023: 634938. Acknowledgements: This research is supported by the Western Norway Regional Health Authority (Helse Vest RHF); sponsor protocol code: F-12829-D10484.
Dementia in social media: Content Analysis of YouTube Videos
Purpose To evaluate the video features and video content features of the dementia-related videos published on the YouTube social media platform. Method Analysis were conducted using the video content analysis method using a directed and summative approach to qualitative content analysis. Results and Discussion The video features and descriptive statistics of the video content features of the 100 most watched videos on the YouTube platform related to dementia were obtained. Analyzed video features; It includes the title of the video, the publication date of the video, the duration of the video, the number of views of the video, the number of likes of the video, the number of dislikes of the video and the number of comments of the video. Video content features: the gender of the speakers, the roles of the speakers, the source of the video, the format of the video, the types of dementia mentioned, the actionable information, the information mentioned in the video content, the informational warning content and the target audience characteristics.┬á It has been concluded that YouTube video content analysis studies make various contributions to the reliability of video contents, the YouTube platform is a promising and valuable tool in terms of public health, YouTube contributes to the field of health education, and the number of video content analysis studies that need to be carried out in this field should be increased. Keywords: YouTube, dementia, video content analysis, aging Affiliation: Gerontology and Ageing Studies Department, Swansea University Faculty of Medicine Health and Life Science, The United Kingdom Corresponding Author Email: 2230274@Swansea.ac.uk ; AuthorsΓÇÖ ORCID iDs: 0000-0002-3608-9874, 0000-0003-3133-2692
Exploring the physical, social and educational benefits of virtual reality exergame for people with dementia through co-designing to promote hand hygiene and influenza vaccine uptake
Purpose┬á The purpose of this project is to develop an educational exergame for people with dementia (PWD) and their caregivers to practice effective handwashing through the use of virtual reality (VR), while delivering educational content related to infection control, and evidence-based resources to educate them about the importance of influenza vaccination.┬á Our objective aims at examining the meaning and value of utilizing educational and social exergaming for PWD in the community and institutional settings, and to explore its physical, social, and educational benefits, including hand hygiene practices and influenza vaccine uptake. ┬áMethod┬á The Behavior Change Wheel [1-2] was used to guide the understanding of factors that influence the adoption of educational learning in hand hygiene and influenza vaccination, which include three domains: (a) modelling (learning through imitation); (b) education (gaining knowledge), and (c) training (practicing skills). Using mixed methods approaches, this project is comprised of co-designing, developing, and pilot-testing the feasibility of exergame, An advisory committee group (12 members) was recruited from Oshawa Senior Community Centre and Durham Region Long-Term Care (LTC) Homes, where they acted as expert panels to provide consultations related to co-designing of exergame. Results and Discussion┬á The development team collaborated with the advisory members (including public health and infection control practice consultants; occupational therapy/rehabilitation consultants, accessibility consultations, health/service providers, older adult with cognitive impairment and their caregivers) to engage in the co-design process. This allowed for the incorporation of user feedback to guide each iteration of technology development with the goal of ensuring the solution is feasible, usable, robust, accessible, and culturally-sensitive from the beginning of conceptualization until implementation. Prior to co-design session, the research team hosted virtual Idea Jam sessions with the team members to provide a forum for discussion about the development of exergame intervention, and the implementation approach. During the co-design phase, the process was guided by the Consolidated Framework For Implementation Research (CFIR) [2] to allow the advisory stakeholders to explore the relevant factors that would facilitate or hinder the development, implementation, and evaluation of VR exergame for PWD, while taking into consideration of their cultural contexts (Figure 1). Major milestones in this phase included content development, such as co-creating and co-designing interactive storyboards for the exergame components, visual assets, and aesthetics. High-level prototyping and iterative design of accessibility features enabled equity and inclusion considerations to address the needs of PWD with physical disability and cognitive impairment. Additional considerations included game mechanics, successful hand tracking interactions based on userΓÇÖs diverse ranges of upper limb mobility, as well as analysis and characterization of VR motion capabilities and signal processing for users with different levels of hand motor skills.┬á There is an urgent need for proactive interventions directed at PWD to mitigate their risk for having ΓÇ£vaccine-preventableΓÇ¥ infections. Our solution is an interactive educational and social exergame, which is designed as a preventative measure to mitigate the risks of infectious diseases, as well as presenting opportunities for PWD and their caregivers to engage in physical activity and cooperative gaming to promote their social connectedness and mental well-being.
Developing Low-Tech Assistive Technology to support Daily Activites for Older People
PURPOSE Can we design technological innovations that support older people without depending on the Internet? Can these technologies be designed with less reliance on electricity or IT sources (Kort, 2024)? Older people, especially those with impaired memory, cannot remember how to use electrical or IT tools. Moreover, they gradually lose the ability to use such tools, which have fundamental limitations for them (Yasuda, 2022). Products without electric power supply are classified as Low-Tech Assistive Technology (AT; Yasuda, 2022). Commercially available electronic and ICT products are categorized as Middle-Tech AT. An advantage of Low-Tech ATs is that they can be used intuitively (Hickey & Bourgeois, 2018). They are usable without much training and/or reading manuals, and easy to maintain. Middle- or High-Tech ATs alone cannot support every aspect of older peopleΓÇÖs daily lives. Although Low-Tech ATs are indispensable for supporting older people, they have been mostly overlooked. Exceptionally, Bourgeois (2014) introduced memory and communication aids for persons with severe dementia. Yasuda (2022) has created various Low-Tech ATs that could be applied to people with MCI and mild dementia. We introduce some Low-Tech ATs. METHOD 1) New Memory Support Diary: Diaries available on the market are designed for healthy individuals, with no suitable options for the memory impaired. Thus, this Diary pages are divided into sections to record meals, physical conditions, errands, and frequently misplaced items. Each section is the size of common sticky-notes. Users are advised to bring sticky-notes when going out and keep the diary open on their desk all day to write whenever needed. 2) Wearable memo-pads: Older people often forget to carry the memo-pads. An ideal solution is wearable memo-pads integrated into clothing or body, allowing immediate note-taking. Various types such as bracelet-, bolo-tie, business-card type memo-pads have been developed. 3) Memory vest: this vest allows users to store the ATs such as memo-pad, smartphone, IC recorder, glasses, wallet, keys, etc. In the reverse side, several pockets made of mesh materials are attached. In the pockets, people can insert paper with messages such as ΓÇ£ItΓÇÖs X day, todayΓÇ¥. People can see them when they open the front part of the vest. DISCUSSION The Low-Tech ATs presented here are easy to use, inexpensive, durable, and usable without electricity. By leveraging each type of AT (Low, Middle, High), it may be possible to prolong the period of independent living for people with MCI or dementia. References Kort, H. (2024). ISG Newsletter, July 2024. Hickey, E. M. & Bourgeois, M. S. (2018). Dementia: Person-centered assessment and intervention, Routledge.┬á Bourgeois, M. S. (2014). Memory book and other graphic cuing systems, Health Professions Press.┬á┬á Yasuda, K. (2022). Rehabilitation for MCI and dementia; Using assistive technology to support daily activities, ┬áUnion Press. ┬á KEYWORDS: Low tech, Middle Tech, Assistive technology, MCI, dementia,┬á Affiliation: Graduate School of Electrical and Electronic Engineering, Kobe University, Japan Corresponding Author E-mail: yasukiyo.12@outlook.jp ┬á ┬á ┬á ┬á ┬á ┬á ┬á
Prioritizing Older Adults: Ethics and Equitability Reflections in Implementing and Deploying Active Assisted Living Systems
Purpose Despite advances in modern medicine allowing older adults to live longer and with increasingly complex needs, health and care provision has not kept up with the growing needs of this group (Hoffman et al., 2021). Active or Ambient Assisted Living (AAL) systemsΓÇöcomprised of IoT devices and designed to improve quality of life, aid in independence, and create healthier lifestylesΓÇöhave great potential to facilitate personalized, efficient care (Kushniruk et al., 2021). Still, little guidance exists for practical and ethical implementation (Fadrique et al., 2020). This project aims to explore how AAL may be feasibly integrated into the continuum of care and provide actionable steps for deployment while considering the concerns and perspectives of users. Method Using qualitative measures, the present study will evaluate the literature on (1) what impacts a userΓÇÖs autonomy, (2) what concerns arise regarding equitability, and (3) the unintended impacts of introducing AAL technologies. The study applies a Public Health and Ethics (PHE) lens, which incorporates the moral implications of public health actions, interventions, and policies, focusing on promoting the common good, protecting population health, and respecting individual rights and autonomy by using systematic frameworks. We will utilize a PHE systematic framework developed by Marckmann and colleagues, which helps researchers analyze the ethical considerations surrounding privacy, data security, consent, and potential discrimination of AAL technology users (Marckmann et al., 2015).┬á Finally, a grey literature scan of existing standards and guidelines on the ethical implementation and deployment of IoT devices in AAL systems will be conducted. Results and Discussion Our exploratory literature review highlights the factors users identify that affect their autonomy in AAL systems, as well as barriers to equitable deployment of AAL technologies existing at the meso (community and institutional) and micro (household and individual) levels (World Commission on the Ethics of Scientific Knowledge and Technology, 2023). Based on these results, we will present recommendations for mitigating equitability issues, ensuring fair access to AAL systems for all demographics and addressing unintended impacts from a PHE perspective. The grey literature scan on existing standards and guidelines on the ethical implementation and deployment of IoT devices in AAL systems identified gaps and inconsistencies in the current standards. Based on the grey literature scan results, we will provide recommendations on how to update the guidelines for the ethical implementation and deployment of AAL technologies. Overall, this study provides actionable insights for stakeholders involved in implementing, deploying, and regulating AAL systems to maximize benefits while minimizing risks for older adults and promoting equitable access to care. AAL systems have the potential to significantly impact the autonomy, equitability, and public health outcomes of older adults. Implementing AAL technologies must be approached carefully while considering ethical issues and likely unintended consequences. Possible trade-offs or compromises in autonomy may occur with the implementation and deployment of AAL systems. Further research is needed to address gaps in the literature and inform practical strategies for effectively integrating AAL technologies into the continuum of care at the macro (health systems and social policy) level. ┬á
Digital Technology Attitude and Life Satisfaction: Mediating through Digital Information Utilization and Social Capital among Middle-aged and Older Adults
Purpose: The scope of digital technology utilization is expanding gradually and significantly impacting our lives (Cotten et al., 2012; Lee et al., 2015; Oh & Yoo, 2018). However, the middle-aged and elderly population are considered a representative group of digital vulnerable groups (Kiel, 2005), and concerns have been raised about experiencing inequality in various areas of life. This study aims to examine how attitudes toward digital technology among the middle-aged and elderly influence life satisfaction through the mediation of digital information utilization and to verify the moderated mediating effect of social capital in this relationship. Method: The analysis utilized elderly data from the 2022 Digital Divide Survey conducted by the Ministry of Science, ICT, and Future Planning and the Korea Information Society Development Institute. The study targeted 2,300 middle-aged and elderly individuals aged 55 and above. To verify the moderated mediating effect, SPSS 23.0 and the Process Macro were employed. Results and Discussion: The analysis results are as follows: Firstly, a partial mediating effect of digital information utilization was observed in the relationship between the attitudes toward digital technology and life satisfaction among middle-aged and elderly individuals. Secondly, the moderating effect of social capital was found to be significant in the relationship between the attitudes toward digital technology and digital information utilization among middle-aged and elderly individuals. Thirdly, it was verified that the social capital of middle-aged and elderly individuals moderates the indirect effect of attitudes toward digital technology on life satisfaction through digital information utilization. Based on the results, the conclusions and recommendations are as follows: Firstly, educational programs should be provided to improve the perception and attitudes toward digital technology among middle-aged and elderly individuals. Secondly, tailored programs considering the levels of middle-aged and elderly individuals should be offered, and diverse contents should be developed to enhance the level of digital information utilization. Thirdly, there should be an expansion of service providers, such as digital assistants. Particularly, it is necessary to actively consider methods for expanding social capital, such as the expansion of the elderly-to-elderly information education model and providing information education through intergenerational solidarity.
Older people┬┤s evaluation panel for development of digital and technology
Older people┬┤s evaluation panel for development of digital and technology The Union for Senior Services, VALLI ┬á Purpose During recent years and as a result of the COVID-19 pandemic, Finnish society, with its varied services, has digitized rapidly. At the same time, the use of technological solutions, for example, in healthcare or elderly care has increased. As a result, many people from different backgrounds, especially older people, find it difficult to use digital and technological services and equipment, as the solutions face many problems in terms of accessibility and utility, among other challenges. This is a challenge not only for the end-users, for example, older people, but also for product developers and companies, if no one is using the service or the product. It is also a challenge to society and the public services, because of the trend of transferring services to the Internet and reducing traditional services. The solution is user-oriented development. User-oriented development means making sure that services and products that are developed are inclusive and people find it beneficial to use and purchase them. User-oriented development offers new knowledge and understanding to digital and technology developers, as there is diversity among the population, as well as the older population. For example, all of the factors of geographical area of residence, wealth, cognitive and physical skills, education level, digital skills, individual┬┤s safety net, mode of living, being included in one or more marginalized group, previous working life and professional, affect the use of digital services and technological equipment. ┬á Method The Union for Senior Services, VALLI, has developed a forum where older people can participate in the development processes of digital and technological services and products. Older people test and evaluate the service or product in the making. They give different perspectives and ideas and explain their needs to the developers so that the developers can fix the service/product. VALLI coordinates this nationwide network for older people. Older people can be involved when they want and choose the method of involvement: they can participate in events and visits, answer questionnaires, and give interviews. The panel is a meeting point for the older people and the developers. In other means, as the developers might not have resources to seek older people for testing and evaluation events, they can contact the coordinator who can contact older people. ┬á Results and Discussion According to different evaluation methods and data, older people┬┤s experience of digital inclusion is increasing due to their Panel activity. When participating in user-oriented development processes, older people learn more about the possibilities of digitalization and technology. Their own rate of use is more likely to increase and their fears and prejudices against technology decrease. With the help of the evaluation panel, digital services or technological products are more accessible and appropriate, and in the long term they are more likely to be purchased. The developersΓÇÖ understanding of the different needs of the elderly is increasing, which helps them with their innovation and development process. The developers are more likely to produce products and services which are purchased. As there are both national (Finnish1) and international (especially EU-level2) policies to increase citizens┬┤ digital inclusion when increasing the level of digitalization, the evaluation panel is one method to support these policies. ┬á The Union for Senior Services, VALLI is a a national non-profit umbrella organization for the care of elderly. VALLI is founded in 1953. The organization has approximately 60 member associations around Finland, which serve about 20 000 older people with 2000 professionals. ┬á ┬á References 1 Finnish Government (2022): Digital Compass. Publications of the Finnish Government 2022:72. http://urn.fi/URN:ISBN:978-952-383-906-9 2 European Commission. Policies: Digital Inclusion. https://digital-strategy.ec.europa.eu/en/policies/digital-inclusion ┬á ┬á Keywords: digital inclusion, older people, user-oriented development Affiliation: The Union for Senior Services, VALLI Corresponding Author Email: suvi.hiltunen@valli.fi
The Union for Senior Services VALLI VALLI ry
Digital Defender 60+: Perspectives on Digital Literacy for the Elderly
Purpose The impact of new information and communication technologies on the aging population is becoming more evident. It is leading to exclusion from family or social activities, which can limit the exercise of basic human rights. To combat this issue, The Public Defender's Office of the State of Amazonas partnered with FUnATI to promote the rights of vulnerable populations and conduct research on aging. As a result of this collaboration, the Digital Defender 60+ course was created. This course aims to train older adults in new concepts and practices required for citizenship in an increasingly digital world. The course trains older adults who can then share their knowledge with others. Method To collect data related to the exclusion of the elderly from the virtual environment, a qualified hearing was sought from over sixty-six elderly individuals belonging to different social classes, through an interdisciplinary team led by a public defender, psychologist, pedagogue, journalist, and computer scientist. Based on these data, a course was formulated, lasting eight months, with theoretical and expository classes to provide the missing knowledge and, consequently, empower the Digital Defenders 60+. Additionally, a methodology derived from Theater was used to stage what has been termed digital violence. Scenarios depicting the everyday exclusions and violence suffered by the aging population were developed. Results and discussion It has been identified that family environment is one of the obstacles faced by elderly individuals. Therefore, new practices are being developed that involve children, grandchildren, and nephews to establish stronger bonds and combat ageism prevalent in family relationships. The goal is to create a genuine support network for the elderly to help them navigate the challenges brought by the virtual world. Moreover, with the insights and data gathered during the course, practical stances are being projected in the development of technologies, such as cell phone applications, that possess inclusive designs. In addition to that, a theatrical piece is being created that depicts the daily struggles faced by the elderly population. The aim is to expand the fight against ageism and reach society as a whole.
Exploring Digital Care: Developing Ethical Competencies
Purpose: The advancement of digitization in nursing care is expected to significantly increase in the near future. Nursing staff need appropriate training opportunities that integrate ethical skills alongside digital skills to effectively participate in this transformation (Becka et al., 2020). Most training courses in this area have a rather low ethics component. The ΓÇ£Consultant for Digital HealthcareΓÇ¥ training is intended to close this gap (Kraft et al., 2024). Research question: How does the "Consultants for Digital Healthcare" continuing education program impact the ethical skills development of participants? Method: A mixed-methods design is used to assess the learning impact of the ethics module in terms of ethical skills. Quantitatively, self-assessment of ethical competence is measured using the "Ethical Decision-Making Confidence Scale for Nursing Leaders" (EDMC) (Birkholz et al., 2022). Qualitatively, twelve semi-structured interviews explore connections in ethical competence development with a particular focus on the use of digital technologies. An exploratory approach is therefore being pursued in the new area of ethical competence development for digitally supported care. Results and Discussion: The intervention shows a significant increase in ethical competence, particularly in articulating moral distress, applying ethical decision-making models, and guiding mediation in complex clinical scenarios. The area of explaining one's own ethical decisions using the appropriate ethical terminology and language is increasing less rapidly. Interviews confirm participants' increased awareness of ethical dimensions in digitally supported nursing practice and willingness to consider ethics in technology use and in the implementation of new technologies. Thus the further training impacts ethical skills in a comprehensive sense, on a cognitive, affective and practical level. These include a variety of general areas of ethical competence, such as knowledge of ethical principles or awareness of the ethical dimension of professional behavior and specific technology-related competence areas, such as willingness to take ethical aspects into account when using technology. The training intervention effectively enhances ethical competence among participants. The results presented here result from the subjective self-assessment of the participants. Thus, future research should explore the correlation between subjective self-assessments and objective measures of ethical competence and the possibility of developing further instruments for evaluation. In addition, further research is needed on the relationship between ethical and digital skills and what it takes to learn and apply competent and professional ethical behavior in the area of digitalization of care.
Ethical dimensions in human-robot interactions in the field of gerontechnology
ISSUE: The rapid development and deployment of robotic applications in gerontechnology, such as socially assistive robots for companionship and daily assistance, virtual coaches, and virtual agents for health monitoring or cognitive support, have the potential to significantly enhance the quality of life for older adults (G├│ngora Alonso et al., 2019). However, this advancement brings forth a multitude of ethical challenges that need to be addressed from various stakeholder perspectives. Primary users, such as older adults, along with informal and formal caregivers, regulators, and healthcare providers, are directly impacted by these technologies. Ethical concerns also extend to companies developing socially assistive robots and the programmers designing the systems for robot behavior control and data handling (Sharkey & Sharkey, 2012; Van Wynsberghe, 2016). This symposium aims to explore and address these critical ethical issues, ensuring that the integration of robotic applications in gerontechnology is conducted in a manner that respects the dignity, privacy, and rights of all involved parties. CONTENT Our symposium is designed to bring together speakers from France, Japan, and South Korea. STRUCTURE Dacunha et al. address the ethical challenges of integrating social robots in geriatric care, focusing on developing and assessing an educational module for health professionals. Key issues include obtaining consent, managing risks related to judgment impairment, and preventing excessive attachment to robots among cognitively impaired older adults. Conducted in France, the project involved a literature review, interviews with 20 geriatric care professionals, and the creation of 10 training videos. These videos, evaluated by 44 healthcare professionals, provided ethical and practical recommendations for conducting robot-assisted activities. The positive feedback underscores the importance of addressing ethical concerns and training needs for responsible robot use in geriatric settings. Vall├⌐e and Auberg├⌐ discuss the impact of humanoid design, perceived usefulness, and expressiveness on the acceptability and trust in human-robot interactions. Using a living lab approach, their studies involving the Miroki robot in hospitals and nursing homes revealed that robots introduced as subjects with high expressiveness were perceived as more flexible and trustworthy. Ogawa discusses the effects of cognitive functions on understanding robot speech, revealing that older adults with cognitive decline struggle to comprehend robot speech compared to human speech. The study highlights the need for specific technical features and alternative communication methods in social robots to aid older adults with dementia, bridging the digital divide and addressing ethical implications in human-robot interaction by ensuring accessibility for vulnerable populations. Choi presents public perceptions of care robots in the context of South Korea's rapidly aging population and shrinking caregiver workforce. Her study, involving an online survey of 1,668 participants, revealed significant variability in knowledge and definitions of care robots, with higher education levels correlating with better understanding. Ethical implications are critical, highlighting the need for public communication and discussions to ensure human-centered and ethically responsible development of care robots. Finally, Blavette et al.'s presentation focuses on participatory design in developing social robots for geriatric care. Engaging 45 residents from four French geriatric institutions, their study assessed their needs and preferences through focus groups and interviews. Key features valued by older adults included video-conferencing, object delivery, and cognitive games, which could enhance their quality of life and social connectedness. The findings underscore the importance of involving end-users in the design process to ensure ethical and practical success in technological innovations for geriatric care. CONCLUSION This symposium will explore the participatory design of social robots for geriatric care, addressing ethical challenges such as consent, attachment, and the development of training modules for health professionals. Factors influencing trust in human-robot interactions, the comprehension of robot speech by older adults with cognitive decline, and public perceptions of care robots in rapidly aging societies will also be examined. The critical importance of incorporating ethical reflection in the design, assessment, and deployment of robot-mediated services for older adults will be emphasized, ensuring these technologies are developed and implemented responsibly and respectfully.
Developing Sustainable and Ethically Valid Gerontechnology: A Comprehensive Approach to Aging, Diversity, and Participation
The purpose of this presentation is to describe the development process of sustainable and ethically valid co-development in gerontechnology. Our joint development of gerontechnology is based on WHO's Healthy Aging 2030, the UN's Sustainable Development Goals (1-5, 8-11, and 16-17), and the EU's horizontal principles. Our goal is to enable good aging and life, requiring the participation of aging populations in the development of gerontechnology while considering their diversity and equality in the community.
Advancing Diabetic Foot Care: Incorporating Horizontal Shear Forces in Orthopaedic Insoles through Generative Design
Purpose In Germany, people with diabetes mellitus receive excellent medical care, resulting in an increasing number of elderly diabetes patients. As of 2022, approximately 340,000 German adults were affected by type 1 diabetes, with almost 30% of them being over the age of 70. Additionally, about eight million people suffered from type 2 diabetes, with 25% of them being over the age of 75 (Zeyfang et al., 2022). Diabetes frequently co-occurs with polyneuropathy, which can result in reduced sensation of pressure and pain. This can lead to diabetic foot syndrome, a condition characterized by pathological changes in the foot. Morbach et al. (2021) reported that the likelihood of diabetic foot syndrome in individuals with diabetes ranges from 19%-34%. To prevent foot ulceration or necrosis, it is critical to identify and relieve calluses and pressure points in a timely manner. Diabetes patients are often fitted with orthopaedic insoles to relieve particularly stressed areas. Personalization of footwear is achieved through 3D impressions using plaster or impression foam, coupled with pressure measurements during walking using pedography. However, traditional podography only records vertical forces directed towards the ground, neglecting the horizontal shear forces that contribute to blistering caused by friction. The objective of this study is to investigate the feasibility of developing orthotic insoles that account for horizontal shear forces using generative design and additive manufacturing techniques. Method Generative design methodologies are used to develop a soft orthopaedic insole that targets stress points on the foot. Biomechanical load models are created to encompass various gait phases, including initial contact, loading response, mid stance, and terminal stance, factoring both vertical and horizontal forces. Autodesk Fusion 360 software allows for the creation of load cases for each gait phase, considering the corresponding force magnitudes based on Jacqueline Perry's 'Gait Analysis' (Perry, 1992). The insole's basic shape is initially adjusted using free-form surfaces. Results and Discussion This study demonstrates the feasibility of generative design for orthopedic insoles, considering horizontal shear forces. Generative design involves generating material based on applied load, force flow, material, and manufacturing process. The amount of material generated increases with the applied load (Garland et al., 2021; Zwettler, 2020), resulting in increased strength in heavily loaded areas of the insert. This, in turn, can counteract the relief of these areas. Additionally, the current approach to static analysis should consider the foot's dynamic behavior during walking to ensure optimal shock absorption and support. Generative design and additive manufacturing have the potential to enhance foot care for diabetics by accounting for horizontal shear forces that can reduce the risk of pressure points and foot ulcers. Additive manufacturing can reduce material consumption compared to traditional subtractive methods such as milling. Additionally, the use of bioplastics in additive manufacturing can improve environmental sustainability.
Participation of U3A students in virtual activities during the Covid-19 pandemic
Purpose The pandemic resulting from the emergence of a new coronavirus, known as COVID-19, set in quickly and unexpectedly, bringing several changes in the routine and quality of life of individuals, especially the older ones. Due to the need for social isolation during the pandemic, many educational and health promotion programs stopped being in-person and began to be provided virtually, as was the case with classes at Universities for the Third Age (U3A). The U3A consists of spaces to promote Healthy Ageing through permanent education, promoting knowledge, leisure, education and socialization. However, technological insertion for older people still represents a challenge for the community, as many have difficulties in handling these technologies, which therefore may impact participation in actions provided virtually, such as U3As during the pandemic, and reduce the social interaction provided by these tools (Blanco, Ces├írio & Castro, 2021). Therefore, the objective of the present study is to identify whether older individuals participants in a U3A participated in virtual activities during the Covid-19 pandemic, as well as whether they already used or started using information and communication technology (ICT) in this period. Method This is a cross-sectional study, with a qualitative approach and was carried out with participants from a U3A located in the city of S├úo Carlos, Brazil. During the covid-19 pandemic, this U3A stopped carrying out in-person activities and started carrying out virtual activities on online platforms. One hundred and nineteen U3A participants aged 50 years or over, who participated in a previous survey conducted in 2019, were invited to participate in the current study. The individuals who accepted were interviewed in person in 2023, after the return of the U3A's in-person activities. A questionnaire developed by the researchers was applied in the interview, which contained sociodemographic questions and four other questions, namely: 1) Did you participate in U3A classes during the pandemic?; 2) Did you use any ICT before the pandemic, such as cell phones, computers and internet?; 3) During the pandemic, did you start using any of these technologies?; 4) Do you currently use any of these technologies? Data were recorded using relative frequency and absolute frequency, mean and standard deviation. Results and Discussion Among the 119 individuals, 65 were unable to be contacted, 21 did not agree to participate again, 2 moved to another city and 1 died. Therefore, 30 individuals participated in the research, the majority of them were female (83.3%) and aged between 60 and 75 years (80.0%). Regarding education, a predominance of individuals with completed secondary education (46.6%) or higher education (36.6%) was observed. Regarding information about participation in U3A's virtual activities during the pandemic, only 10 individuals (33.3%) participated in classes remotely, all of whom used ICT before, during and after the pandemic. Of the 20 individuals who did not participate in U3A's virtual activities, 19 used ICT before and during the pandemic and all 20 used it post the pandemic (Figure 1). Although the sample was broadly digitally engaged and had a high level of education, there was no adherence to this virtual learning methodology, as observed in the study by Formosa (2021), which portrays the difficulties of older individuals participating in U3As in adopting activities in an online format, highlighting the importance of accessible technologies for this audience and training for their use.
Exploring the Potential of image diagnosis exams at home: The Health2Home Project
Participants: H. S. M. Kort (the Netherlands), L. J. Lorenzi (Brazil), P. C. Castro (Brazil).ISSUE Healthcare is undergoing a paradigm shift towards digitalization, with eHealth playing a pivotal role in delivering services, especially for older users. Despite the increase in the use and perception of the potential of home imaging diagnosis to assist in health care planning, a notable gap persists in recognizing the specific attributes of this service and understanding the perceptions of end users. Clearly defining these design concepts could help in their development and improvement and provide scientific evidence for the implementation of these services in public and private health, facilitating access to them. CONTENT Our symposium is designed to bring together speakers from the Netherlands and Brazil participants of Health2Home (H2H) project. H2H is a collaborative research activity and network between University of Applied Sciences (HU), Mobi Diagnostics (Mobimagem, 2023), Federal University of Paran├í (UFPR) and Federal University of S├úo Carlos (UFSCar), aiming to explore the potential of home care exams and image diagnosis, for older users. This project aims to understand the opinion and feasibility of eHealth services in the view of users and providers. As far as users and providers are concerned, the study hypothesizes that health2home services (mobile diagnostics and eHealth services) are cost-effective (lower costs when compared to outpatient services), and reliable, and they generate fewer insecurities by avoiding dislocation. There will be less exposure to other diseases, and older people have the comfort of examinations being performed at home. The speakers will highlight: (1) Literature review and exploration of the market, (2) User experience and centered design, and (3) Cost-Minimization Analysis. STRUCTURE This symposium proposal aims to present three papers associated with the H2H project, focusing on the design services, costs and user experience aspects. These papers draw insights from various research strands across the participating universities and companies. Kort will introduce the "Health2Home" project, a initiative centered on home-based imaging diagnostic services. She will also present preliminary results from a market review of companies that provide home diagnostic services in the countries that publish the most in the area around the world. Lorenzi will discuss user satisfaction with a home-based imaging diagnostic service in Brazil, exploring different facets of service satisfaction based on user feedback. Complementarily, Castro will present a Brazilian case study comparing the actual costs of diagnosing individuals at home after a fall versus at an urgent care facility.This symposium proposal aims to present three papers linked to the H2H project, addressing the area from a design and user experience perspective, combining insights from multiple research strands across the involved universities and companies. CONCLUSION The proposed symposium will offer a platform for sharing insights and fostering collaboration among researchers, practitioners, and stakeholders interested in leveraging image diagnosis in eHealth for older users. Through the presentation of the three linked papers, we aim to contribute to the advancement of knowledge and practice in the field of home-based diagnostic imaging services, ultimately enhancing the wellbeing and ageing-in-place of older adults.
Influence of the educational of Northeastern Brazilian older adults on their proficiency with mobile devices
Purpose Technological culture is a global reality. Its social practices are mediated by information and communication technologies, which contribute to social processes and facilitate everyday activities, such as sending instant messages, paying bills online, and so forth. Given the increase in life expectancy and the goal of active aging, digital mobile technologies are important for older people to interact with and relate to contemporary changes around them ΓÇô as these devices vary greatly and constantly and offer a wide range of accessible use options (Nimrod, 2020). Hence, this study aimed to analyze the influence of the educational attainment of Northeastern Brazilian older adults on their proficiency with mobile devices. Method This cross-sectional analytical study was conducted in 2023 with community-dwelling older adults in Recife, Northeastern Brazil. Data were collected based on their years of school attendance (17, 11, 8, and 4 years, and no formal education) and the Mobile Proficiency Questionnaire (MPDQ) (Roque & Boot, 2018), validated for Brazilian Portuguese. The Mobile Device Basics (MPDQb) has 9 questions and its score ranges from 9 to 45. The Kruskal-Wallis test and then the Dunn test were used for comparison data analysis between the groups (Figure 1). Results and Discussion Altogether, 311 older adults, with a mean age of 69.8 years, were interviewed. The mean MPDQb score was 30.5┬▒8 (or 3.4), corresponding to 68%┬▒18% of the highest possible score (45) in the domain. The following MPDQb items had the lowest scores: adjusting the size of the text (mean score=2.0), copying and pasting a text with the touchscreen (mean score=2.2), connecting to a wi-fi network (mean score=2.3), and adjusting screen brightness (mean score=2.9). Those who had attended school for 17 years (n=108) had an MPDQb score=34.6┬▒5.7; for 11 years (n=89), an MPDQb score=31.6┬▒6.6; for 8 years (n=56), an MPDQb score=27.6┬▒8.5; for 4 years (n=49), an MPDQb score=24.1┬▒8.6; and those with no formal education (n=9), an MPDQb score=22.1┬▒3.7; Kruskal-Wallis test=p<0.0001. The MPDQb score was significantly higher among those who attended school for 17 years than in the other groups; post hoc Dunn test=p<0.05. Thus, although older people with higher education levels had a significantly higher mean MPDQb score than the other groups, proficiency in basic mobile device functions may not be considered good, since their mean score is far from the highest possible one for the domain. This can be justified by the fact that these people were already adults or older when they began using mobile device technology, influencing how they manage difficulties in handling the device, which is relevant to their proficiency (Raimundo; Gil; Bernardo, 2019). Therefore, further initiatives aimed at digital inclusion are needed to demystify the use of technological devices for older people, ensuring their self-confidence and better quality of life.
Technology to support persons with cognitive impairment with everyday activities
Participants: W.A. Rogers (USA), N. Charness (USA), R. M. Mudar (USA), M. van Tilborg (Netherlands), and H. Kort (Netherlands). ISSUE Cognitive impairment is a common age-related health issue worldwide in older adults. Currently, around 50 million live with a severe form of cognitive impairment and this number is expected to reach 132 million by 2050 (WHO, 2024). Persons with cognitive impairment (PwCI) experience changes in one or more cognitive functions including memory, attention, language, executive function impacting their ability to independently carry out everyday activities. Advances in technology offer promising avenues to support PwCI with these everyday activities provided these technologies are carefully designed to meet the unique needs and preferences of this population. CONTENT Our symposium is designed to bring together speakers from the USA and Netherlands on the theme of using technology to support PwCI in their everyday activities. The speakers will highlight: 1) how technology interventions can assist PwCI by addressing the challenges experienced in their everyday activities, 2) considerations for developing technology, and 3) examples of research on technology-based supports and interventions conducted in USA and Netherlands. STRUCTURE Rogers will discuss the development of a system to support personal activities and reinforce cognition (SPARC) for PwCI sharing insights from evaluation of the research literature on needs of PwCI, interviews with clinicians, and a focus group with technical experts. This multi-faceted needs assessment approach will guide the design of the system to support everyday activities, primarily in the home environment.┬á Charness will outline the AUGMENT project focusing on creating tutorials for applications such as Google Maps and UBER to support mobility for people with cognitive impairment (CI).┬á Spatial navigation is often impaired in addition to memory for those with mild cognitive impairment (MCI), post-stroke CI, and traumatic brain injury (TBI).┬á Charness will discuss design and usability challenges for tutorial development. Mudar will talk about the MedManage study focusing on redesigning and optimizing a mobile medication adherence system for medication self-management in persons with MCI. Persons with MCI are at increased risk of medication non-adherence due to deficits in prospective memory and mobile health interventions offer promising avenue to support medication self-management. Mudar will discuss how Medication Education, Decision Support, Reminding, and Monitoring-Memory (MEDSReM-M) mobile app was developed to meet the needs of those with MCI through cognitive walkthroughs, needs assessments, and usability testing. van Tilborg will describe her current research for enhancing self-management of the use of (artificial tears) eye drops for people with Parkinson disease, to prevent visual impairment. The role of the person with Parkinson disease and that of the professionals involved will be addressed. Professor Kort, will act as the discussant, bringing together the perspective of the different Gerontechnology domains that are addressed in this symposium, namely Housing and Daily living, Mobility and Transport, and Health and Self-esteem. CONCLUSION The symposium will present interdisciplinary and international perspectives on developing and implementing technologies to support aging in place to support autonomy and quality of life in PwCI.┬á┬á
Association of Age, Education, and Cognition with Digital Health Literacy in Older Adults
Prop├│sito: O advento da transforma├º├úo digital apresenta v├írios desafios, com a literacia digital em sa├║de a servir como ferramenta no contexto da promo├º├úo digital da sa├║de. A literacia em sa├║de digital (eHealth literacy) engloba as compet├¬ncias e conhecimentos essenciais para que os indiv├¡duos interajam com as tecnologias de sa├║de de forma eficaz, permitindo-lhes abordar e resolver quest├╡es relacionadas com a sa├║de (Faux-Nightingale et al., 2022). Este estudo tem como objetivo investigar a associa├º├úo entre idade, escolaridade, cogni├º├úo e letramento digital em sa├║de entre idosos atendidos na aten├º├úo prim├íria ├á sa├║de. M├⌐todo: Um estudo anal├¡tico transversal foi realizado em 2023 com idosos residentes na comunidade em Recife, Pernambuco, Nordeste do Brasil. A alfabetiza├º├úo em sa├║de digital foi avaliada por meio da eHealth Literacy Scale adaptada para o Brasil (eHEALS-Br), medindo as habilidades percebidas dos indiv├¡duos para encontrar, avaliar e aplicar tecnologias de informa├º├úo a problemas de sa├║de, com escores que variam de 8 a 40 pontos e classifica├º├╡es baseadas no n├¡vel educacional (Mialhel et al., 2023). Idade, escolaridade e cogni├º├úo tamb├⌐m foram avaliadas por meio do Cognitive Screener de 10 pontos (10-CS) (Apolin├írio et al., 2016). Os dados foram analisados por meio de estat├¡stica descritiva e inferencial. Resultados e Discuss├úo: Participaram 311 idosos, com m├⌐dia de idade de 69,8 anos, sendo que a maioria vivia sem companheiro (58,5%). O baixo letramento em sa├║de digital foi mais prevalente (47,6%) e associou-se ├á escolaridade (p=0,001) e cogni├º├úo (p=0,004). A idade n├úo influenciou significativamente a alfabetiza├º├úo em sa├║de digital. Apesar de a maioria ter mais de 9 anos de estudo, persistiu a baixa literacia digital em sa├║de, possivelmente devido a dificuldades de acesso e compreens├úo da informa├º├úo no ambiente digital. A aus├¬ncia de d├⌐ficits cognitivos impactou positivamente a alfabetiza├º├úo em sa├║de digital, com resultados satisfat├│rios quanto ao uso de tecnologias para estimula├º├úo cognitiva (Viviani et al., 2023). Assim, interven├º├╡es que promovam a inclus├úo digital por meio da alfabetiza├º├úo em sa├║de digital podem ajudar a reduzir a infodemia e potencialmente ter impactos positivos na mem├│ria e na cogni├º├úo.
Maria das Gra├ºas Wanderley de Sales Coriolano
Optimizing Virtual Health to Empower Caregivers: Informal CaregiversΓÇÖ Experiences of Virtual Care
Background: The COVID-19 pandemic accelerated the shift from traditional in-person healthcare to virtual care, impacting the role of unpaid caregivers. In the US, 21% of the population provide unpaid care (1). In Canada, more than 75% of healthcare is provided by informal, unpaid caregivers (2). Most unpaid caregivers are between 50 to 75 years old and provide care to their parents and/or partners (3). Informal caregivers oversee a large portion of a patient's care, many of whom are older adults, women, and racialized. Despite their significant contribution, the perspectives of caregivers regarding virtual care remain overlooked in health research. This study, as part of a larger multidisciplinary research effort, aims to explore caregiver experiences with virtual care, foster collaboration among virtual healthcare and caregiving stakeholders, and co-develop a participatory research agenda focused on developing virtual care solutions that can empower caregivers and promote equity. Methods: To gain insights into caregivers' experiences with virtual care, we conducted a comprehensive scoping review and 12 key informant interviews between September 2023 and March 2024. Our scoping review adhered to the JBI methodology for search strategy and followed the PRISMA-ScR protocol for reporting. We systematically searched academic databases, including PubMed, Web of Science, CINAHL, and Scopus, as well as grey literature sources such as reports and keyword searches from related CSOs/NGOs. Our search focused on variations of "caregiver" and "telemedicine" or "virtual care," emphasizing experiences, perceptions, attitudes, and views. We included articles published in English from January 2013 to July 2023, resulting in 69 articles for review. Additionally, we conducted 12 key informant interviews with representatives from various stakeholder groups, including informal caregivers, health authorities, clinicians, patients, virtual care technology companies, and community organizations. Results and Discussion: Both the literature and interviews revealed that existing research and practice often failed to adequately address caregivers' unique experiences, and frequently tend to view caregivers and patients as a single unit with less recognition of caregiver needs and experiences as separate from patientsΓÇÖ. Caregivers expressed a mix of positive and negative attitudes towards virtual care, citing benefits such as convenience and easier access to specialists, alongside concerns about communication with clinicians and privacy issues. There was a recognized need for tailored care, with some caregivers preferring in-person interactions, while others preferred a hybrid care model. Moreover, caregivers' experiences varied based on their roles and the type of virtual care utilized, emphasizing the importance of personalized approaches. Despite some reporting improvements in wellbeing and access to support, challenges such as navigating complex health information and disparities in access to care persisted. Interviews also revealed that caregiver-inclusive technologies are in demand, and the digital divide presents challenges especially for older caregivers. These findings will provide the basis for further steps of this research project including co-developing a research agenda aimed at improving the effectiveness of virtual care services.
Konstikoppa┬« Traveling Technology Exhibition for the Older People
Konstikoppa┬« Traveling Technology Exhibition for the Older People The Union for Senior Services VALLI ┬á Purpose Konstikoppa┬« is a traveling technology exhibition for older people. It is packed in a large suitcase. Konstikoppa┬« spreads information about technology that makes life easier, more meaningful, and safer for older people. The equipment of Konstikoppa┬« supports independent living in your own home. The equipment selected for Konstikoppa┬« is easy to use and affordable. Equipment can be found in most supermarkets, home appliance stores, and electronics stores. In other words, the content of Konstikoppa┬« is low-tech. There are four (4) categories in Konstikoppa┬«: 1) Lighting, 2) Home security 3) Communication and tracking 4) Memory aids. In addition, there is a fifth category, 5) Entertainment/ Participation. Konstikoppa┬« is maintained with public funding and is not loaned out for commercial purposes. Besides older people, students from different training programs can also borrow Konstikoppa┬«. It helps students to understand the needs of older people. Konstikoppa┬« is a good practice which has inspired other organizations in Finland to start their own lending activities. There are also a couple of virtual technology markets and temporary physical places older people can visit to test and borrow equipment. The need for this kind of activity is becoming wider and wider. ┬á Method The equipment of Konstikoppa┬« is packed in a large suitcase. Different senior organizations and groups can borrow the suitcase free of charge. There are two identical suitcases. From the website┬┤s reservation calendar the borrower can check when Konstikoppa┬« is available and then make a reservation. When making the reservation, the borrower is committing to the terms of borrowing Konstikoppa, sending the suitcase to the next place (if it┬┤s not coming home for maintenance), and giving feedback after the presentation event. Konstikoppa┬« travels via parcel services with the Finnish bus company Matkahuolto. Konstikoppa┬« includes an easy guide and presentation cards for the facilitator (e.g. the group leader). It is suggested that the facilitator reserves approximately 2 hours for the event. ┬á Results and Discussion According to the feedback given by older people and their group leaders, there are positive effects on attitudes to technology. When testing small technological devices with their own hands in a peaceful place without any stress of buying anything, older people can increase their interest in technology. Purchasing technology is easier when an individual knows what kind of technology is suitable for their situation and needs. Also, older people may not even know about the low-tech equipment available in their nearby stores. If they donΓÇÖt know, they canΓÇÖt get any help with technology. With the help of the low-tech equipment of Konstikoppa┬«, the later needs of so-called high tech or heavier technology are easier to adapt. Konstikoppa┬« is also one solution to increase older people┬┤s digital inclusiveness. The method is recognized by the Finnish Institute for Health and Welfare (THL).1 The challenge of Konstikoppa┬« is to keep it up to date, since technology develops fast. Updating the equipment will need resources. The practical part of a traveling exhibition also involves restricting the content to small equipment. For example, the virtual glasses need to be sent in a different package and therefore the borrower has to request them separately. ┬á The Union for Senior Services, VALLI is a a national non-profit umbrella organization for the care of elderly. VALLI is founded in 1953. The organization has approximately 60 member associations around Finland, which serve about 20 000 older people with 2000 professionals. ┬á ┬á References 1Anttila, Heidi (ed.). National coordination of age technology: Towards continuity and cooperation. Proposal for the national coordination model for age technology and for related measures for 2023ΓÇô2027. Pages 36-38. Finnish Institute for Health and Welfare (THL). Discussion Paper 7/2023. Helsinki, Finland 2023. ISBN 978-952-408-039-2 (online publication) ┬á Keywords: independent living, low tech, digital inclusion, health technology, technology exhibition Affiliation: The Union for Senior Services, VALLI Corresponding Author Email: suvi.hiltunen@valli.fi ┬á Acknowledgment This good practice is supported by the Union for Senior Services, VALLI. VALLI is funded by the Funding Centre for Social Welfare and Health Organisations in Finland (STEA). ┬á
Validation of audiovisual educational gerontotechnology content for elderly people with chest pain
Purpose Technologies targeted at health education for elderly people are important in the face of the challenges of aging. The use of information and communication technologies must consider the needs and expectations of the elderly, improving their quality of life and facilitating social inclusion (PAHO, 2023). Considering chest pain one of the most frequent complaints in urgent and emergency services (Miranda; Rampalliotti, 2019), the objective of the study was to validate the content of an audiovisual educational gerontotechnology related to the care of elderly people complaining of chest pain in the urgency and emergency service. Method Methodological research developed in southern Brazil to develop audiovisual educational gerontotechnology, in which the stage presented corresponds to the content validation of the gerontotechnology script, prepared based on an integrative literature review. The inclusion criteria for expert judges were: being a professional nurse, with expertise in the area of gerontology and/or urgency and emergency, and meeting at least one characteristic of two requirements, such as: professional experience, authority on the subject, skill in the type of study, qualification in a specific test, according to Jasper (1994). It was an exclusion criterion to partially respond to the questionnaire. Recruitment was carried out by searching for teaching staff from the Undergraduate Nursing courses with the best evaluation by the Brazilian Ministry of Education, considering the national territory. 103 professionals were invited, however, the final sample consisted of 20 participants. The invitation letter was sent via email; in addition, the Free and Informed Consent Form approved by the local Ethics Committee; the questionnaire to characterize the profile of expert judges; the video script; and the structured questionnaire for content validation, in electronic format (Google Forms┬«) (Figure 1). The adapted health content validation instrument (Leite, et al, 2018) contained 12 questions related to the proposed gerontotechnology, with space for suggestions and criticisms. A Likert-type scale was used, renamed to: 1- completely disagree, 2- partially disagree, 3- partially agree and 4- totally agree. Results and Discussion The majority of participants were female (n=19; 95%), aged between 30 and 40 years old (n=18; 90%), who work professionally in the southern region of the country (n=18; 90%) and had specialization (n=18; 90%). As for professional practice, the hospital area predominated (n=17; 85%), with experience in urgency and emergency (n=15; 75%), having worked in this specialty for more than five years (n=13; 65%). The calculation of the Content Validity Index resulted in a final average of 0.92. Considering the minimum acceptable value of 0.80, the educational gerontotechnology script was considered adequate and validated. All of the judges' suggestions were accepted, aiming to make educational gerontotechnology more accessible to the target audience. ┬á
Perceptions of older adults about the influence of physical activity on aging-in-place
Purpose: To describe the perceptions of a group of older adults about how physical activity can influence aging in place. Methodology: Exploratory, cross-sectional, qualitative study. 119 older adults living in the community were interviewed based on a structured script with an open question about ΓÇ£what current needs may influence your future?ΓÇ¥, followed by questions focused on the health and well-being demands of the home/ house, finances, transport, social participation. Thematic content analysis was used for data analysis. Results and discussion: Participants were men (23.1%) and women (76.9%), with an average age of 67.7 years, married (51.1%), widowed (24.5%), with more than 10 years of study (59.1%), 45.7% retired and 40.4% continue to work. Of these, 75 have chronic health conditions, such as metabolic, orthopedic, neurological and psychiatric disorders, among others. Participants highlight that healthy eating, physical activity (PAF), sleep and rest, leisure, financial health and adequate housing are the main aspects that influence aging-in-place. Of the total number of interviewees, 78 participants referred to the importance of physical activity (PAF) as a predictor of healthy aging. In terms of looking at present needs and future perspectives, they highlight the importance of PAF as a response to the impacts of chronic diseases on health and functional capacity in the face of the presence of osteopenia, chronic pain, high blood pressure, diabetes, among other conditions. They mention the importance of PAF for maintaining functional capacity, seeking to remain active, independent in carrying out daily activities and maintaining mobility in the city. They highlight as essential the social connections that are established in the physical activity groups they attend (Pilates, yoga, gymnastics in the square, etc.) and in walking activities in the neighborhood. Gyasi (2020) notes that interventions focusing on loneliness and active aging should target physical activity and interpersonal engagement among older people. The results demonstrate that maintaining functional capacity to carry out daily activities and social connections with the community are important pillars for aging-in-place. Studies involving the practice of physical activity by older adults have had great resonance in the scientific production of gerontechnology, demonstrating the alignment of this field of knowledge with strategies for active and healthy aging. Research focusing on the adoption of technology for the practice of remote physical activities; on the feasibility, safety and effects of exergames; the effectiveness of interventions based on digital technologies to promote active aging; in capturing and monitoring signals; in solutions aimed at assisted living environments, in addition to important studies related to aging-in-place, mobility in the city, friendly environments, as shown in figure 1. Identifying the aspects related to the practice of physical activity by older adults and how the field of knowledge of gerontechnology is driven by these demands, demonstrates the indisputable relevance of gerontechnology in the promotion, prevention, maintenance of health to maintain and increase quality of life in old age, in addition to impacting the entire longevity ecosystem.
Health-related consumer wearable use for elderly people
Purpose: Wearables ΓÇô intelligent end devices worn on the body ΓÇô can be used to record vital signs (DeClercq et al., 2017). The forecasts clearly show that wearables are going to increase in the future (Fotteler & Denkinger, 2021). Seifert et al. (2020) writes of a potential for older people. It was found that it is possible to monitor health remotely with the wearable (Olmedo-Aguirre et al., 2022). Furthermore, wearables are also described as creating a greater awareness of physical activity among older people (Gu et al., 2024). In addition, wearables can be used by older people to lead a self-determined life for longer period of time(Chung et al., 2023; Garcia Reyes et al., 2023). Especially, the acceptance of the health-related use of consumer wearables in everyday life and the associated health empowerment for healthier aging was not analyzed in the previous studies yet. This led to the following research question: What experiences do people have aged 60 and older with the usefulness of health functions of wrist-worn consumer wearables in everyday life? Methods: Eleven qualitative semi-structured interviews were conducted with people aged 60 and older in Germany between January and May 2024. Six men and five women were included in the interviews. The age range of the interviewed people were between 60 - 74 years. The research participants were selected by using the snowball system (Kruse, 2015). The researchers apply the principle of theoretical saturation. These interviews were transcribed and analyzed using Mayring's method of qualitative content analysis (Mayring, 2023). Furthermore, the results were interpreted by using the Technology Acceptance Model 2 (TAM2) to draw conclusions about perceived usefulness via intention to use. (Venkatesh & Davis, 2000). Results and Discussion: Six of eleven interviews had already been analyzed at that time, the abstract was set up. The results analyzed that measuring their vital signs and thus making them visible is important to older people. The interviewees felt safe by using the wearable and were better able to assess their subjective perceived health. The wearables were used to check heart rate, ECG and blood pressure. The devices were deliberately selected by older people according to the desired characteristics. For example, an Apple Watch was purchased to monitor atrial fibrillation or a smartwatch from Kardena to measure blood pressure. Older people have a positive attitude towards wearables and sometimes recognize a motivating factor. In addition, a wearable could have a health-promoting and preventive effect and lead to a longer independent life. Data protection was not considered particularly important in the research group. In the context of the TAM2 model, Job Relevance and Result Demonstrability were found to be the most significant factors for Perceived Usefulness for older people. Furthermore, wearables assume to be a possibility for older people to be aware of illnesses much earlier and to enable faster health interventions and promote their health literacy. Further scientific research is needed in that field.
Preventing isolation of people with dementia: Effectiveness and challenges of communication robots
Participants: R Yamazaki-Skov (Denmark), X Liu (China), J Yang (Japan) R Makino (Japan), M Furukawa (Japan). ISSUE Social isolation and loneliness among older adults is a growing public health and public policy concern, made even more apparent by the COVID-19 pandemic. Social isolation and loneliness shorten older adultsΓÇÖ lives, and damage their mental and physical health and quality of life. (WHO, 2021). A review conducted in 2015 indicated that social isolation and loneliness were associated with a 29% and 26% increased likelihood of mortality. (Holt-Lunstad et. al). Especially, people with dementia (PWD) intend to avoid talking to people around them due to their declining cognitive function. Preventing social isolation and loneliness in people with dementia can not only increase their own wellbeing but also reduce social care costs. A key concept in dementia care is to help PWD maintain communication and keep connections with their families, caregivers, and environment. However, with the increasing number of older adults living alone and the shortage of caregivers, this has become difficult. Therefore, several communication robots have been developed to cope with this problem, and recently it has been reported that they were effective by using the reminiscence methods. Reminiscence methods are known to be effective in maintaining the communication skills of PWD and preventing the occurrence of behavioral and phycological symptoms of dementia (BPSD), such as wandering, shouting, and problematic behavior. This symposium aims to discuss how to develop easily accessible communication robots that can prevent isolation and loneliness for people with disabilities. The goal of this symposium is to clarify what problems existed on this process and what was attempted to solve them. CONTENT 1. Yamazaki-Skov (Denmark) will present an overview of research on intervention for PWD using communication robots. With/without the reminiscence method, the WoZ model was mostly applied for communication robot, and artificial intelligence (AI) robots showed potential for conversations with PWD. 2. Liu (Chaina) will present the effectiveness of the reminiscence method with using modified Pepper, a commercially available robot, into a WoZ model. The WoZ model showed almost the same effectiveness as the reminiscence method performed by a human coordinator.3. Yang (Japan) will report the results of an interactive experiment by implementing an AI model into RoBoHoN, a commercially available communication tool. Specifically, the changes they have made to RoBoHoN so far are as follows. ΓæáChanged the voice recognition installed in RoBoHoN to Google STT ΓæíImplemented GPT-4 model (AI model) in RoBoHoN ΓæóOn top of Γæí, we will present about the development of an AI model using RoBoHoN, which generates repetitive utterances automatically. 4. Makino (Japan) will present a project to analyze social workers' conversational behavior with the aim of finding a distinctive conversational model that can contribute AI to maintain conversation with PWD. The findings of the interaction analysis will be useful in considering what communication role should be assigned in the robot's conversation with PWD. 5. Furukawa (Japan) will analyze a case in which a communication robot was used by PWD who lives alone, and will report on the problems found in its use. CONCLUSION The presentations will show the effectiveness of communication robots preventing isolation and loneliness of PWD. Furthermore, in the development of AI communication robots, we will propose a multidisciplinary team approach that includes analysis of chat-based conversation corpora, behavioral analysis, and social system analysis.
Food demands for the Health and Well-Being of the Elderly: contributions of Gerontechnology to aging-in-place
Purpose: Eating is a central daily activity in our lives and changes arising from the aging process can alter our abilities to choose food, prepare meals, use equipment, use meal and food purchase and delivery services, among other tasks involved in this activities. To describe the demands of elderly people in relation to food as a component of health and well-being for Aging-in-Place and the possible contributions of gerontechnology in this context. Method: Exploratory, cross-sectional, qualitative and quantitative study. 119 older adults living in the community were interviewed. The study question was ΓÇ£What are the needs related to health and well-being that may influence your aging in place?ΓÇ¥ Thematic content analysis was used. Results and Discussion: Participants were men (23.1%) and women (76.9%), with an average age of 67.7 years, married (51.1%), widowed (24.5%), older than 10 years of study (59.1%), 45.7% retired and 40.4% continue working. Of these, 75 have chronic health conditions, such as metabolic, orthopedic and neuropsychiatric changes, among others. As for what influences aging-in-place, food, physical activity, sleep and rest, leisure, financial health and housing stand out as the main aspects. Of the total number of interviewees, 65 participants mentioned concerns related to food as a health and well-being priority. The priorities for aging-in-place, related to food, refer to the adoption of a healthy, rich and adequate diet for their current health conditions; maintain autonomy and independence (have mobility to go to the market, autonomy to choose food, do your own shopping and prepare meals); have a functional environment without architectural barriers and with adequate equipment to compensate for the losses of aging and have financial conditions that make such changes viable. These results highlight the potential of gerotechnology to support independent living and compensate for the changes of aging with a focus on the 5Ps ΓÇô person, products, specialized personnel, services, policies. The growing demands for care for the elderly population have expanded the field of gerontechnology with a focus on food, encompassing studies related to technology for carrying out sensory tests and facilitating food choices, recipes and services (Jung et al., 2022); the use of robots to support daily life and assist with meals (Orso, VierI & Gamberini, 2018); the usability of assistive technology resources for dietary support, food intake monitoring systems for nutritional management (Lai, Chao, 2014), or even, assistance solutions, based on Information and Communication Technologies for security, complex and cognitively demanding tasks (Grossi et al., 2014); recognizing the importance of nutrition in the social and cultural lives of the elderly and gerontechnological support in healthy aging that impacts the present and future. Identifying the demands and priorities of health, nutrition and well-being of the elderly and those involved in Aging-in-Place actions contributes to the field of gerontechnology in its objective of promoting independent living and quality of life in old age and expansion of the longevity ecosystem.
Brain Mapping-Based Interhemispheric Brain Coordination Exercises and Gerontechnology for Improving Cognitive Function in the Elderly
This study proposes and investigates the effects of brain-mapping-based bilateral brain coordination exercises for addressing cognitive decline in the elderly. Conducted over 8 weeks, the study involved 23 seniors aged 65 to 80. EEG measurements were used to compare brainwave patterns before and after the exercises. The results showed significant changes in certain brainwave patterns, indicating that the exercises help enhance cognitive function in the elderly. Additionally, the study suggests using technology to monitor the exercises and provide personalized feedback, supporting effective implementation.
Vital Oldies with Adapted Old Martial Arts
Tutorials for continued use of mHealth application among older adults: Research proposal
Purpose: According to the Pew Research Center, 65% of older Americans had a smartphone in 2021, compared to 13% in 2012 (Faverio, 2022). The three leading objectives of mobile applications targeting older adults are improving their well-being, reducing stress, and providing entertainment (Portenhauser et al., 2021). The usability studies, on the other hand, reveal a different picture. The target groups of those mobile applications complain about the complicated design preventing them from using those health applications continuously (Cajita et al., 2018). American Association of Retired Persons (AARP) found that despite the rising trends in older adultsΓÇÖ use of smart technologies, only 13% of surveyed seniors benefit from health management devices (Kakulla, 2023). Considering the low digital literacy rates among this age group, proper instructions can be one of the solutions the app designers can offer to the older end users. To address the mHealth design issue, this experimental study aims to identify the best practices for building the mHealth instructional guide for older adults. Method: Participants 65 years old and above will be recruited for the experimental study. After administering a pre-test questionnaire to understand the mobile technology acceptance beliefs among them, the participants will be split into experimental and control groups. Both groups will receive one-time in-person instruction on how to use the app. Following this hands-on instruction, the experimental group will be guided to access an on-demand tutorial for the instances in which they experience any technical difficulties in the future use of the application. Three months later, both groups will be approached with the post-test questionnaire aiming to show the changes in mobile technology acceptance attitudes. Implications: The study has a design implication, providing an end-user-directed perspective on mHealth use and potential improvements in tutorial design. Besides, the study is expected to show the differences in the impact of different modalities on mHealth knowledge
Biography Work in Long-Term Care: How to Stimulate Digital Geographic Storytelling?
Purpose Older adults in long-term care homes suffer from high rates of depression and a decrease in quality of life (QoL). The COVID-19 pandemic crisis has shown the need to provide tools that can be used online and counteract challenges such as loneliness in older people. Technology-assisted biography work, e. g. using the BaSeTaLK Webapp (Figure 1), enhances QoL and mood among residents of long-term care homes (Giordano et al., 2023). However, such interventions are limited to interpersonal work. Digital presentations of ┬átold life story could offer the opportunity of an enduring autonomous biography work, as the technical tool might be constantly used to stimulate life narratives in private space. In addition, the focus on memories connected to specific locations could further enhance individual life reflections. There is currently no appropriate tool which utilizes the promising aspects of enduring biography work and enhanced stimulation of memories through digital location-related presentations. In order to broaden the perspective of gerontechnological solutions and better address impacts on QoL, the aim of the study is to conceptualize a technical solution appropriate for older adults to stimulate ΓÇÿDigital Geographic StorytellingΓÇÖ in long-term and to prevent depression and improve QoL. In this presentation, we will focus on a first literature-based demonstrator design and the participatory approach through repetitive involvement of potential users in the further development process. Method The study will be conducted in a mixed-methods design with an agile, user-oriented approach, divided into two phases: A first phase of biographic-narrative interviews and the development of a technical system to analyse and present life stories adjusted to the specific needs of older people, and a second phase as a feasibility study. Results and Discussion In particular, as a starting point, we will present a criteria catalogue derived from the literature that summarizes the requirements a digital tool must meet to serve as a permanent conversation initiator for life story narratives. Furthermore, we will present considerations on how the participatory development process should be structured. We will be able to present a preliminary demonstrator of the presentation tool adapted to the needs of older people. References Giordano, K., Lauer, N., Leusch, V., Kreiter, D., & Corsten, S. (2023). Tablet-based biography work in long-term care homes to support quality of life and prevent depression.┬áEducational Gerontology, 1-14. Keywords: technology-assisted biography work, long-term care, quality of life, digital geography storytelling
Digital literacy and health of older people in a Korean rural village
Digital literacy plays a significant role in the health and well-being of older adults. The purpose of this research is to analyze the level of digital literacy of older people residing in a rural village in Korea and explore the relationship between digital literacy and their health. A secondary data analysis was conducted from the Korean Social Life, Health, and Aging Project (KSHAP). The KSHAP cohort K included participants aged 60 years or older. A survey involving 573 rural residents was conducted from January to March in 2023. When education level, work, marital status and income level were controlled the overall health was influenced by the smartphone use ability (R2=0.123, p<0.05). Digital access had effect on independent living (R2=0.128, p<0.05) and physical pain (R2=0.091, p<0.05). Use of digital device also influenced physical pain (R2=0.108, p<0.01) and depressive mood (R2=0.241. p<0.05). Smartphone use ability also showed positive effect on mobility (R2=0.1029, p<0.05. The findings of KSHAP suggests some implications for improving digital literacy among older adults in rural Korea to support healthier aging. Continued effort for enhancing accessibility to the digital devices and providing more opportunities for digital capacity-building is needed in rural areas.
Technology-enhanced medication taking and symptom monitoring
Purpose: Taking medications correctly is a challenge worldwide. If your mother is not taking her medications, you worry. If you are the director of a behavioral health center with 4000 active and aging patients, you worry more. Technology can play a critical role in supporting medication taking. There are three challenges: 1) reinforcing medication taking, 2) monitoring adherence, adverse reactions, and side effects, and 3) connecting the care team to intervene when problems arise. Our three-component platform is designed to be a solution for all three challenges. This study focused on adult and older adult individuals taking antipsychotic medications who are at risk of Tardive dyskinesia (TDD). TDD is a late-developing, debilitating side effect of dopamine receptor-blocking medications, particularly antipsychotics, with risk increasing with age. Characterized by involuntary facial, trunk, and extremity movements, TDD is difficult to treat, potentially irreversible, and varies in severity from mild to debilitating. While tetrabenazine-based drugs can reduce symptoms, they are under-prescribed, with only 40,000 of the estimated 2.6 million individuals affected receiving treatment. Early detection of TDD is critical for timely intervention to prevent permanent disability, yet assessments are rarely performed, as it is challenging for even the most qualified diagnosticians to provide the frequent monitoring necessary. This challenge is exacerbated by the shift to telemedicine and the increasing patient load on mental health professionals. An efficient, automated method for TDD detection is crucial for improving patient outcomes and reducing the burden on healthcare providers. Method Participants (n=268) across three studies completed video-recorded abnormal involuntary movement scale (AIMS) assessments and semi-structured interviews, yielding 268 usable video clips. A vision transformer machine learning architecture was employed to analyze these recordings. Convolutional recurrent neural networks (CRNNs) were also used to evaluate changes over time in the visual data. The modelΓÇÖs performance was assessed using the Receiver Operating Characteristics curve (ROC) and the Area Under the Curve (AUC).┬áResults and Discussion┬áThe TDtect model, trained on a hold-out set (20% of samples), achieved an AUC of 0.984 (95% CI, 0.93 to 1.0), with a sensitivity of 1.0 and specificity of 0.951 in the validation cohort of Study 1. Across the combined cohorts of Studies 1, 2, and 3, the model reached an AUC of 0.89. These results indicate that the model reliably detects TDD, outperforming human raters. The algorithmΓÇÖs high sensitivity and specificity demonstrate its potential for early detection and intervention in TDD, improving patient care and reducing permanent symptoms. The next step in the research is to utilize the full platform for improving medication adherence, monitoring, and intervention by the care team.
A Lifestyle Monitoring System for Older Adults Living Independently Using Low-Resolution Smart Meter Data
Purpose There are three types of technologies commonly used in home monitoring services: (1) Wearable devices, which can be uncomfortable and intrusive to users; (2) Ambient sensors, which require extra installation; and (3) household meters, such as smart electricity and water meters. Smart household meters are becoming an essential part of the smart city infrastructure. Previous research focused on applying NIALM techniques to identify specific appliance usage using high-resolution smart meter data (one data every 10 seconds) [Delvin and Hayes, 2019]. This approach employs supervised learning, which is difficult to implement in practical situations and may cause privacy concerns. Japanese power companies have used low-resolution smart-meter data (one data every 30 minutes) to monitor the lifestyle of older adults living independently. Their approach relies entirely on power consumption data and does not map to appliance usage. In this study, we aim to develop a lifestyle monitoring system using low-resolution smart meter data (one data every 15 minutes) for older adults living independently at home. Power consumption data is mapped to appliance usage (0/1), which often relates to the olderΓÇÖs activities of daily living (ADL). Indices of ΓÇ£activityΓÇ¥ and ΓÇ£regularityΓÇ¥ of appliance usage based on comparison with the pattern of the past 28 days are calculated. Method As shown in Figure 1, the electricity consumption data of the previous day (96 data points) was collected. A threshold (the red line in Figure 1) was calculated by taking the average of all ΓÇ£valleysΓÇ¥ in the power consumption curve. Electricity consumption data for that day is compared with the threshold, and ΓÇ£0ΓÇ¥ (inactive) is returned for data lower than the threshold, and ΓÇ£1ΓÇ¥ (active) for data higher than the threshold. The ΓÇ£active scoreΓÇ¥ is then calculated to quantify the residentΓÇÖs daily activity by finding the percentage of ΓÇ£activeΓÇ¥ (1s) in the 96 data points of the day. Self-comparison is made between the usage data for the day and the norm data for the past 28 days (as shown in Figure 2) to understand whether there is a deviation in lifestyle from the long-term norm. Low and High norms are also calculated from the 28-day data by sorting the data in ascending order and then getting the average of each of the two halves (14 days). The regularity of the daily lifestyle is also assessed by calculating the correlation coefficient (CC) of the previous dayΓÇÖs appliance usage data with the norm of 28 days. Results and Discussion The active score of the norm in Figure 2 is 38.0, with the lower norm at 10.9 and the higher norm at 65.2. The active score in Figure 1 for the previous day is 59.4 and receives a blue light on the dashboard for a normal activity level. An activity score higher than the high norm receives a green light on the dashboard for high activity levels; a yellow light on the dashboard indicates a low activity level┬á (activity score between the norm and low norm), and a red light signals an abnormally low activity level (activity score lower than the low norm). Regularity is assessed and categorized into high regularity (green light, CC >= 0.7), normal regularity (blue light, 0.5 <= CC < 0.7), low regularity (yellow light, 0.30 <= CC < 0.5), and abnormal regularity (red light, CC < 0.3). The CC depicted in Figure 2 registers at 0.703, suggesting a high level of regularity (green light). The lifestyle monitoring dashboard is being implemented in TaiPowerΓÇÖs smart meter App.┬á
Remote Heart Rate Monitoring with Contactless Ambient Technology Using Machine Learning for Aging Population
Purpose As the global population continue to age, tracking vital signs such as heart rate becomes crucial (Dias & Paulo Silva Cunha, 2018). However, traditional methods for monitoring these vital signs, particularly through wearable sensors, often present challenges. As noted in the study (Vijayan, Connolly, Condell, McKelvey, & Gardiner, 2021), wearables can be cumbersome for users, particularly older adults who may find these devices uncomfortable or intrusive, potentially leading to low adherence and compromising the reliability of health data collection. However, the rise of non-invasive Ambient Assisted Living (AAL) technology offers a more accessible solution (Lussier et al., 2020). By utilizing sensors embedded within the living environment, AAL systems can continuously gather vital health data without requiring direct interaction or causing discomfort to the individual. This research focuses on merging effortless smart home ambient technology and machine learning to predict the heart rate of old individuals. The primary aim is to accurately monitor heart rate during daily activities using non-intrusive, remote methods facilitated by AAL technology, without requiring active participation from the subjects. Method This study was conducted in a specially designed smart home environment (Figure 1) equipped with a wide range of non-contact ambient sensors, which were used to collect environmental, electrical, and presence data. Heart rate benchmark data was collected using the Empatica E4 wristband. Forty participants were selected and instructed to perform 23 specific daily activities, organized into five practical phases, within this smart home setting. The data collected from the smart home environment and the heart rate readings were subsequently analyzed using five widely used machine learning methods: Support Vector Regression, K-Nearest Neighbor, Random Forest, Decision Tree, and Multilayer Perceptron. Results and Discussion The machine learning models delivered notable predictive results, averaging a Mean Absolute Error of 7.329. Notably, the Random Forest model excelled above the rest, registering a Mean Absolute Error of 6.023 and a Scatter Index at 9.72%. This model excelled in identifying the correlation between daily activities and fluctuations in heart rate, showcasing a peak R2 value of 0.782 during the activity of morning exercises. The proposed non-invasive method offers a novel perspective on remote monitoring heart rate variations across daily living activities. This study's insights hold substantial relevance for public health. Leveraging contact-free smart home tech to estimate heart rate during everyday tasks allows health professionals to grasp a person's cardiovascular health more holistically. Such insights pave the way for tailored interventions, preventive actions, and lifestyle changes, ultimately aiming to lower cardiovascular disease risks and enhance overall health. ┬á References Dias, D., & Paulo Silva Cunha, J. (2018). Wearable Health DevicesΓÇöVital Sign Monitoring, Systems and Technologies. Sensors, 18(8), 2414. https://doi.org/10.3390/s18082414 Lussier, M., Aboujaoud├⌐, A., Couture, M., Moreau, M., Lalibert├⌐, C., Giroux, S., ΓÇª Bier, N. (2020). Using Ambient Assisted Living to Monitor Older Adults With Alzheimer Disease: Single-Case Study to Validate the Monitoring Report. JMIR Medical Informatics, 8(11), e20215. https://doi.org/10.2196/20215 Vijayan, V., Connolly, J. P., Condell, J., McKelvey, N., & Gardiner, P. (2021). Review of Wearable Devices and Data Collection Considerations for Connected Health. Sensors (Basel, Switzerland), 21(16), 5589. https://doi.org/10.3390/s21165589 ┬á Keywords: ambient assisted living, smart home, machine learning, heart rate monitoring
Exploring the Invisible: The Vital Role of 'Doing Nothing' in the Digital Age for Older Adults' Agency
Purpose Can we ever ΓÇÿdo nothingΓÇÖ when we are ΓÇÿalways onΓÇÖ in our accelerated digitalized world? In our ever-evolving digitalized landscape, the positive impact of technology on everyday life is undeniable. Increased technology use, however, also presents a potential risk of disrupting crucial phases of doing nothing (DN) (Vorderer 2015). Drawing from an interdisciplinary integrative literature review, this contribution presents a framework (Fig.1) that illuminates the ambiguous nature of DN. It suggests that phases of DN are accompanied by vital mental processes, partly described in theories as the ΓÇ£internal conversationΓÇ¥ (Archer 2003) or ΓÇ£internally-focused thoughtsΓÇ¥ (Immordino-Yang et al. 2012), that allow individuals to reflect on their goals and desires within the existing structures, thus playing a key role in their agency ΓÇô the ability to actively make decisions and shape their lives. This contribution will discuss the interplay between DN and mental processes especially against the backdrop of technology use. The frequent notifications coming along with social media contribute to dependencies, especially in younger generations who are said to be more susceptible to those detrimental effects than older generations. (Sharifian et al. 2021, Fitz et al. 2019) This contribution will explore the individual strategies older adults employ to manage and mitigate the impact of technology use and what (especially the younger part of) society might learn from those strategies, ultimately discussing the importance of DN in an accelerated digitalized world. Method Testing and applying the framework in the field, the contribution discusses empirical findings from the SMART-AGE project which explores the impact of different digital assistive systems on the lives of older adults aged 67 and older (n=750). It draws on a sub-sample (n=20) and utilizes a mixed-methods design, combining qualitative and quantitative ecological momentary assessment (EMA) data with additional insights from semi-structured interviews concerning the topics DN, internally focused thoughts and technology use. Results and Discussion Findings indicate that DN is indeed associated with various mental processes, ranging from daydreaming to reflexive deliberations susceptible to external stimuli, such as smartphone notifications. However, they also show certain resilience of the research participants against the addictive nature of technology use, especially social media. Acknowledging this, we critically re-evaluate the common understandig of learning processes associated with technology use as a one-way street, where the ΓÇ£oldΓÇ¥ should learn from the ΓÇ£youngΓÇ¥, and instead suggest a more balanced perspective on this relationship. Drawing upon the wisdom of older adults, we discuss strategies for striking a balance between digital engagement, real-world experiences and DN, emphasizing technology as a tool rather than a crutch. By leveraging these insights, individuals, particularly of younger generations, can learn to optimize technology use for personal growth, meaningful connections, and overall well-being. References Archer, M. S. (2003). Structure, agency, and the internal conversation. Cambridge University Press. Fitz, N., Kushlev, K., Jagannathan, R., Lewis, T., Paliwal, D., & Ariely, D. (2019). Batching smartphone notifications can improve well-being. Computers in Human Behavior, 101, 84ΓÇô94. https://doi.org/10.1016/j.chb.2019.07.016 Immordino-Yang, M. H., Christodoulou, J. A., & Singh, V. (2012). Rest Is Not Idleness: Implications of the BrainΓÇÖs Default Mode for Human Development and Education. Perspectives on Psychological Science, 7(4), 352ΓÇô364. https://doi.org/10.1177/1745691612447308 Sharifian, N., Kraal, A. Z., Zaheed, A. B., Sol, K., Morris, E. P., & Zahodne, L. B. (2021). Measurement Invariance of Social Media Use in Younger and Older Adults and Links to Socioemotional Health. Innovation in Aging, 5(2), igab009. https://doi.org/10.1093/geroni/igab009 Vorderer, P. (2015). Der mediatisierte Lebenswandel: Permanently online, permanently connected. Publizistik, 60(3), 259ΓÇô276. https://doi.org/10.1007/s11616-015-0239-3 Keywords: doing nothing, internal conversation, technology use, agency, older adults Affiliation: Interdisciplinary Ageing Research (IAW), Goethe University Frankfurt, Germany Corresponding Author Email: j.ewert@em.uni-frankfurt.de AuthorsΓÇÖ ORCID iDs: 0009-0005-1482-9068 Acknowledgement The project SMART-AGE (P2019-01-003; 2021-2026) is funded by the Carl Zeiss Foundation.
On-demand system to support patients in home-parenteral nutrition
Purpose The aging society is challenging for the healthcare system. Particular attention needs to be given to the nutrition of older people. For instance, in 2021, 3,000 people in care homes received Parenteral Nutrition (PN), to be added by approximately 9,000 people with Home Parenteral Nutrition (HPN). PN is life-saving, but the complication rate is significantly higher than in oral and/or enteral nutrition (Gerber, 2020). PN at home is given during the day or at night. During the day, patients are tied to the nutrition fluid (via infusion stand/rucksack) since HPN is typically administered by a nursing service (AWMF Registry No. 073/021). This fact disturbs HPN patients and leads to fewer social activities. As a result, the psychological illness rate is significantly higher (Emanuel, 2022). From a medical point of view, daily nutrition therapy can be interrupted. However, this can pose risks, e.g., if fat residues obstruct the port catheter, which can cause infections and/or metabolic complications (Tempel, 2009). Strict catheter care and sterile work are essential to avoid infections. Patients can self-manage the nutrition fluid if they or their relatives are professionally trained and confident. However, patients often feel overstrained (especially the elderly), although clarification about the dangers and management can help to better understand the conditions (Payen, 2013). To give them more confidence, an on-demand-based solution must be found so that patients can act in a more self-determined way. Method A comprehensive literature review on health risks was carried out. Based on this knowledge, focus group discussions were conducted to discover new aspects through different contributions from the participants (approach see Figure 1). Five professionals with experience in HPN participated in two focus group discussions. Ethical clearance was granted by the Ethics Committee of the German Society for Nursing Science for this project. The first focus group centered on the current situation, and the second on a vision for the future. The previously documented HPN process was discussed step by step. The discussions were analyzed using the qualitative content analysis approach. In addition, a process analysis has taken place from a technical point of view to tackle the functions of an on-demand system. Both the current status and the vision are the basis for the specification of a digital HPN on-demand support system. Results and Discussion This project aims to address the challenges and risks in HPN and to support patients with a situation-based digital system. The group discussions confirmed that patients often feel insecure in self-managing HPN. The issues mentioned affected both, technical as well as process challenges. Technical challenges such as a difficult-to-handle connection system are not the focus of this analysis. Process issues can be categorized into hardware and software aspects during the typical HPN process steps, as well as those arising in exceptional circumstances causing uncertainties. Generally, an on-demand emergency plan is highly advisable. The findings are utilized to develop a user interface design, which should be further tested in the next project phase through the cognitive walkthrough method involving users.
Purpose. Due to a lack of suitable housing options, many autistic adults continue to live with their parents or family members. Their difficulties with executive functions and communication are often too great for them to live independently. If there are no additional disabilities, residential care homes are not an option for them. Nevertheless, many autistic persons have the desire to shape their own lives. There is a great need in suitable housing options that meet their needs. Furthermore, it is also considered important for a good long-term prognosis (Prei├ƒmann, 2022). Considering the aging society, the need for such housing options, which enable autistic persons to live independently, while offering support services that meet their needs, is even greater. Therefore, the design of an autism-specific housing complex for adults was chosen and worked on for a Master thesis in the master program Inclusive Design ΓÇô Inclusive Architecture at the Frankfurt University of Applied Sciences. Method Based on the findings of a systematic literature research, a building project was defined and architectural aspects for the development of a barrier-free environment for autistic people were compiled. This was mainly based on specific literature and autobiographical case studies of autistic persons and their relatives. Following this, a building site was selected and analyzed. This included an analysis of the urban environment and accessibility in order to demonstrate the strength and weakness of the selected location for the chosen building project. An architectural concept for an autism-specific housing complex for adults was then developed based on the findings from the research and analysis. Results and Discussion When developing the concept, the previously researched aspects of autism-specific architecture were taken into account with regard to outdoor and green spaces, the design of the rooms, the building furnishings and the technical building equipment. The consideration of sensory perceptions and behavioral characteristics of autistic persons was also crucial for the development of a concept, as these can be influenced by the physical and sensory environment (Kessel, 2015). Attention was paid to this, for example, it was ensured that functions with the same sensory qualities were arranged coherently and that there were transition areas in between so that the residents could adjust to the new environment. Retreat options, fixed points for easier orientation and predictability of the building's areas were also taken into account when developing the concept. To avoid an exclusive living concept, the residents of the residential complex should be a heterogeneous group of autistic and non-autistic people. The concept comprises a residential complex consisting of two apartment buildings which are accessed via a shared, sheltered inner courtyard. Support services are available in form of a service center, an occupational therapy and a group room for support groups. Housing and support services are spatially separated from each other. The use of these services is not bound to living in the residential complex. Various communal areas with different activities give residents the opportunity to interact socially with each other while retreat rooms are available if required. The green and communal areas were designed with great detail. The housing concept is suitable for adults of all ages. Almost all residential apartments and all communal areas are accessible for persons with disabilities, allowing residents to continue living in their homes into old age. The concept therefore not only meets the needs of autistic persons for a stable place to live (Prei├ƒmann, 2017), but also addresses their desire to lead a self-determined life in their own home in old age (Theunissen, 2016).
Generation, Inequality and Technological Competence in Later Life
Purpose Almost everyone wants to maintain their independence in old age and live at home for as long as possible. The demographic change is significantly increasing the demand for elderly care in Germany. In this context, technological innovations can contribute directly and indirectly to improving the quality of life while maintaining autonomy, as well as supporting prevention and rehabilitation (Hoff/Pottharst 2023). However, social inequalities and consequences are often not taken into account in the development of digital technologies. Taking a participatory gerontological perspective, the question arises which factors influence the use of technology. The presentation based on my dissertation (Pottharst, 2022) combines theoretical approaches of technology generations (Sackmann/Winkler, 2013) with those of social inequality. This allows for conclusions to be drawn about the acceptance, competence and use of technology by older individuals. Methods The study investigates the influence of cohort membership and dimensions of social inequality on technology competence and use in later life. A regional sample of 269 individuals aged 60 and above was randomly surveyed in the district of Goerlitz (Saxony) between 2015 and 2017 as part of the project 'Trust in Assistance Technologies for Inclusion of the Elderly' (VATI). The survey was conducted in two waves, with the same individuals interviewed each time (VATI-AAL-Panel, t1 n = 269, t2 n = 109). The sample was then divided into two focus groups using a mixed-methods approach. These groups were distinguished by their attitudes towards technology. Group differentiation was based on the technology commitment scale developed by Neyer et al. (2012). The qualitative results in 2019 (t3) were triangulated using quantitative statistical methods and confirmed through multivariate analyses. Results and Discussion The findings suggest that the concept of technology generations should be reconsidered and used in conjunction with intersectional approaches. Today, new technologies seem to be developing faster than it takes generations to emerge. Technology generations seem to be gradually dissolving in the digital revolution (Gilleard 2018). Therefore, technology routines of older adults are likely influenced by imprints in the life course and current social situation. Additionally, a moderation analysis confirms a result discovered in the focus groups (Figure 1): A high level of self-perceived technological competence does not necessarily lead to an increased use of technology. Age is a moderating variable here (interaction effect). In some cases, awareness of the limitations of unreliable or inadequate digital technology can result in rejection. Overall, it is important to ensure that older people have access to new technologies while also respecting their freedom to choose whether or not to use them. ┬á References Neyer, F. J., Felber, J., & Gebhardt, C. (2012). Development and validation of a brief measure of technology commitment. Diagnostica, 58(2), 87-99. https://doi.org/10.1026/0012-1924/a000067 Pottharst, B. (2022). Generation, Ungleichheit, Technik. Technikkompetenz im h├╢heren Lebensalter. Wiesbaden: Springer. https://doi.org/10.1007/978-3-658-38736-5 Gilleard, C. (2018). The place of age in the digital revolution. In S. Taipale, T.-A. Wilska, & C. Gilleard (Eds.), Digital Technologies and Generational Identity: ICT Usage Across the Life Course (pp. 11-22). London: Routledge. Hoff, A., & Pottharst, B. (2023). The role of assistive technologies in home care delivery in Germany between vision and reality. In K. Hamblin & M. Lariviere (Eds.), Care Technologies for Ageing Societies: An International Comparison of Care Systems. Bristol University Press. https://doi.org/10.51952/9781447364825.ch004 ┬á ┬á Keywords: technology generations, social inequality, intersectionality, technology competence, technology commitment Address: Faculty of Social Sciences, University of Applied Sciences and Arts Bielefeld, Germany Email: bill.pottharst@hsbi.de ┬á Acknowledgement This research was supported by University of Vechta and University of Applied Sciences Zittau/Goerlitz
Financial challenges for successful aging-in-place: feelings and concerns of a group of Brazilian older adults
Purpose: To describe the financial demands, feelings and concerns of Brazilian elderly people that can influence their aging-in-place (AIP) to serve as input in the choice of technologies, improving the financial management of vulnerable older adults. Such management can ensure resources that favor personal and environmental factors or even absorb security costs. Methodology: Exploratory, cross-sectional, qualitative study (Figure 1). A group of 119 older adults were interviewed using the question ΓÇ£Regarding your finances, what are your current needs that can influence your aging-in-place?ΓÇ¥ Results and discussion: Participants were men (23.1%) and women (76.9%), with an average age of 67.7 years, married (51.1%), widowed (24.5%), with more 10 years of study (59.1%), 45.7% retired and 40.4% continue working; 75 had chronic health conditions. Thirty-three denied financial needs because they were retired and received a pension; be supported by the family, be financially stable and independent. To think about the AIP, the financial demands of the remaining 86 participants were organized into the categories Present and Future Demands (DPF) and Autonomy and Independence. These include the fact that they have to continue working to supplement their income, seek retirement benefits and achieve financial stability for basic expenses in the present (food, water, electricity, housing) and in the future (diapers, medicine, caregivers, etc.), in addition to maintaining health insurance in old age, and concerns about the lack of financial reserves for emergencies and old age expenses. They highlight debt and the need to pay off bank loans and debts owed to children and grandchildren. As for Autonomy and Independence, they want to manage their own money, as well as have the skills to use internet banking and maintain their current lifestyle, enjoying comfort, leisure and good health. The feelings and concerns describe the fear of financial losses associated with functional decline, frustration at not having planned other sources of income and accumulation of assets aiming for financial independence. Feelings related to financial demands are related to AIP in all its dimensions, requiring knowledge of the demands of the present to resize the future. Supported by the WHO (2016) 5P construct for successful AIP (place, person, politics, personal services and products), finance appears as an essential aspect. The production of knowledge in gerontechnology and finance has addressed the potential of digital technologies for financial education (Doll& Hollerweger, 2022); financial resources as the main barrier in the implementation of gerontechnology, pointing out several schemes that can function as one of the financial drivers for AIP, such as savings, for example (Franchimon & Van Der Vlies, 2010) in addition to financial condition as a predictor of satisfaction with life (Lein et al, 2014). Financial challenges are directly linked to the dimensions of gerontechnology, as it generates interdisciplinary knowledge to design technology, services and environments that can support independent living and care, and as an interdisciplinary field, it can offer paths for the development skills to generate income, use digital technologies that enable financial operations and governance of everyday life, promoting autonomy and independence in old age.
Feasibility Study for Lifestyle Monitoring of Older Adults Living Independently at Home Using Smart Water Meter Data
Purpose There are three types of technologies commonly used in home monitoring services: (1) Wearable devices, which can be uncomfortable and intrusive to users; (2) Ambient sensors, which require extra installation; and (3) household meters, such as smart electricity and water meters. While smart electricity meter data have been used for long-term lifestyle monitoring of independent older adults (Ruano et al., 2019), few studies use smart water meter data for the same purpose. A study by Wilhelm et al. (2023) exploited water consumption data from smart meters for human activity event recognition. This paper presents a feasibility study for lifestyle monitoring of older adults living independently at home using smart water meter data.┬áMethod┬áA water meter was installed in a 61-year-old male testerΓÇÖs home who lives alone, retrieving water consumption data at 10-second intervals. Water consumption data (Figure 1 top) was collected for 7 days, and the tester was asked to record the ADLs when using water during that period. Water consumption data with a flow rate of less than 0.2 liters per 10 seconds was considered noise and filtered out. Water usage ADL events (Figure 1 bottom) were collected by identifying 60 seconds of consecutive non-water consumption before and after each event. Events shorter than 20 seconds were considered not ADL and were removed. The water consumption data was converted to water usage ADL activity in 15-minute periods (0/1 in Figure 2 top), returning ΓÇ£1ΓÇ¥ when there were water usage ADL events in the 15 minutes and ΓÇ£0ΓÇ¥ for periods with no water usage ADL events. A self-comparison was conducted between the daily water usage ADL activity data and the 4-week norm to identify deviations in lifestyle patterns. Activity levels were assessed by comparing the active score (AS) with the norms AS for the previous 28 days. Low and high norms were determined from the userΓÇÖs preceding 28-day data by averaging the ASs of the 14 days with lower and higher ASs, respectively. Regularity was assessed by calculating the correlation coefficient (CC) between the day's water usage ADL activity data and the 4-week norm. Results and Discussion A total of 54 events from 8 types of water usage ADL events (flushing toilet 13, handwashing 6, bathing 5, morning hygiene 6, evening hygiene 9, meal preparation 6, post-meal cleaning 8, and laundry 1) were recorded. The algorithm described above identified 58 water usage ADL events, and 53 were true events, which yielded a sensitivity of 98.1% and a positive predictive value of 91.4%. ΓÇ£Laundry,ΓÇ¥ a long-duration event, was identified as 4 independent water usage ADL events. Two other false events were noise that was not filtered out. After confirming the accuracy of the algorithm, Figure 2 shows the water usage ADL activity data for one day and the 4-week ┬ánorm. The norm AS is 7.33, with high and low norms of 12.65 and 2.01, respectively. The one-day water usage ADL activity resulted in an AS of 9.38, between the high norm and norm, indicating a normal activity level. An AS higher than the norm indicates a high activity level, an AS between the norm and low norm signals a low activity level, and an AS lower than the low norm indicates an abnormally low activity level. The CC of the one-day water usage ADL activity data is 0.32, indicating a low regularity level. The CC higher than 0.7 indicates a high regularity level, the CC between 0.7 and 0.5 shows a normal regularity, and the CC lower than 0.3 indicates an irregular level. Based on this feasibility study, a lifestyle monitoring system using smart water meter data will be constructed.
Universal Design as an Approach to Sustainable Gerontechnology
Purpose┬áToileting and bathing have long been associated with successful aging at home (e.g., Harris, et al., 2015; Yang and Sanford, 2012).┬áThe majority of assistive technologies to support self-care activities among older adults, such as grab bars, commode chairs and tub benches, are specialized devices that are typically non-residential in character and fixed in place or difficult to adjust. This approach to integrating non-adaptable specialized technologies into existing living environments has implications not only for adoption and acceptance, but also for disuse, abandonment, and replacement as individualsΓÇÖ functional abilities may vary unpredictably and decline over time. In contrast, universal design, which is everyday design, presents an approach to the development of more sustainable technologies that are not only compatible with residential environments, but are useful and usable across the lifespan of both an individual and the product.┬á┬áThis paper will contrast universal design to traditional specialized design of┬á┬ágerontechnologies, highlighting examples from 3 ongoing self-care projects in the Rehabilitation Engineering Research Center TechSAge to develop user-controlled, adjustable, and repositionable toilet and bathing technologies that can be seamlessly integrated into bathroom environments.┬áMethod┬áVoice-controlled adjustable technologies with embedded force and pressure sensors for data collection, including a toilet/grab bar to aid transfers and a repositionable bathtub that converts to a curbless shower, have been constructed and installed in the Georgia Tech AwareHome. In addition, a soft robotic shower wand is in the modeling phase prior to installation at the University of Illinois LIFE Home. The three projects use repeated measures designs of simulated use to demonstrate usability and usefulness of prototype technologies. To date, repeated trials have been conducted in which 15 ambulatory older adults with mobility limitations transfer to/from the toilet system using the minimum U.S. code-based┬áconfiguration┬á(17ΓÇ¥/43.18 cm toilet height and 33ΓÇ¥/83.82cm grab bar height) and up to three user-adjusted configurations to identify the user-preferred configuration.┬á┬áResults and Discussion┬áBalance and stability can be determined by the distribution of body weight on the seat as measured by the mean area of pressure in the seat (Palmer, Knight, & Perring, 2010), where the smaller area of pressure indicated greater stability and balance. Using the embedded sensors to measure and analyze the area of the ellipse generated by the change in center of pressure or movement of users on the seat (Silva et al., 2017), preliminary analyses indicate that higher seat and grab bar height in the preferred configuration had a smaller mean area of pressure (0.0671) than the standard configuration (0.0771).┬á┬áAlthough not statistically different, the trend suggests that seat and grab bars located at heights greater than the standard code configuration may lead to better stability during toilet transfer and sitting. Whereas the preliminary analysis examined mean area of pressure from initial seat contact to offloading, we expect to find significant results when data are analyzed at each distinct transfer stage, lowering (i.e., initial contact), stationary sitting, and rising (final contact). Current assistive technologies that are fixed in place or difficult to adjust may not effectively accommodate unpredictable fluctuations in functional abilities of older adults. In contrast, universal design user-controlled adjustable technologies present a more sustainable approach as they not only have the potential to be seamlessly integrated into any bathroom environment, but also have the potential to be useable and useful for any user at any point in time. ┬á┬á References Harris, F., Yang, H. Y., & Sanford, J. (2015). Physical environmental barriers to community mobility in older and younger wheelchair users.┬áTopics in Geriatric Rehabilitation,┬á31(1), 42-51.┬á Palmer EJ, Knight DJ, Perring S. The effects of variations in functional reach test performance on the centre of pressure profiles in healthy elderly females. Physiother Theory Pract. 2010;26(2):101-109. DOI: 10.3109/09593980903071784 Silva, M. G., Moreira, P. V. S., & Rocha, H. M.. (2017). Development of a low cost force platform for biomechanical parameters analysis. Research on Biomedical Engineering, 33(3), 259ΓÇô268.┬áhttps://doi.org/10.1590/2446-4740.01217 Yang, H. Y., & Sanford, J. A. (2012). Home and community environmental features, activity performance, and community participation among older adults with functional limitations.┬áJournal of Aging Research,┬á2012. Keywords:┬áuniversal design, aging-in-place, assistive technology, toilet and bathing technologies Affiliation: Dept. of Occupational Therapy, College of Nursing and Health Professions, GA State University Corresponding Author Email:┬ájsanford1@gsu.edu ┬á
A Scoping Review for Assistive Technologies for Healthy Ageing: A Conversation
Purpose In 2024,more than 2.5 billion people required one or more assistive products. It is estimated that by 2050, as the global population continues to age, over 3.5 billion people will require one or more assistive devices. Not only are assistive technologies (AT) one of the four pillars supporting global health, they are a critical element for the improvement of functioning by individuals with age- and health-related disabilities. These disabilities are recognized not only as global public health and human rights issues but also as consequences of the social determinants of health and as milestones for the sustainable development goals. However, determining the questions and how to effectively answer these questions requires both a transparent and rigorous methodological approach. This paper addresses the development of a framework to evaluate (or measure) the effectiveness or efficacy of gerontechnologies (GT) and assistive technologies (AT) to address effective ageing in place. Method Since we wanted to ensure transparency and rigour of the process, we used the PRISMA Scoping Review Protocol (Tricco et al., 2018) as our working map. Phase 1 is a beta stage to establish process and viability. The first step was to determine the question(s) to be addressed in this review and identify outcomes of interest. This required us to establish definitions, scope of review, and eligibility criteria. For example, successful adoption and use of hard, soft, or digital technologies by elderly people, who may have existing limits on function or physiology, must also address the behavioral and social components of these technologies. Categories of devices needed to be defined to allow the selection of validated measures and design/build standards to assess specific criteria of said technologies. Eligibility criteria were informed by condition or domain being studied, population, and possible intervention(s)/ exposure(s). Selection of information sources (academic and grey) and concept construction for the searches and translation were informed by definitions, scope, and eligibility criteria. An inter-rater reliability level of 80% will be met for the screening and data extraction processes. Sixteen (16) data items for extraction were identified, which were attributes describing: condition/domain; population; and intervention/exposure. Since this is a scoping review, there is no requirement for formal risk of bias or level of confidence assessment at the individual study level. Results and Discussion To date, we have established a preliminary scoping review protocol. However, when the test searches were run in PubMed alone, retrieval results numbered 50,000 plus records. Adding in the remaining 10 suggested databases, would result nearly double that amount. Hence, due to the scope of the proposed study, our next step is to revise the protocol into a main study, with several smaller focused areas, due to the complexity of the questions being asked, and the number of topics of interest to the workgroup. The main study will be an overview of ageing-in-place technologies, using both new experimental and observational studies (last 5 years), supplemented with existing review articles to build in a comprehensive view. Study design acceptability will be based on quantitative and qualitative designs which are┬á conducted either as stand-alone studies (quantitative or qualitative) or as part of a larger mixed-methods approach. Inclusion criteria will focus on 1) specific population-oriented outcomes (clinical/cost-effectiveness or acceptability) and 2) design elements, which address acceptability, availability, affordability, or usability, again from a population-oriented perspective as well as design/build evaluative measures. The accompanying focused area studies under consideration may address 1) ethics, 2) policy/government initiatives, and 3) forecast/trends. We also now have access to Covidence, an essential tool for screening and extraction.┬á
Criteria and Assessment of Assistive Technologies for Ageing-in-Place
Participants: H.S.M. Kort (the Netherlands), T. Marquine Raymundo (Brazil), H Nap (the Netherlands ), M Zegwaard (the Netherlands), D. Laan (the Netherlands) & M. van Tilborg (the Netherlands) with as discussant K Shae (Switzerland). ISSUE: Ageing can be in good health. Unfortunately, due to biological processes, ageing will occur with a high risk of both cognitive and functional decline, while ageing people desire to live as they have been doing before. Although ambitions differ across individuals a general ambition is to age-in-place. Ageing-in-place (AiP) comprises more than the living and housing conditions but also concerns being able to continue to enjoy activities such as sports, hobbies, work, traveling, shopping, and other activities including the activities needed for daily living. Technology alone is though not sufficient to bring about the necessary support for aging. Supportive communities helping older people to age in place could be a relevant asset as well. The same accounts for ambient intelligence technologies to support ageing-in-place by monitoring clients in the home to provide. an increased sense of safety and security (van Hoof et.a., 2011). Older people within their communities will use assistive technologies (AT) for themselves or to support others. Understanding their view on AT is therefore of utmost importance as well as understanding their view on AiP. This will give researchers appropriate directions for the design of AT, the development of appropriate use, access, affordability, and procurement of AT (WHO GReAT report 2022). CONTENT Our symposium is designed to present different views on ageing in place and the meaning of assistive technologies for older people. The symposium will share data to help us understand that AiP by use of AT depends on older people's views, regulations, and policy, while the assessment of AT for AiP should be person-centered as well. Furthermore, the view on AT should be more than compensating for decline. STRUCTURE Kort and Marquine Raymundo will elaborate on the concept of ageing-in-place from the view of older people, the view of professionals and scientists in AT. Laan & van Tilborg will report on experts' views in the ISG community on assessment criteria for AT in AiP. After this Zegwaard & Nap will present the development of two examples of value assessment metrics for AT for older people. In the end, a different angle on assistive technology for AiP for older people will be given by emphasizing the additional use of AT by demonstrating the use of canes and walkers from the perspective of internal and external arts. Shae the representative from WHO will act as a discussant of the symposium CONCLUSION: the view of older people and their caregivers on AiP depends on the economic status of a country region. Challenges associated with AiP, emphasize the need for user-centered design and comprehensive support systems of AT. The assessment tool to be developed focuses on the interplay between what the technology offers and the concrete needs and person-centered care. The final presentation shows that AT could be used beyond the purpose of functional decline. ┬á References Hoof, van, J., Kort, H. S. M., Rutten, P. G. S., & Duijnstee, M. S. H. (2011). Ageing-in-place with the use of ambient intelligence technology: perspectives of older users. International Journal of Medical Informatics, 80(5), 310-331. https://doi.org/10.1016/j.ijmedinf.2011.02.010 Global report on assistive technology. Geneva: World Health Organization and the United Nations ChildrenΓÇÖs Fund (UNICEF), 2022. Licence: CC BY-NC-SA 3.0 IGO ┬á Keywords: frailty, dependence, self-confidence, AT, care professionals, martial arts. Affiliation: Utrecht University of Applied Sciences, Technology for Healthcare Innovations, NL Corresponding Author Email: Helianthe.kort@hu.nl AuthorsΓÇÖ ORCID iDs: H.S.M. Kort 0000-0001-9735-1015, Acknowledgment: no financial support was provided. We thank all authors and contributors to the abstracts.
Interdisciplinary, technology-supported, climate-friendly professional housing advice as a contribution to improving the living environment in Brandenburg
Purpose The article unfolds the heterogeneous supply structure of professional housing counselling in the in Brandenburg, which is to be established there. Professional housing counselling is intended to inform those seeking advice and relatives reactively or preventively (Niepel, 1997) about the options for designing age-appropriate, independent and self-determined housing and living with the focus on strengthening individual lifestyles, relationships and networks. Internationally, studies on housing counselling focus on medical aspects (Carnemolla & Bridge, 2020).Overall, differences can be observed in terms of the institutional location, form of counselling and professional group of counsellors, who are increasingly including technology counselling, which consists of smart home applications and ambient assisted living systems,. (Weidekamp-Maicher et. al., 2022). Whether the conversion, extension and energy-efficient refurbishment as well as climate protection are successful for both the 55.1% of people living in rented accommodation and the 44.9% (Destatis, 2024) who own their own home depends on the extent to which support programmes prevent "residential segregation" as part of future development (Gro├ƒmann, 2020). In Brandenburg, housing advice is offered at 45 contact points of the care support centres by full-time employees as free, outreach or telephone advice. Independent providers and tradespeople are also part of the counselling process. (Brandenburg care support centres, n.d.a; Brandenburg care support centres, n.d.b; Hahnel et al, 2021) On the one hand, the quality of the counselling is ensured by client-centred counselling, which embeds the individual in their specific social and material circumstances and living environment (Seithe 2008). On the other hand, biographical work is of great importance in dealing with the needs of the target group, in that the ageing person is seen as the designer of their environment and thus of their decisions (van Rie├ƒen et al. 2017; Krecan-Kirchbichler & Klingenberger 2012). The preventive aspect of preventive home visits is also important (Blotenberg & Seeling, 2021). It is used to prevent the increase in the need for care, which in Brandenburg is 7.3% (Statista, 2023; MSGIV, 2023) compared to the national average (6.0%). In the transfer of knowledge on practical issues such as housing (Ludwig, 2008), areas of tension in the provision of services of general interest, demographic change and transformation are addressed. For this reason, an interdisciplinary perspective that combines well-founded social expertise and specialist competences from different subject areas must be brought together in a multi-professional negotiation process. Method Extensive research was carried out to develop the research field, which reflected the status of professional housing counselling in Germany as well as in Brandenburg and which highlighted research desiderata such as the lack of a housing concept in Brandenburg. In addition, individual aspects such as the financing of housing counselling and the development of structures were empirically examined in an exploratory process. Results and Discussion The results show that housing counseling in Germany is inconsistent and that a concept is needed in Brandenburg that takes particular account of structural weaknesses. It also needs to be clarified how multi-professional counseling skills can be networked on an interdisciplinary basis.
Benefit and usability of a senior tablet and an emergency smartwatch for older adults and their relatives: results from a prospective user study
Introduction Assistive technologies (ATs) have the potential to promote quality of life and independent living of older adults but also to relieve the burden of caregivers and relatives. However, evidence on effectiveness of ATs in the real-world application remains scarce. We conducted a prospective, exploratory user study to test the perceived benefit and satisfaction with different ATs in the real-world environment. Methods Community-dwelling adults aged ΓëÑ 65 and their relatives tested either a tablet with a simplified interface or a smartwatch with programmable emergency contacts for eight weeks in their everyday life. Benefits and usability of AT were assessed by all older adults and their relatives using different assessment tools employed prior to and/or after the intervention. Outcome measures included the Technology Usage Inventory (TUI), Quebec User Evaluation of Satisfaction with Assistive Technology 2.0 (QUEST 2.0) and Canadian Occupational Performance Measure (COPM). Results 17 older adults and 16 relatives were included. Participants in the smartwatch group were slightly frailer and more dependent but reported higher technology acceptance and satisfaction scores than those of the tablet group. In the tablet group, relatives had better technology acceptance and satisfaction ratings than older adults. Identified everyday issues with the COPM included contact/communication and entertainment/information for the tablet, safety and getting help in emergency situations for the smartwatch, and AT usability for both devices. Conclusions This study highlights remaining obstacles for a widespread and effective application of ATs in everyday life of older adults and their relatives. While the results do not provide evidence for a positive effect regarding communication deficits, benefits could be shown for the area of safety.
Accessible Routes: Evaluation and Implementation of an Inclusive Indoor Navigation App for People with Disabilities
Purpose The management and guidance of people in buildings and industrial properties or university campuses is still a challenge. There is no standardized concept that meets the diverse requirements of the various users. Few or no consideration is given to supporting the various requirements of people with inclusion needs. Particularly in situations requiring assistance or danger, it is necessary for people with disabilities to be able to rely on systems that provide them with special support. Dynamic changes such as the temporary unavailability of traffic routes are very important (Nguyen et al., 2022). People with disabilities are among the most vulnerable groups in building fires (Hostetter and Naser, 2022). A system is needed that offers both individual dynamic and situation-dependent support and at the same time provides emergency and special situations as well as sufficient inclusion support via a mobile app with offline fallback protection. Method For a safe guidance and management of individuals both indoors and outdoors, the specific disabilities of individuals must be taken into account. Our system aims specifically at assisting individuals with disabilities. Various support options have been explored for different scenarios of personal limitations and integrated into a holistic approach to technical support for personalized person navigation, designed with sustainability in mind. Common disabilities such as visual impairment, hearing impairment, and mobility limitations have been considered. People with different disabilities have, among other things, the same wishes with regard to what a suitable passenger guidance system should contain, for example the wish to avoid carpeted floors (Gupta et al.,2020). The foundation of our person guidance system is an inclusion compliant mathematical model of pathways within a building complex, including stairs, elevators, and ramps. The basic data is continuously updated and retrieved by the app to ensure it operates with real-time information. For example, in the case of navigating individuals with mobility impairments, automatically optimized barrier-free alternative routes can be offered. The geometries of the pathways are crucial for safely guiding individuals in special situations. Our approach utilizes self-designed person-counting sensors to initially detect enclosed individuals and to offer separate escape routes for them based on their limitations. Self-developed actuators can dynamically display alternating escape routes. A high-contrast display shows pictograms or directional indicators tailored to different scenarios. Additionally, the actuator includes a speaker to produce statements or click sounds, such as tones at 880 Hz, which are acoustically very well locatable. Results and Discussion Our inGuide app utilizes Bluetooth Low Energy (BLE) beacons for position determination. Navigation is also possible without Bluetooth using QR codes. Navigation can be configured to be either visual or auditory, and can be supplemented by optoacoustic actuators capable of directing various individuals through multiple channels. Our system integration is shown in Figure 1. Conceptually, existing building technology systems such as lighting or electroacoustic installations can be incorporated to achieve maximum cost-effectiveness and sustainability of the procedures. Thus, the system is retrofittable in existing structures. Additionally, new constructions offer direct integration possibilities to ensure the most efficient deployment.
Intervention Mapping of a Mobility Outcomes Monitoring System for Geriatric Patients
Purpose Evidence suggests that providing training and follow-up for older adults with mobility limitations after mobility device provision can improve adherence to device use and function (Best & al., 2016), but there is a lack of systematic and coordinated services. To address this gap, a theoretically informed digital intervention called MOvIT+Γäó was designed to provide remote monitoring and support for older adults and their caregivers (Auger & al., 2022). This paper explicitly describes how, using intervention mapping (Eldredge & al., 2016) and a novel approach to a collective decision-making method, the features of the intervention were linked with intervention usersΓÇÖ needs and program outcomes for older adults using mobility assistive technology, their caregivers, and health professionals. Methods Auser-centered design grounded in a 6-step intervention mapping approach (Eldredge & al., 2016). Results and Discussion In step 1, a logic model was created, a governance structure for the project was established, and 66 potential functionalities were identified. For step 2, a novel modified TRIAGE approach was used to prioritize 36 intervention features (Table 1). Step 3 consisted of establishing a theoretical framework and creating 28 use-case scenarios for all intervention users (assistive technology users, caregivers, clinicians, managers, and research staff). In step 4, the digital infrastructure for the monitoring intervention was constructed and more than 130 training resources were gathered to address an array of potential problems with the use of assistive technologies. In step 5, an iterative implementation plan was devised with the steering committee and improved continuously by the participating sitesΓÇÖ feedback. Lastly, for step 6, an evaluation protocol was finalized. In conclusion, by utilizing an intervention mapping approach, the complexities of a multi-component digital intervention were manageable due to the stepwise approach and the resulting logic model. The systematic and collaborative approach used ensures the intervention features will meet targeted objectives. Furthermore, the explicit links between intervention features and behavior changes will assist evaluation in future studies.
Aging cities: Assessing the Urban Impact on the Active Mobility of the Elderly Population
In a climate of an accelerated aging population and urban densification, with a related increase in the amount of gray infrastructure, this study investigates the relationship between urban design, road safety and the walking mobility of the elderly. The growing elderly population is a global reality, with an ever-larger number of older people living in urban centers. The lack of planning in cities reveals significant challenges for safer and more inclusive urban design, especially regarding accessibility and walking mobility for the elderly in their trips and access to public spaces. Safe and comfortable transportation for the elderly is essential to ensure that they can continue to experience the city life while maintaining their autonomy and well-being. However, the high number of falls in the urban environment and the high rate of pedestrians being involved in accidents with motor vehicles, in which 36% of traffic accidents are fatal among elderly pedestrians suggests a correlation that limits their use and appropriation of the city's public spaces. This scenario has significant implications for the senior citizens and is associated with frailty, dependency, institutionalization and mortality. With this perspective in mind, it is essential to discuss the issue in view of its effects on the social, political and public health spheres, since it has a direct influence on safety preventing the risk of falls and traffic accidents, leading to consequences in terms of quality of life, mobility, well-being and social inclusion. In this context, urban design has an important role to play in designing safe, accessible and welcoming environments that encourage walking and the use of public spaces in the city, as well as active participation of the elderly population in society. This research aims to analyze the contribution of urban design to road safety for elderly pedestrians in their journeys and access to public open spaces. Method The research is part of a dissertation study in which part of the methodological approach designed will be used as procedures: bibliographical and documentary research for theoretical basis, and evaluations of public space based on criteria previously drawn up from manuals and guides found and analyzed in the bibliographical review stage. Results and Discussion After an analysis of the main access routes to Bom Pastor Square shows that there are considerable limitations when it comes to the safety of elderly pedestrians. These routes lack adequate infrastructure to provide a comfortable walk, facing a series of obstacles that significantly impair the walker's experience. In addition, there is a clear prioritization of car lanes, without sufficient efforts to reduce vehicle speeds, which directly compromises pedestrian safety
A Social and Environmental Impact of the TV Program 'Golden Girls' on Viewers
Purpose How can we foster a positive mindset towards aging and late life? Are there any environmental factors, such as media and content, that can significantly influence society's perceptions and attitudes towards aging? The field of environmental gerontology focuses on studying the physical and social environments in which older adults live, and their interactions, in order to improve their quality of life. There is little gerontological research on the effects of TV programmes on individuals as they age. While there is research on the effectiveness of celebrity endorsement in marketing (Singh, R. P. et al, 2018), Celebrity Attitude(Hitlan, R. T. et al, 2021), Media Influence(Kristen Harrison, 2009), and Fan Engagement(Cao et al, 2024), studies on older celebrities are hard to find. This study aims to assess the impact of the "Golden Girls" program, in which features famous singers in their 50s and 60s challenge the idol culture in South Korea. It explores perceptions across different age groups and seeks to provide recommendations for the use of aging celebrities in TV programs as an environmental strategy to improve life in old age. Method Hypothesis 1: The viewing effect will vary according to how closely celebrities match their image. Hypothesis 2: The viewing effect will vary by age. Hypothesis 3: People who experience a significant viewing effect are more likely to watch similar programs in the future. A 5-point scale (not at all, slightly, moderately, very much, extremely) was used for measurement, and the survey was conducted using Google Forms and paper questionnaires. The study targeted a random sample of viewers of the program. Analysis was conducted using SPSS to test the hypothesis through reliability, difference analysis, and regression analysis. Results and Discussion The survey sample consisted of 330 cases, with 42.3% male and 57.7% female participants. The average age was 53.46, with a minimum age of 21 and a maximum age of 78. The reliability of the survey was demonstrated by a Cronbach's alpha of .919. There was no significant difference in the effects of programs between males and females (t=-.688, p=.492). Regression analysis showed a significant difference in the effects of programs depending on how closely it was aligned with the viewer's self-image (t=-5.382, p=.000, R2=.121, F=28.384), whereas no significant difference was found according to age (t=-169, p=.866, R2=.000, F=0.029). Viewers who experienced a strong effect from the program showed a higher intention to watch similar programs in the future (t=12.027, p=.000, R2=.413, F=144.655). The effects of programs were particularly notable in several areas: feeling empowered to take on challenges (3.54), believing in overcoming personal hurdles (3.61), feeling capable of developing new talents (3.42), dreaming new dreams (3.48), and finding new meaning in life (3.64). These results suggest that older individuals are highly inspired by celebrities' seemingly impossible challenges, fostering dreams and hope. It indicates that portraying the challenges and successes of people of similar age, physical appearance, behavior, and attitudes in TV media significantly contributes to enhancing life in later years. While applauding the challengers, as mentioned in other comments, the skepticism about whether the general public can undertake a similar challenge suggests a perceived distance from such feats. Thus, broadcasting the attempts of ordinary people could also be a valuable environmental approach.
Connection to the world ΓÇô older afro-brazilian quilombolas and their information and communication technologies
Purpose: The use of information and communication technologies (ICTs) has increased significantly in recent years. Thus, in today's world, social participation, whether in consumption, in governance, in access to information, or in social contacts, is strongly linked to the possibility of using ICTs and can represent a factor of social exclusion. In Brazil, internet access has increased, but excluded groups remain. Illiterate people remain scarcely present, despite having increased their participation on the internet from 20.7% in 2019 to 42.6% in 2023. Only 38.2% of older people accessed the internet in 2019, which increased to 57.5 % by 2023. Despite progress, more than 40% of people over 60 continues not to access the internet. Considerable progress can be seen in rural areas, where in 2019, only 61.1% accessed the internet, in 2023 there are already 83.3%, only slightly less than in urban areas with 89.7% in 2023. In relation to race, the differences were not strong, and an increase was noted in each ethnic group, in white people from 79.9% to 89.4% between 2019 and 2023, in black people from 76.8% to 87.7% (all data from the Regional Center of Studies for the Development of the Information Society ΓÇô CETIC, accessible at https://cetic.br). With these changes, arises the question, how this is concretely reflected for older people in a traditional quilombola community, a community formed by descendants of enslaved Afro-Brazilian people. What are the means of communication used by older members of this community and what are the consequences of the use of ICTs for this population. Method: The research was carried out in the quilombola community of Palmas, Bag├⌐ΓÇôRS, Brazil, between June 2023 and March 2024. Visits and interviews were carried out with 17 members from this community, men and women, aged 61 to 85, with up to six years of education. Results and discussion: In the interviews, two means of communication appeared, cell phones and community radio. Of the 17 people, 15 have their own cell phone, two share their cell phone with their children. However, in many cases, the connection is limited. For the participants, the cell phone plays a central role as a communication tool in a community with large distances between houses, keeping them updated on events both inside and outside the quilombo. A more complicated aspect is that they frequently receive commercial proposals through phone calls and messaging applications, mainly to convince them to take out a payroll loan, a form of credit deducted directly from retirement, and which is seen as one of the main causes of debt of older people in Brazil (Doll & Cavallazzi, 2017). The other medium, community radio, is listened to by all participants. The results show that the cell phone has already entered even remote places and point to the cell phone's potential as a facilitator of digital inclusion among quilombola older people, but it also shows the dangers of this communication channel as it offers possibilities for unwanted and invasive advertising, or even scams. In this situation, community radio, listened to by 100% of the older members interviewed, which is controlled and carried out by the own community, could offer a channel for conscious consumption education. ┬á
The experiences of Finnish people over 75 years old with digital health and social services
The experiences of Finnish people over 75 years old with digital health and social services S. Hiltunen, S. Lakoma, P. Torkki, E. Laukka, M. Jansson, H. H├ñrk├╢nen, A. Verho, P. Pennanen, R.-L. Leskel├ñ ┬á Purpose Like the rest of Finnish society, social and health care is becoming more and more digitalized. The digital use of social and health care services has increased strongly during the last 10 years. The COVID-19 pandemic accelerated digitalization, and development work of the digitalization was carried out on a fast schedule. At the same time, Finland's population is aging rapidly, and social and health services need to be made more efficient. Digital services must be customer-oriented and different target groups need to find digital services useful to take root into society's services. So far, there is not much information about the experiences of using digital health and social services among different target groups. In 2023, The Finnish Publications of the GovernmentΓÇÖs analysis, assessment, and research activities -department published a study Impact of digital services in health and social care1. As a part of this study, the University of Helsinki and The Union for Senior Services, VALLI, conducted a survey for people over 75 years old. ┬á Method This survey is a quantitative cross-sectional study. Questionnaire was considered the most suitable method for exploring the usage and user experiences of digital social and healthcare services among citizens aged over 75. The questionnaire was developed based on relevant literature and other surveys addressing the same topic. Questionnaire was developed by the research team with the help of an expert from the Union of Senior Services VALLI. In the questionnaire, questions were addressing social and healthcare services, as well as the electronic utilization of these services. The questionnaire also drew upon a previous survey on the digital inclusion of the elderly conducted by VALLI in 2022. This foundation was supplemented with the aforementioned questions from the National FinSote survey. The older people played an integral role in the testing and development phases of the digital inclusion survey. The questionnaire consisted of four sections. The first section gathered participant demographic information, including age, gender, place of residence, and any potential constraints (e.g., sensory limitations, mobility restrictions, or financial limitations) related to the use of digital social and healthcare services. The second section of the questionnaire collected information regarding the use of smart devices and the internet. The initial question inquired whether the participant used digital social and healthcare services at all, with response options of yes or no. There was an option to answer either by electric form or by paper. Altogether, 1102 persons over 75 years answered the questionnaire, from 140 different municipalities in Finland. ┬á Results and Discussion The survey revealed that people over 75 experience that the availability and access to social and healthcare service is challenging. They would be willing to adopt digital social and health care services with potential benefits for access to care in individuals with physical disabilities and long travelling distances. This requires addressing the barriers for usage. According to the survey, those barriers needed to develop are e.g.more accessible digital services (including cognitive accessibility), the education of social and health care professionals to use the digital connections with their customers, more information about what kind of services and possibilities there are in the digital social and health care services, more individualized digital support to the older people and more dialog between the end-users and the developers of the digital services. The survey revealed that older individuals appreciate being heard and taken into consideration. Their under-represented experiences are especially important in the development of inclusive digital health and social services.┬á┬á ┬á ┬á The Union for Senior Services, VALLI is a a national non-profit umbrella organization for the care of elderly. VALLI is founded in 1953. The organization has approximately 60 member associations around Finland, which serve about 20 000 older people with 2000 professionals. ┬á ┬á References ┬á 1 P.Pennanen, M. Jansson, P.Torkki, M.Harjumaa, I. Pajari, E.Laukka, S.Lakoma, H. H├ñrk├╢nen, A. Verho, S. Martikainen, A. Kouvonen, R.-L. Leskel├ñ (2023). Impact of digital services in health and social care. Finland: Publications of the GovernmentΓÇÖs analysis, assessment and research activities 2023:52. http://urn.fi/URN:ISBN:978-952-383-059-2 ┬á S. Hiltunen, P. Torkki, S. Lakoma (2023). The experiences of people over 75 years old with digital social and health services. Finland: University of Helsinki & The Union for Senior Services, VALLI. https://www.valli.fi/wp-content/uploads/2023/10/Yli-75-vuotiaiden-kokemukset-digitaalisista-sosiaali-ja-terveyspalveluista.pdf ┬á Laukka E., Lakoma S., Torkki P., H├ñrk├╢nen H., Jansson M., Leskel├ñ R.-L., Pennanen P., Verho, A (submitted 2024) Listening to older people: Assessing preferences in the utilization of digital health and social services. ┬á ┬á Keywords: digital inclusion, digital health care and social services, older people Affiliation: The Union for Senior Services, VALLI & University of Helsinki, Faculty of Medicine, Department of Public Health & Nordic Healthcare Group Finland & University of Oulu, Research Unit of Health Sciences and Technology (HST) & ┬áRMIT University Australia Corresponding Author Email: suvi.hiltunen@valli.fi Acknowledgement This research was supported by The Finnish GovernmentΓÇÖs analysis, assessment and research activities.
Siloed and fragmented: Understanding communities of design and implementation involved in English technology-enabled care services
Purpose: In the last ten years, we have seen an increasing emphasis from industry, government departments, and some local authorities embrace digital technology to ΓÇÿmoderniseΓÇÖ care systems and arrangements (Wright and Hamblin, 2023). One challenge for new digital technology, like other complex interventions, is the capacity to which they can become quickly and sustainably embedded into care services and systems (Hamblin and Lariviere, 2023). This presentation explores one dimension that affects the capacity for new digital innovations to penetrate care services: the divide between actors responsible for developing care technology and those responsible for their implementation in care systems. Method: This presentation draws on multi-sited ethnographic research (Marcus, 1995) with care technology developers (n=5), national housing organisations (n=2), adult social care providers (n=3), and national charities for carers and older people in England (n=2). The author (ML) carried out observations and interviews with members of each organisation to explore challenges and opportunities for accelerating implementation and uptake of digital innovations to support ΓÇÜageing in placeΓÇÿ. Observations were recorded as field-notes and analysed thematically and discursively with interview transcripts. Results and Discussion: This presentation focuses on one main theme from this study: the linguistic, operational, and strategic paradigms of actors responsible for developing care technology and those responsible for their implementation in care systems. Care providers, technology developers, and people with lived experience have championed the importance of co-production to ensure care experienced individuals can inform the design of new care service delivery models and complex interventions, like technology-enabled care products. While ΓÇÿuser involvementΓÇÖ or ΓÇÿpatient and public involvementΓÇÖ was noted to have increased over the last five years in care services and with human-centred designers, however, innovators (i.e., new start-ups) did not always have the knowledge, networks, or skills to understand the care system, procurement, and localised service delivery models to sustain their business. Such difficulties have led to interminable ΓÇÿpilotitisΓÇÖ projects within care provider organisations where new technologies are frequently trialled locally without any potential to scale or sustain them in service delivery. Even when designers were aware of local care contexts and care marketplace, they often articulated goals to use disruptive innovation to improve support for older people whereas social care and housing providers were often entrenched in legacy technology programmes and focused on secured, sustainable and properly evaluated products to include in their services. I argue that there needs to be further brokering between communities involved in the design and implementation of digital care innovation to construct shared language and meaning to harmonise strategies for improved support of older people. Keywords: digital innovation, social care, implementation, design, care. AuthorΓÇÖs Affiliation: Department of Nursing, Midwifery and Health, Northumbria University, Newcastle-upon-Tyne, United Kingdom. AuthorΓÇÖs Email: matthew.lariviere@northumbria.ac.uk Acknowledgements: This research was supported by the Economic and Social Research Council (ES/S002049/1). References: Hamblin, K. A. and Lariviere, M. J. (eds.) (2023). Care technologies for ageing societies: An international comparison. Bristol, UK: Bristol University Press. Marcus, G. E. (1995). Ethnography in/of the World System: The Emergence of Multi-Sited Ethnography. Annual Review of Anthropology, 24, 95ΓÇô117. http://www.jstor.org/stable/2155931 Wright, J. A. and Hamblin, K. A. (2023). ΓÇÿTechnology and adult social care in EnglandΓÇÖ in Hamblin, K. A. and Lariviere, M. J. (eds.) Care technologies for ageing societies: An international comparison. Bristol, UK: Bristol University Press. ┬á
E-GOVERNMENT IMPACT ON THE GREY DIGITAL DIVIDE
Purpose: To better understand the link between E-Government initiatives and the Grey Divide. Method: Mixed method approach was used including literature review, information related to RogerΓÇÖs Innovation Diffusion Theory, cross walk analysis and international policy experience. Results and Discussion: E-government is defined as the use of ICTs to more effectively and efficiently deliver government services to citizens (United Nations, 2024). The primary characteristics of democratic governments as stated by Abraham Lincoln: A government of the people, by the people and for the people. However, E-government renders this social institution faceless and devoid of social interaction. A proportion of the population is excluded, thereby creating the digital divide or those that benefit from the digital age and those who do not (IEEE, No Date.). The ΓÇ£Grey Digital DivideΓÇ¥ is due to barriers of perception, access and use resulting in the exclusion of older citizens (Millward, 2003)┬á from the benefits of digital participation arising from reasons beyond the usual factors related to disadvantage such as income although there are intersectionalities. Implementing generic and targeted policies for older citizens is critical because they are important beneficiaries of major policies such as pensions and health. A major difference in expectations can cause exclusion. Governments expect digitally competent citizens that can find information and access services and programs shifting responsibility to the user. Older citizens expect the right to government services regardless of their digital competences. This results in policy failure and inequitable results. There is the misguided optimism that with time the whole population will be digitally savvy, not recognizing that technology advances much faster than population adoption.┬á While younger people can use prescriptive policies, older people forge personal technological pathways. According to the theory of innovation diffusion, the factors that would accelerate adoption among older people are: Relative advantage or the acceptance that the new idea or product is better than the one that is being replaced; Compatibility of the innovation with their values, experiences and needs; Complexity or how difficult the innovation is to understand and use, Trialability or the extent and opportunity to try and experiment before adoption; and Observability to the extent to which there are tangible results. For many older people, E-government fails all these factors. Unless there are wrap around policies to address these multiple needs, older people will be excluded. Successful policy experiences can be shared. At the international level the United Nations suggests that to meet the priority of serving the whole public, a hybrid system is recommended, ensuring inclusion (UN DESA, 2022). At the national level, each of the five factors for adoption can be addressed. Relative advantage is addressed by automatic enrolment and pre-populated tax forms as in Finland. Compatibility of values is the principle of the Silver Surfer project in Luxembourg that uses older volunteers to train their peers in digital technology. To diminish complexity, in Romania, public libraries provide free e-skills learning paced for older people.┬á When older people are part of the design and testing process of products and services as in the UK, trialability is enhanced. In Slovenia, a mobile banking vehicle provides┬áface-to-face┬ásupport to older persons in┬áusing their mobile phones and other digital devices┬áto perform online banking services where they experience tangible results and observability is achieved. E-government must be equitable and inclusive, not only efficient.┬á ┬á References IEEE (No date) The digital divide and society.┬á https://ctu.ieee.org/the-digital-divide-and-sociology/ Millward, P. (2003). The ΓÇÖgrey digital divideΓÇÖ: Perception, exclusion and barriers of access to the Internet for older people.┬áFirst Monday,┬á8(7). https://doi.org/10.5210/fm.v8i7.1066 United Nations. (2024). UN E-Government Database.┬á https://publicadministration.un.org/egovkb/en-us/Overview Rogers, E. M. (1983). Diffusion of innovations (3rd┬áed.). New York: Free Press of Glencoe. ISBN┬á9780029266502. United Nations DESA. (2022). The future of digital government. UN E-Government Survey 2022. New York. ISBN 978-92-1-12321-34 Keywords: E-government, Grey Divide, Older citizens, inclusive policies, Theory of Innovative Diffusion Affiliation: ENCELL National Centre for Lifelong Learning, J├╢nk├╢ping University, Sweden Corresponding Author Email: Satya.Brink@gmail.com AuthorsΓÇÖ ORCID iDs: 0000-0002-0007-1445
Digital Skills of Older Brazilians: An Analysis using the Cross-Culturally Adapted Questionnaire of Proficiency in Information and Communication Technology
Introdu├º├úo: O cen├írio digital est├í em constante evolu├º├úo, e a pandemia de COVID-19 impulsionou o acesso ├á tecnologia. Todas as faixas et├írias, incluindo os mais velhos no Brasil, est├úo se envolvendo com a tecnologia e adquirindo habilidades em Tecnologia da Informa├º├úo e Comunica├º├úo (TIC). Este trabalho tem como objetivo mapear as habilidades digitais de idosos no Brasil, utilizando o Question├írio de Profici├¬ncia em Uso de Tecnologia da Informa├º├úo e Comunica├º├úo adaptado transculturalmente. Metodologia: A pesquisa baseou-se na aplica├º├úo de um question├írio socioecon├┤mico e do question├írio adaptado para o contexto brasileiro de profici├¬ncia no uso de tecnologias de informa├º├úo e comunica├º├úo, abrangendo seis subescalas: conhecimentos b├ísicos de inform├ítica, uso de impressoras, comunica├º├úo, internet, calend├írio/agenda e entretenimento. Al├⌐m das an├ílises de m├⌐dias, foram realizadas correla├º├╡es entre idade, escolaridade e profici├¬ncia em TIC. Resultados: Participaram do estudo 179 participantes com 60 anos ou mais, de nove estados brasileiros (Rio Grande do Sul, Santa Catarina, Paran├í, S├úo Paulo, Rio de Janeiro, Mato Grosso do Sul, Par├í, Para├¡ba e Alagoas). Entre os participantes, 29,1% eram do sexo masculino e 70,9% do sexo feminino. Quanto ao estado civil, a maioria dos participantes ├⌐ casada (49,7%), seguida de vi├║vas (21,2%), divorciadas (16,2%) e solteiras (10,1%). Em rela├º├úo ├á idade, a distribui├º├úo ├⌐ variada, com aproximadamente um ter├ºo dos participantes nas faixas et├írias de 66-70 anos (29,1%) e 71-75 anos (27,4%). Em rela├º├úo ├á renda, h├í uma ampla gama de situa├º├╡es, com 36,9% dos participantes tendo renda acima de cinco sal├írios m├¡nimos no Brasil (acima de R$ 1.312,69), enquanto 3,4% t├¬m renda inferior a um sal├írio m├¡nimo (inferior a R$ 262,54). Em rela├º├úo ao n├║mero de pessoas no domic├¡lio, a maioria dos participantes mora com uma a tr├¬s pessoas (66,5%). Al├⌐m disso, ├⌐ relevante destacar que 65,4% dos participantes possuem computador em casa. Os resultados indicam um n├¡vel geral razo├ível de profici├¬ncia digital entre os participantes mais velhos. A subescala "Conhecimentos B├ísicos de Inform├ítica" apresentou m├⌐dia de 3,45, indicando um n├¡vel s├│lido de habilidade. Por outro lado, a subescala "Calend├írio/Agenda" apresentou m├⌐dia de 2,18, sugerindo uma ├írea potencial de melhoria. Os quartis destacaram a variabilidade nas compet├¬ncias digitais, com alguns participantes apresentando menor profici├¬ncia em determinadas ├íreas. A an├ílise de correla├º├úo entre idade e profici├¬ncia em TIC foi de -0,25, indicando uma fraca correla├º├úo negativa, o que significa que n├úo h├í tend├¬ncia de que, ├á medida que a idade aumenta, a profici├¬ncia em TIC tenda a diminuir. Por outro lado, a correla├º├úo entre educa├º├úo e profici├¬ncia em TIC foi de 0,68, revelando uma correla├º├úo positiva moderadamente forte, indicando que, ├á medida que a educa├º├úo aumenta, a profici├¬ncia em TIC tende a aumentar. Discuss├úo: O fato de a maioria dos idosos estar buscando familiarizar-se com a tecnologia demonstra o reconhecimento da import├óncia dessas habilidades para a participa├º├úo na sociedade moderna. Isso ├⌐ particularmente relevante em um mundo p├│s-pand├¬mico onde as atividades remotas e digitais se tornaram essenciais. No entanto, tamb├⌐m identificamos desafios significativos que os idosos enfrentam ao adotar tecnologias digitais. A relev├óncia desses resultados reside na necessidade de desenvolvimento de estrat├⌐gias efetivas de inclus├úo digital para idosos. Como a sociedade depende cada vez mais da tecnologia, deixar essa popula├º├úo para tr├ís pode resultar em exclus├úo social e econ├┤mica. Conclus├úo: Este estudo contribui para a compreens├úo das habilidades digitais dos idosos brasileiros, destacando a necessidade cont├¡nua de programas de treinamento digital adaptados ├ás necessidades identificadas. Correla├º├╡es entre idade, escolaridade e profici├¬ncia fornecem insights valiosos, orientando estrat├⌐gias para promover a inclus├úo digital efetiva entre os idosos. O caminho para a inclus├úo digital come├ºa com uma an├ílise abrangente e uma abordagem informada para atender ├ás necessidades espec├¡ficas de cada grupo demogr├ífico.
Post-COVID symptoms and managing return-to-work
Purpose Coronavirus disease 2019 (COVID-19) infection is associated with risk of persistent neurocognitive and neuropsychiatric complications (Colizzi M, 2024), termed "post-COVID".┬áThese persistent symptoms negatively impact health, quality of life, and work productivity (Ida FS, 2024). The study aimed to investigate the frequency of post-COVID-19 syndrome and associated factors on patients work ability and issues of returning to work. Method A retrospective analysis of patients presenting to a post-COVID outpatient clinic at Marburg University Hospital, Department of Psychiatry and Psychotherapy, Germany was conducted. Patients received basic socio-demographics, structured examination, psychometric diagnostic and neuropsychological examination. Results and Discussion In total, 113 patients participated in this study with an average age of 45.2 ┬▒12.07 years. ┬á65.49 % of patients were women. In 98.23% of the cases the initial infection was mild. The most frequent symptoms of admission included fatigue (84.07%), cognitive decline (99.12%), affective symptoms (56.63 %) and insomnia (41.59%). The symptom duration could be determined for 324 days from infection to admission to the post-covid outpatient clinic. Moreover, 54,59% of patients showed a reduced work productivity or were unable to return to work. These results show long-term effects of post-COVID-19 syndrome on cognitive and emotional functioning and sleep quality and underline the substantial impact on work ability. Our findings lead to the conclusion that for post-COVID patientsΓÇÖ modifications of work environments and tasks as well as education on how to pace one selves' resources to match energy levels with work activities is important to dimminish burdens for returning to work (Stra├ƒburger C, 2023). Supportive internet- and mobile-based interventions (IMI) might be a useful approaches for psychosocial diagnostics and interventions and provide an opportunity to optimize medical and occupational rehabilitation for post-COVID patients. ┬á References Colizzi M, Comacchio C, De Martino M, Peghin M, Bontempo G, Chiappinotto S, Fonda F, Isola M, Tascini C, Balestrieri M, Palese A. COVID-19-induced neuropsychiatric symptoms can persist long after acute infection: a 2-year prospective study of biobehavioral risk factors and psychometric outcomes. Ir J Psychol Med. 2024 Feb 14:1-8. doi: 10.1017/ipm.2023.53. Epub ahead of print. PMID: 38351842. Ida FS, Ferreira HP, Vasconcelos AKM, Furtado IAB, Fontenele CJPM, Pereira AC. Post-COVID-19 syndrome: persistent symptoms, functional impact, quality of life, return to work, and indirect costs - a prospective case study 12 months after COVID-19 infection. Cad Saude Publica. 2024 Feb 19;40(2):e00022623. doi: 10.1590/0102-311XPT026623. PMID: 38381867; PMCID: PMC10877695. Stra├ƒburger C, Hieber D, Karthan M, J├╝ster M, Schobel J. Return to work after Post-COVID: describing affected employees' perceptions of personal resources, organizational offerings and care pathways. Front Public Health. 2023 Nov 27;11:1282507. doi: 10.3389/fpubh.2023.1282507. PMID: 38089028; PMCID: PMC10715408. ┬á Keywords: Long Covid, neuropsychiatric symptoms, return to work Affiliation: Department/Faculty, University name, country Corresponding Author Email: nicole.cabanel@fb4.fra-uas.de AuthorsΓÇÖ ORCID iDs: 0000-0003-0093-7859
Purpose A consequence of the increase of the retirement age to 67 years in the Netherlands is that employees are required to work at least 2 years longer than before. This increase in the retirement age, but complex working conditions, such as open-plan offices and the use of new technology, pose challenges for older workers to continue performing optimally at work. One of these challenges are age-related change in cognitive domains, such as attention, working memory, and flexibility, that take place during the normal human aging process (Mozolic et al., 2011). These age-related changes result from a decrease in neural connectivity in the brain, particularly in the prefrontal cortex, which is relied upon for complex cognitive processes. A cognitive training program could limit these changes and optimize capabilities that contribute to the sustainable employability and future work skills of older workers (Dahlin et al., 2008). We therefore developed an online Future Work Skills training for older workers to make them resilient to these age-related changes at an age (50 and above) when they may not experience them fully yet. We expected more improvement in performance among older workers who participated in the future work skills training group than the older workers who only received general information about cognitive functioning. ┬á Method The training program focused on cognitive domains (attention, working memory, flexibility) that are most affected by age and could benefit from a dedicated training program (Dahlin et al., 2008; Karbach & Kray, 2009; Mozolic et al., 2011). Participants first took part in an online pretest session, then proceeded to work on six online training sessions (that had to be completed within a 3-week period) and finished with a posttest. The pretest and posttest involved working memory, flexibility, and attention tasks where the tasks were the same, but the materials were different. This allowed us to measure the degree of improvement on a task from the training during the posttest compared to the pretest. Participants in the training sessions were randomly assigned to either a future work skills training group or a general information group. In the future work skills group, participants learned to better ignore physical distractions (such as noises and pop-ups) to improve their attention and inhibition skills, to apply memory strategies (mnemonics) to improve their working memory, and switch between tasks with multiple interruptions to improve their flexibility. In contrast, the general information group only involved watching videos about cognitive domains and answering questions about them. Results and Discussion The results demonstrated higher performance on the verbal working memory and flexibility tasks in the future work skills training group over time relative to the general information group. For the attention task and the numerical working memory task, there was an improvement in performance for both groups. Overall, the results of this study show transfer from trained skills to performance on another task in a similar domain. The findings demonstrate an effective method to contribute to the sustainable employability of older workers in a positive and constructive manner. ┬á
Cyberschool for grandparents: an innovative crowdfunded intergenerational educational program. Effects on grandparentsΓÇÖ self-reported digital competences.
Purpose We have previously described the baseline features of grandparents attending our ΓÇ£Cyber School for GrandparentsΓÇ¥: a crowd-funded innovative intergenerational educational program aimed to train secondary school students (aged 15-17 years) to become cyber tutors for their grandparents, creating dyads (Colombo et al., 2022). At variance with previous intergenerational programs on ICT use, such initiative showed relevant innovative features: the educational lessons were embedded in the studentsΓÇÖ school program instead of being offered on a volunteering basis, the students independently planned and implemented the cyber sessions for their grandparents outside the school as extra-curricular activities (Rolandi et al., 2022). Here we aim to assess pre - post intervention changes on seniorsΓÇÖ self-reported digital skills and attitude (primary outcomes), and psychosocial well-being (secondary outcome). Method The course consisted of 7 classroom lessons divided into 3 modules: theory (1 lesson), research methodology (2 lessons), practice (4 lessons). The training integrated 2 approaches: psychological-geriatric and media-educational. All selected instruments for quantitative measures were suitable for online self-compiling by both young students and older adults; Italian versions or translation were used. The students helped and supervised grandparents to manage possible technical and/or sensory difficulties with the online compiling procedure. We explored digital literacy [Mobile Device Proficiency Questionnaire (MDPQ) Short Form], attitudes toward Internet [Attitudes Toward Computer/Internet Questionnaire (ATCQ)], and wellbeing [Mental Health ContinuumΓÇôShort Form (Italian MHCΓÇôSF)]. At the end of the sessions, the grandparents filled out a questionnaire with both closed and open answers. Results and Discussion The post-intervention questionnaire was compiled by 27 seniors out of 63 (43%). Comparing the main features of post-assessment respondents and non-respondents, no significant differences were found on seniorsΓÇÖ socio-demographics, baseline ICT use, living arrangement and frailty. As regards primary outcome measures, we found a significant improvement on seniorsΓÇÖ self-reported digital competences (MDPQ-SF, p < 0.001), while no significant differences were found on the attitude toward Internet dimensions (ATCQ). Considering secondary outcome measures, no significant changes were found on psychosocial well-being (MHC-SF). As from grandparentsΓÇÖ responses to close-ended questions, satisfaction levels were very high for all of the questions, with a high prevalence of positive responses (83% on average considering the sum of ΓÇ£Completely agreeΓÇ¥ and ΓÇ£Quite agreeΓÇ¥ responses). The higher agreement was found for the following sentences: ΓÇ£The teaching sessions with my tutor were pleasantΓÇ¥ (96%) and ΓÇ£I think that what I have learned will be useful in the futureΓÇ¥ (93%). The participants also reported a perception of improved social participation (74%), in the only questions not directly linked to technology usage or to the learning experiences with the students. Grandparents reported among the main strengths of the study the opportunity to relate and communicate with the younger tutors and learning new things. In the event of next similar initiatives, limitations of this experiences must be taken into account. Among the weaknesses seniors referred the lack of time (ΓÇ£Few sessionsΓÇ¥) and the difficulties to meet the tutor due to reciprocal other commitments or to the pandemic context (ΓÇ£We didn't always manage to see each other for a long time due to the commitments of bothΓÇ¥). Others reported learning difficulties (ΓÇ£Not always being able to put the things learned into practiceΓÇ¥; ΓÇ£The topics sometimes were complex and the tablet setup was confusingΓÇ¥), whilst some did not enjoy the survey questionnaires to be compiled. ┬á References ┬áColombo, M., Rolandi, E., & Guaita, A. (2022). Cyberschool for grandparents: an innovative crowdfunded intergenerational ┬á┬á┬áeducational program. GrandparentsΓÇÖ baseline features according to web access. Gerontechnology, 21(s), 1ΓÇô1. https://doi.org/10.4017/gt.2022.21.s.596.pp4 ┬áRolandi, E., Sala, E., Colombo, M., Vaccaro, R., & Guaita, A. (2022). Designing an Innovative Intergenerational Educational ┬á┬á┬á┬áProgram to Bridge the Digital Divide: The Cyber School for Grandparents Initiative. In Lecture Notes in Computer Science (including subseries Lecture Notes in Artificial Intelligence and Lecture Notes in Bioinformatics): Vol. 13331 LNCS. https://doi.org/10.1007/978-3-031-05654-3_28 ┬á Keywords: intergenerational educational program, ICT use, grandparents, digital skills and attitude, psychosocial well-being Affiliation: Golgi Cenci Foundation, Abbiategrasso (Milan), Italy Corresponding Author Email: m.colombo@golgicenci.it AuthorsΓÇÖ ORCID iDs: Mauro Colombo: https://orcid.org/0000-0003-4565-3112 Elena Rolandi: https://orcid.org/0000-0003-0043-2471 Antonio Guaita: https://orcid.org/0000-0003-3954-5932 ┬á Acknowledgement BiUniCrowd [Bicocca University (Milan, Italy)] for crowdfunding; Fondazione Ticino Olona [Legnano (Milan, Italy)] for crowdfunding; Neil Charness & Walter Boot [CREATE] for their kind support about MDPQ Italian version; CREMIT [Catholic University, Milan] for educational and geragogic support; Mauro Invernizzi [EMPORIA] for technological supply ┬á ┬á<img src="[binary]
Uncovering diverse internet use patterns among baby boomers using machine learning
Purpose The internet enables people to connect to resources, and previous research has contributed to understanding how people use the internet in their later lives (e.g., Llorente-Barroso et al., 2023; Vulpe & Cr─âciun, 2020). However, a gap exists in knowledge about different clusters of baby boomers who tend to have better digital skills compared older generations, based on a sophisticated analysis of time spent across a diverse spectrum of online activities. Additionally, little research has discussed older usersΓÇÖ perceptions of internet overuse. This study aims to explore different types of internet use patterns among baby boomers, with a focus on perceived internet overuse, while examining the relationship between internet use patterns, social capital, and living arrangements. Method Data came from the 2022 Smartphone Overdependence Survey in Korea, which included baby boomers in their 60s (N = 4,442). Cluster analysis, empowered by machine learning techniques, was applied to the data to explore the complex patterns of internet use based on the seven features: (a) the proportion of time allocated to four types of internet use (communication, leisure, living, and work), (b) use level across seven categories (search, leisure, communication, commerce, finance, living, and education), (c) use diversity measured using the Shannon index, (d) digital skills assessed through six items, (e) perceived level of internet overuse, (f) perceived level of problematic use, and (g) efforts for healthy internet use. Prior to the clustering analysis, five random subsamples were selected to check the Hopkins statistic for assessing clusterability (Waggoner, 2020). The mean Hopkins statistic is 0.82 indicates good clusterability. The hierarchical clustering method with Ward linkage was chosen for validation testing. Social capital was assessed using three items about family, friends, and society. Results and Discussion The results showed six clusters of baby boomers with distinct internet use patterns: (a) balanced all-rounders (n=1,227), (b) leisure connectors (n=1,040), (c) mindful masters (n=949), (d) leisure enthusiasts (n=490), (e) learning communicators (n=477), and (f) basic communicators (n=259). Notably, the cluster called mindful masters (21%) demonstrated the most advanced level of internet use, evident in their engagement with financial or educational purposes and their possession of the highest use diversity and skills. Conversely, the basic communicators cluster (6%) exhibited the lowest use diversity and skills, dedicating approximately 97% of internet use time solely to communication. The results further revealed that mindful masters, balanced all-rounders, and learning communicators displayed the highest levels of social capital, while basic communicators had the lowest. Living arrangements also differed significantly across clusters. Mindful masters and balanced all-rounders were more likely to live with younger generations, whereas basic communicators were more likely to live alone. The findings highlight the diversity in internet use patterns among baby boomers, emphasizing the crucial need to consider the various clusters of older internet users and their social contexts when developing policies to address the digital divide. Additionally, the study suggests the existence of a marginalized group of baby boomers living alone with limited digital skills, underscoring the need for social interventions to support this group.┬á
Participatory research on digital (in)equalities in care relationships among older people living alone
Purpose: The digital age adds new cultural expectations of care, collaboration and mutuality, and has the potential to perpetuate inequalities between generations, income groups and countries due to available care resources and infrastructure. Living alone raises specific challenges to care work and on and offline caring relationships. Digitalisation has contributed to the connectedness of young and old age groups at the same time as increasing support needs for older people coming to terms with digital developments both in terms of equipment and life administration. The European project EQualCare aims to further understanding of, and policy development on, the intersections of digitalisation with intergenerational care work and care relationships of older people living alone, and to contribute to reducing inequalities through collaboration and participatory research. Method: This paper aims to give insight into the process of participatory action research (PAR) with older people in the community across four countries and reflects on experiences made by academic and co-researchers. Following the emancipatory underpinnings of PAR, which aims to reduce inequalities through collaboration and co-design, EQualCare involved nine teams of co-researchers across Finland, Germany, Latvia and Sweden making older people the centre of policy development. Co-researchers were involved in formulating research aims, collecting data, reflecting on data, formulating and disseminating recommendations for local policy stakeholders. Results and Discussion: Co-researchersΓÇÖ motivation to invest considerable time and effort was driven by a desire to create a more equal future for older people living alone. Moreover, they were keen to involve marginalised older people and became frustrated when this proved difficult. Power dynamics played a role throughout the process but became productive as roles and responsibilities were renegotiated. Doing PAR with older people can be emotionally challenging for co-researchers when negative feelings around ageing are encountered.
An evaluation study on the Gerontech Ambassadors' training program: A Technology Acceptance Model-Based Study
Purpose By 2030, every one in four residents in Singapore will be aged above 65 (NPTD, 2023). With this surge in the ageing population, it is critical for older adults to age well in the community. To age well is being able to live in an environment that supports and maintains oneΓÇÖs intrinsic capacity and functional ability is key to healthy ageing (WHO, 2019). The use of assistive technology products appropriately can facilitate such an environment (Haufe et al., 2019). To increase the usage of assistive technology, Singapore University of Singapore (SUSS), SG Assist, funded by Ngee Ann Kongsi, established the Gerontech Ambassador (GTA) Program where older adults were recruited as GTAs. The GTAs underwent an experiential learning experience, where they learnt the theory, role play, as well as practicing as GTA in exhibitions and conferences. The purpose of this paper is to evaluate the effectiveness of the program. Mixed method, consisting of surveys and individual interviews, was used. Four components are investigated: (1) the acceptance level of gerontechnology of the participants; (2) the perception of the ease and sustainability to integrate gerontechnology to their daily lives; (3) the understanding, skills, and ability in gerontechnology as well as taking the role of the GTA; (4) the satisfaction of the program.┬áMethod 24 older adults from the community volunteered for the Gerontech Ambassadors (GTA) training program. They were given a pre-measurement 10-scale survey. The survey consisted of four sections, namely Senior Technology Acceptance Model (STAM) (Chen et al, 2020), 6A model (Truglio-Londrigan et al, 2003), ASK model (Bakarman, 2011) and Kirkpatrick (Smidt et al, 2009). STAM measures their acceptance to gerontechnology; 6A measures the possible sustainability and usage of gerontechnology; ASK indicates the change in ability, skills, and knowledge; Kirpatrick measures the satisfaction of the program (Figure 1). At the end of the three-month program, a similar post-survey was done. 16 participants completed both pre-post surveys. Five of these participants were interviewed for greater understanding of their experience.┬áResults and Discussion All components in ASK had significant (p=0.05) increases in score: ability (M=3.06, SD=2.86), skills (M=1.69, SD=2.61) and knowledge (M=1.81, SD=2.70). 6A had two components with significant increase in score: adequacy (M=1.00, SD=1.71) and awareness (M=3.06, SD=2.86). Kirpatrick had a high score of (M=9.00, SD=1.06). However, STAM score did not show significant changes. The above results indicate the participants had gained knowledge, skills and ability to conduct themselves as GTA, with improved awareness of gerontechnology and believed these products can sufficiently support those who need it. They were extremely satisfied with the program. Most of them who volunteered for the program had had very high STAM pre scores to begin with. They had a positive perception of technology, with some technical competence. In this case, no significant change in their technology acceptance level.
Re-acquisition of Leisure Activities by Motorized Braiding Machine for the Physically Challenged and Its Effects
The purpose of this study was to provide new assistive devices to those who find leisure activities fulfilling but have been forced to discontinue them due to physical disability, to help them regain their zest for life. A new motorized assistive device was made for a person who had difficulty making braids with the assistive device due to neck pain, in collaboration with the person herself, the rehabilitation staff, and the manufacturer. A survey was conducted before the provision of the device and during the improvement process to inquire about satisfaction with leisure activities and the fulfillment of life, and it was confirmed that the device was developed to enable the patient to resume making braiders satisfactorily.
Bridging Participation and Work in a Mature and Older People Community on Facebook in Brazil
Purpose Brazil is undergoing accelerated demographic change and it will have the sixth oldest population in the world by 2050 (UN, 2022). Although the unemployment rate in Brazil is decreasing (PNAD Cont├¡nua, 2024), older adults, who represent 15% of the labor market, face many difficulties in remaining or returning to the formal job market, having to find alternative ways of earning income or staying active and productive. In this sense, this research aims to investigate the participation of Brazilian people aged 50 and over in an online community on Facebook focused on exchanging experiences and information about work in later life. We argue that the use of digital platforms can be a means of raising awareness about the scenario of the Brazilian labor market. Online groups can be a place to find job opportunities, expand social networks, develop skills for (re)insertion into the market, as well as being a channel for publicizing and conducting business among other mature people. Method In this exploratory research, we used Content Analysis (Bardin, 1977) to organize, systematize, and categorize data collected on a public Brazilian Facebook group with 33.794 members. The first phase (pre-analysis) consisted of skimming the feed,formulating hypotheses and objectives, and preparing the material. After collecting posts of the first quarter of 2024, in the second phase (material exploration) we coded every post to its unit of record and context, and grouped them into categories according to similarities or differences in semantic. We also analyzed the frequency and average engagement (likes and comments) of each category. The last phase is treatment of results and interpretation. Currently, we have used Nvivo to perform the analysis and further explore some categories. Results and Discussion In the first quarter of 2024, 366 posts were made by 119 different people. While one person posted 85 times, 76 people posted just once. The data indicate a predominance of men both in terms of individual posts and in the total number of authors, with a lower participation from women in both categories. The posts were categorized in 30 different themes, including news, personal service advertising, share of personal content, inspirational content, publicizing personal jobs, and educational and leisure opportunities. The categories with the highest engagement (sum of comments and likes) were inspirational content (n=833, average of 25.24 per post), personal service advertising (n=595, average of 11.44 per post), news (n=544, average of 7.6 per post), and publicizing personal jobs (n=491, average of 21.34 per post). The preliminary results indicate a variety of themes discussed in the group, even though its focus is work in later life. We could also point out that there is a plurality of voices and there is room for participation, despite only a small part (0.35%) of group members actively posted. Currently, we are working on further analyzing the content of work-related and inspirational content categories, as they had the highest engagement rate.
Morning SNS roll-call message and eldersΓÇÖ replies: Word-based analysis on seasonal change.
During the COVID-19 period, elders had severe problems, such as social isolation and difficulties in keeping physical activities.┬á NPO ΓÇ£Energize older people by health degrade prevention,ΓÇ¥ Oita prefecture local government and ICT company Somelight Co. Ltd have different promotive activities, including lectures on mobile devices, zoom video conferencing, and LINE messenger.┬á One of these projects, Somelight Co. and NPO, began the ΓÇ£Nou-Waka 365 (Brain-Young)ΓÇ¥ morning roll-call in LINE in July 2021. 82 elderly participants received mass messages at 7 am every morning. The mass message includes advice on health, nutrition, physical activities, and seasonal greetings.┬á Although making a reply to the mass massage was voluntary, many of the participants replied.┬á Stuff at Somelights made different replies to each participant.┬á Three years and more have passed; the roll-call and reply activities are still active. This paper presents text analysis results on a participantΓÇÖs replies through seasons.
Experiences and Contexts of Remote Work among Older, Mid-Life and Young Adults: The Case for Age-Specific Remote Work Interventions
Purpose Over half of the U.S. workforce works from home at least one day per week. The shift to remote work, catalyzed by the Covid-19 pandemic, has revolutionized our relationship with work. Evidence from multiple nationally-representative surveys indicates that working remotely, at least some of the time, has benefits for worker well-being (Parker Horowitz, & Minkin 2020; 2022; Saad & Wigert, 2021). However remote workers also have been found to struggle with stress and social isolation. To date there has been little research conducted on the impact of remote work on well-being across the adult life course. This study examines how older remote workers (aged 65+) compare to mid-life (aged 45-64) and young adult (aged 18-44) remote workers in terms of their experiences with remote work and its impact on well-being (Figure 1). Method Data are from a survey module within a large U.S. nationally representative monthly survey, The Survey of Consumer Attitudes (SCA), (Curtin, Presser, & Singer, 2005; Curtin, Singer, & Presser, 2007). The SCA has been conducted since 1940 and monthly since 1977 (Curtin et al., 2005; Curtin et al., 2007). The SCA captures the impact of the expectations of consumers on their spending and saving behavior. It is administered monthly by telephone to a nationally representative sample of adults age 18 and older (Curtin et al., 2007). Participants provided informed consent prior to being surveyed. We developed a 5-minute supplemental module focused on remote work that was included in the SCAΓÇÖs December 2021 and January 2022 surveys. Participants in this study (n=370) were all working remotely at least part of the time. Results and Discussion Bivariate analyses indicate that older remote workers were significantly less likely than younger remote workers, but more likely than mid-life remote workers, to report feeling anxious and lonely sometimes or more often. In a multivariate regression model, the finding concerning feelings of anxiety remained after adjusting for sociodemographic characteristics (b = -0.35; p<0.001). The curvilinear relationship between age and anxiety highlights the need for development of age and environment-specific interventions to promote remote worker well-being across the adult life course. ┬á References Curtin, R., Presser, S., & Singer, E. (2005). Changes in telephone survey nonresponse over the past quarter century. Public opinion quarterly, 69(1), 87-98. Curtin, R., Singer, E., & Presser, S. (2007). Incentives in random digit dial telephone surveys: A replication and extension. Journal of Official Statistics, 23(1), 91. Parker, K., Horowitz, J. M., & Minkin, R. (2020). How the coronavirus outbreak hasΓÇôand hasnΓÇÖtΓÇôchanged the way Americans work. Pew Research Center, 9. Parker, K., Horowitz, J., & Minkin, R. (2022). COVID-19 pandemic continues to reshape work in America. Pew Research Center. Saad, L., & Wigert, B. (2021). Remote work persisting and trending permanent. Gallup News Insights, 13. ┬á Keywords: remote work, older adults, life-course, well-being, environment Address: Institute for Social Research, University of Michigan, United States Email: jessfran@umich.edu ┬á
Exploring oportunities for the development of innovative projects in Gerontechnology: a design education experience
Purpose Population aging is a global process that demands strategies and actions aimed at promoting means for independence, social participation and quality of life. Despite important technological advances and their contributions through products, systems and environments developed with a focus on the older population, there are still numerous demands for the design and successful implementation of assistive solutions in Gerontechnology. Fostering innovation with a focus on aging is, therefore, not only necessary, but also strategic considering the potential that the silver economy has and will represent in the global market. Therefore, it is important that the training of students from areas most directly related to development and innovation considers the demands and opportunities that the global scenario related to aging offers. This study aims to report an experience in Design education based on a collaboration between two higher education institutions in Brazil (Sao Paulo State University ΓÇô UNESP) and Argentina (Universidad Nacional del Litoral ΓÇô UNL). Method The collaboration was developed from two joint disciplines: Inclusive Design (UNESP) and Ergonomics (UNL). The students worked in groups of, on average, 5 members, composed of students from both institutions, and developed projects based on project demands raised in material on healthy aging from the Organizaci├│n Panamericana de la Salud (Anon, 2020). As an international collaborative design project initiative, groups of students carried out visits to centers and institutions that support elderly people in Brazil and Argentina, seeking to identify common demands and opportunities. The collaboration between the disciplines was carried out over a full academic semester, and resulted in twelve conceptual design projects developed jointly by students from both institutions. Results and Discussion The main categories of solutions developed by the student groups were related to positioning and transportation and transfer assistance (4), feeding assistance (3), bathing assistance (1), communication (smartphone, 1), dexterity and cognition training (1), physical training (1) and memoir (1). It can be observed that independence in basic activities of daily living was the main objective of the projects developed by the groups, with emphasis on mobility and feeding, which suggests that these may be problems experienced by many elderly people (Desai et al., 2001). Indeed, Furthermore, the analysis of the solutions proposed by the group indicates that, when developing the project, they considered meeting the needs of users with greater difficulties, an aspect common to Inclusive Design approaches (Yelding, 2003), as well as ergonomic (anthropometric) parameters for sizing project. It is therefore concluded that the disciplines of Inclusive Design and Ergonomics have potential for application in Gerontechnology projects, as they provide means for an analysis and development approach focused on the needs of users with greater difficulties. Finally, it is concluded that the experience described here of teaching Design based on international collaboration within South America between UNESP and UNL made it possible to broaden the understanding of demands and opportunities for design in the context of Gerontechnology.
AGE AND INCOME INFLUENCE THE DIGITAL PROFICIENCY BY ELDERLY PEOPLE FROM BRAZILIAN NORTHEAST
Purpose: In Brazil, the total of people aged 65 or more is 22.169.101, representing 10.9% of the population and an increase of 57.4% in comparison to 2010 when it was 14.081.477 or 7.4% of the population. Elderly people in Brazil are those aged 60, population that represents 32.113.490 (15.6%), an increase of 56,0% in comparison to 2010, when it was 20.590.597 (10.8%) (IBGE, 2022). Population aging is a global phenomenon. This change can also be seen in the age composition of poverty in Brazil, especially in northeast region. In 2020, 69% of elderly brazilians lived with personal income monthly of up to 2 basic salary (BS) (SNF, 2021). The fast progress of technologies is also a global phenomenon. Technology is inserted in many contexts of life, like health, mobility, leisure, housing, etc (Raymundo, 2019). Despite being an advantage in contemporary times, it is also a challenge for elderly people who had less contact with technology throughout their lives (Raymundo, 2019) and who are exposed to context of social exclusion. The main goal of this research is show if the proficiency in cell phone use by elderly people is impaired by age range and income range. Method: Cross-sectional study approvaled by ethics committee. Recife is a city of Pernambuco state, in Brazilian northeast and Recife is divided in 8 health districts (zones), but the research was made in the sociability groups for elderly people in health district 4 with support of city hall. The health district 4 has 13 neighborhood. A health district is a minimum organizational unit of the Brazilian health system. Sociodemographic questionnaire (age range and income range) and Mobile Proficiency Questionnaire (MPDQ), validated for Brazilian Portuguese (Raymundo, 2024) were used to data collect. The age range was: 60-69, 70-79 and over 80 years old. The income range was: less 1 BS, 1 BS, 1.1-3 BS and more than 3 BS. The MPDQ, Mobile device basics (MPDQb), has 9 questions and each one receive score from 1 to 5 points (range 9-45 points). Kruskal-Wallis test was done to compare the groups. Results and discussion: The total of 311 elderly people participated of the study, 268 women (86%) and 43 men (14%). The mean of MPDQb in sample was score 30.5. People aged 60-69, n=159 and MPDQb score=31.8┬▒8.1; 70-79, n=130 and MPDQb score=29.5┬▒7.8 and over 80 years old, n=22 and MPDQb score=26.2┬▒6.1. Kruskal-Wallis test=p=0.0005, people aged 60-69 years have MPDQb score significantly higher than people aged 70-79 and over 80 years old, post hoc Dunn test=p<0.05. People with income less than 1BS, n=12 and MPDQb score=28.9┬▒6.9; 1BS, n=91 and MPDQb score=28.2┬▒9.5; income of 1.1-3BS, n=133 and MPDQb score=29.9┬▒7.5 and more than 3BS, n=75 and MPDQb score=34.4┬▒5.5. Kruskal-Wallis test=p<0.0001. People with income over 3BS have MPDQb score significantly higher score than others income range, post hoc=Newman-Keuls test p<0.05. Age and income influence the MPDQb, probaly because people with advanced age had less contact with technologies throughout their lives and the lowest income increase the social exclusion and digital exclusion as well (Raymundo, 2019).
Maria das Gra├ºas DAS GRA├çAS WANDERLEY DE SALES Coriolano
SATISFACTION OF ELDERLY PEOPLE FROM BRAZILIAN NORTHEAST ABOUT DIGITAL INCLUSION PROGRAM
Purpose: In Brazil, the total of people aged 65 or more is 22.169.101, representing 10.9% of the population and an increase of 57.4% in comparison to 2010 when it was 14.081.477 or 7.4% of the population. Elderly people in Brazil are those aged 60, population that represents 32.113.490 (15.6%), an increase of 56,0% in comparison to 2010, when it was 20.590.597 (10.8%) (IBGE, 2022). Population aging is a global phenomenon. The fast progress of technologies is also a global phenomenon. Technology is inserted in many contexts of life, like health, mobility, leisure, housing, work, education, etc (RAYMUNDO, 2019). Despite being an advantage in contemporary times, it is also a challenge for elderly people who have had less contact with technology throughout their lives (RAYMUNDO, 2019) and who are exposed to context of social exclusion. This dilemma boosts the proposition of models of digital inclusion supported by senior technology (OPAS, 2023), the Digital Proficiency and Literacy in Health Program (DPLHP). Method: Cross-sectional study approvaled by ethics committee. The DPLHP consists in three workshops with three hours each, once a week aiming to teach how to use the cell phone and how to navigate the internet for search health information. At the end of the PDPLH was carried out an assessment for analyzing the satisfaction of the elderly people about the Program. The content of the workshops was centered on the elderly peopleΓÇÖs need or wish of learning some tasks on their cell phone. A booklet was prepared by the researcher team and given to the elderly people, explaning step by step of many tasks in the cell phone. The design of the groups in the workshops was one teacher for each four elderly persons (1:4) to increase the interaction between the participants. Recife is a city of Pernambuco state, in Brazilian northeast and Recife is divided in 8 health districts (zones), but the research was made in the sociability groups for elderly people in health district 4 with support of city hall. The health district 4 has 13 neighborhood. A health district is a minimum organizational unit of the Brazilian health system. The researcher team had 14 teachers and the research was made in 8 months. Results and discussion: The total of 237 elderly people participated of the DPLHP, 204 women (86%) and 33 men (14%), 166 persons (70%) affirmed were ΓÇ£very satisfiedΓÇ¥ and 59 (25%) affirmed were ΓÇ£satisfiedΓÇ¥. The others (n=12=5%) affirmed were ΓÇ£little satisfied or dissatisfiedΓÇ¥ with the Program. Participating in this Program improved the knowledge about the topic for 54 persons (23%), improved the mental health for 15 persons (6%) and both for 164 persons (69%). For 4 persons (2%) the Program didnΓÇÖt improve anything. The Program received a grade of 9.1 (┬▒1.1), median of 10. The feedbacks about the Program highlighted the requirement of ΓÇ£more times a weekΓÇ¥, ΓÇ£more classesΓÇ¥, ΓÇ£longer durationΓÇ¥, ΓÇ£classes with specific topicsΓÇ¥ and ΓÇ£color bookletΓÇ¥. The satistaction of elderly people and the feedbacks are very important qualitative indicators for success and continuity of the Program.
Understanding the feeling of being overwhelmed by the internet: The role of digital literacy among older adults
Purpose The digital transformation creates new opportunities for older adults to improve their wellbeing. In particular, this includes the opportunity to stay in the home environment for longer, e.g. through ambient assisted living, as well as digital health applications and telemedicine for better health management. In order to be able to use these services successfully, digital literacy is required. It is a multifactorial concept that integrates various areas of competence. However, older adults have lower digital literacy compared to society as a whole (St├╝rz et al., 2022). Digital technologies can also cause a feeling of being overwhelmed. This results above all from the wealth of information on the internet, which is perceived as challenging when it comes to health issues, for example, and became particularly apparent during the Covid-19 pandemic (Ware et al., 2017). But the user can also be overwhelmed during the learning process itself due to the wide range of possible applications (Borghouts et al., 2022). As a consequence, this can lead to knowledge of digital technologies not being expanded (Finkelstein et al., 2023). This feeling of being overwhelmed is not only experienced by people without digital literacy, but also by those who have used certain tools in the past and are now confronted with new tasks that require advanced digital literacy (Jokisch & G├╢bl, 2022). Previous studies have barely addressed the association between digital literacy and the feeling of being overwhelmed. This study therefore examines which specific areas of digital competence are required in order to avoid feeling overwhelmed by the internet. Method A representative cross-sectional survey of 3,782 German adults aged 65 and over (average age = 74.18┬▒6.10; 56.2% female) was conducted between August and September 2021. Results and discussion Using a logistic regression model adjusted for age, gender, education and income, we found that the dependent variable feeling overwhelmed was significantly positively associated with the competence areas of information and data literacy (OR=1.20, CI 1.06-1.35), safety (OR=1.36, CI 1.18-1.56) and problem solving (OR=1.70, CI 1.50-1.94). Older adults with higher education were more likely to feel overwhelmed (OR=0.64, CI 0.40-0.85). There was no significant association between this feeling and the ability to communicate, to collaborate and to produce creative content on their own. The results suggest that there are specific areas of digital competence that are linked to the absent feeling of being overwhelmed when using the Internet. Educational programs relating to digital technologies should therefore focus on these competences in order to counteract the feeling of being overwhelmed and to enable and motivate people to acquire in-depth knowledge of digital services. Similarly, developers of digital technologies are called upon to integrate intuitive and comprehensible options into their products that make them safer and empowers older adults to solve problems independently. This allows older adults to participate in and benefit from the digital transformation. ┬á References Borghouts, J., Eikey, E. V., De Leon, C., Schueller, S. M., Schneider, M., Stadnick, N. A., Zheng, K., Wilson, L., Caro, D., Mukamel, D. B., & Sorkin, D. H. (2022). Understanding the role of support in digital mental health programs with older Adults: UsersΓÇÖ Perspective and Mixed Methods study. JMIR Formative Research, 6(12), e43192. https://doi.org/10.2196/43192 ┬á Finkelstein, R., Wu, Y., & Brennan-Ing, M. (2023). Older adultsΓÇÖ experiences with using information and communication technology and tech support services in New York City: findings and recommendations for post-pandemic digital pedagogy for older adults. Frontiers in Psychology, 14. https://doi.org/10.3389/fpsyg.2023.1129512 ┬á Jokisch, M., & G├╢bl, L. (2022). Leben ohne Internet ΓÇô gehtΓÇÖs noch? [Life without internet - is it still possible?] BAGSO Germany. Retrieved March 9, 2024, from https://www.bagso.de/studie/leben-ohne-internet-gehts-noch ┬á St├╝rz, R. A., Stumpf, C., Schlude, A., & Putfarken, H. (2022). Das bidt-SZ-Digitalbarometer [bidt-SZ-digital barometer]. (bidt ΓÇô Analysis and studies No. 7). bidt Munich. Retrieved March 9, 2024, from https://publikationen.badw.de/en/047888907 ┬á Ware, P., Bartlett, S. J., Par├⌐, G., Symeonidis, I., Tannenbaum, C., Bartlett, G., Poissant, L., & Ahmed, S. (2017). Using eHealth Technologies: Interests, Preferences, and Concerns of Older Adults. Interactive journal of medical research, 6(1), e3. https://doi.org/10.2196/ijmr.4447 ┬á Keywords: digital literacy, overwhelming, education Affiliation: Institute for Applied Research, Catholic University Freiburg, Germany Corresponding Author Email: linda.goebl@kh-freiburg.de AuthorsΓÇÖ ORCID iDs: https://orcid.org/0000-0002-1832-8560
Washable, absorbent underwear with low environmental impact for long-term care.
Purpose In the Netherlands, approximately 1 million people (around 750,000 women and 250,000 men) have some form of incontinence (Ooms et al. 2023). 50% among the elderly residents in nursing homes and 90% in care facilities suffer from incontinence (Largo & Theunissen 2009). In long-term care, more than half of the waste consists of incontinence materials. It is important for our climate and therefore for everyone's health to reduce this enormous mountain of disposable incontinence materials. As a result, there is a significant CO2 emission.Reducing this CO2 emission is one of the five pillars of the Green Deal Sustainable Care 3.0. The Green Deal Sustainable Healthcare is an initiative of the Dutch government to make the healthcare sector more sustainable. The aim is to reduce CO2 emissions in the healthcare sector while simultaneously improving the quality of care. The use of reusable incontinence materials is a good example in this regard. Priovention is committed to ending CO2 emissions from disposable diapers. To address this, they've developed the INDI (Intelligent Diaper), a sustainable, washable absorbent underware, and the Ecosystem, a local collection, washing, and delivery service tailored for care facilities. This initiative not only reduces CO2 emissions but also enhances the quality of life for care recipients by prioritizing comfort. Priovention also aims to support healthcare personnel through future technological innovations. Success hinges on the support of all staff in long-term care facilities, considering factors like costs, product usage, logistics, and alignment with initiatives like the Green Deal Sustainable Care. Method A mixed-method approach was used to investigate the impact of INDI and its ecosystem on cost savings and waste reduction in healthcare institutions. Qualitative methods included a literature review and analysis of secondary data. Quantitative analysis, such as break-even analysis, was conducted to determine the number of residents needed to cover INDI costs. Interviews with stakeholders supplemented data collection. Additionally, a tour of Priovention provided insights into product and company objectives. Results and Discussion Our results indicate that the use of INDI and its associated ecosystem can have impact on cost reduction and waste reduction in long-term care. Priovention's optimization strategies for the logistical process, such as adaptation to various care facilities, implementation of advanced route planning systems, batch processing of INDI units, collaboration between care facilities, flexible pickup and delivery schedules, advanced RFID technology, technological innovations, and continuous performance evaluation, could contribute to a more flexible and efficient use of INDI in diverse care environments. Compared to disposable incontinence materials, INDI has several positive features such as environmental friendliness, comfort, hygiene, improved traceability, customized product options, and durability. These benefits contribute to reducing CO2 emissions and waste, aligning with sustainable practices. Despite these advantages, there are also challenges and obstacles, such as initial costs for care facilities, logistical challenges, the need for acceptance and collaboration and volume differences. Striking a balance between ecological benefits and feasibility in diverse care facilities remains crucial. The literature review supports Priovention's innovative approach, emphasizing sustainability in long-term care. INDI and the ecosystem play an essential role in reducing CO2 emissions, minimizing waste, and contributing to broader sustainability initiatives in healthcare. Funding: EFRO Opportunities for West III. We thank Stephany Penja, Caty Recordino, Nian Shwaan, Minor Programme Technology & Health, University of Applied Sciences Utrecht, for their assistance in this research. Further, we would like to thank Lotte den Hertog and Bart Villerius from Priovention for their collaboration in this project.
Proficient use of mobile devices for communication among Northeastern Brazilian older adults and associated factors
Purpose: The use of the Internet and social networks improves older peopleΓÇÖs quality of life, providing recreation, entertainment, acquisition of new skills and occupational activities, communication, and access to information (WHO, 2024). The digital inclusion of older people is a challenge within the global technological expansion. As smartphones with Internet access increase in popularity, individuals who were previously digitally excluded now have at their fingertips equipment that allows communication in different forms (Quialheiro et al., 2023). However, older people's access to digital technologies differs between regions of the world and socioeconomic profiles. Proficient technology use is an important indicator of digital inclusion ΓÇô which is specifically important concerning older adults. This study aimed to identify factors associated with proficiency in the use of mobile devices for communication among older people. Method: This cross-sectional study included 311 older people participating in social groups in RecifeΓÇÖs Health District IV, Pernambuco, Brazil. Data were collected through interviews and protocols. The studyΓÇÖs dependent variable was the proficient use of mobile devices for communication, which was measured with the Mobile Device Proficiency Questionnaire (MDPQ) ΓÇô Communication Domain (Roque, Boot, 2016). The MDPQ communication score ranges from 1 to 5. Demographic and socioeconomic variables were analyzed to identify associated factors. Simple and multiple Poisson Regression models were analyzed to identify the prevalence ratio between the associated factors. Variables with a p-value < 0.25 in the simple analysis were chosen for the multiple analysis. Conclusions were reached with a significance level of 5%. Results and Discussion: The mean score of older adultsΓÇÖ proficient use of mobile devices for communication was 2.31 (SD: 1.03). The median of 2.11 was defined as the cutoff point, leaving 52.4% of the study population below the median, considered as low proficiency in mobile devices for communication. The World Health Organization considers the information and ability to use communication technologies as an important indicator for older peopleΓÇÖs visibility in sustainable development (WHO, 2024). The simple analysis of factors associated with the proficient use of mobile devices for communication identified literacy, education, occupation, and family income as factors associated with low proficiency. In the multiple analysis, education and marital status remained in the model. The prevalence of low proficiency with mobile devices for communication was 2.17 times higher in the group of older adults who studied 0 to 4 years than in those who studied 17 years or more. The prevalence among older widows was 50% higher than among older married people. The influence of education on older peopleΓÇÖs digital inclusion corroborates the literature (Soundararajan et al., 2023) (Ang, Lim, Malhotra, 2021). The findings indicate the importance of investing in education as part of digital inclusion policies for older people, which reduces barriers for them to access technologies.
Developing a quality assessment framework for health technology in human movement care: A E-Delphi study
Purpose: Worldwide healthcare faces major challenges. Digital health technology can potentially be part of a solution for the problem, but implementing and upscaling digital health technology remains challenging. One of the main barriers of healthcare professionals seem to be related to not having sufficient information or knowledge about the available technology and to make an educated decision to use a specific technology for a specific patient. This lack of knowledge can be translated into not knowing what technology is available and not knowing what the quality of technology is. Meanwhile several assessment frameworks are being developed, but these frameworks are specifically developed to assess one type of technology (i.e. mobile apps) or can only be executed with support from the developer1. Therefore we aimed to develop a quality assessment framework for digital health technologies from the perspectives of experts in the field. Method: A national e-Delphi procedure was conducted2. Thirty experts were included with expertise in physical therapy, research, health technology development, teaching (in physical therapy) and policy advisors. The Delphi consisted of four rounds and each round consisted of a questionnaire and an anonymized report. The first three rounds consisted of questions regarding (1) Information framework (2) Proposed criteria for the quality assessment framework and (3) Presentation. The fourth round a conceptual rubric was proposed. Consensus was reached when >70% of the experts agreed or a 7.0 or higher was scored on a criterium. Results/ discussion: After four rounds, this Delphi study resulted in an information framework, a quality assessment framework, a presentation label and a rubric. The information framework includes 15 items that describe functions, goals, costs and available scientific literature of the technology (2) a quality assessment framework consisting of 15 criteria that assess the technology in three categories: Healthy & Safe, Usability and Data safety. The experts found it important to present an overall score, a subscore per category and user-reviews. The experts also agreed on the proposed rubric which results in a five-star scoring system. This study showed what experts found important to assess before using digital technology in practice. Nevertheless, it remains important to consider whether the technology suits the digital literacy, health literacy of the patient and healthcare professional and whether technology supports in reaching the treatment goals. Additionally, technologies are rapidly evolving and therefore scores can change quickly, so keeping the scores up to date is challenging. 1. ┬á┬á┬á┬á┬á┬á┬á┬á Hoogendoorn P, Versluis A, van Kampen S, McCay C, Leahy M, Bijlsma M, et al. What Makes a Quality Health App-Developing a Global Research-Based Health App Quality Assessment Framework for CEN-ISO/TS 82304-2: Delphi Study. JMIR Form Res 2023 2. ┬á┬á┬á┬á┬á┬á┬á┬á J├╝nger S, Payne SA, Brine J, Radbruch L, Brearley SG. Guidance on Conducting and REporting DElphi Studies (CREDES) in palliative care: Recommendations based on a methodological systematic review. Palliat Med 2017 Sep 1;31(8):684ΓÇô706.┬á
Economic analysis of the use of a technological platform in the promotion of the health of adults and elderly people in Brazil
PURPOSE: In the wake of the COVID-19 pandemic, the world has faced significant economic distress, as evidenced by billionaire losses, severe financial crises, medical inflation of 25%, and an 88% loss ratio (Soley-Bori et al, 2021). This period has also highlighted critical health issues, such as the dangers of a sedentary lifestyle (Katzmarzyk et al, 2012). Notably, in Brazil, falls are the third leading cause of death among elderly people, a concern that is projected to significantly exacerbate healthcare costs. To address these challenges, Techbalance introduced the Health Promotion and Disease Prevention Program (H.P.D.P.P.), a technological solution incorporating predictive analysis software to mitigate the risks of falls and injuries, supported by a data collection and processing application and a website for individual health management reports. This study aims to showcase the financial and health benefits of implementing the H.P.D.P.P. by Unimed Sul Paulista, analyzing its impact over a retrospective six-month period and a prospective year-long evaluation. METHOD: In 2022, Unimed Sul Paulista provided services to 36,144 beneficiaries, incorporating the TechBalance technology into its coordinated care management system. Two hundred beneficiaries were randomly selected from the 801 individuals actively participating in the program for a detailed study. The participants were divided into two groups: a control group (CG) and an intervention group (IG), each comprising 100 beneficiaries. Both groups underwent evaluations at the program's outset, but only the IG was reassessed after six months. The analysis over this six-month period focused on several key financial metrics: general expenses per beneficiary before and after the program's implementation, direct rehabilitation expenses for the IG compared to conventional physical therapy costs, and the financial implications of femoral neck fractures in the IG versus the CG. Additionally, the study projected the cost savings from avoided orthopedic surgeries within the program's first six months and compared the total cost of implementing the TechBalance program for all 801 participants against that of traditional care methods. Furthermore, an ROI (return on investment) was calculated for the 801 beneficiaries over a 12-month period postimplementation. This comprehensive study received approval from the Ethical Research Committee of UNIMED. RESULTS AND DISCUSSION: Over a six-month period, Unimed Sul Paulista's implementation of the TechBalance H.P.D.P.P. yielded notable improvements among participants:8% improved and 82% maintained their frailty levels, while 52% showed motor enhancements, primarily due to increased exercise-related strength, balance, and coordination. The program effectively reduced the prevalence of weight gain and dizziness, which are major factors in deterioration. A detailed analysis of health risks revealed a shift: the risk in the high-risk group marginally increased from 12.6% to 13%, that in the medium-risk group decreased significantly from 61.1% to 55%, and that in the low-risk group increased from 26.3% to 32%, suggesting that the intervention was particularly beneficial for those at medium and low risk. Economically, the intervention group experienced 71.31% cost reduction in areas such as accidents, rehabilitation, and orthopedic surgeries compared to the control group, with a projected return on investment (ROI) of 2.21 times the cost over 12 months for the 801 beneficiaries. This outcome not only demonstrates the financial viability of TechBalance's H.P.D.P.P. but, it also underscores the value of integrating technology with individual-centered care coordination, promoting physical activity, and embracing lifestyle medicine practices to enhance beneficiaries' quality of life and reduce healthcare costs (Pedersen & Saltin, 2015). The significant savings and positive health outcomes call for further research to validate these findings over a longer term and across the broader project population. References Soley-Bori,┬áM; Ashworth, M.;┬áBisquera,┬áA.; Dodhia,H.;┬áLynch,┬áR.; Wang,Y;┬áand┬á Fox-Rushby,J. (2021) Impact of multimorbidity on healthcare costs and utilisation: a systematic review of the UK literature, British Journal of General Practice┬á2021;┬á71┬á(702):┬áe39-e46.┬áDOI:┬áhttps://doi.org/10.3399/bjgp20X713897 Katzmarzyk PT, Lee I-M (2012). Sedentary behaviour and life expectancy in the USA: a cause-deleted life table ┬á┬á┬áanalysis. BMJ Open 2012;2: e000828. doi:10.1136/ bmjopen-2012-000828 Pedersen, B. K., & Saltin, B. (2015). Exercise as medicine ΓÇô evidence for prescribing exercise as therapy in 26 different chronic diseases. Scandinavian Journal of Medicine & Science in Sports, 25, 1-72. https://doi.org/10.1111/sms.12581 ┬á KEYWORDS : Digital Transformation, Health Promotion, Outcomes, Protocols, ROI MAIN AFFILIATION AND COUNTRY OF FIRST AUTHOR Affiliated Professor of the Discipline of Geriatrics and Gerontology, Paulista School of Medicine, Federal University of S├úo Paulo, Brazil CORRESPONDING AUTHOR EMAIL: dramaraiademello@gmail.com; AuthorsΓÇÖ ORCID iDs: 0000-0001-9542-3134
Healthcare-Platform - Inclusive Working and Living
Purpose The objective of establishing the "Healthcare Platform - Inclusive Working and Living" at the Frankfurt UAS is to create a space where students from diverse disciplines can gain insight into the challenges faced by individuals with disabilities and chronic illnesses. They will also explore innovative solutions and advancements in the architectural, technical, social, and healthcare sectors. By raising awareness and understanding of these issues, the platform aims to foster inclusivity and contribute to the realization of the rights outlined in relevant international conventions, such as the Convention on the Rights of Persons with Disabilities. The platform will serve as a space to sensitize students to the realities of living with various disabilities and medical conditions. Through interactive exhibits, presentations, and discussions, students will be encouraged to empathize with individuals facing these challenges and to explore ways in which technology, design, and societal approaches can improve their quality of life. Furthermore, the platform will facilitate discussions on ethical considerations, privacy concerns, and the societal implications of inclusive practices. By engaging students from all disciplines, the platform seeks to cultivate a more inclusive mindset and inspire future generations to work towards a more equitable and accessible society. Method The 'Healthcare Platform - Inclusive Working and Living' is based on existing initiatives within the university, such as sensory experiences and simulations, provided in the interdisciplinary master's program Inclusive Design. These experiences include wearing age simulation suits, using wheelchairs, and simulating various eye diseases and hearing loss. With the current project, the platform will expand its offerings to include virtual reality simulations of disabilities and chronic illnesses. VR-Simulators for visual impairments, hearing impairments, and mobility impairments are currently under development. Interdisciplinary collaboration between different programs should enable the widest possible range of teaching, covering different perspectives. Results and Discussion The platform offers numerous benefits in promoting inclusivity, awareness and understanding of disability and chronic illness among students. However, the establishment and maintenance require significant resources such as financial support, technological infrastructure, and staff. Limited resources can impede the platform's ability to fully achieve its goals and expand its offerings. Additionally, while the platform focuses on inclusivity, it may encounter accessibility challenges within the technological infrastructure. Careful planning and adherence to accessibility guidelines are necessary to ensure that all exhibitions, presentations, and discussions are accessible. Sustaining interest and engagement in the platform will also be an ongoing challenge. Without continued support and involvement from students, faculty, and departments, the platform's impact may diminish over time. Furthermore, interdisciplinary collaboration, while a strength, also presents challenges in overcoming disciplinary boundaries and fostering effective communication and collaboration.
Internet Access, COVID-19 and Psychosocial Health Changes: a Longitudinal Cohort Study on Oldest-Old
Purposes: The accelerated digitalisation of society may pose major challenges for those lacking digital skills. During the COVID-19 pandemic, information and communication technology (ICT) became crucial for staying connected with loved ones and accessing health services (Rolandi et al., 2020; Valla et al., 2024). In this scenario, disparities in ICT use may have exacerbated other forms of inequality, especially among older adults who were less familiar with technology and more vulnerable to severe COVID-19 health consequences. The aim of the present study was to investigate how Internet use affects changes in social capital, physical and psychological health before and after the pandemic among the oldest old population (aged 80 years or older after the pandemic). Methods: We leveraged data from the InveCe.Ab study, a population-based longitudinal cohort of people born between 1935 and 1939 and living in Abbiategrasso, a municipality on the outskirts of Milan, Italy. Participants underwent multidimensional assessment at baseline (2010) and after 2, 4, 8 and 12 years. We restricted our analysis to cohort members who participated in the last wave (i.e., 2022) and who did not have a diagnosis of dementia (N=391). We used linear mixed models to assess the impact of COVID-19 and time on changes in social capital, physical and psychological health, and ICT use in a discontinuity regression design while controlling for age, sex, education and income satisfaction. Then, we assessed the influence of internet use and its interaction with COVID-19 on these changes. Results: COVID-19 had a significant impact on social relationships (╬▓=-4.35, 95% CI -6.38 ΓÇô -2.32, p= <0.001), cultural activities (╬▓=-0.56, 95% CI -0.76 ΓÇô -0.37, p= <0.001), cognitive functioning (╬▓=-1.00, 95% CI -1.28 ΓÇô -0.72, p= <0.001), depressive symptoms (╬▓= 0.42, 95% CI 0.10 ΓÇô 0.74, p=0.009), physical health (╬▓= 0.07, 95% CI 0.04 ΓÇô 0.10, p= <0.001) and ICT use (╬▓= -0.11, 95% CI -0.18 ΓÇô -0.03, p=0.008). Internet use predicts greater social relationships (╬▓=3.34, 95% CI 0.61 ΓÇô 6.07, p=0.017), cognitive functioning (╬▓= 0.70, 95% CI 0.33 1.06, p= <0.001) and reduced depressive symptoms (╬▓=-0.49, 95% CI -0.91 ΓÇô -0.06, p=0.025) over time. The interaction term of internet use * COVID-19 was significant for cultural activities (╬▓=-0.73, 95% CI -1.22 ΓÇô -0.24, p=0.003) and cognitive functioning (╬▓=1.36, 95% CI 0.67 ΓÇô 2.05, p= <0.001). Conclusions: The pandemic had adverse effects on older adultsΓÇÖ health and social capital. Contrary to expectations, even ICT use dropped significantly after the pandemic. Internet users maintained higher social relationships and psychological health regardless of time and COVID-19 status (see Figure 1). However, COVID-19 was associated with a steeper decline in cognitive functioning among internet nonusers. Policymakers may develop initiatives to encourage ICT adoption among older adults or strengthen their digital skills.
A Study on Care Management Practices for Supporting Low-Income Elderly People in Japan
Purpose Osaka City has the largest number of households on welfare. In the case of Low-Income Elderly people who require support or nursing care, care managers in the community comprehensive support centers or the home-based care centers are responsible for providing consultation and support for living at home, including the use of home-based care services.The objective of the present study is to examine the relationships Relationships between Support in and outside the workplace, supports from the comprehensive Community General Support Center and Care Management Practices for Supporting Low-Income elderly people in Japan. Method we conducted in January and February 2021 a survey with self-administered questionnaires, that were mailed to 800 randomly selected care management centers and comprehensive community support centers in Osaka City, Japan. Regarding COI disclosure, We have no financial relationships to disclose. All study procedures were approved by the Ethical Review Board of Human Subject Research at the BAIKA WomenΓÇÖs University. Structural Equation Modeling was performed to examine the relationship between the variables. This research is supported by The six independent variables related to care management practices were: Arrangements in Financial supports for Formal service costs; Care planning and Implementation; Financial Support and Evaluation; Contract and Explanations; Assessment; and Contract and Coordinating Informal support and Formal services in care planning. The four dependent variables related to supports from the comprehensive Community General Support Center , Support in the workplace were: supports from administrator and colleague.The analysis method was a structural equation modeling. Results and Discussion The response rate was 19.1% (N=153).As a result, the goodness of the fit indices was acceptable. Financial Support and Evaluation were associated with supports from the comprehensive Community General Support Center. We concluded that the care management practices were significant in supporting economically disadvantaged the elderly through the linkage between the elderlyΓÇÖs needs and social resources(especially with supports from the comprehensive Community General Support Center∩╝ë. It is important for care managers to support the elderly by sharing roles with the community support centers. ┬á Keywords: Care Management, Low-Income Elderly People Affiliation: BAIKA WomenΓÇÖs University Corresponding Author Email: ayabe@baika.ac.jp Acknowledgement:This research was supported by the Japan Society of Care Management and BAIKA WomenΓÇÖs University
An Academic Approach for Private Gerontechnology Certification and Establishment of Gerontechnology Graduate Schools in Korea
Participants: Ye-Jong Lee(Korea), Woo-Joung Shim(Korea), Sun-Ja Chang(Korea), Hong-Gyun Kim(Korea), Chun-Hee Choi(Korea). ISSUE Gerontechnology is a design aimed at improving the lives of older people. In Korea, the average life expectancy exceeds 80 years, with many older individuals living beyond 90. Socially, retirement begins before the age of 60, and over 8 million baby boomers are entering retirement. These individuals have 30-40 years or more of life ahead of them, and it is essential to guide them on how aging will progress, how to prevent and compensate for aging, and how to improve their quality of life by evaluating and organizing relevant technologies. In particular, in the case of caregiving, it is crucial to address the reluctance of individuals to become care recipients and their inability to actively respond to such needs. Therefore, it is important to promote the dissemination of Gerontechnology experts, including scholars, researchers, and other professionals, who can address these issues from the perspectives of the individuals involved, consultants, and providers. We aim to introduce and operate Gerontechnology Planners in Korea and gather key figures responsible for establishing Gerontechnology Graduate Schools to discuss what needs to be done from an academic perspective. STRUCTURE Woo-Joung Shim will present on the establishment and operation plans of the Gerontechnology Graduate School and compare it with other courses. Based on the roles and research directions of Gerontechnology researchers, he will propose the educational goals, course composition, curriculum, degree requirements, industry-academia-research network plans, and ISG collaboration strategies for the Gerontechnology Graduate School. Sun-Ja Chang will present a private certification for Gerontechnology Planners, including job contents, the criteria for qualification assessment, and the curriculum for planners. She will also mention the potential of the Gerontechnology Planner and the competencies that policymakers, researchers, and suppliers need to possess. Hong-Gyun Kim will explain the Gerontechnology toolkit used by users and planners. He will mention comprehensive tools aimed at improving life by setting and solving life goals, beyond just product services. Chun-Hee Choi will present cases of Gerontechnology planning. Utilizing the Gerontechnology tool kit, she will showcase life improvement planning conducted by Gerontechnology users, researchers, suppliers, and consulting experts. She will also discuss the issues with the tools and their potential development directions. CONCLUSION In the context of the aging paradigm and rapidly evolving scientific and technological era, the introduction of certification programs and the operation of a graduate school to train experts in innovating later life are timely and expected to contribute significantly to the advancement of Gerontechnology. Successful aging is a response to the combination of the aging of society and rapidly emerging new technologies, and training in Gerontechnology must be dynamic and expansive1. The establishment of a Gerontechnology Graduate School and the introduction of certification for Gerontechnology Planners are good initiatives. Therefore, it is essential to have ongoing, in-depth discussions on various visions, objectives, practical experiences, and development directions related to these introductions. References 1. G. Gutman (Convener) (2018). Beyond master classes: Other innovative opportunities for training in Gerontechnology. Participants A. Sixsmith (Canada), Y-L Hsu (Taiwan) H. Kort (Netherlands). Gerontechnology, 17(s),200s. https://doi.org/10.4017/gt.2018.17.s.195.00 Keywords: Gerontechnology Graduate School, Gerontechnology Planner, Gerontechnology Tool Kit Affiliation: 1KAPASS Gerontech Institute, Republic of Korea. 2Dept. Social Welfare, Gimcheon University, Republic of Korea. Corresponding Author Email: Woo-Joung Shim; fskorea@hanmail.net, Ye-Jong Lee; claton@hanmail.net
Wired and not Tired? Internet Use and Sleep in Older Adults
Purpose┬áSleep health is an important aspect of overall well-being, particularly among older adults(Ravyts & Dzierzewski, 2022), who might experience changes in sleep patterns and quality due to multimorbidity┬á(Kim et al., 2009). In recent years, the increasing use of the internet by older adults has introduced new factors into the sleep health equation.┬áIncreased use of digital devices for socializing, information, and entertainment might be beneficial for cognitive and social health┬á(Ghazi et al., 2022)┬ábut could also harm sleep quality due to blue light exposure and disrupted schedules.┬áThe aim of this study is to investigate sleep health among internet users┬áMethod┬áA cross-sectional survey was carried out under the longitudinal research project ΓÇÿSwedish National Study on Aging and Care-BlekingeΓÇÖ (SNAC-B). Questionnaires were sent to 587 participants aged 60 and above, out of which 436 respondents were received, resulting in a response rate of 74.2% for the survey. Sleep health was measured using a SATED questionnaire┬á(Buysse, 2014), and┬áinternet use was a binary question. We analysed internet usage's impact on sleep health using the Mann-Whitney Test and multivariate linear regression, incorporating confounding variables (C.V).┬áResults and Discussion┬áThe findings of this study showed that older adults who use the internet have significantly better sleep health scores compared to non-internet users (p-value:0.005). In regression, we found that the significant positive effect of internet use on sleep health observed in Model 1 without C.V (B = 0.601, p = 0.022) is reduced and becomes non-significant in Model 2 with C.V age, gender, education, and living status (B = 0.150, p = 0.610).┬áModel 2 explains 4.8% of the variance in sleep health scores, while Model 1 explains 1.5%, showing an improved explanatory power with the additional predictors.┬áThis indicates that the relationship between internet use and sleep health is likely influenced by other factors.┬áSince the relationship between internet use and sleep health becomes non-significant (rather than significantly negative) when including confounders, it implies that internet use does not have a significantly negative effect on sleep health. These results may be explained by the increase in eHealth literacy in this population┬á(Ghazi et al., 2023),which correlates to more responsible technology use for health information, promoting better habits like improved sleep, and enhancing sleep quality┬á(Milanti et al., 2023). ┬á References Buysse, D. J. (2014). Sleep Health: Can We Define It? Does It Matter?┬áSleep,┬á37(1), 9ΓÇô17. https://doi.org/10.5665/sleep.3298 Ghazi, S. N., Anderberg, P., Berglund, J. S., Berner, J., & Dallora, A. L. (2022).┬áPsychological Health and Digital Social Participation of the Older Adults during the COVID-19 Pandemic in Blekinge, SwedenΓÇöAn Exploratory Study.┬áInternational Journal of Environmental Research and Public Health,┬á19(6), 3711.┬áhttps://doi.org/10.3390/ijerph19063711 Ghazi, S. N., Berner, J., Anderberg, P., & Sanmartin Berglund, J. (2023).┬áThe prevalence of eHealth literacy and its relationship with perceived health status and psychological distress during Covid-19: a cross-sectional study of older adults in Blekinge, Sweden.┬áBMC Geriatrics,┬á23(1), 5.┬áhttps://doi.org/10.1186/s12877-022-03723-y Kim, J.-M., Stewart, R., Kim, S.-W., Yang, S.-J., Shin, I., & Yoon, J.-S. (2009). Insomnia, Depression, and Physical Disorders in Late Life: A 2-year Longitudinal Community Study in Koreans.┬áSleep,┬á32(9), 1221ΓÇô1228.┬áhttps://doi.org/10.1093/sleep/32.9.1221 Milanti, A., Chan, D. N. S., Parut, A. A., & So, W. K. W. (2023). Determinants and outcomes of eHealth literacy in healthy adults: A systematic review.┬áPLOS ONE,┬á18(10), e0291229. https://doi.org/10.1371/journal.pone.0291229 Ravyts, S. G., & Dzierzewski, J. M. (2022).┬áSleep and Healthy Aging: A Systematic Review and Path Forward.https://doi.org/10.1080/07317115.2022.2064789
The Association of Amount and Source of Dietary Protein with Muscle Mass and Strength in Old Age
Purpose Age-associated losses of muscle mass and strength are important predictors of disability in older persons. Although several mechanisms contribute to the decline in muscle mass and function seen with ageing, the process is accelerated by an inadequate protein intake (Cruz-Jentoft et al, 2019). However, the optimal amount and source of protein and the role of protein intake over the life course remain uncertain (Nishimura et al, 2023). In a sample of community-dwelling adults in Western Norway, the current study examined cross-sectional and longitudinal associations over 20 years of dietary protein intake with appendicular skeletal muscle mass (ASMM) and muscle strength measured by handgrip strength (HGS) in older age. Method Dietary intake was assessed using a paper-based food frequency questionnaire (FFQ) in middle age and a web-based FFQ in older age within the community-based Hordaland Health Study. ASMM was estimated by bioelectrical impedance analysis and HGS was measured using a handheld dynamometer. Results and Discussion Adjusted linear regression analyses revealed a negative cross-sectional association between the substitution of total protein and animal protein, with fat and carbohydrates, on ASMM in women. No longitudinal associations were found between substitution of dietary protein intake and ASMM in either sex. Similarly, no cross-sectional or longitudinal associations were evident between substitution of dietary protein intake and HGS in either sex. Notably, we did not find substitution of animal protein by plant protein to be associated with ASMM or HGS, suggesting that the source of protein may be less important, particularly when the requirement for total energy intake and total protein intake is fulfilled. This is highly relevant considering the predominantly plant-based diet promoted by emerging dietary recommendations, based on diet-health relationships and environmental sustainability concerns. Despite the general perception that older adults may benefit from an increased dietary protein intake, longitudinal evidence linking protein intake in midlife to muscle mass and function in older age is scarce. The current study is a valuable contribution to the knowledge on protein intake adequacy in older adults with high-functional capacity, which may have implications for policymakers establishing dietary recommendations (Sabir et al, 2024).
Profiling Older Adults for Understanding Their Technology Adoption
Previous research studies conducted within AAL Programme show light on the intriguing phenomenon of technology adoption through emphasizing the high heterogeneity of older adults in needs, preferences, and expectations, when compared to other younger groups. The decline which comes with ageing, largely varies: a person aged 60 shows a similar state of health as a person aged 70 or even 80. The functional capacity, which factors in the physical, psychological, and social variables is intimately related with the technology adoption, but there is large variance within the age group in relation to the functional capacity (Raed et al, 2023; Bae et al, 2020). Therefore, we need to reiterate two key matters in understanding the relation of older adults with technology. A) Older adults are a very heterogeneous population, way more diverse than the younger cohorts. B) There are transitions between categories as the ageing process means to pass from one category to another, from successfully ageing into normal ageing and/ or pathological ageing, the reverse process being exceptional.
Technology Adoption by Professional Caregivers
Purpose. Technology acceptance is one of the most intense topics of discussion in the information system literature. We will refer to the state of the art of the theory of technology adoption (2021 onwards), particularly to the refinements and the critiques to the Technology Adoption Model (Davis, 1989), often referred as TAM. The core of the theory went unchanged for the decades: the emphasis is put on the perception of the potential user which would base its decision of accepting or rejecting a technology starting from the a) perceived usefulness and b) the perceived is of use. Developed from the TAM, The Unified Theory of Acceptance and Use of the Technology (UTAUT, Venkatesh, 2003) is one of the most widely cited theory. Along the perceived usefulness and ease of use, it introduces new contextual moderating variables, increasing its reliability. However, we will work with UTAUT adapted to the care sector by Wutz et al (2023). UTAUT2 per se has been developed in the context of adult working population, while the health care sector has its own idiosyncrasies and the post-working population its own market segmentation (Venkatesch, 2012; Golant 2017) Moreover, we will refer here to the HofstedeΓÇÖs cultural dimensions which have a direct effect on technology acceptance. Latest research shows that there is a direct, moderating, and mediating role of cultural dimensions in technology acceptance models (Jan et al, 2022; Metallo et al, 2022). In the case of care organizations, the following three factors have a direct effect on the technology acceptance within the organization: Uncertainty avoidance, Individualism and Power Distance. It was shown that Uncertainty Avoidance is the best predictor for Perceived Ease of Use (Effort Expectancy) and has a positive effect. In cultures such as Portugal, users will try to avoid risk more than in Danmark. Individualism and Power Distance are best predictors of Behavioral Intension (Intension to use). Where is a higher degree of individualism, the intention to use is expected to be lower - When individualism is high, there is more to overcome for employees to use new technology.┬á Higher the Power Distance, higher the intension to use within care organization. In countries with high Power distance (i.e. Portugal), with the strong support of senior management, employees will be more likely to use the new technology. Method. We have undertaken a qualitative approach to UTAUT and inquired into professional caregiversΓÇÖ perceptions in 3 countries: Denmark, Portugal and Romania, though interviews and testimonials of those 10 involved.┬á ┬á Results and Discussion Gender as a moderator. We argue in favor of mainstreaming gender in technology adoption needs and analysis because the care sector is overwhelmingly womenized. When senior management are men, performance expectancy matter most than effort expectancy. Women tend to give less emphasis on perceived usefulness and are inclined to adopt technology that requires little or no effort and, thus, they tend to emphasise perceived ease of use (A4A Field Work, 2024; Srite and Karahanna). Age as a moderator. Most of the PCPs were between 45-54 years old, one very young and one older. The large majority has more than 10 yearsΓÇÖ experience as care provider. According to the interviews, those who are younger, would engage with the A4A Solution easier: they felt that their stress is reduced, while for the person aged between 55-65 yrs old, the stress is not reduced at all. Similar, except for the person aged between 55 and 65, everyone sees in the adoption of A4A Solution a more efficient time spending within the organization, time to feel more relaxed (less accidents, less emergencies), peace of mind and scaling up. Cultural factors as moderators. A) Uncertainty avoidance: It is emblematic how Denmark (which scores 23 points at Uncertainty Avoidance) perceived A4A Solution comparative to Romania, which scores 99 (Jan et al, 2024). PCPs from Denmark would try to adapt the Solution to their needs, put things in perspective and an emphasis on learning. The 2 PCPs from Romania or those from Portugal, tend to see if the A4A Solution is fit to their needs and show lower availability into making this work ΓÇô extra effort. However, all PCPs supported tested but the perseverance, diligence and stubbornness would vary. It is relevant to notice that the willingness to involve into testing is common only to large businesses because small PCP businesses are already exhausted. In conclusion, based on the country of origin, the PCPs would risk to put effort for gaining efficiency, and therefore Effort expectancy stays as a cultural factor. Power Distance. In countries with high Power distance (i.e. Romania and Portugal), with the strong support of senior management, employees will be more likely to use the new technology. Hindering factors Our findings also show that PCPs in Portugal worried about efficiency and implementation. In Romania, it has been thoroughly discussed in the pre-recruitment stage that PCPs on the field do not have technology literacy and monitoring would be another task which is not in the job description. Moreover, taken data-based decision would require a legislative change in the job description. Comparatively, in Denmark, technology is part of the job and, therefore, the openness is higher.
Roundtable: Gerontechnology, for Low- and Middle; Income countries; experiences lessons and challenges
Purpose The HelpAge global network and the International Society for Gerontechnology (ISG) are exploring opportunities for collaboration. On the one hand, ISG members may share learning from ageing and gerontechnology explorations, design, innovations, and interventions while members of the HelpAge global network share their views and experiences on what technological innovations can be introduced into Low- and Middle-Income countries (LMICs) and how to make these more accessible and affordable in low-resource settings and enhance older peopleΓÇÖs participation in its design. Method In April 2024, HelpAge invited a sample of its Network Members to respond to a short online survey to capture their experiences, lessons, and challenges in using Gerontechnology in their work with older people in LMICs. Eight organizations from 7 countries responded, all of whom are happy to continue engaging on this topic (see Table 1). The survey comprises three questions: experience with technology (Q1), challenges to adapting technologies for older people (Q2), and views on key gaps in the availability and suitability of technologies for ageing populations (Q3). In addition, on May 15, 2024, a webinar was hosted by the HelpAge Global network together with ISG to have more in-depth discussions and explore potential benefits. Results and Discussion Results related to Q1 are: that there are significant opportunities for the use of technology for ageing people. There are mobile apps to promote self-management and well-being by monitoring health data and offering services and resources. Also, digital literacy programs can be used to empower older people to engage with technology confidently through training, basic smartphone usage, and more. Technological innovations for older people offer exciting possibilities for a more independent and fulfilling life when ageing. Findings regarding Q2 are: user-related challenges are reported including physical limitations (reduced dexterity, vision impairments), cognitive challenges (memory issues), lack of habit in using technology, and information overload. Technological solutions do use smartphones as an interface which requires digital skills and access to the internet and data storage. The former can be lacking or low while the latter could be absent or not affordable in LMICs. Key gaps coming from Q3 are that technology products are often designed without sufficient attention to expected age-related declines in dexterity or vision, hindering user interaction. Many technologies have complex interfaces and technical terminology which pose challenges for users with varying levels of technological literacy. In addition, there is a need to provide personalization and tailoring of technological innovations to better fit older peopleΓÇÖs capabilities (Castro et.al., 2020). There is also a need to consider cultural nuances and linguistic preferences. Technological innovations usually cater to higher socioeconomic classes and neglect older people with limited resources. The work of Jes├║s-Azabal et. al. 2023 also presented at the webinar though showed that it is possible to design technological solutions for older people with limited resources and access to the Internet. Charness showed that it pays off to include older people from the start of the design of technological innovation (Charness, et.al., 2022) while Costa-Castro presented that a commercial party in Brazil targets the needs of older people providing tailored services in health diagnostics at home. In Gerontechnology students are educated to design user-friendly, easy-to-use, robust technological solutions for older people. Mainstream industry though is not familiar yet with gerontechnology. In this roundtable, further collaboration will be explored as well as a discussion of how to reach mainstream industry designing technologies for older people. ┬á References Gerontechnology; HelpAge Network Member experiences, survey summary, June 2024 Castro PC, Romano LB, Frohlich D, Lorenzi LJ, Campos LB, Paix├úo A, et al. (2020) Tailoring digital apps to support active ageing in a low-income community. PLoS ONE 15(12): e0242192. https://doi.org/10.1371/journal.pone.0242192 Manuel Jes├║s-Azabal, Javier Berrocal, Vasco N. G. J. Soares, Jos├⌐ Garc├¡a-Alonso, and Jaime Gal├ín-Jim├⌐nez. 2023. A self-sustainable opportunistic solution for emergency detection in ageing people living in rural areas. Wirel. Netw. 29, 5 (Jul 2023), 2353ΓÇô2370. https://doi.org/10.1007/s11276-023-03294-9 Charness, N., & Boot, W. R. (2022). A Grand Challenge for Psychology: Reducing the Age-Related Digital Divide. Current Directions in Psychological Science, 31(2) 187ΓÇô193. https://doi.org/10.1177/0963721421106814444┬á ┬á Keywords: older people; rural areas; limited resources; learning communities Affiliation: Utrecht University of Applied Sciences, Technology for Healthcare Innovations, NL Corresponding Author Email: helianthe.kort@hu.nl; AuthorsΓÇÖ ORCID iDs: H.S.M. Kort 0000-0001-9735-1015 Acknowledgment All participants of the survey and those attending the webinar are thanked for their valuable contributions. ┬á Table 1. Overview of the countries and organizations participating in the HelpAge Global Network Survey ┬á Country Organisation Argentina LeDor VaDor Foundation Brazil Federal University of Santa Catarina (UFSC) Brazil Paulista School of Medicine, Federal University of S├úo Paulo (UNIFESP) Costa Rica The Costa Rican Gerontological Association (AGECO) India HelpAge India Moldova HelpAge Moldova Thailand Foundation for Older Persons' Development Vietnam HelpAge International
Technology & Aging Crossing Borders: Expanding ISG Membership and Chapters Across the World
Technology & Aging Crossing Borders: Expanding ISG Membership and Chapters Across the World S. Kwon, W. D. Kearns, G. M. Gutman (Conveners) ┬á Participants: Y. Afacan (Turkey), J. M. Garcia-Alonso (Spain), P. C. Castro (Brazil), G. M. Gutman (Canada), S. Ishihara (Japan), W. D. Kearns (USA), S. Kwon (South Korea, Germany), F. O. Medola (Brazil), W. Moyle (Australia), W. A. Rogers (USA), Y. Zheng (Hong Kong). ISSUE After the World Conference of Gerontechnology 2022 in Daegu, South Korea, and before the 14th Biannual Meeting of the International Society for Gerontechnology (ISG), 2-4 September 2024 in Frankfurt, Germany, the reach of the Society ΓÇô broken down by its regional/linguistic groups ΓÇô spans four continents and an additional student chapter (ISG, n.d.-a). The North American chapter comprises Canada and the USA, while South America is represented by Brazil. The Asian ones are as follows: Hong Kong Great Bay Area, Japan, Sinophone, and South Korea. ISGΓÇÖs fourth continent ΓÇô Europe ΓÇô is composed of the Austrian-German-Swiss, Dutch-Flemish, Francophone, and Iberian chapters. Since ISG hosted its first World Conference of Gerontechnology 1991 in Eindhoven, the Netherlands (Graafmans, 2016/2017), and on a more regular basis since its 3rd international meeting in Miami, FL, USA, 2002, three host countries are not part of a chapter (Finland, Italy, Norway) (ISG, n.d.-b). Further, in contrast to North America, Europe and ΓÇô to a certain extent ΓÇô also Asia, the geographical distribution of ISG conference participants 2002-2022 is disproportional, considering country/continent sizes as well as the overall global volume of scholarly activities in tech & aging: Africa makes up <3% of all attendees in 20 years (the highest proportion among 10 occasions), Oceania <5.5%, and South America <3%. It does not suffice that the field of technology and aging bridges a multitude of professions through inter- and multi-disciplinarity (Kwon, 2002). Regional borders must be crossed as well to create optimal effects for all providers and users/consumers of GeronTech products and services on all biopsychosocial levels (Burdick & Kwon, 2017). CONTENT The potentials of new ISG chapters are discussed in this highly interactive roundtable. The panel hails from a variety of different countries, representing multiple professions. The speakers share experiences in establishing current ISG chapters and science centers, as well as in running organizations (among others, the International Association of Gerontology & Geriatrics/IAGG), spin-offs and research & consulting businesses. The special format of the roundtable and its unique subject matter deserve additional explanations: 1) The eventΓÇÖs primary goal lies in producing tangible results for ISG, such as by defining the next concrete steps for the establishment of new chapters and by discussing individual as well as chapter membership benefits for practitioners, policy-makers, researchers, students as well as the general public. 2) The roundtable's cardinal purpose is the demonstration of where/how to find rarely actualized and even untapped opportunities for the creation of new chapters and the enrichment of existing ones. 3) The panel specifically addresses practical problems such as (i) the facilitation of communication across multiple countries, and (ii) appropriate consideration of sociocultural, language-related as well as economic and political barriers. Panelists and the audience alike will obtain valuable insights and hands-on know-how for the establishment and management, as well as the expansion of ISG chapters: This will be achieved by knowledge transfer from the experience of running centers/institutes & organizations/associations. The panel also zooms in on the innervation of ISGΓÇÖs cross-border Student Chapter. STRUCTURE a) Roundtable members provide historical and statistical material from the public domain on the International Society for Gerontechnology, followed by b) a collective assessment of the possibilities as well as necessities for creating new chapters with Australia and Turkey as sample cases. This discourse is nurtured by inside-ISG experiences and outside-ISG ones, e.g. science organizations, businesses and research centers. c) Input is supplied during the roundtableΓÇÖs flow of discussion by speakers from countries that are represented in ISG chapters (Brazil, Germany, Hong Kong, Japan, Korea, USA) and by more nationalities from the floor. The session concludes with discussant G. M. Gutman, who ΓÇô among other roles ΓÇô is a past IAGG president, an ISG chapter president and founder/director of Simon Fraser UniversityΓÇÖs Gerontology Research Centre and its Department of Gerontology. Dr. Gutman will add realistic and realizable insights from the roundtable results for ISG development, as well as for the global field of AgeTech. CONCLUSION In addition to the overall lively research and steady progress of practice in aging & technology, ISG, as the only professional organization of its kind, can and should expand its regional membership for the advancement of gerontechnology. This roundtable provides some vital how-to building blocks in tech & aging for the expansion to new countries, as well as ideas for the enhancement of existing linguistically, culturally or/and geographically based ISG chapters. References Burdick, D. C., & Kwon, S. (2017). Gerontechnology. In J. Stein (Ed.), Reference Module in Neuroscience and Biobehavioral Psychology (pp. 228-237). London, UK: Elsevier, Inc. Graafmans, J.A.M. (2016/2017). The History and Incubation of Gerontechnology. In S. Kwon (Ed.), Gerontechnology: Research Practice, and Principles in the Field of Technology and Aging (pp. 3-11). New York, NY: Springer Publishing. International Society for Gerontechnology [ISG]. (n.d.-a) International Society for Gerontechnology. Retrieved from: https://www.gerontechnology.org/organization/ International Society for Gerontechnology [ISG]. (n.d.-b) International Society for Gerontechnology. Retrieved from: https://www.gerontechnology.org/pastconference/ Kwon, S. (2002). Gerotechnology: An Interdisciplinary Perspective and the Global Networking Dynamics. Gerontechnology, 2(1), 60-62. Keywords: Chapters, Globalization, Expansion, International Society for Gerontechnology, ISG Address: Hanyang University, Seoul, Seongdong-gu, Haengdang-dong, 222 Wangsimrni-ro, Republic of Korea (South) Corresponding Author Email: s.kwon@yonsei.ac.kr; AuthorsΓÇÖ ORCID IDs: https://orcid.org/0000-0002-1328-2735, https://orcid.org/0000-0002-0241-814X, https://orcid.org/0000-0001-8810-2287