Jacqueline Damant

Effects of digital engagement on the quality of life of older people

It is often asserted that older peoples quality of life (QOL) is improved when they adopt information and communication technology (ICT) such as the Internet, mobile phones and computers. Similar assumptions are made about older peoples use of ICT-based care such as telecare and telehealth. To examine the evidence around these claims, we conducted a scoping review of the academic and grey literature, coving the period between January 2007 and August 2014. A framework analysis approach, based on six domains of QOL derived from the ASCOT and WHOQOL models, was adopted to deductively code and analyse relevant literature. The review revealed mixed results. Older peoples use of ICT in both mainstream and care contexts has been shown to have both positive and negative impacts on several aspects of QOL. Studies which have rigorously assessed the impact of older peoples use of ICT on their QOL mostly demonstrate little effect. A number of qualitative studies have reported on the positive effects for older people who use ICT such as email or Skype to keep in touch with family and friends. Overall, the review unearthed several inconsistencies around the effects of older peoples ICT use on their QOL, suggesting that implicit agreement is needed on the best research methods and instrumentation to adequately describe older peoples experiences in todays digital age. Moreover, the available evidence does not consider the large number of older people who do not use ICT and how non-use affects QOL.

Technology-based tools and services for people with dementia and carers: Mapping technology onto the dementia care pathway

The extent to which technology may be able to support people with dementia and their carers along the care pathway and in different care settings is of interest to policy makers and governments. In this paper we provide an overview of the role of technology in dementia care, treatment and support by mapping existing technologies – by function, target user and disease progression. Technologies identified are classified into seven functions: memory support, treatment, safety and security, training, care delivery, social interaction and other. Different groups of potential users are distinguished: people with mild cognitive impairment and early stages of dementia, people with moderate to severe dementia and unpaid carers and health- and social care professionals. We also identified the care settings, in which the technologies are used (or for which the technologies are developed): at home in the community and in institutional care settings. The evidence has been drawn from a rapid review of the literature, expert interviews and web and social media searches. The largest number of technologies identified aim to enhance the safety and security of people with dementia living in the community. These devices are often passive monitors, such as smoke detectors. Other safety interventions, such as panic buttons, require active intervention. The second largest number of interventions aims to enhance people’s memory and includes global positioning systems devices and voice prompts. These technologies mostly target people in the early stages of dementia. A third group focusing on treatment and care delivery emerged from the literature. These interventions focus on technology-aided reminiscence or therapeutic aspects of care for people with dementia and their carers. While the review found a range of technologies available for people with dementia and carers there is very little evidence of widespread practical application. Instead, it appears that stakeholders frequently rely on everyday technologies re-purposed to meet their needs.

The Mainstreaming on Ambient Intelligence project

The Mainstreaming on Ambient Intelligence (MonAMI) project, funded under the European Commission’s IST e-Inclusion work programme (FP6 framework), set out to demonstrate that accessible, useful services for older, and disabled people can be delivered using mainstreamed systems and platforms. An open platform, based on an Open Services Gateway initiative (OSGi Alliance™, 2011), framework, was developed to deliver a bouquet of Ambient Assisted Living services. The services were developed with a Design for All (European Commission, 2000) approach, in consultation with potential users in the following areas: • Monitoring: home (environmental and appliance control), health. • Time management. • Safety and security: safety at home, visitor validation, activity detection. • Communication and networking. The platform integrated elements from reliable self-organizing networks, wearable devices, user interaction technology, monitoring capability, and service infrastructures and delivered services on mainstream devices such as broadband internet and third-generation mobile telephones. In addition, to facilitate use and user interaction, the consortium designed an innovative user interface (UI), using Universal Control Hub architecture (Zimmerman, 2009). The services were first tested by older and disabled users in laboratory settings in six feasibility and usability centres across Europe (France, Germany, Slovakia, Spain, Sweden, and the UK). Once the platform, services and UI were found to be feasible, usable, and appropriate to user needs, a living-scale field trial was carried out in three communities (Kosice, Slovakia; Stockholm, Sweden; and Zaragoza, Spain), where 70 users, 45 carers, and 14 care staff employed the services in users’ homes over a three-month period. In addition to testing the scalability of the platform, the trial evaluated the services’ potential of meeting the long-term care needs of older and disabled people and the support needs of caregivers. The commercial viability and economic effects on long-term care financing were also evaluated in order to understand the impact of mainstream implementation of the MonAMI concept, as part of the Ambient Assisted Living Open Association (AALOA, 2010) initiative. The MonAMI project ran for 57 months and came to completion in May, 2011.

Does ambient intelligence lead to e-inclusion of older people?

Purpose The threat of isolation from mainstreamed economic, cultural and civic life is a driving force behind policy initiatives which promote and fund the research, development and deployment of ambient intelligence for older people. The European Commission (EC) invests heavily in research programs developing new information and communication technologies (ICT) to enable older people to successfully carry out their activities of daily living1,2. However, the question arises whether these new ICT methods designed for older people are addressing the fundamental issue of e-inclusion. The MonAMI approach hypotheses that when ICT services designed for older people employ mainstreamed devices, and if older people accept and use these ICT solutions, this will facilitate their inclusion into the information age. Method The Mainstreaming of Ambient Intelligence (MonAMI) project is developing ambient intelligent services based on open source technology which can be used with mainstreamed devices (e.g., web browser, mobile telephone, touch screen). Services include monitoring and alert systems which allow users to check, control, and be notified of the status of their home environment (e.g. opening and closing doors, turning on and off lights) through an accessible user interface. MonAMI services also include a range of functionalities which allow caregivers to remotely monitor the safety of their loved-ones, such as a presence alert which sends a notification to caregivers if the vulnerable person is out of a ‘safe range’. Two rounds of pilot testing were conducted in six laboratory settings across Europe. Older and disabled users were invited to try out the MonAMI services in a controlled environment, during which they were interviewed about their previous use of mainstream ICT and whether they felt that MonAMI services could help them in various domains of their every-day life. A planned ‘living lab’ evaluation will be conducted in 2010. Older people with at least one disability will have MonAMI services installed in their home for a minimum of six months. Before the installation of the services, each participant and their caregivers will be interviewed individually to establish their baseline level of ICT-use and then a second time to assess any changes. Results & Discussion The literature demonstrates3,4 that older people more readily adopt ICT which resemble devices they are already familiar with (e.g. telephone, television). The development of MonAMI services incorporates this ideology and responds to justified criticism of earlier ambient living ‘solutions’; blaming poor uptake-levels on the design of ICT services and devices which is yet to fully appreciate the complexity of older people’s needs5,6. The results of the pilot tests demonstrated that compared to non-users, older people who previously used email and were generally enthusiastic about trying new technologies perceived that MonAMI services could be useful in controlling their physical home environment and meal preparation. The presentation will include lessons learned from these pilot tests and possible solutions for improving the adoption of ambient solutions by older people with little or no experience with ICT.