No full-text available
To read the full-text of this research,
you can request a copy directly from the authors.
Reactions to a Remote-Controlled Video-Communication Robot in Seniors' Homes: A Pilot Study of Feasibility and Acceptance
Abstract
Objective:
Remote telepresence provided by tele-operated robotics represents a new means for obtaining important health information, improving older adults' social and daily functioning and providing peace of mind to family members and caregivers who live remotely. In this study we tested the feasibility of use and acceptance of a remotely controlled robot with video-communication capability in independently living, cognitively intact older adults.
Materials and methods:
A mobile remotely controlled robot with video-communication ability was placed in the homes of eight seniors. The attitudes and preferences of these volunteers and those of family or friends who communicated with them remotely via the device were assessed through survey instruments.
Results:
Overall experiences were consistently positive, with the exception of one user who subsequently progressed to a diagnosis of mild cognitive impairment. Responses from our participants indicated that in general they appreciated the potential of this technology to enhance their physical health and well-being, social connectedness, and ability to live independently at home. Remote users, who were friends or adult children of the participants, were more likely to test the mobility features and had several suggestions for additional useful applications.
Conclusions:
Results from the present study showed that a small sample of independently living, cognitively intact older adults and their remote collaterals responded positively to a remote controlled robot with video-communication capabilities. Research is needed to further explore the feasibility and acceptance of this type of technology with a variety of patients and their care contacts.
... Many people, especially home-bound older adults [1], feel lonely, which can lead to increased illness and mortality [2], and decreased quality of life [3]. Loneliness can come from not only social loneliness (i.e., loneliness from not having people around) but also emotional loneliness (i.e., loneliness from lacking a reliable partner [4,5]. ...
... Similar research has been conducted surrounding older adults' loneliness and the impact artificial companion robots can provide [8,9]. Similarly, mobile telepresence robots are especially helpful for people, invoking a deeper sense of interaction and improving health and social connection [4,5,10,11]. ...
... In this paper, we present a seven-month qualitative case study of four older adults with mobile telepresence robots-an important, but understudied topic [4,14,15]. We interview the adults monthly as they progress through their acceptance phases [13]. ...
Loneliness is increasingly common, especially among older adults. Technology like mobile telepresence robots can help people feel less lonely. However, such technology has challenges, and even if people use it in the short term, they may not accept it in the long term. Prior work shows that it can take up to six months for people to fully accept technology. This study focuses on exploring the nuances and fluidity of acceptance phases. This paper reports a case study of four older adult participants living with a mobile telepresence robot for seven months. In monthly interviews, we explore their progress through the acceptance phases. Results reveal the complexity and fluidity of the acceptance phases. We discuss what this means for technology acceptance. In this paper, we also make coding guidelines for interviews on acceptance phases more concrete. We take early steps in moving toward a more standard interview and coding method to improve our understanding of acceptance phases and how to help potential users progress through them.
... However, thus far, there is limited available evidence concerning the implementation and usefulness of TRs in a home-dwelling OA population. TRs have so far been studied mainly in controlled settings [39][40][41][42][43][44][45][46][47][48][49], although some studies involving OAs have been conducted in institutional settings (hospital services or senior residences) [50][51][52][53][54][55][56][57][58] and a few of them at home [59][60][61][62][63]. In particular, studies conducted with OAs at home have highlighted the benefits and issues associated with the use of TRs. ...
... With regard to the benefits of using TRs at home, cognitively healthy users have had a positive experience [60][61][62][63]. Participants in the experiments reported good acceptance, usability, perceived usefulness [59], and reliability of the TRs [63]. ...
... They considered the mobility, entertainment, and obstacle detection features of the robot to be satisfactory [61]. They mentioned that TRs could be beneficial for physical health, psychological well-being, social contact, and independent living [60]. In the trial carried out by Bakas et al [62], OAs showed an improvement in quality of life and sleep, as well as a decrease in depression following a TR intervention. ...
Background:
There is a growing prevalence of loneliness and social isolation among older adults (OAs). These problems are often associated with depressive states, cognitive decline, sleep disorders, addictions, and increased mortality. To limit loneliness and social isolation in OAs, some authors recommend the use of new communication technologies to maintain a social link with family members as well as with health and social care professionals. Among these communication tools, telepresence robots (TRs) seem to be a promising solution. These robots offer users the possibility of making video calls with their relatives, social workers, and health care professionals, to maintain social contact and access to support services while living at home. Nevertheless, TRs have been relatively unstudied in real-life environments.
Objective:
The main objective of this study is to measure the impact of a 12-week intervention using a TR on the feeling of loneliness and on social isolation of OAs living at home. Its secondary objective is to establish recommendations for the implementation of TRs in the studied context.
Methods:
A nonrandomized study will be conducted among 60 OAs living at home who will participate in the study for 24 weeks. During this period, they will host a TR for 12 weeks to use it in their home. After the end of the intervention a 12-week follow-up ensues. In total, 4 evaluations will be performed over the entire experimental phase for each participant at weeks 0, 6, 12, and 24. A multidimensional assessment of the impact of the robot will be performed using a multimethod approach including standardized scales and a semistructured interview. This assessment will also help to identify the ergonomic aspects that influence the robot's usability and acceptability among OAs.
Results:
Data collection started in September 2020 and is expected to be completed in early 2023. In August 2022, 56 participants were recruited for the study. Data analysis will take place between August 2022 and is expected to be completed in early 2023.
Conclusions:
The DOMIROB study will provide new knowledge on the impact of social TRs in OAs living at home. The results will make it possible to suggest technological, ethical, and organizational recommendations for the use and implementation of TRs for OAs in real-life settings.
Trial registration:
ClinicalTrials.gov NCT04767100; https://clinicaltrials.gov/ct2/show/NCT04767100.
International registered report identifier (irrid):
DERR1-10.2196/40528.
... Questions related to perceived usefulness and perceived ease of use were used to assist in understanding stakeholders' preferences regarding technology and identify adaptations that can be made to the robot (ie, the mobile robot, as both concepts may affect stakeholders' attitude toward using the mobile robot, which can then influence their behavioral intention to use the mobile robot and thereafter, affect actual use). We conducted a literature review to understand the types of questions and qualitative themes found in previous research studies relating to mobile telepresence robots as well as other types of robots that have been developed to assist people with ADRD [18][19][20][21][22][23]. On the basis of this literature review, we developed interview questions that focused on domains that we established a priori to help guide our understanding of how stakeholders perceive the mobile robot's usefulness and ease of use: (1) technology use, (2) design and functionality of the robot, (3) future applications to be incorporated into the robot, and (4) overall opinions about the robot. ...
... For example, stakeholders perceived the videoconferencing function (already available in the robot) to be useful in facilitating communication with friends or family members and for video telehealth visits with providers, which helps strengthen relationships by bridging the distance between individuals [26]. However, similar to previous research that highlights the importance of developing robots based on stakeholder feedback [18,19,27], incorporating several adaptations regarding the robot's design, functionality, and applications would be critical to enhance use for their needs, such as additional development of voice command and help button functions as well as applications related to medication reminders or dispensers and emergency response access [20]. These were perceived as critical features or applications to help people with MCI or ADRD maintain independent living at home; stakeholders raised concerns that these may be barriers to adoption if not incorporated. ...
... Our findings echo previous studies that highlight the importance of aligning and customizing technology functions and applications to end-product users [12,18,19,[28][29][30][31]. ...
Background:
By 2050, nearly 13 million Americans will have Alzheimer disease and related dementias (ADRD), with most of those with ADRD or mild cognitive impairment (MCI) receiving home care. Mobile telepresence robots may allow persons with MCI or ADRD to remain living independently at home and ease the burden of caregiving. The goal of this study was to identify how an existing mobile telepresence robot can be enhanced to support at-home care of people with MCI or ADRD through key stakeholder input.
Objective:
The specific aims were to assess what applications should be integrated into the robot to further support the independence of individuals with MCI or ADRD and understand stakeholders' overall opinions about the robot.
Methods:
We conducted in-person interviews with 21 stakeholders, including 6 people aged >50 years with MCI or ADRD living in the community, 9 family caregivers of people with MCI or ADRD, and 6 clinicians who work with the ADRD population. Interview questions about the robot focused on technology use, design and functionality, future applications to incorporate, and overall opinions. We conducted a thematic analysis of the data obtained and assessed the patterns within and across stakeholder groups using a matrix analysis technique.
Results:
Overall, most stakeholders across groups felt positively about the robot's ability to support individuals with MCI or ADRD and decrease caregiver burden. Most ADRD stakeholders felt that the greatest benefits would be receiving help in emergency cases and having fewer in-person visits to the doctor's office. Caregivers and clinicians also noted that remote video communication with their family members using the robot was valuable. Adding voice commands and 1-touch lifesaving or help buttons to the robot were the top suggestions offered by the stakeholders. The 4 types of applications that were suggested included health-related alerts; reminders; smart-home-related applications; and social, entertainment, or well-being applications. Stakeholders across groups liked the robot's mobility, size, interactive connection, and communication abilities. However, stakeholders raised concerns about their physical stability and size for individuals living in smaller, cluttered spaces; screen quality for those with visual impairments; and privacy or data security.
Conclusions:
Although stakeholders generally expressed positive opinions about the robot, additional adaptations were suggested to strengthen functionality. Adding applications and making improvements to the design may help mitigate concerns and better support individuals with ADRD to live independently in the community. As the number of individuals living with ADRD in the United States increases, mobile telepresence robots are a promising way to support them and their caregivers. Engaging all 3 stakeholder groups in the development of these robots is a critical first step in ensuring that the technology matches their needs. Integrating the feedback obtained from our stakeholders and evaluating their effectiveness will be important next steps in adapting telepresence robots.
... Moreover, aged care providers need to familiarize residents with the technology and ensure that they are aware of its Videoconferencing for social connectedness among older adults purposes and features since some residents might be confused why their loved ones were on the screen, but they could not touch them. This recommendation was highlighted in the reviewed papers (Beringer et al. 2013;Boman et al. 2014a;Boman et al. 2014b;Moyle et al. 2014;Moyle et al. 2019;Moyle et al. 2020;Seelye et al. 2012;Tsai et al. 2010b;Zamir et al. 2021). ...
... Banbury et al. 2017;Beringer et al. 2013;Boman et al. 2014a;Boman et al. 2014b;Hemberg et al. 2018;Moyle et al. 2014;Moyle et al. 2019;Moyle et al. 2020;Sacco et al. 2020;Seelye et al. 2012;Tsai et al. 2010a;Tsai et al. 2010b;Zamir et al. 2021;Zamir et al. 2018). ...
... Boman et al. 2014a;Boman et al. 2014b;Moyle et al. 2014;Moyle et al. 2019;Moyle et al. 2020;Seelye et al. 2012;Tsai et al. 2010b;Zamir et al. 2021). In this case, an amount of learning was required to use videoconferencing. ...
Videoconferencing has been increasingly used for social connectedness in residential aged care (RAC). In sensitive settings such as RAC, it is important that technologies are introduced with careful consideration of people's needs and experiences with the technology, to ensure that the desired benefits are realised. This paper reviews research evidence about older adults using videoconferencing for social connectedness and issues raised by that use in order to identify strategies RAC providers can adopt to achieve a greater likelihood of sustainability. Fourteen articles were included for in-depth review. Devices featuring videoconferencing in the studies reviewed ranged from tablets to telepresence robots. Most study participants perceived videoconferencing as beneficial for social connectedness. The implementation of videoconferencing in RAC is impacted by differences in sociotechnical systems. This paper contributes key considerations for the future design and implementation of videoconferencing for social connectedness in RAC and opportunities for future work in this area.
... Five studies investigated participants living at home: four of the five involved participants living independently. [25][26][27][28] One study took place in a palliative care unit, 29 and three did not identify the setting. [30][31][32] The studies included a range of methods including two randomised controlled trials (RCTs), 25,33 controlled quasiexperimental study 28,[34][35][36] and qualitative research. ...
... 30,37 Six collected mixed-methods data. 26,28,29,32,38,39 Only 10 studies used standardised instruments (the UCLA Loneliness Scale, Short Form [36] Health Instrument, DeJong Gierveld Loneliness Scale and Quality of Life Scale 28,29,35 ) to measure changes in isolation and lon eliness. 25,[27][28][29][33][34][35][36]38,39 The most common scale used to measure social isolation was the UCLA Loneliness Scale. ...
... A number of studies included findings outlining the experiences of those who had connected with older people through ICT (eg family members, spouses, friends and students). 26,29,31,37 ...
Objective:
To examine the effectiveness of information and communication technologies (ICTs) in reducing social isolation in older people and draw recommendations from previous literature appropriate for informing ICT use in future mandated periods of isolation.
Methods:
A systematically conducted review of key databases to identify studies investigating ICT interventions that targeted social isolation or loneliness among older people.
Results:
Fifteen articles were identified. All articles used ICT as an intervention for targeting social isolation with varying results. Most studies reported positive impacts on social isolation, but this was identified more in self-reporting compared to changes in baseline measures. The types of ICT used included videoconferencing, Internet-based applications and purpose-designed applications. A number of factors were also identified throughout the studies that impacted uptake that should be considered when implementing ICT.
Conclusions:
Overall, we found evidence of ICT improving social connectedness of older people to some extent although more rigorous research in future is needed. Recommendations from previous literature highlight the importance of including older people in purposeful design, engaging families and support networks, and providing ongoing ICT training and support so that systems and skills are in place for future periods of mandated isolation. The literature also warns us not to rely on ICT as the only avenue for social interaction either during or outside periods of social distancing.
... In the selected publications, robots were used in hospitals, laboratories, care homes for the elderly, and private homes. A total of 16 studies were carried out in Europe [26,35,36,[38][39][40][41][42][43][44][45][46]48,50,[53][54][55], 4 in America (USA) [19,34,49,51], 1 in Asia (Japan) [44], and 3 in Oceania (New Zealand and Australia) [37,47,52]. Experimental times ranged from 1 day to 18 months. ...
... The selected articles included studies carried out with healthy OAs (four studies) [19,35,43,44], as well as OAs suffering from mild neurocognitive disorders (two studies) [36,49], major neurocognitive disorders or dementia (one study) [47], or multiple comorbidities (one study) [34]. Four studies included one healthy group and one mild cognitive impairment (MCI) group [19,34,49,51]. Twelve studies did not report information on the characteristics of the recruited OAs [26,38,40,42,45,[47][48][49][50]52,55]. ...
... The number of older participants in the studies ranged from n = 1 to n = 53. Six studies included family members, [26,42,47,48,50,51], and eight included health professionals (nurses, orderlies, occupational therapists) [34,36,37,40,45,47,48]. ...
Social isolation is a common phenomenon among the elderly. Retirement, widowhood, and increased prevalence of chronic diseases in this age group lead to a decline in social relationships, which in turn has adverse consequences on health and well-being. The coronavirus COVID-19 crisis worsened this situation, raising interest for mobile telepresence robots (MTR) that would help create, maintain, and strengthen social relationships. MTR are tools equipped with a camera, monitor, microphone, and speaker, with a body on wheels that allows for remote-controlled and sometimes autonomous movement aiming to provide easy access to assistance and networking services. We conducted a narrative review of literature describing experimental studies of MTR involving elderly people over the last 20 years, including during the COVID-19 period. The aim of this review was to examine whether MTR use was beneficial for reducing loneliness and social isolation among older adults at home and in health and care institutions and to examine the current benefits and barriers to their use and implementation. We screened 1754 references and included 24 research papers focusing on the usability, acceptability, and effectiveness of MTR. News reports on MTR use during the COVID-19 period were also examined. A qualitative, multidimensional analysis methodology inspired by a health technology assessment model was used to identify facilitating and limiting factors and investigate if and how MTR could reduce social isolation in elderly people. Reviewed studies provide encouraging evidence that MTR have potential in this regard, as experiments report positive feedback on MTR design and core functionalities. However, our analysis also points to specific technical, ergonomic, and ethical challenges that remain to be solved, highlighting the need for further multidimensional research on the design and impact of MTR interventions for older adults and building on new insights gained during the COVID-19 pandemic.
... The category "Assistance" represent the largest group of articles encompassed in this systematic literature review. This category comprises 40 papers, gathering research from 2010 to 2017, and also in this case the overwhelming majority of the study took into consideration robots as the technology used: 26 out 40 papers (Granata et al., 2010(Granata et al., , 2013Gross et al., 2011Gross et al., , 2012Wu et al., 2011Wu et al., , 2012Wu et al., , 2013Wu et al., , 2014Wu et al., , 2016Pino et al., 2012Pino et al., , 2015Seelye et al., 2012;Bruno et al., 2013;Schroeter et al., 2013;Nishiura et al., 2014;Pahl and Varadarajan, 2015;Tapus, 2016, 2017;Broughton et al., 2016;Nakahara et al., 2016;Reppou et al., 2016;Bellotto et al., 2017;Darragh et al., 2017;Foukarakis et al., 2017;Korchut et al., 2017;Tsardoulias et al., 2017). The remaining papers are shared between two types of technology: namely, personal devices and wearable sensors, making up 14 out 40 papers (Mitseva et al., 2009;Martínez et al., 2011;Sacco et al., 2012;Diaz-Orueta et al., 2014;Meiland et al., 2014;Batista et al., 2015;König et al., 2015a;Lazarou et al., 2016;Mainetti et al., 2016Mainetti et al., , 2017Vasileiadis et al., 2016;Kyriazakos et al., 2017;Mighali et al., 2017;Stavropoulos et al., 2017). ...
... The authors found that people with MCI had more difficulty with technology than healthy older adults, and they were confused about the robot's purpose and function. For this reason, technology should be introduced to them as early as possible to give them time to become familiar with it, and to increase acceptance and longterm use (Seelye et al., 2012). ...
... Even if neither the first nor the second are totally enthusiastic to the idea of living with a companion robot, healthy subjects seems to have a more positive attitude toward this kind of robots. For this reason, and thinking to maximize the residual ability to learn how to use robots, it is recommended to introduce elderly people, even those with MCI, to the robots as early as possible (Pino et al., 2012;Seelye et al., 2012). A last comment concerning the attitude of elderly people and this type of technology is drawn to the fact that in coming years we will begin to meet elderly individuals who are increasingly confident and more expert with technologies. ...
Alzheimer's disease, and dementia, represent a common cause of disability and one of the most relevant challenges in the health world. In addition, these conditions do not have, at moment, a pharmacological treatment that can stop the pathological progress. Mild cognitive impairment (MCI), defined as the borderline between normal aging and early dementia, represents a meaningful field of study because, in the transition to dementia, clinicians have defined a useful therapeutic window. Additionally, due to the lack of effective pharmacological interventions, recent years have seen an increase in research into new technological solutions to assess, stimulate, and assist patients afflicted with Alzheimer's disease. This review aims to outline the use of information and communication technologies in the field studying MCI. Particularly, the goal is to depict the framework and describe the most worthwhile research efforts, in order to display the current technologies available, describe the research objectives, and delineate prospective future researches. Regarding data sources, the research was conducted within three databases, PubMed Central, Web of Science, and Scopus, between January 2009 and December 2017. A total of 646 articles were found in the initial search. Accurate definition of the exclusion criteria and selection strategy allowed identification of the most relevant papers to use for the study. Finally, 56 papers were fully evaluated and included in this review. Three major clinical application areas have been portrayed, namely “Cognitive Assessment,” “Treatment,” and “Assistance.” These have been combined with three main technological solutions, specifically “Sensors,” “Personal Devices,” and “Robots.” Furthermore, the study of the publications time series illustrates a steadily increasing trend, characterized by the enrollment of small groups of subjects, and particularly oriented to the subjects assistance using robots companion. In conclusion, despite the new technological solutions for people with MCI have received much interest, particularly regarding robots for assistance, nowadays it still owns vast room for improvement.
... A total of 205 records were identified via preliminary database searching. After eliminating duplicates, 166 records were screened and eighteen studies were included in this review (see Figure 1): one randomized controlled trial (Yueh et al., 2001), four longitudinal (Arthanat, Vroman, & Lysack, 2016;Bla zun, Saranto, Kokol, & Vo sner, 2012;Sohlberg, Fickas, Ehlhardt, & Todis, 2005;van Middendorp, Watkins, Park, & Landymore, 2015) and thirteen descriptive studies (Chou, Chang, Lee, Chou, & Mills, 2013;Laffont et al., 2007;Lancioni et al., 2010;Lin, Tang, & Kuo, 2012;Papa, Cornacchia, Sapio, & Nicolo, 2016b;Saracchini, Catalina, & Bordoni, 2015;Savolainen, Hanson, Magnusson, & Gustavsson, 2008;Schettini et al., 2015;Seelye et al., 2012;Sellers, Ryan, & Hauser, 2014;Torta et al., 2014;Wherton et al., 2012;Wu et al., 2015), among them, two series of cases (Lancioni et al., 2010;Sohlberg et al., 2005) and one case report (Sellers et al., 2014). ...
... Most of the studies included only apparently healthy participants with communication limitations due to natural aging related changes (Arthanat et al., 2016;Bla zun et al., 2012;Chou et al., 2013;Lin et al., 2012;Papa et al., 2016b;Saracchini et al., 2015;Savolainen et al., 2008;Seelye et al., 2012;Torta et al., 2014;Wherton et al., 2012;Wu et al., 2015) and the others included persons with a pathological problem that prevented them from usual communication (Laffont et al., 2007;Lancioni et al., 2010;Schettini et al., 2015;Sellers et al., 2014;Sohlberg et al., 2005;van Middendorp et al., 2015;Yueh et al., 2001). Description of the studies according to sample, instrument, main findings and potential values are presented in Table 2. ...
... First, we will discuss the interventions that used AT for people with speech problems, such as a speech synthesizer (Laffont et al., 2007), microswitches (Lancioni et al., 2010), BCI (Schettini et al., 2015;Sellers et al., 2014) or ECTS (van Middendorp et al., 2015). Second, interventions via any type of robot or videoconferencing systems (Chou et al., 2013;Savolainen et al., 2008;Seelye et al., 2012;Torta et al., 2014) will be discussed. Third, we will deliberate the studies which used Information and Communication Technologies as a type of AT (Arthanat et al., 2016;Bla zun et al., 2012;Lin et al., 2012;Papa et al., 2016b;Saracchini et al., 2015;Sohlberg et al., 2005;Wu et al., 2015). ...
Objective: Describe the use of assistive technology to enhance communication opportunities for older adults.
Methods: A systematic review was conducted in two databases, PubMed and Web of Science, by using two different searches in each. The search was limited to original articles, in English language, including people aged 60 years and older that used any type of assistive technology for communication. The articles found in the initial search were filtered by title, abstracts and the remaining articles were fully read.
Results: Eighteen studies were included in this review after the reading of full-texts. Most of the studies included apparently healthy participants with communication limitations due to aging related changes and the others included people with some pathology that prevent them from normal communication.
Conclusion: Four categories of assistive technology were identified: assistive technology for people with speech problems; robot or videoconferencing systems; Information and Communication Technologies and, other types of assistive technology for communication, such as hearing aids and scrapbooks. Assistive technology for communication of older adults is not only used by people with disabilities that prevent them from usual communication. They are mostly for older adults without a pathological communication problem.
... The older adults' opinions towards the system were primarily positive, although concerns were noted as well (Beer & Takayama, 2011). Similarly, in previous studies with older adults, their family, caregivers, and healthcare workers, participants perceived advantages and disadvantages of telepresence (Cesta, Cortellessa, Orlandini & Tiberio, 2012;Helal & Abdulrazak, 2006;Seelye et al., 2012). Yet, results from these studies showed that these participants also held predominately positive attitudes toward telepresence systems. ...
... In these prior studies, potential benefits of telepresence were identified, including visualization, remote monitoring, time efficiency, reducing isolation, mobility, feeling of "being there", convenience, and health diagnosis (Beer & Takayama, 2011;Seelye et al., 2012;Cesta et al., 2012;Rantanen, 2013). Concerns about using telepresence technology that were discussed in these studies included privacy (Beer & Takayama, 2011;Cesta et al., 2012;Rantanen, 2013;Seelye et al., 2012), ease of use (Beer & Takayama, 2011;Seelye et al., 2012), size of the system (Cesta et al., 2012;Rantanen, 2013), and low level of technology autonomy (Cesta et al., 2012). ...
... In these prior studies, potential benefits of telepresence were identified, including visualization, remote monitoring, time efficiency, reducing isolation, mobility, feeling of "being there", convenience, and health diagnosis (Beer & Takayama, 2011;Seelye et al., 2012;Cesta et al., 2012;Rantanen, 2013). Concerns about using telepresence technology that were discussed in these studies included privacy (Beer & Takayama, 2011;Cesta et al., 2012;Rantanen, 2013;Seelye et al., 2012), ease of use (Beer & Takayama, 2011;Seelye et al., 2012), size of the system (Cesta et al., 2012;Rantanen, 2013), and low level of technology autonomy (Cesta et al., 2012). ...
Mobility is a key component for older adults to maintain wellness and health while aging-in-place independently. However, older adults with mobility impairments may experience challenges in remaining socially connected. Telepresence systems hold much potential to help older adults with mobility impairments. However, telepresence systems are not specifically designed with this population’s capabilities and limitations in mind – creating many potential usability barriers. We conducted a heuristic evaluation of three telepresence systems. The results of the evaluation indicated a range of design issues. Issues related to the base height, un-adjustable screen height, camera resolution, microphone/speaker quality, and sensor sensitivity were categorized as hardware problems. Usability issues caused by poor network connectivity, lack of privacy settings, lack of notifications of the system status, and limited control of the system were identified as software problems. It is critical that designers consider and address these findings to ensure that telepresence systems are usable by individuals with a wide range of abilities.
... The older adults' opinions towards the system were primarily positive, although concerns were noted as well (Beer & Takayama, 2011). Similarly, in previous studies with older adults, their family, caregivers, and healthcare workers, participants perceived advantages and disadvantages of telepresence (Cesta, Cortellessa, Orlandini & Tiberio, 2012;Helal & Abdulrazak, 2006;Seelye et al., 2012). Yet, results from these studies showed that these participants also held predominately positive attitudes toward telepresence systems. ...
... In these prior studies, potential benefits of telepresence were identified, including visualization, remote monitoring, time efficiency, reducing isolation, mobility, feeling of "being there", convenience, and health diagnosis (Beer & Takayama, 2011;Seelye et al., 2012;Cesta et al., 2012;Rantanen, 2013). Concerns about using telepresence technology that were discussed in these studies included privacy (Beer & Takayama, 2011;Cesta et al., 2012;Rantanen, 2013;Seelye et al., 2012), ease of use (Beer & Takayama, 2011;Seelye et al., 2012), size of the system (Cesta et al., 2012;Rantanen, 2013), and low level of technology autonomy (Cesta et al., 2012). ...
... In these prior studies, potential benefits of telepresence were identified, including visualization, remote monitoring, time efficiency, reducing isolation, mobility, feeling of "being there", convenience, and health diagnosis (Beer & Takayama, 2011;Seelye et al., 2012;Cesta et al., 2012;Rantanen, 2013). Concerns about using telepresence technology that were discussed in these studies included privacy (Beer & Takayama, 2011;Cesta et al., 2012;Rantanen, 2013;Seelye et al., 2012), ease of use (Beer & Takayama, 2011;Seelye et al., 2012), size of the system (Cesta et al., 2012;Rantanen, 2013), and low level of technology autonomy (Cesta et al., 2012). ...
For older adults with mobility impairment, maintaining health and wellness while aging-in-place independently is crucial. Telepresence technology, such as Kubi, can be potentially beneficial for this target population to stay socially connected [1]. However, the Kubi robot is not specifically designed for older adults with mobility impairment. For this target population to adopt the technology successfully, it is important to ensure that they would not experience usability barriers. Thus, we conducted usability testing of Kubi with five older adults with self-reported mobility impairment. The findings indicated both hardware and GUI problematic issues for this population. Hardware problems were primarily related to the base. GUI usability issues were caused by system visibility and control of the robot. These findings provide direction for improving the usability of telepresence robots, particularly for adults aging with mobility impairment.
... Self-Efficacy measures a user's self-assessed evaluation of their capacity and ability to complete certain tasks, pos- (Luperto et al. 2022) n/a (Hebesberger et al. 2017) n Open response feedback on usability (Wu et al. 2017;Seelye et al. 2012) n/a I-MC Obj Task success rate: accepting a video call, mute and unmute the microphone and speakers, etc. Table 2: Summary of a subset of the sample common metrics for HAI. sess knowledge of specific skills, and the ability to carry them out. ...
... For subjective evaluation, tools like Unified Theory of Acceptance & Use of Technology (UTAUT) (tier 1) (Heerink et al. 2010) or the System Usability Scale (SUS) to evaluate performing hobbies (E-H) (tier 2) (Barg-Walkow et al. 2017) are used. Objective measures typically refer to the successful completion of tasks, such as participants answering and making calls, powering the device on and off, or adjusting its settings, performing tasks related to managing communication with others (I-MC) (Seelye et al. 2012). ...
Artificial intelligence (AI) has applications in assisting older adults to age in place and provide support to them and their caregivers as their cognition declines with age. However, effective assessment methods of this technology are needed in order to benchmark their performance and a common set of metrics and evaluation methods would enable such assessments to be compared to one another. To this end, we propose a common framework for human-AI interaction involving care recipients and their care networks. From the results of a literature review exercise, a framework with sample metrics, related measures, qualified evaluation tools, and contextual factors that impact assessment are reviewed. This paper provides a sample of common metrics in one of the framework’s measurement spaces (human-AI interaction) and discusses some of the impacts of contextual factors and how use of the common metrics and evaluation framework can be used for meta-analysis and to guide future research. Additional future articles are planned to cover the other measurement spaces in the framework (system performance, task performance, and well-being), including their particular common metrics and evaluation methods. This effort aims to provide guidance for researchers in this domain as well as highlight measurement gaps that can be filled by future research.
... 3) Driving hazards were not communicated clearly by the robot. 4) Robot transitions from solid floor to carpet [108] were problematic. Participants perceived that the robot is easy to use. ...
... If this communication breaks, then the users would not get the right feedback that can lead to dissatisfaction. Table 3 [80] [93][94][95], [99][100], [103], [106][107][108], [110][111][112][113], [117] revealed some technical issues on robots' performance which lead to dissatisfaction among the older persons. In any situation, when the communication breaks, there are ergonomics factors appeared between the users and the robots. ...
In the advancement of human-robot interaction technology, assistive social robots have been recognized as one of potential technologies that can provide physical and cognitive supports in older person’s care. However, a major challenge faced by the designers is to develop an assistive social robot with prodigious usability and user experience for older persons who were known to have physical and cognitive limitations. A considerable number of published literatures was reporting on the technological design process of assistive social robots. However, only a small amount of attention has been paid to review the usability and user experience of the robots. The objective of this paper is to provide an overview of established researches in the literatures concerning usability and user experience issues faced by the older persons when interacting with assistive social robots. The authors searched relevant articles from the academic databases such as Google Scholar, Scopus and Web of Science as well as Google search engine for the publication period 2000 to 2021. Several search keywords were typed such as ‘older persons’ ‘elderly’, ‘senior citizens’, ‘assistive social robots’, ‘companion robots’, ‘personal robots’, ‘usability’ and ‘user experience’. This online search found a total of 215 articles which are related to assistive social robots in elderly care. Out of which, 54 articles identified as significant references, and they were examined thoroughly to prepare the main content of this paper. This paper reveals usability issues of 28 assistive social robots, and user experience feedback based on 41 units of assistive social robots. Based on the research articles scrutinized, the authors concluded that the key elements in the design and development of assistive social robots to improve acceptance of older persons were determined by three factors: functionality, usability and users’ experience. Functionality refers to ability of robots to serve the older persons. Usability is ease of use of the robots. It is an indicator on how successful of interaction between the robots and the users. To improve usability, robot designers should consider the limitations of older persons such as vision, hearing, and cognition capabilities when interactingwith the robots. User experience reflects to perceptions, preferences and behaviors of users that occur before, during and after use the robots. Combination of superior functionality and usability lead to a good user experiencein using the robots which in the end achieves satisfaction of older persons.
... They used two commercial robots and studied two condition of conference room meetings and moving hallway conversations. Seelye et al. [2] built a telepresence robot with a video feed for improving the daily social connectedness of seniors. They noticed that both the elderly and the people connecting to them via the remote operated system responded positively. ...
... Latency measurements for scenario (1) and(2). ...
... Autonomy is a key feature to provide uninterrupted access to the system, enabling it to provide assistance in everyday life [2]. -Privacy: Especially in nursing homes and public buildings, the system should give a clear indication when audio input is being processed and transmitted to external servers [1,8,25,38]. The activation and deactivation of the listening function of the system should be easily possible for the user. ...
... This makes the interaction with the VUI less natural and puts a burden on the memory load of users. Furthermore, similar to related research [1,25,38] privacy and transparency concerns have been raised by participants and should be taken into account for an updated version of the developed system. Lastly, several limitations had to be made during for the conducted usability test. ...
Elderly people and especially people with dementia often experience social isolation and need assistance while performing activities of daily living. We investigate a novel approach to cope with this problem by integrating voice assistants and social assistance robots. Due to the special communication needs of people with mild cog-nitive impairment, the design of interfaces of such systems is to be based on the particular requirements of the target user group. This paper investigates, how a voice user interface should be designed for elderly users with mild cognitive impairment-such as an early stage of dementia-to provide personalised support throughout activities of daily living. A context and user analysis delivered a set of 11 guidelines for voice user interfaces for people with demen-tia. For a pilot study we selected those strategies often applied by caregivers in their communication with people with dementia and evaluated the voice user interface among elderly participants and healthcare workers who reported a high feasibility, usefulness and acceptance of the designed system.
... Adhering to the assessment items for qualitative research [19,20], the authors ensured the rigor of this research and double-checked the participants' understanding by summarizing and explaining the interviews immediately after finishing the interviews. ...
... In this research, the needs for and acceptance of the elderly regarding robotic technology services were determined to be significantly high, which is consistent with the study Seelye et al. [20] conducted on elderly people who were able to live independent lives and had no cognitive disorders, similar to the participants of the present study; the researchers determined that they had a positive utility and acceptance of robotic technology services. However, this differs from the findings of a study conducted by Wu et al. [21], in which 11 seniors lived with robots for four weeks, after which their acceptance and level of use of the robotic technologies were analysed. ...
Background:
The rate of aging in Korea is extremely fast compared to major countries. We examined the key demands of community-dwelling older adults with regard to Connected Active Space technology, which provides tailored assistance with daily living performance through robotic services.
Methods:
This study is based on a mixed-method design, through a quantitative survey (n = 234) first phase, followed by a qualitative study with focus group interviews (n = 23) to explore the needs and acceptance of community-dwelling aged people concerning the application of robot technology in their daily lives.
Results:
The scores concerning the need for and acceptance of robot services to assist daily living performance were high, at 7.2 and 7.9 out of 10 points, respectively. Further, for both needs and acceptance, timely reaction to emergency situations, early detection of emergency situations, help to locate objects, assistance with mobility, and assistance in memory recall were prioritized (in that order). In a thematic analysis of qualitative data from three focus-group interviews, a 'mismatch between desires and functional capacity' was the core characteristic of living as an older person and 'being a friend and helper' was the most desired trait of a robot service.
Conclusion:
Although most of the participants lived independently, they regularly experienced difficulties regarding buying products, transportation, using phones, and preparing meals. If appropriate assistance technology is developed, this population can maintain its independence. Thus, it is necessary to address main needs, including detecting and addressing emergency situations, locating objects, assisting mobility and memory recall, and assisting with daily living performance. New robot services that can be tailored to the functions or abilities of the elderly must be developed based on individually collected information.
... A recent dog-like robot called MiRo has been developed to do home patrolling and security [36]. Another class of service robots is non-mobile or mobile robots without manipulator such as Vgo, designed primarily for clinician and caregiver use to monitor elders [22][23][24], the HOBBIT prototype robots, focused on preventing and detecting falls in elders [25], Kompai communication assistant [27,28], and Giraff companion robot [26]. ...
... Studies show the PARO can be used to effect longlasting changes in mental health as supported by changes in brain activation patterns pre-and post-use of the robot. The Vgo telepresence robot has been shown to provide opportunity to connect elders to their caregivers and family by providing a virtual "in person" environment [21][22][23][24]. The Kompai robot offered an opportunity for a low-cost communication [28]. ...
The high cost of elder care combined with the shortage of caregivers lead us to consider how service robots can be affordably leveraged to support the independence of elders and the work of their caregivers and clinicians. Our objective is to gain design insight into tasks older adults desire to accomplish daily in a low-resource, assisted living setting and how an affordable service robot could suit. A need-finding design approach consisting of focus groups and surveys was completed with three stakeholders groups: Elders, Clinicians, and Caregivers. Stakeholders were asked to identify and then prioritize service tasks by importance and frustration. Thirty-six unique high priority tasks were identified. Instrumental activities of daily living, a desire to have their preferences known, leisure activities, and increased opportunities for socialization were the most important tasks that the elders wanted a low-cost mobile service robot to address. Clinicians and caregivers prioritized highly safety-related reminders and assistance in complying with care plans in assessment of elder task needs. Service robots exist that do some, but not all of these desired tasks. An effective and affordable service robot requires design trade-offs in terms of cost, preference and complexity. A low-cost robot targeting reminders, companion walking, hydration and fetching assistance was suggested as an initial prototype. Prototypes may address high priority desires of all stakeholders, but robots that can intervene and affect long-lasting changes in elder care are still needed.
... They support remote monitoring and long-distance control and facilitate interactions between older adults with dementia and their CGs [28]. Another study placed VGo robot in the homes of older adults who are independent and exhibit intact cognitive functioning [29]. They had generally positive feedback about the robot and found that it enhanced their physical health, well-being, social connectedness, and ability to live independently. ...
As a result of a rapidly aging population and the increasing prevalence of dementia among older adults, technological solutions are increasingly being considered to facilitate caregiving. This research investigates the perspectives of 20 caregiving dyads on VGo, a telepresence social robot with features designed to support caregiving. Care recipients (CRs), aged 65 and older, diagnosed with Alzheimer’s disease and related dementias, along with their primary caregivers (CGs), evaluated the robot through an online interview study. The interviews integrated informative videos showcasing VGo’s features and functions. Insights from the interviews revealed diverse expectations, interests, and reservations. The majority of CGs and their CRs perceived the robot’s features as beneficial. In particular, the voice command capability was appreciated as an alternative to using smartphones and as a way to manage home appliances. The community feature, however, did not align well with many participants’ lifestyles, and participants had a number of suggestions to enhance the robot’s notification function. Based on the interview results, the study offers a set of design recommendations for telepresence social robots in home caregiving contexts. This investigation highlights the promise of social robots in caregiving contexts and underscores the need for further improvements to ensure they fit users’ needs.
... A few buttons and an intuitive display were among the preferred characteristics. A proposed method to enhance older adults' experience with robot control is to provide training in navigating the interface and moving the robot [63,64]. Said training, in addition to simplified control functions, would increase technology acceptance levels. ...
The social integration of older adults has been shown to be vital for successful aging. Innovative communication technologies, such as telepresence robots, can protect older adults against loneliness and social isolation by helping them stay connected to their social networks. This human-centered qualitative study aims to identify the attitudes (research question 1, RQ1), intentions to use (RQ2), and requirements (RQ3) of older adults for robot-mediated communication (RMC) via a telepresence robot. Semi-structured individual interviews were conducted with N = 30 older adults from Germany, who evaluated storyboard illustrations depicting a fictional RMC scenario between a grandparent and their adult grandchild. The study identified 3 attitude groups towards telepresence robots among participants: positive, negative, and conflicting attitudes (RQ1). Furthermore, based on their intentions of use, participants were classified into reluctant future users (n = 12), future non-users (n = 10), and enthusiastic future users (n = 8) (RQ2). Finally, the study identified technological, social, and age-related requirements of older adults for a telepresence robot (RQ3). Practical recommendations are provided based on these findings, such as leveraging older adults’ current technology-related skills, adapting technologies to older adults’ lifestyles and social networks, and designing technologies that contribute to older adults aging in place. This study contributes to the human-centered design of telepresence robots that support the social integration of older adults.
... Furthermore, technical and practical aspects should be addressed. For instance, minimizing the impact on the home and optimizing the sensor network, by limiting the number of devices, provide great advantages for the acceptance of the whole system [35][36]. Active and Assisted Living (AAL) robotics should be adaptive to changing environments, as well as easily configurable to satisfy the user's needs [37]. ...
In this paper, a new ecosystem to support older adults and their caregivers in an indoor living environment is proposed. The GUARDIAN ecosystem is designed to address the different needs of end users in different countries. The ecosystem consists of a socially assistive robot (SAR), including sensors, and two mobile applications (one for caregivers and one for the older user). Starting from a user-centred and value-sensitive co-design approach, three key user requirements have been identified: monitoring, reminding, and social companionship. User requirements were translated into technical requirements to develop a flexible system architecture. Usability tests were performed to verify the satisfaction level about the GUARDIAN concept. User tests were carried out in three different countries involving 13 older adults, 14 informal carers and 15 formal carers showing that the proposed ecosystem satisfies the user requirements. These results confirm the feasibility of the application of the GUARDIAN ecosystem in living indoor environments.
... Service robots with telepresence capabilities can also aid elderly patients in their homes. The VGo telepresence robot has been shown to provide the opportunity to connect elders to their caregivers and family by providing a virtual "in-person" environment (Seelye et al., 2012). Feedback from interviews with healthcare professionals and elder adults were positive and supported the notion that telepresence robots are beneficial in healthcare (Van Den Berg et al., 2012;Vermeersch, Sampsel, & Kleman, 2015). ...
To address shortages in rehabilitation clinicians and provide for the growing numbers of elder and disabled patients needing rehabilitation, we have been working towards developing an affordable socially assistive robot for remote therapy and health monitoring. Our system is being designed to initially work via remote control, while addressing some of the challenges of traditional telepresence. To understand how to design a system to meet the needs of elders, we created a mobile therapy robot prototype from two commercial robots and demonstrated this system to clinicians in two types of rehabilitation care settings, a daycare setting and a inpatient rehabilitation setting. We propose to introduce the prototype as a social and therapy agent into clinician-patient interactions with the aim of improving the quality of information transfer between the clinician and the patient. This paper describes an investigative effort to understand how clinicians who work with elders accept this prototype. Clinicians from each setting differed in their needs for the robot. Those in daycare settings preferred a more social robot to encourage and motivate elders to exercise as well as monitor their health. Clinicians in the inpatient rehabilitation setting desired a robot with more therapeutic and treatment capabilities. Both groups wanted a robot with some autonomy that was portable, maintainable, affordable, and durable. We discuss these results in detail along with the ethical implications of increasing the robots autonomy and suggest additional requirements for achieving a smarter robot that can meet the clinicians social, health monitoring and prognostication desires.
... For example, the Lifestyle Redesign program, an OT initiative encompassing education, discussions of personal experiences, and recreational activities was most effective in increasing social function and reducing depressive symptoms [187,195,196]. Most studies regarding assistive technology (n=16 studies) reported on assistive robots [262][263][264][265][266][267][268][269][270], such as the seal-like Paro robot, to facilitate social interactions and aid in daily living activities [263,266,267,269,270], and significant improvements in psychological well-being were reported during group interactions [271]. Small humanoid robots were particularly effective at improving social engagement and providing a trusting, emotional relationship [265]. ...
Background:
Social prescription programs represent a viable solution to linking primary care patients to nonmedical community resources for improving patient well-being. However, their success depends on the integration of patient needs with local resources. This integration could be accelerated by digital tools that use expressive ontology to organize knowledge resources, thus enabling the seamless navigation of diverse community interventions and services tailored to the needs of individual users. This infrastructure bears particular relevance for older adults, who experience a range of social needs that impact their health, including social isolation and loneliness. An essential first step in enabling knowledge mobilization and the successful implementation of social prescription initiatives to meet the social needs of older adults is to incorporate the evidence-based academic literature on what works, with on-the-ground solutions in the community.
Objective:
This study aims to integrate scientific evidence with on-the-ground knowledge to build a comprehensive list of intervention terms and keywords related to reducing social isolation and loneliness in older adults.
Methods:
A meta-review was conducted using a search strategy combining terms related to older adult population, social isolation and loneliness, and study types relevant to reviews using 5 databases. Review extraction included intervention characteristics, outcomes (social [eg, loneliness, social isolation, and social support] or mental health [eg, psychological well-being, depression, and anxiety]), and effectiveness (reported as consistent, mixed, or not supported). Terms related to identified intervention types were extracted from the reviewed literature as well as descriptions of corresponding community services in Montréal, Canada, available from web-based regional, municipal, and community data sources.
Results:
The meta-review identified 11 intervention types addressing social isolation and loneliness in older adults by either increasing social interactions, providing instrumental support, promoting mental and physical well-being, or providing home and community care. Group-based social activities, support groups with educational elements, recreational activities, and training or use of information and communication technologies were the most effective in improving outcomes. Examples of most intervention types were found in community data sources. Terms derived from the literature that were the most commonly congruent with those describing existing community services were related to telehealth, recreational activities, and psychological therapy. However, several discrepancies were observed between review-based terms and those addressing the available services.
Conclusions:
A range of interventions found to be effective at addressing social isolation and loneliness or their impact on mental health were identified from the literature, and many of these interventions were represented in services available to older residents in Montréal, Canada. However, different terms were occasionally used to describe or categorize similar services across data sources. Establishing an efficient means of identifying and structuring such sources is important to facilitate referrals and help-seeking behaviors of older adults and for strategic planning of resources.
... United States Seelye et al [48] Positive effects of using the system were: eliminated blind spots in the home and improved working style of caregivers. Negative effects mainly regarded the work stress, as caregivers cannot rest in the break time because of the video recording, and caregivers were heavily stressed about the reduced and violation of privacy rights for themselves, coworkers, and residents. ...
Background:
The aging society posits new socioeconomic challenges to which a potential solution is active and assisted living (AAL) technologies. Visual-based sensing systems are technologically among the most advantageous forms of AAL technologies in providing health and social care; however, they come at the risk of violating rights to privacy. With the immersion of video-based technologies, privacy-preserving smart solutions are being developed; however, the user acceptance research about these developments is not yet being systematized.
Objective:
With this scoping review, we aimed to gain an overview of existing studies examining the viewpoints of older adults and/or their caregivers on technology acceptance and privacy perceptions, specifically toward video-based AAL technology.
Methods:
A total of 22 studies were identified with a primary focus on user acceptance and privacy attitudes during a literature search of major databases. Methodological quality assessment and thematic analysis of the selected studies were executed and principal findings are summarized. The PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) guidelines were followed at every step of this scoping review.
Results:
Acceptance attitudes toward video-based AAL technologies are rather conditional, and are summarized into five main themes seen from the two end-user perspectives: caregiver and care receiver. With privacy being a major barrier to video-based AAL technologies, security and medical safety were identified as the major benefits across the studies.
Conclusions:
This review reveals a very low methodological quality of the empirical studies assessing user acceptance of video-based AAL technologies. We propose that more specific and more end user- and real life-targeting research is needed to assess the acceptance of proposed solutions.
... United States Seelye et al [48] Positive effects of using the system were: eliminated blind spots in the home and improved working style of caregivers. Negative effects mainly regarded the work stress, as caregivers cannot rest in the break time because of the video recording, and caregivers were heavily stressed about the reduced and violation of privacy rights for themselves, coworkers, and residents. ...
BACKGROUND
Aging society posits new socio-economic challenges, to which a potential solution is Active and Assisted Living (AAL) technologies. Visual-based sensing systems are technologically among the most advantageous ones in providing health and social care, however, they come at the risk of violating rights to privacy. With the immersion of video-based technologies, privacy-preserving smart solutions are being developed, however, the user-acceptance research about these developments is not yet being systematized.
OBJECTIVE
With this scoping review, we aim to gain an overview of existing studies examining older adults and/or their caregivers` viewpoints on technology acceptance and privacy perceptions specifically toward video-based Active Assisted Living technology.
METHODS
A total of 22 studies were identified with a primary focus on user acceptance and privacy attitudes during a literature search of major databases. Methodological quality assessment and thematic analysis of the selected studies were executed and principal findings were summarized. PRISMA-ScR guidelines were followed on every step of this scoping review.
RESULTS
The results demonstrate that acceptance attitudes toward video-based active assisted living technologies are rather conditional, and are summarized into 5 main themes seen from the two end-user perspectives, caregiver and care receiver. With privacy being a major barrier to video-based AAL technologies, security and medical safety were identified as the major benefit across the studies.
CONCLUSIONS
This review reveals a very low methodological quality of the empirical studies assessing user acceptance of video-based AAL technologies. We propose that more specific and more end-user, real-life targeting research needs to be done about the acceptance of proposed solutions.
... Our work is inspired by prior studies on the long-term use of robot telepresence systems. Seelye et al. showed the feasibility and positive acceptance of using a teleoperated robot among a sample of independently living older adults [30]. They found that the use of a teleoperated robot increased the older adults' social connectedness when talking to their friends and adult children. ...
The practice of social distancing during the COVID-19 pandemic resulted in billions of people quarantined in their homes. In response, we designed and deployed VectorConnect, a robot teleoperation system intended to help combat the effects of social distancing in children during the pandemic. VectorConnect uses the off-the-shelf Vector robot to allow its users to engage in physical play while being geographically separated. We distributed the system to hundreds of users in a matter of weeks. This paper details the development and deployment of the system, our accomplishments, and the obstacles encountered throughout this process. Also, it provides recommendations to best facilitate similar deployments in the future.We hope that this case study about Human-Robot Interaction practice serves as inspiration to innovate in times of global crises.
... Furthermore, the main limitation of this study lies in the sample size, and more samples will provide more reliable results. Obviously, the qualitative research of small samples has also obtained interesting findings in previous related studies [83,84]. In subsequent studies, we should expand the scale of participants as much as possible. ...
The development of robot technology provides many possibilities for the life support of the elderly. This study explored the acceptability of robots to assist the elderly from the perspective of future designers. A quantitative questionnaire (58 copies) and a qualitative one-to-one interview (10 people) were conducted to explore the attitude of future designers towards the use of robots to assist the elderly. One-sample Wilcoxon signed-rank test statistic was used to analyze the data of the questionnaire. The results show that the mean and median of 11 of the 12 dimensions of the acceptability questionnaire are greater than 3 (3 represents uncertain and neutral attitude), and 10 have statistical significance (p < 0.05). Also, the interview results show the positive attitude of future designers. The research shows that future designers hold a positive and open attitude towards the use of robots to assist the elderly. The research findings can help people understand the attitude of future designers and provide some reference for subsequent robot design and development.
... 16: Actuation efficiency of a ball drive actuator for linear X and Y motion as a function of ψ and rotation about Z as a function of α ...
... Telepresence robots have been tested in different settings for their potential to support social relationships for elderly people. Both lab and in-home short trials have reported mostly positive perceptions of mobile telepresence systems e.g., [18,19]. In addition, long-term studies of a telepresence robot supporting independent living have shown positive influences [4,20]. ...
Robotic telepresence is a potential technology to help alleviating the loneliness of elderly people. The impacts of long-term use of telepresence robots in residential care are not well known. We were interested in how using a telepresence robot influences the resident, family members and care workers at a facility, and what challenges and solutions there are for wider adoption of such robots in residential care. With a telepresence robot Double, we arranged a series of three trials in two separate residential care facilities: one 12-week trial in a private facility and two successive 6-week trials in a public facility. In each trial, we installed the telepresence robot in a room of a long-term care home resident for communicating with her/his family members. Based on the results, telepresence robots do increase presence and possibly engagement of family members in residential care, but privacy is a central concern. The mobility of a telepresence robot is hard to utilize in residential care, and to be able to do so, ethical consideration and guidelines are needed. We provide a draft of such ethical guidelines.
... Research has shown that the form of a telepresence robot can influence the perceptions and behavior of both the operator and the individuals interacting with the robot [5,6,7,8], yet there is little research into the form of telepresence robots in terms of social acceptance and perceived suitability for a given context. Healthcare and care for the elderly are two key areas of telepresence research, with a number of studies highlighting the potential benefits and exploring the acceptability of such systems [9,10,11,12,13]. As the technology progresses and becomes more widespread, the suitability of the hardware design for a given application should be considered to ensure positive user experiences. ...
Research has shown that the form of a telepresence robot can affect the thoughts and behaviour of both the operators and individuals interacting with the robot, however there has been little research into how potential users perceive the various forms of robot in a range of social contexts. This paper reports on a survey study which sought to investigate this topic. The study finds that perceptions of suitability differ across the various forms of telepresence robot and that perceptions of suitability for specific activities were affected by gender.
Mobile telepresence robots can help reduce loneliness by facilitating people to visit each other and have more social presence than visiting via video or audio calls. However, using new technology can be challenging for many older adults. In this paper, we examine how older adults use and want to use mobile telepresence robots, how these robots affect their social connection, and how they can be improved for older adults’ use. We placed a mobile telepresence robot in the home of older adult primary participants ( N = 7; age 60+) for 7 months and facilitated monthly activities between them and a secondary participant ( N = 8; age 18+) of their choice. Participants used the robots as they liked between monthly activities. We collected diary entries and monthly interviews from primary participants and a final interview from secondary participants. Results indicate that older adults found many creative uses for the robots, including conversations, board games, and hide ‘n’ seek. Several participants felt more socially connected with others and a few had improved their comfort with technology because of their use of the robot. They also suggested design recommendations and updates for the robots related to size, mobility, and more, which can help practitioners improve robots for older adults’ use.
A fundamental paradigm shift for in-home sensing is apparent. Special-purpose sensing, where there is a one-to-one relationship between sensors and applications, is evolving into general-purpose sensing, where there is a many-to-many relationship between sensors and applications. This new shift may impact how individuals think about in-home sensing, where utility and comfort are often linked to applications rather than sensed data. We explore the evolution of individuals' perceptions as they become increasingly and contextually aware of sensor capabilities and data characteristics. Through a multi-phase study where 12 participants were progressively led through six exposure conditions across laboratory and home environments, we find that exposure changes represent inflection points for perceptions of utility and comfort with data collection. These changes define opportunities for increasing trust in sensing infrastructures via data- and context-aware interventions, managing over-reliance on awareness notifications, and providing data-enabled "what if" analyses to balance comfort and utility within an individual's unique context and environment.
Background
Smart home health technologies (SHHTs) have been discussed in the frame of caregiving to enable aging-in-place and independence. A systematic review was conducted in accordance with the PRISMA guidelines to gather the up-to-date knowledge on the benefits and barriers of using SHHTs in the care of older persons from the perspective of older persons and their caregivers.
Methods
Ten electronic databases were reviewed for empirical peer-reviewed literature published from 01.01.2000 to 31.12.2021 in English, German, and French reporting on experimental, qualitative, quantitative, and other empirical study designs were included. Included studies contained user-feedback from older persons over 65 years of age or their caregivers (formal and informal). We used an extraction document to collect relevant data from all included studies and applied narrative synthesis to analyze data related to benefits and barriers of SHHTs.
Results
163 empirical peer-reviewed articles were included, the majority of those published between 2014 and 2021. Five first-order categories of benefits and five of barriers were found with individual sub-themes. SHHTs could be useful in the care context where continuous monitoring is needed. They improve self-management and independent living of older persons. Barriers currently exist with respect to ease of usability, social acceptance, and cost.
Conclusions
SHHTs could be useful in the care context but are not without concerns. Researchers and policy makers can use the information as a starting point to better understand how the roles and outcomes of SHHTs could be improved for the care of older persons, while caregivers of older adults could use our findings to comprehend the scope of SHHTs and to decide when and where such technology could best address their individual family needs. Limitations lie in the possible exclusion of relevant articles published outside the inclusion criteria as well as the fact that due to digital divide, our review represents opinions of those who could and wanted to participate in the included 163 studies.
Trial registration
This review has been registered as PROSPERO CRD42021248543. A protocol was completed in March 2021 with the PRISMA-P guidance. We have extended the review period from 2000 to 2020 since the registration of the protocol to 2000–2021.
As life expectancy increases, social and health assistance requires sustainable and affordable solutions possibly usable from one's own domestic environment. In this article, we propose a transformer-based approach combined with a
task-planning
system and enhanced with AI sub-modules to run on low-cost telepresence robots in order to support more advanced and autonomous assistance services. The proposed system allows to dynamically generate and adapt in autonomy heterogeneous robotic actions according to the information emerged during the interaction. The AI-enhanced telepresence robot was assessed in an unstructured domestic environment by 10 users. The results show an accuracy of more than 95% in the expected robot's functioning. The participants judged the system efficient, useful and intuitive, and showed a positive inclination to re-use the robot in the future. Such outcomes derive both from a proper coordination among the heterogeneous AI sub-modules in the system and from the fast capability to frequently co-adapt the interaction.
Wireless sensor networks (WSN) are useful in medicine for monitoring the vital signs of elderly patients. These sensors allow for remote monitoring of a patient’s state of health, making it easier for elderly patients, and allowing to avoid or at least to extend the interval between visits to specialized health centers. The proposed system is a low-cost WSN deployed at the elderly patient’s home, monitoring the main areas of the house and sending daily recommendations to the patient. This study measures the impact of the proposed sensor network on nine vital sign metrics based on a person’s sleep patterns. These metrics were taken from 30 adults over a period of four weeks, the first two weeks without the sensor system while the remaining two weeks with continuous monitoring of the patients, providing security for their homes and a perception of well-being. This work aims to identify relationships between parameters impacted by the sensor system and predictive trends about the level of improvement in vital sign metrics. Moreover, this work focuses on adapting a reactive algorithm for energy and performance optimization for the sensor monitoring system. Results show that sleep metrics improved statistically based on the recommendations for use of the sensor network; the elderly adults slept more and more continuously, and the higher their heart rate, respiratory rate, and temperature, the greater the likelihood of the impact of the network on the sleep metrics. The proposed energy-saving algorithm for the WSN succeeded in reducing energy consumption and improving resilience of the network.
The book presents the state of the art of the Internet of Things (IoT), applied to Human-Centered Design (HCD) projects addressed to ageing users, from the perspective of health, care and well-being. The current focus on the ageing population is opening up new opportunities for the development of niche solutions aimed at the niche category of older users who are beginning to experience physical and cognitive decline but are still independent and need to maintain their autonomy for as long as possible. The combination between the needs expressed by older users and the opportunities offered by the recent innovative technologies related to the Internet of Things allows research institutions, stakeholders, and academia to target and design new solutions for older users, safeguarding their well-being, health, and care, improving their quality of life.
This book discusses and analyses the most recent services, products, systems and environments specifically conceived for older users, in order to enhance health, care, well-being and improve their quality of life. This approach is coherent with the percept of AAL or enhanced living environment, looking to the users’ comfort, autonomy, engagement and healthcare. The book describes and analyses aspects of HCD with older users looking to the emerging technologies, products, services, and environments analysed in their actual application in different areas, always concerning the design for the elderly related to the IoT, just as the development of biomonitoring devices, tools for activity recognition and simulation, creation of smart living environments, solutions for their autonomy, assistance and engagement enhancing health, care and wellbeing. The book is intended for researchers, designers, engineers, and practitioners in healthcare to connect academia, stakeholders, and research institutions to foster education, research and innovation.
The population of elderly people has increased rapidly over the last decades in Europe, and today, Italy is the oldest European country. In this context, robotics and other emerging technologies are increasingly proposed as potential solutions to improve the autonomy and quality of life of the elderly. This chapter aims at investigating the acceptance of the most recent technological solutions, in the field of IoT and assistive and social robotic services for elderly people, taking into account the availability of results from both the design phase and clinical studies, to ensure and verify the usability and acceptability of the solutions. This review shows that there are several robots that have been developed to not only provide companionship to older adults, but also to cooperate with them during health and lifestyle activities, such as facilitating reminiscence through cognitive stimulation, remembering tasks to be done, monitoring vital signs and whether they fall down, while at the same time entertaining them. Despite the undeniable usefulness of SARs, developers are often forced to prioritize the improvement of specific technical features due to the unavailability of resources and the different degrees of flexibility and acceptability imposed by unstructured settings, as private homes. The analysed studies sought to explore the usability and acceptability of the latest technological solutions in the field of IoT and social assistive robotics for older people, taking into account the availability of results from both the design stages and clinical trials, ensuring a patient-centred approach to older people. Understanding how to integrate IoT and smart solutions into the care pathway as well as in the daily life of the end-users is another crucial aspect for research in the field, which will be addressed within this chapter.KeywordsInternet of ThingsHuman-centred designElderlySocial assistive robotsAcceptance
Telepresence has the potential to assist older adults to stay socially connected and to access telehealth. Telepresence was initially created for office use, thus the usability of telepresence for older adults remains unknown and there is a lack of design recommendations, particularly those with an emphasis on users’ age-related needs and limitations. To bridge the gap, this study assessed two telepresence user interfaces (UIs). One UI was designed to mimic common features founds in commercially available telepresence systems. Another UI was designed based on design guidelines for older adults. Each UI was integrated to a virtual driving environment created via Unity. To assess the usability of both UIs, thirty older adults participated in usability testing. Questionnaires and semi-structured interview were administered following each UI test sessions. Results of this study provide insight on what usability features are critical for the aging population to use telepresence, such as high color contrast, automated controls, and consistent icons.
Telepresence robots can be beneficial for older adults by helping them stay socially connected and to access telehealth services; both factors are vital in maintaining health and wellness while aging in place. For older adults to willingly use telepresence technology, it is important to ensure that they do not experience barriers to adoption, such as issues with usability and privacy. In this study, we present a two-part research endeavor. Firstly, we developed two telepresence user interfaces (UIs): (1) the control condition—a generic UI design based on currently available telepresence robots; and (2) the experimental condition—a modified UI that was designed specifically for older adults’ capabilities and limitations, which also incorporated enhanced privacy features. Secondly, we conducted an in-depth within-subjects mixed-methods assessment of both UIs with 30 older adults (aged M=71.00, SD=5.50, range=61-84 years). Both qualitative and quantitative data yielded positive results, suggesting that older adults perceived the experimental condition to be more usable and private than the control condition. The older adult participants provided insight on which usability and privacy features were perceived as critical, specifying features such as obstacle detection, adjustable robot height, and the ability to restrict room access. By conducting this preliminary study, we investigated what usability features are deemed critical for older adult usage of telepresence. Our goal is to improve the ease of use of telepresence robots, and to enable older adults to remain socially connected while aging in place.
With an ageing population, more and more older people are expected to remain in their living environment. Mobile robots, whose market is expected to increasingly grow, could assist them for specific tasks. Existing studies, however, show that potential users have privacy concerns. In this paper, we therefore aim at understanding factors influencing these concerns and exploring their preferences with regards to different aspects related to informational privacy. In a quantitative study with 1090 German-speaking older adults, we show that female and non-owners of robots tend to express more concerns about their privacy than others.
This paper provides an overview of the literature concerning Seniors’ psychological perspective in exploiting assistive robots and the embodied conversational agents. The main theoretical models devoted to assess user’s technology acceptance are briefly reviewed along with a description of the main factors empirically found to be positively/negatively associated with Seniors’ acceptance level. Special attention is reserved to barriers generated by Seniors’ representations of social assistive technologies, such as, a stigma or threat to their autonomy, infantilization, privacy interferences, fear of dehumanization and isolation.
The proportion of older adults who live alone in single households is growing continuously. In the care of these solo-living older adults, electronic assistive technology (EAT) can play an important role. The objective of this review is to investigate the effects of EAT on the wellbeing of community-dwelling older adults living alone in single households. A systematic review of English articles was conducted based on PMC, Scopus, Web of Science and the Cochrane database. Additional studies were identified from the references. In total, 16 studies were identified, six of them with follow-up. There is evidence that EAT can improve the physical and mental wellbeing of older adults. There was little evidence that EAT can improve social wellbeing. We conclude that more personalized designs and interventions, and more user engagement could be embedded in the design of EAT for solo-living community-dwelling older adults and that more evidence is needed regarding the effects of those interventions.
Purpose
The purpose of this paper is to investigate the publicity around the implementation of the Zora robot in elderly-care services in Lahti, Finland. The aim is to discover opinions concerning the use of robots in elderly care as well as the arguments and justifications behind those opinions. Zora is a humanoid robot intended to promote mobility and rehabilitation. The Lahti pilot was the first Zora pilot in Finland in public elderly-care services. It received much publicity, both regionally and nationally.
Design/methodology/approach
This study is based on an empirical case study on the implementation of the Zora robot in elderly-care services. The data consist of interviews with personnel who operated Zora and comments from the general public about the “Zora” robot. Two data sources were used: 107 comments were collected from online and print media, and the personnel (n=39) who worked with Zora were interviewed. The data were analysed by means of interpretative content analysis.
Findings
The results show that public opinion is mainly negative, but that the commentators apparently have little information about the robot and its tasks. The personnel had more positive views; they saw it as a recreational tool, not as a replacement for their own roles.
Originality/value
There is clearly a need for more information, for a better informed discussion on how robots can be used in elderly care and how to involve the general public in this discussion in a constructive way.
Pre-print available at: http://urn.fi/URN:NBN:fi-fe2018122051383
Background:
Social robots are currently a form of assistive technology for the elderly, healthy, or with cognitive impairment, helping to maintain their independence and improve their well-being.
Objective:
The main aim of this article is to present a review of the existing research in the literature, referring to the use of social robots for people with dementia and/or aging.
Methods:
Academic databases that were used to perform the searches are IEEE Xplore, PubMed, Science Direct, and Google Scholar, taking into account as date of publication the last 10 years, from 2007 to the present. Several search criteria were established such as "robot" AND "dementia," "robot" AND "cognitive impairment," "robot" AND "social" AND "aging," and so on., selecting the articles of greatest interest regarding the use of social robots in elderly people with or without dementia.
Results:
This search found a total of 96 articles on social robots in healthy people and with dementia, of which 38 have been identified as relevant work. Many of the articles show the acceptance of older people toward social robots.
Conclusion:
From the review of the research articles analyzed, it can be said that use of social robots in elderly people without cognitive impairment and with dementia, help in a positive way to work independently in basic activities and mobility, provide security, and reduce stress.
Die Forschung zur kontrovers diskutierten Robotik in der Pflege und Begleitung von Personen mit Demenz steht noch am Anfang, obwohl bereits erste Systeme auf dem Markt sind. Die zentrale Frage besteht darin, ob und wie sich Telepräsenzroboter im Alltag von Personen mit Demenz integrieren lassen und wie sich diese Integration auf das Lebensarrangement der Menschen mit Demenz und der betreuenden Personen auswirkt.
Elderly people moving into assisted living facilities often face profound changes in their daily routines and social relationships, which may lead to feelings of social isolation and even to depression. Telepresence robots can alleviate this by enabling easily accessible virtual presence of family members and other close ones at the ward. Telepresence robots have been tested in different care environments with often positive responses, but there are still challenges, both technical and non-technical, that hinder the wider adoption of the robots in residential care settings. We seek for more understanding of the non-technical challenges by studying the use of a telepresence robot Double in a residential care facility. In a 12-week field trial, we installed a telepresence robot in a room of a long-term care home resident for communicating with her family members. The qualitative interview data included the perspectives of the resident, her family members and care workers at the ward. The results confirm the potential of telepresence robots in assisted living in order to increase the presence of family members to the resident and vice versa; the study also provides insight about how the increased presence of family members may affect the care work.
Reliance on socioemotional assistive robots is projected to increase, yet little is known about how our ability to perceive their emotional expression is impacted by psychological factors. In high-risk and high-tension domains such as emergency services and healthcare, how might the cognitive and physiological stress we are experiencing influence how we read a humanoid robot's nonverbally conveyed emotions? Using a novel paradigm, we asked participants under experimentally-induced acute stress vs. low stress to evaluate a set of normed emotional body language poses conveyed by a physically-present vs. virtually-instantiated humanoid robot. Participants rated each pose for emotional valence (positivity/negativity) and arousal (calm/excited). Acute stress increased the perception of negative valence in negative high arousal poses, consistent with stress-induced hypervigilance. Surprisingly, stress diminished the perception of arousal in high arousal poses, whereas repeated presentation of the low arousal poses increased perception of arousal. Participants rated emotion similarly for the physically-present vs. virtually-present robot, although positively-valenced poses conveyed by the physical robot were perceived as more positive and more animate. We propose that perceptions of emotional arousal may be especially vulnerable to context effects and misattribution. These findings have implications for how assistive robots can best be designed for high-risk and high-tension contexts.
Assistive social robots, a particular type of assistive robotics designed for social interaction with humans, could play an important role with respect to the health and psycho-logical well-being of the elderly. Objectives Assistive social robots are believed to be useful in eldercare for two reasons, a functional one and an affective one. Such robots are developed to function as an interface for the elderly with digital technology, and to help increase the quality of life of the elderly by providing companionship, respectively. There is a growing attention for these devices in the literature. However, no comprehensive review has yet been performed to in-vestigate the effectiveness of such robots in the care of the elderly. Therefore, we systematically reviewed and analyzed existing literature on the effects of assistive social robots in health care for the elderly. We focused in particular on the com-panion function. Data Sources A systematic search of MEDLINE, CINAHL, Psy-cINFO, The Cochrane Library databases, IEEE, ACM libraries and finally Google Scholar was performed for records through December 2007 to identify articles of all studies with actual subjects aimed to assess the effects of assistive social robots on the elderly. This search was completed with information derived from personal expertise, contacts and reports. Study Selection and Data Extraction Since no randomized controlled trials (RCT)'s have been found within this field of research, all studies reporting effects of assistive robotics in elderly popula-tions were included. Information on study design, interventions, controls, and findings were extracted for each article. In medical journals only a few articles were found, whereas about 50 publications were found in literature on ICT and robotics. Data Synthesis The identified studies were all published after 2000 in-dicating the novelty of this area of research. Most of these publications contain the results of studies that report positive effects of assistive social robots on health and psychological well-being of elders. Solid evidence indicating that these ef-fects can indeed be attributed to the actual assistive social robot, its behavior and its functionality is scarce. Conclusions There is some qualitative evidence as well as limited quantitative evidence of the positive effects of assistive social robots with respect to the elderly. The research designs, however, are not robust enough to establish this. Confounding variables often cannot be excluded. This is partly due to the chosen research designs, but also because it is unclear what research methodology is adequate to investigate such effects. Therefore, more work on methods is needed as well as robust, large-scale studies to establish the effects of these devices. Assistive social robots in elderly care: a review G8(2)Review-Broekens-v4.indd 1 29-5-2009 10:52:03
Soziale Beziehungen stellen einen wichtigen Faktor für den Erhalt der Lebenszufriedenheit im Alter dar. Wenig bekannt ist, welchen Einfluss erhöhte soziale Unterstützung auf das Wohlbefinden kognitiv beeinträchtigter Menschen hat. In zwei vergleichenden Studien in der Schweiz und Österreich mit insgesamt 84 kognitiv beeinträchtigten Personen (65–98 Jahre) in stationärer Betreuung wurde deshalb in einem Kontrollgruppendesign untersucht, ob sich die Erhöhung sozialer Unterstützung positiv auf das Wohlbefinden auswirkt. Dazu wurden Interventionen bei kognitiv beeinträchtigten Menschen in Form von emotionaler sozialer Unterstützung durch freiwillige Besucher durchgeführt. In beiden Studien konnte ein positiver Zusammenhang zwischen der Erhöhung sozialer Unterstützung durch freiwillige Helfer und dem Wohlbefinden der Probanden festgestellt werden. Die Untersuchungen zeigen auf, dass soziale Unterstützung und Zuwendung generell von kognitiv beeinträchtigten Menschen registriert und als wohltuend empfunden werden. = Social relationships are an important factor for maintaining life satisfaction in elderly people. Little is known, however, about the influence of increased social support towards the well-being of cognitively impaired people. This is why two comparative studies in Switzerland and Austria, with 84 cognitively impaired individuals (aged between 65 and 98) with in-patient treatment, used a control group design to examine whether increased social support would have a positive effect on the well-being of these individuals. To this end, interventions in the form of emotional social support through volunteer visitors for dementia patients were carried out. In both studies, a positive association between increased social support by volunteer assistants and well-being emerged. The investigations show that social support and attention are generally registered and perceived as creating a pleasantly soothing feeling in cognitively impaired people.
Reminder systems support people with impaired prospective memory and/or executive function, by providing them with reminders of their functional daily activities. We integrate temporal constraint reasoning with reinforcement learning (RL) to build an adaptive reminder system and in a simulated environment demonstrate that it can personalize to a user and adapt to both short- and long-term changes. In addition to advancing the application domain, our integrated algorithm contributes to research on temporal constraint reasoning by showing how RL can select an optimal policy from amongst a set of temporally consistent ones, and it contributes to the work on RL by showing how temporal constraint reasoning can be used to dramatically reduce the space of actions from which an RL agent needs to learn.
The pervasive sensing technologies found in smart homes offer unprecedented opportunities for providing health monitoring and assistance to individuals experiencing difficulties living independently at home. A primary challenge that needs to be tackled to meet this need is the ability to recognize and track functional activities that people perform in their own homes and everyday settings. In this paper, we look at approaches to perform real-time recognition of Activities of Daily Living. We enhance other related research efforts to develop approaches that are effective when activities are interrupted and interleaved. To evaluate the accuracy of our recognition algorithms we assess them using real data collected from participants performing activities in our on-campus smart apartment testbed.
Social relationships are an important factor for maintaining life satisfaction in elderly people. Little is known, however, about the influence of increased social support towards the well-being of cognitively impaired people. This is why two comparative studies in Switzerland and Austria, with 84 cognitively impaired individuals (aged between 65 and 98) with in-patient treatment, used a control group design to examine whether increased social support would have a positive effect on the well-being of these individuals. To this end, interventions in the form of emotional social support through volunteer visitors for dementia patients were carried out. In both studies, a positive association between increased social support by volunteer assistants and well-being emerged. The investigations show that social support and attention are generally registered and perceived as creating a pleasantly soothing feeling in cognitively impaired people.
There are many home telecare technologies which have been developed specifically for chronic diseases and there are some more generic technologies that could be used as well. For home telecare, the equipment must be certified, the operational routines must be reformed, the infrastructure must be in place, the market must be prepared, the health authorities must be convinced that the system will work and the cost-effectiveness must be evaluated. Organizational and societal changes, such as cost reduction policies and an aging population, are the main driving forces for the development of home telecare, especially for elderly patients. At the moment there is no holistic model for scientific evaluation from different perspectives (e.g. clinical, legal, technical). We suggest that more research on home telecare and its effects needs to be conducted, in order to provide evidence for optimizing the use of this promising technique.
Preferences for long-term care alternatives include both place of care and persons to provide care. In this analysis, these elements are separated for mature adults (N-1503, ages 40-70) regarding future care needs. Most adults preferred care in home/community settings by kin or non-kin, with few deeming nursing homes acceptable. Demographics and personal knowledge, experience, and expectations were marginally likely to influence preferences; males were more likely to prefer care in paid/professional settings. Women, who more often expressed preference for kin/home care, face demographic trends reducing available female kin who might be caregivers.
Although there is a great deal of success in rehabilitative robotics applied to patient recovery post stroke, most of the research to date has dealt with providing physical assistance. However, new rehabilitation studies support the theory that not all therapy need be hands-on. We describe a new area, called socially assistive robotics, that focuses on non-contact patient/user assistance. We demonstrate the approach with an implemented and tested post-stroke recovery robot and discuss its potential for effectiveness.
We describe a pilot study involving an autonomous assistive mobile robot that aids stroke patient rehabilitation by providing monitoring, encouragement, and reminders. The robot navigates autonomously, monitors the patient's arm activity, and helps the patient remember to follow a rehabilitation program. We also show preliminary results from a follow-up study that focused on the role of robot physical embodiment in a rehabilitation context.
We outline and discuss future experimental designs and factors toward the development of effective socially assistive post-stroke rehabilitation robots.
We examined the requirements for robots in home telecare using two focus groups. The first comprised six healthcare professionals involved in geriatric care and the second comprised six elderly people with disabilities living in the community. The concept of an in-home telepresence robot was illustrated using a photograph of a mobile robot, and participants were then asked to suggest potential health care applications. Interview data derived from the transcript of each group discussion were analyzed using qualitative induction based on content analysis. The analyses yielded statements that were categorized under three themes: potential applications, usability issues and user requirements. Teleoperated mobile robotic systems in the home were thought to be useful in assisting multidisciplinary patient care through improved communication between patients and healthcare professionals, and offering respite and support to caregivers under certain conditions. The shift from a traditional hospital-centred model of care in geriatrics to a home-based model creates opportunities for using telepresence with mobile robotic systems in home telecare.
The best solution to the looming shortage of nurses and doctors may be to move chronic disease monitoring and care out of hospitals and into people's homes.
Along with identifying effective medications, the development and evaluation ofbehavioral interventions to assist in managing symptoms and improving quality of life inpersons with MCI is critical. In this chapter, we first review the literature on behavioralinterventions used with healthy older adults and individuals with MCI and AD. We thenreport on a pilot study from our research group that examined the feasibility of twobehavioral interventions to improve daily function and quality of life in individuals withMCI. One intervention used electronic memory devices to compensate for memoryimpairment and the other intervention used cognitive-behavioral therapy techniques andtraining with non-electronic memory aids. Challenges associated with implementing abehavioral intervention for MCI patients are discussed, along with recommendations forestablishing an MCI treatment program. Further development and validation ofbehavioral interventions that could be accessible to and employed by clinics andhospitals where MCI patients receive diagnosis and treatment are needed.
For elders who remain independent in their homes, the home becomes more than just a place to eat and sleep. The home becomes a place where people care for each other, and it gradually subsumes all activities. This article reports on an ethnographic study of aging adults who live independently in their homes. Seventeen elders aged 60 through 90 were interviewed and observed in their homes in 2 Midwestern cities. The goal is to understand how robotic products might assist these people, helping them to stay independent and active longer. The experience of aging is described as an ecology of aging made up of people, products, and activities taking place in a local environment of the home and the surrounding community. In this environment, product successes and failures often have a dramatic impact on the ecology, throwing off a delicate balance. When a breakdown occurs, family members and other caregivers have to intervene, threatening elders' independence and identity. This article highlights the interest in how the elder ecology can be supported by new robotic products that are conceived of as a part of this interdependent system. It is recommended that the design of these products fit the ecology as part of the system, support elders' values, and adapt to all of the members of the ecology who will interact with them.
The growth in popularity of smart environments has been quite steep in the last decade and so has the demand for smart health
assistance systems. A smart home-based prompting system can enhance these technologies to deliver in-home interventions to
a user for timely reminders or a brief instruction describing the way a task should be done for successful completion. This
technology is in high demand with the desire for people who have physical or cognitive limitations to live independently in
their homes. In this paper, we take the approach to fully automating a prompting system without any predefined rule set or
user feedback. Unlike other approaches, we use simple off-the-shelf sensors and learn the timing for prompts based on real
data that is collected with volunteer participants in our smart home testbed.
Physical performance measures predict health and function in older populations. Walking speed in particular has consistently predicted morbidity and mortality. However, single brief walking measures may not reflect a person's typical ability. Using a system that unobtrusively and continuously measures walking activity in a person's home we examined walking speed metrics and their relation to function. In 76 persons living independently (mean age, 86) we measured every instance of walking past a line of passive infra-red motion sensors placed strategically in their home during a four-week period surrounding their annual clinical evaluation. Walking speeds and the variance in these measures were calculated and compared to conventional measures of gait, motor function and cognition. Median number of walks per day was 18±15. Overall mean walking speed was 61±17 cm/s. Characteristic fast walking speed was 96 cm/s. Men walked as frequently and fast as women. Those using a walking aid walked significantly slower and with greater variability. Morning speeds were significantly faster than afternoon/evening speeds. In-home walking speeds were significantly associated with several neuropsychological tests as well as tests of motor performance. Unobtrusive home walking assessments are ecologically valid measures of walking function. They provide previously unattainable metrics (periodicity, variability, range of minimum and maximum speeds) of everyday motor function.
Quality of life in dementia has been studied in clinical settings. There is less population-based research on life satisfaction and cognition.
(1) To compare the overall life satisfaction (LS), LS with material circumstances (LS (material)), and LS with social circumstances (LS (social)) of older adults with no cognitive impairment, with cognitive impairment no dementia (CIND), and with dementia; (2) To examine the effect of cognition on LS across a broad spectrum of cognition; and (3) To explore the effect of factors such as depressive symptoms, functional impairment, education, and social support.
1620 community-dwelling older adults with a mini-mental state examination (MMSE) score > 10, sampled from a representative list were interviewed.
Age, gender, education, social networks, and social supports were all self-reported. The MMSE, the Centre for Epidemiologic Studies-Depression (CES-D), and the Older Americans Resource Survey (OARS) were used. Dementia was diagnosed by clinical examination using DSM-IIIR criteria. LS was measured using the Terrible-Delightful Scale. Factor analysis identified two factors: LS (material), and LS (social). A global item measuring overall LS was also used.
Those with dementia and CIND had lower LS than those with normal cognition, but the effect was relatively small. There was a gradient in LS which extended into the normal range of cognition. Depressive symptoms and functional status were strongly associated with LS.
Cognition is associated with LS, but the effect is fairly small. Most older adults are satisfied with life.
To determine the efficacy of portable electronic aids such as personal digital assistants (PDAs), pagers or mobile phones for patients with cognitive deficits by means of a systematic review. The usability of these aids is also briefly discussed.
PubMed, CINAHL, PsychINFO, EMBASE and MEDLINE were searched up to February 2009. The references of identified and relevant articles were scanned to find additional relevant titles.
Papers referring to 'electronic aids', 'cognition' and 'brain injury' were included. The population had to be adult and have cognitive impairments as a result of acquired brain injury. Outcome measures were change in cognitive or occupational performance or the level of participation in daily life. The criteria of Cicerone et al. were used to evaluate the quality of the retrieved studies.
Twenty-eight papers presenting 25 studies were reviewed. The total number of participants was 423. Most identified papers described case reports or non-randomized clinical trials. Only one randomized controlled trial was identified, in which the NeuroPage proved effective in supporting prospective memory. Other kinds of assistive technology such as PDAs and voice recorders showed positive results in supporting retrospective and prospective memory.
The efficacy of assistive technology in general is not yet sufficiently studied in randomized controlled trials, although promising results has been reported. Furthermore, several survey studies established that both potential users and clinicians have optimistic expectations about the usability of assistive technology.
Several studies have demonstrated a global increase in morbidity and mortality in elderly subjects with low social support or high comorbidity. However, the relationship between social support and comorbidity on long-term mortality in elderly people is not yet known. Thus, the present study was performed to evaluate the relationship between social support and comorbidity on 12-year mortality of elderly people. A random sample of 1288 subjects aged 65-95 years interviewed in 1992 was studied. Comorbidity by Charlson Comorbidity Index (CCI) score and Social Support by a scale in which total score ranges from 0 to 17, assigning to lowest social support the highest score, were evaluated. At 12-year follow-up, mortality progressively increase with low social support and comorbidity increasing (from 41.5% to 66.7% and from 41.2% to 68.3%, respectively; p<0.001). Moreover, low social support progressively increases with comorbidity increasing (and 12.4±2.5 to 14.3±2.6; p<0.001). Accordingly, multivariate analysis shows an increased mortality risk of 23% for each increase of tertile of social support scale (Hazard ratio=HR=1.23; 95% CI=1.01-1.51; p=0.045). Moreover, when the analysis was performed considering different degrees of comorbidity we found that social support level was predictive of mortality only in subjects with the highest comorbidity (HR=1.39; 95% CI=1.082-1.78; p=0.01). Thus, low social support is predictive of long-term mortality in the elderly. Moreover, the effect of social support on mortality increases in subjects with the highest comorbidity.
Robotic assistive devices are used increasingly to improve the independence and quality of life of persons with disabilities. Devices as varied as robotic feeders, smart-powered wheelchairs, independent mobile robots, and socially assistive robots are becoming more clinically relevant. There is a growing importance for the rehabilitation professional to be aware of available systems and ongoing research efforts. The aim of this article is to describe the advances in assistive robotics that are relevant to professionals serving persons with disabilities. This review breaks down relevant advances into categories of Assistive Robotic Systems, User Interfaces and Control Systems, Sensory and Feedback Systems, and User Perspectives. An understanding of the direction that assistive robotics is taking is important for the clinician and researcher alike; this review is intended to address this need.
Older people are an important and growing sector of the population. This demographic change raises the profile of frailty and disability within the world's population. In such conditions, many old people need aides to perform daily activities. Most of the support is given by family members who are now a new target in the therapeutic approach. With advances in technology, robotics becomes increasingly important as a means of supporting older people at home. In order to ensure appropriate technology, 30 caregivers filled out a self-administered questionnaire including questions on needs to support their proxy and requirements concerning the robotic agent's functions and modes of action. This paper points out the functions to be integrated into the robot in order to support caregivers in the care of their proxy. The results also show that caregivers have a positive attitude towards robotic agents.
The neuropsychologic test battery from the Uniform Data Set (UDS) of the Alzheimer's Disease Centers (ADC) program of the National Institute on Aging consists of brief measures of attention, processing speed, executive function, episodic memory, and language. This paper describes development of the battery and preliminary data from the initial UDS evaluation of 3268 clinically cognitively normal men and women collected over the first 24 months of utilization. The subjects represent a sample of community-dwelling, individuals who volunteer for studies of cognitive aging. Subjects were considered "clinically cognitively normal" based on clinical assessment, including the Clinical Dementia Rating scale and the Functional Assessment Questionnaire. The results demonstrate performance on tests sensitive to cognitive aging and to the early stages of Alzheimer disease in a relatively well-educated sample. Regression models investigating the impact of age, education, and sex on test scores indicate that these variables will need to be incorporated in subsequent normative studies. Future plans include: (1) determining the psychometric properties of the battery; (2) establishing normative data, including norms for different ethnic minority groups; and (3) conducting longitudinal studies on cognitively normal subjects, individuals with mild cognitive impairment, and individuals with Alzheimer disease and other forms of dementia.
The number of older Americans afflicted by Alzheimer disease and related dementias will triple to 13 million persons by 2050, thus greatly increasing healthcare needs. An approach to this emerging crisis is the development and deployment of intelligent assistive technologies that compensate for the specific physical and cognitive deficits of older adults with dementia, and thereby also reduce caregiver burden. The authors conducted an extensive search of the computer science, engineering, and medical databases to review intelligent cognitive devices, physiologic and environmental sensors, and advanced integrated sensor networks that may find future applications in dementia care. Review of the extant literature reveals an overwhelming focus on the physical disability of younger persons with typically nonprogressive anoxic and traumatic brain injuries, with few clinical studies specifically involving persons with dementia. A discussion of the specific capabilities, strengths, and limitations of each technology is followed by an overview of research methodological challenges that must be addressed to achieve measurable progress to meet the healthcare needs of an aging America.
The concept of cognitive impairment intervening between normal ageing and very early dementia has been in the literature for many years. Recently, the construct of mild cognitive impairment (MCI) has been proposed to designate an early, but abnormal, state of cognitive impairment. MCI has generated a great deal of research from both clinical and research perspectives. Numerous epidemiological studies have documented the accelerated rate of progression to dementia and Alzheimer's disease (AD) in MCI subjects and certain predictor variables appear valid. However, there has been controversy regarding the precise definition of the concept and its implementation in various clinical settings. Clinical subtypes of MCI have been proposed to broaden the concept and include prodromal forms of a variety of dementias. It is suggested that the diagnosis of MCI can be made in a fashion similar to the clinical diagnoses of dementia and AD. An algorithm is presented to assist the clinician in identifying subjects and subclassifying them into the various types of MCI. By refining the criteria for MCI, clinical trials can be designed with appropriate inclusion and exclusion restrictions to allow for the investigation of therapeutics tailored for specific targets and populations.
The authors' aim was to investigate the representations, wishes, and fears of family caregivers (FCs) regarding 14 innovative technologies (IT) for care aiding and burden alleviation, given the severe physical and psychological stress induced by dementia care, and the very slow uptake of these technologies in our society.
A cluster sample survey based on a self-administered questionnaire was carried out on data collected from 270 families of patients with Alzheimer's disease or related disorders, located in the greater Paris area. Multiple Correspondence Analysis was used in addition to usual statistical tests to identify homogenous FCs clusters concerning the appreciation or rejection of the considered technologies.
Two opposite clusters were clearly defined: FCs in favor of a substantial use of technology, and those rather or totally hostile. Furthermore the distributions of almost all the answers of appreciations were U-shaped. Significant relations were demonstrated between IT appreciation and FC's family or gender statuses (e.g., female FCs appreciated a tracking device for quick recovering of wandering patients more than male FCs: p = 0.0025, N = 195).
The study provides further evidence of the contrasted perception of technology in dementia care at home, and suggests the development of public debates based on rigorous assessment of practices and a strict ethical aim to protect against misuse.
What do family caregivers of Alzheimer's disease patients desire in smart home technologies? Contrasted results of a wide survey
- V Rialle
- C Ollivet
- C Guigui
- C Herve
Rialle V, Ollivet C, Guigui C, Herve C. What do family caregivers of Alzheimer's
disease patients desire in smart home technologies? Contrasted results of a
wide survey. Methods Inf Med 2008;47:63-69.