Jennifer Boger

The use of computer vision in an intelligent environment to support aging-in-place, safety, and independence in the home

This paper discusses the use of computer vision in pervasive healthcare systems, specifically in the design of a sensing agent for an intelligent environment that assists older adults with dementia during an activity of daily living. An overview of the techniques applied in this particular example is provided, along with results from preliminary trials completed using the new sensing agent. A discussion of the results obtained to date is presented, including technical and social issues that remain for the advancement and acceptance of this type of technology within pervasive healthcare.

The use of an intelligent prompting system for people with dementia

perform routine activities: They cannot remember the proper sequence of steps or how to use the necessary tools. Strategies commonly used by caregivers involve continually providing reminders or cues. Family caregivers find assisting their loved ones to be particularly upsetting and embarrassing, as it necessitates invasion of privacy and role reversal. This difficult situation often results in the family caregiver not being able to cope, and the affected person being placed in a care facility. In response to the unique needs of older adults with dementia, we have been developing a new prompting device that uses artificial intelligence (AI) to automatically monitor an older adult during a common self-care activity (i.e., hand washing) and provide prompts as needed.

A haptic-robotic platform for upper-limb reaching stroke therapy: Preliminary design and evaluation results

BackgroundIt has been shown that intense training can significantly improve post-stroke upper-limb functionality. However, opportunities for stroke survivors to practice rehabilitation exercises can be limited because of the finite availability of therapists and equipment. This paper presents a haptic-enabled exercise platform intended to assist therapists and moderate-level stroke survivors perform upper-limb reaching motion therapy. This work extends on existing knowledge by presenting: 1) an anthropometrically-inspired design that maximizes elbow and shoulder range of motions during exercise; 2) an unobtrusive upper body postural sensing system; and 3) a vibratory elbow stimulation device to encourage muscle movement.MethodsA multi-disciplinary team of professionals were involved in identifying the rehabilitation needs of stroke survivors incorporating these into a prototype device. The prototype system consisted of an exercise device, postural sensors, and a elbow stimulation to encourage the reaching movement. Eight experienced physical and occupational therapists participated in a pilot study exploring the usability of the prototype. Each therapist attended two sessions of one hour each to test and evaluate the proposed system. Feedback about the device was obtained through an administered questionnaire and combined with quantitative data.ResultsSeven of the nine questions regarding the haptic exercise device scored higher than 3.0 (somewhat good) out of 4.0 (good). The postural sensors detected 93 of 96 (97%) therapist-simulated abnormal postures and correctly ignored 90 of 96 (94%) of normal postures. The elbow stimulation device had a score lower than 2.5 (neutral) for all aspects that were surveyed, however the therapists felt the rehabilitation system was sufficient for use without the elbow stimulation device.ConclusionAll eight therapists felt the exercise platform could be a good tool to use in upper-limb rehabilitation as the prototype was considered to be generally well designed and capable of delivering reaching task therapy. The next stage of this project is to proceed to clinical trials with stroke patients.

An Intelligent Powered Wheelchair to Enable Mobility of Cognitively Impaired Older Adults: An Anticollision System

Older adults with cognitive impairments are generally prohibited from using powered wheelchairs, because of the high risk of collisions with people and objects. This paper describes and presents the preliminary results of a system that uses an infrared sensor to provide anticollision and a prompting system for a powered wheelchair that helps guide the user safely past obstacles. Trials with the prototyped system detected collisions and stopped the chair in 95% of trials with an object and generated no false alarms

Engaging Older Adults with Dementia in Creative Occupations Using Artificially Intelligent Assistive Technology

Engagement in creative occupations has been shown to promote well-being for older adults with dementia. Providing access to such occupations is often difficult, as successful participation requires face-time with a person who is knowledgeable in facilitating engagement as well as access to any required resources, such as an arts studio. In response, a computer-based device, the Engaging Platform for Art Development (ePAD), was created to with the aim of enabling more independent access to art creation. ePAD is a an artificially intelligent touch-screen device that estimates a clients level of engagement and provides prompts to encourage engagement if the client becomes disengaged. ePAD is customizable such that an art therapist can choose themes and tools that they feel reflect their clients needs and preferences. This article presents a mixed-methods study that evaluated ePADs usability by six older adult (with mild-to-moderate dementia) and art therapist dyads. Usability measures suggest that all participants found ePAD engaging but did not find prompts effective. Future development of ePAD includes improving the prompts, implementing the recommendations made by participants in this research, and long-term testing in more naturalistic art therapy contexts.

The future of intelligent assistive technologies for cognition: Devices under development to support independent living and aging-with-choice

A persons ability to be independent is dependent on his or her overall health, mobility, and ability to complete activities of daily living. Intelligent assistive technologies (IATs) are devices that incorporate context into their decision-making process, which enables them to provide customised and dynamic assistance in an appropriate manner. IATs have tremendous potential to support people with cognitive impairments as they can be used to support many facets of well-being; from augmenting memory and decision making tasks to providing autonomous and early detection of possible changes in health. This paper presents IATs that are currently in development in the research community to support tasks that can be impacted by compromised cognition. While they are not yet ready for the general public, these devices showcase the capabilities of technologies one can expect to see in the consumer marketplace in the near future.

Assistive computing devices: a pilot study to explore nurses' preferences and needs.

Healthcare errors among nurses are common because of the fast-paced work environment, in which extensive data must be analyzed and quick decision making is required. Assistive computing devices can help reduce nursing errors by providing timely access to client information and by assisting nurses with client monitoring, decision making, and bedside documentation. The purpose of this pilot study was to determine what assistive computing device features, functions, and input/output modalities nurses would find most useful as support for their nursing duties. Twenty nurses completed a questionnaire that examined their needs and preferences. Data analysis revealed a strong desire for capabilities related to facilitating information access and administering safe medication. The results of this study will be used to develop design criteria for an assistive computing device that will aim to improve the performance of nurses through appropriate information and data support.

Development of a robotic device for upper limb stroke rehabilitation: A user-centered design approach

Stroke is one of the major causes of permanent adult disability. Stroke frequently affects motor control of the arm, leading to diffculties in doing activities of daily living. This research focuses on developing an upper limb rehabilitation robotic prototype through user-centered design to aid stroke survivors in rehabilitating their arm. To gather requirements from end users, stroke therapy sessions were observed and a survey of stroke therapists was conducted. End user requirements were evaluated to determine technical targets for the mechanical design of the prototype. Evaluation of the prototype was done with stroke therapists in a focus group and a preliminary biomechanical study. As user-centered design would require more iterations of design, testing and evaluation, this project reports a first step in developing an affordable, portable device, which could increase access to stroke rehabilitation for the arm.

Examining the impact of familiarity on faucet usability for older adults with dementia

BackgroundChanges in cognition caused by dementia can significantly alter how a person perceives familiarity, impacting the recognition and usability of everyday products. A person who is unable to use products cannot autonomously complete associated activities, resulting in increased dependence on a caregiver and potential move to assisted living facilities. The research presented in this paper hypothesised that products that are more familiar will result in better usability for older adults with dementia. Better product usability could, in turn, potentially support independence and autonomy.MethodsThis research investigated the impact of familiarity on the use of five faucet designs during 1309 handwashing trials by 27 older adults, who ranged from cognitively intact to the advanced (severe) stages of dementia. Human factors methods were used to collect empirical and self-reported data to gauge faucets’ usability. Participants’ data were grouped according to cognition (i.e., no/mild, moderate, or severe dementia). Logistic regression, ranking by odds, and Wald tests of odds ratios were used to compare performance of the three groups on the different faucets. Qualitative data were used in the interpretation of quantitative results.ResultsResults indicated that more familiar faucets correlated with lower levels of assistance from a caregiver, fewer operational errors, and greater levels of operator satisfaction. Aspects such as the ability to control water temperature and flow as well as pleasing aesthetics appeared to positively impact participants’ acceptance of a faucet. The dual lever design achieved the best overall usability.ConclusionsWhile work must be done to expand these findings to other products and tasks, this research provides evidence that familiarity plays a substantial role in product usability for older adults that appears to become more influential as dementia progresses. The methods used in this research could be adapted to analyse usability for other products by older adults with dementia.

Zero Effort Technologies: Considerations, Challenges and Use in Health, Wellness, and Rehabilitation

This book introduces zero-effort technologies (ZETs), an emerging class of technology that requires little or no effort from the people who use it. ZETs use advanced techniques, such as computer vision, sensor fusion, decision-making and planning, and machine learning to autonomously operate through the collection, analysis, and application of data about the user and his/her context. This book gives an overview of ZETs, presents concepts in the development of pervasive intelligent technologies and environments for health and rehabilitation, along with an in-depth discussion of the design principles that this approach entails. The book concludes with a discussion of specific ZETs that have applied these design principles with the goal of ensuring the safety and well-being of the people who use them, such as older adults with dementia and provides thoughts regarding future directions of the field. Table of Contents: Lecture Overview / Introduction to Zero Effort Technologies / Designing ZETs / Building and Evaluating ZETs / Examples of ZETs / Conclusions and Future Directions