Clifton Phua

Deployment of assistive living technology in a nursing home environment: methods and lessons learned

BackgroundWith an ever-growing ageing population, dementia is fast becoming the chronic disease of the 21st century. Elderly people affected with dementia progressively lose their autonomy as they encounter problems in their Activities of Daily Living (ADLs). Hence, they need supervision and assistance from their family members or professional caregivers, which can often lead to underestimated psychological and financial stress for all parties. The use of Ambient Assistive Living (AAL) technologies aims to empower people with dementia and relieve the burden of their caregivers.The aim of this paper is to present the approach we have adopted to develop and deploy a system for ambient assistive living in an operating nursing home, and evaluate its performance and usability in real conditions. Based on this approach, we emphasise on the importance of deployments in real world settings as opposed to prototype testing in laboratories.MethodsWe chose to conduct this work in close partnership with end-users (dementia patients) and specialists in dementia care (professional caregivers). Our trial was conducted during a period of 14 months within three rooms in a nursing home in Singapore, and with the participation of eight dementia patients and two caregivers. A technical ambient assistive living solution, consisting of a set of sensors and devices controlled by a software platform, was deployed in the collaborating nursing home. The trial was preceded by a pre-deployment period to organise several observation sessions with dementia patients and focus group discussions with professional caregivers. A process of ground truth and system’s log data gathering was also planned prior to the trial and a system performance evaluation was realised during the deployment period with the help of caregivers. An ethical approval was obtained prior to real life deployment of our solution.ResultsPatients’ observations and discussions allowed us to gather a set of requirements that a system for elders with mild-dementia should fulfil. In fact, our deployment has exposed more concrete requirements and problems that need to be addressed, and which cannot be identified in laboratory testing. Issues that were neither forecasted during the design phase nor during the laboratory testing surfaced during deployment, thus affecting the effectiveness of the proposed solution. Results of the system performance evaluation show the evolution of system precision and uptime over the deployment phases, while data analysis demonstrates the ability to provide early detection of the degradation of patients’ conditions. A qualitative feedback was collected from caregivers and doctors and a set of lessons learned emerged from this deployment experience. (Continued on next page) (Continued from previous page)ConclusionLessons learned from this study were very useful for our research work and can serve as inspiration for developers and providers of assistive living services. They confirmed the importance of real deployment to evaluate assistive solutions especially with the involvement of professional caregivers. They also asserted the need for larger deployments. Larger deployments will allow to conduct surveys on assistive solutions social and health impact, even though they are time and manpower consuming during their first phases.

A Possibilistic Approach for Activity Recognition in Smart Homes for Cognitive Assistance to Alzheimer’s Patients

Providing cognitive assistance to Alzheimer’s patients in smart homes is a field of research that receives a lot of attention lately. The recognition of the patient’s behavior when he carries out some activities in a smart home is primordial in order to give adequate assistance at the opportune moment. To address this challenging issue, we present a formal activity recognition framework based on possibility theory and description logics. We present initial results from an implementation of this recognition approach in a smart home laboratory.

Health and wellness monitoring through wearable and ambient sensors: exemplars from home-based care of elderly with mild dementia

Monitoring and timely intervention are extremely important in the continuous management of health and wellness among all segments of the population, but particularly among those with mild dementia. In relation to this, we prescribe three design principles for the construction of services and applications. These are ambient intelligence, service continuity, and micro-context. In this paper, we provide three exemplars from our research and development activities that illustrate the use of these design principles in the construction of services and applications. All the applications are drawn from the field of care for mild dementia patients in their living quarters.

An integrated framework for human activity classification

This paper presents an integrated framework to enable using standard non-sequential machine learning tools for accurate multi-modal activity recognition. We develop a novel framework that contains simple pre- and post-classification strategies to improve the overall performance. We achieve this through class-imbalance correction on the learning data using structure preserving oversampling (SPO), leveraging the sequential nature of sensory data using smoothing of the predicted label sequence and classifier fusion, respectively. Through evaluation on recent publicly available activity datasets comprising of a large amount of multi-dimensional sensory data, we demonstrate that our proposed strategies are effective in improving classification performance over common techniques such as One Nearest Neighbor (1NN) and Support Vector Machines (SVM). Our framework also shows better performance over sequential probabilistic models, such as Conditional Random Field (CRF) and Hidden Markov Model (HMM) and when these models are used as meta-learners.

2-layer Erroneous-Plan Recognition for dementia patients in smart homes

People with dementia lose their ability to learn, solve problems, and communicate. And they are all around us. To potentially replace some of their diminished memory and problem-solving abilities, Erroneous-Plan Recognition (EPR) aims to detect defects or faults in the execution of correct plans by the dementia patient, and send timely audio and visual prompts to the dementia patient and caregiver in order to correct these faults. The scope of this work is for the patient who lives alone in a smart home. One challenge is that the definition of plan can be very subjective. It is necessary to regard a plan as an Activity of Daily Living (ADL), choose the ADLs to monitor, and deploy available sensors to acquire data. With the sensor data, there can be activity recognition, followed by plan recognition. Another challenge is the highly random and erroneous behaviour of dementia patients. Multiple, sequential, and independent layers of error detection can be arranged in a prioritised manner to detect specific errors first, and provide an error probability if no specific errors are detected. On the whole, most of the EPR results are very good as they are at least 0.9, indicating that the data is linearly separable. The 2-layer EPR system, which uses the blacklist and whitelist as Layer 1 and naive Bayes classifier as Layer 2, is significantly more accurate than each individual layer. In fact, 5 out of 6 actors have an accuracy above 0.9. With the encouraging results, there will be more technical and domain challenges which we can address in the near future.

Improving the accuracy of erroneous-plan recognition system for Activities of Daily Living

Using ambient intelligence to assist people with dementia in carrying out their Activities of Daily Living (ADLs) independently in smart home environment is an important research area, due to the projected increasing number of people with dementia. We present herein, a system and algorithms for the automated recognition of ADLs; the ADLs are in terms of plans made up encoded sequences of micro-context information gathered by sensors in a smart home. Previously, the Erroneous-Plan Recognition (EPR) system was developed to specifically handle the wide spectrum of micro contexts from multiple sensing modalities. The EPR system monitors the person with dementia and determines if he has executed a correct or erroneous ADL. However, due to the noisy readings of the sensing modalities, the EPR system has problems in accurately detecting the erroneous ADLs. We propose to improve the accuracy of the EPR system by two new key components. First, we model the smart home environment as a Markov decision process (MDP), with the EPR system built upon it. Simple referencing of this model allows us to filter erroneous readings of the sensing modalities. Second, we use the reinforcement learning concept of probability and reward to infer erroneous readings that are not filtered by the first key component.We conducted extensive experiments and showed that the accuracy of the new EPR system is 26.2% higher than the previous system, and is therefore a better system for ambient assistive living applications.

ACARP: auto correct activity recognition rules using process analysis toolkit (PAT)

Activity recognition within ambient environments is a highly non-trivial process. Such procedures can be managed using rule based systems in monitoring human behavior. However, designing and verification of such systems is laborious and time-consuming. We present a rule verification system that uses model checking techniques to ensure rule validity. This system also performs correction of erroneous rules automatically, therefore reducing reliance on manual rule checking, verification and correction.

Multiple people activity recognition using MHT over DBN

Multiple people activity recognition system is an essential step in Ambient Assisted Living system development. A possible approach for multiple people is to take an existing system for single person activity recognition and extend it to the case of multiple people. One approach is Multiple Hypothesis Tracking (MHT) which provides capabilities of multiple people tracking and activity recognition based on the Dynamic Bayesian Network Model. The advantage of such systems is that the number of people can vary, while the disadvantage is that the activity recognition configuration cannot be done if only multiple people data is available for training.

From Context to Micro-context – Issues and Challenges in Sensorizing Smart Spaces for Assistive Living

Most smart home based monitoring / assistive systems that attempt to recognize activities within a smart home are targeted towards living-alone elderly, and stop at providing instantaneous coarse grained information such as room-occupancy or provide specific programmed reminders for taking medication etc. In our work, we target multiple residents, while restricting the use of wearable devices / sensors. In addition we do away with video due to privacy concerns. In this paper we present the design challenges and issues in putting together a sensor network for obtaining micro-context information in multi-person smart spaces. In order to support greater levels of ambient intelligence we support fine grained spatio-temporal data and context acquisition. The architecture is being currently developed into a prototype in a modular fashion for deployment and testing in a variety of environments, and is being concurrently evaluated and tested in real conditions, prior to deployment in a facility for elderly residents with mild cognitive disorder.

Activity recognition using correlated pattern mining for people with dementia

Due to the rapidly aging population around the world, senile dementia is growing into a prominent problem in many societies. To monitor the elderly dementia patients so as to assist them in carrying out their basic Activities of Daily Living (ADLs) independently, sensors are deployed in their homes. The sensors generate a stream of context information, i.e., snippets of the patients current happenings, and pattern mining techniques can be applied to recognize the patients activities based on these micro contexts. Most mining techniques aim to discover frequent patterns that correspond to certain activities. However, frequent patterns can be poor representations of activities. In this paper, instead of using frequent patterns, we propose using correlated patterns to represent activities. Using simulation data collected in a smart home testbed, our experimental results show that using correlated patterns rather than frequent ones improves the recognition performance by 35.5% on average.