Julie Doyle

Lessons learned in deploying independent living technologies to older adults' homes

Independent living technologies are fast gaining interest within both academia and industry, amid the realization that the world’s population is ageing. Technology can increase the quality of life of older people, allowing them to age-in-place and helping them to remain physically, cognitively and socially engaged with their environment. However, little research in this area is applied. The paper argues for the necessity of moving such technology out of the research laboratory and into the home, where its real impact on the lives of older adults can be assessed. Moreover, a series of recommendations are outlined, encompassing the life cycle of independent living technologies, from ethnographic assessment, through to design, deployment and evaluation. This work is based on lessons learned in deploying such technologies to older people in over 200 homes. This paper can act as a guide for other researchers interested in developing technologies with older people.

The reliability of the quantitative timed up and go test (QTUG) measured over five consecutive days under single and dual-task conditions in community dwelling older adults.

The timed up and go (TUG) test is a commonly used assessment in older people with variations including the addition of a motor or cognitive dual-task, however in high functioning older adults it is more difficult to assess change. The quantified TUG (QTUG) uses inertial sensors to detect test and gait parameters during the test. If it is to be used in the longitudinal assessment of older adults, it is important that we know which parameters are reliable and under which conditions. This study aims to examine the relative reliability of the QTUG over five consecutive days under single, motor and cognitive dual-task conditions. Twelve community dwelling older adults (10 females, mean age 74.17 (3.88)) performed the QTUG under three conditions for five consecutive days. The relative reliability of each of the gait parameters was assessed using intra-class correlation coefficient (ICC 3,1) and standard error of measurement (SEM). Five of the measures demonstrated excellent reliability (ICC>0.70) under all three conditions (time to complete test, walk time, number of gait cycles, number of steps and return from turn time). Measures of variability and turn derived parameters demonstrated weak reliability under all three conditions (ICC=0.05-0.49). For the most reliable parameters under single-task conditions, the addition of a cognitive task resulted in a reduction in reliability suggesting caution when interpreting results under these conditions. Certain sensor derived parameters during the QTUG test may provide an additional resource in the longitudinal assessment of older people and earlier identification of falls risk.

Inferring health metrics from ambient smart home data

As the population ages, smart home technology and applications are expected to support older adults to age in place and reduce the associated economic and societal burden. This paper describes a study where the relationship between ambient sensors, permanently deployed as part of smart aware apartments, and clinically validated health questionnaires is investigated. 27 sets of ambient data were taken from a 28 day block from 13 participants all of whom were over 60 years old. Features derived from ambient sensor data were found to be significantly correlated to measures of anxiety, sleep quality, depression, loneliness, cognition, quality of life and independent living skills (IADL). Subsequently, linear discriminant analysis was shown to predict participants suffering from increased anxiety and loneliness with a high accuracy (≥70%). While the number of participants is small, this study reports that objective ambient features may be used to infer clinically validated health metrics. Such findings may be used to inform interventions for active and healthy ageing.

Effect of a dual task on quantitative Timed Up and Go performance in community-dwelling older adults: A preliminary study.

The Timed Up and Go test (TUG) is used as a measure of functional ability in older adults; however, the method of measurement does not allow us to determine which aspects of the test deficits occur in. The aim of the present study was to examine the ability of the quantitative TUG (QTUG) to measure performance during the TUG test under three different conditions – single task, motor task and cognitive dual task – and to compare performance between fallers and non‐fallers in high‐functioning community‐dwelling older adults.

Exploring healthcare professionals' preferences for visualising sensor data

Monitoring technologies and sensors have huge potential to support elderly people live independently at home. Providing healthcare professionals with access to sensor data displaying a patients activities and health vitals could deliver numerous benefits, including allowing continuous care, presenting positive/negative trends which healthcare professionals can act upon, or alerting to immediate problems. This paper presents three phases of early-stage research from a larger study, which is concerned with investigating how sensor technologies can be utilised to facilitate frail elderly people transition from hospital to home. The focus of the research discussed in this paper is to explore healthcare professionals preferences for using and visualising sensor data.

Addressing medication management for older people with multimorbidities: a multi-stakeholder approach

Multimorbidity, the presence of two or more chronic conditions, places a significant burden on health systems globally. People managing multiple chronic conditions face burdensome and complex treatment plans. Polypharmacy, the prescription of several drugs, is typical in this cohort, adding to the treatment burden and potentially resulting in dangerous drug interactions. The goal of our work is to design a medication management application for older people with multimorbidity, and those within their care ecosystem. In this paper we present findings from interviews and focus groups with 124 participants, including older adults, informal and formal carers, and healthcare professionals. We outline six design requirements and describe how our design process is grounded in a strong, theoretical behaviour change approach that will allow us to fully evaluate the effectiveness of our design for medication management for those with multimorbidity, supported by their care network.

Designing Digital Goal Support Systems for Multimorbidity Self-Management: Insights from Older Adults and their Care Network

Older people with multiple chronic conditions face significant challenges self-managing health and wellbeing. Digital behaviour change interventions can motivate and empower self-management. Goal-setting, combined with progress feedback, is a technique often used in such interventions. However, there is little knowledge of digital goal-setting practices of older people, particularly those with multiple complex health conditions. In this paper, we describe an extensive qualitative study with older people with multiple chronic conditions and members of their care network, exploring issues around current practices setting and meeting health and wellbeing goals. Our findings indicate that there are unique challenges for this cohort that may prevent them from setting and meeting goals, including lack of support and feedback, and the impact of their illnesses. We outline a series of digital design features to address challenges relating to goals for this cohort, highlighting those specific to multimorbidity.

058Experiences and Perceptions of Self-Management for Older Adults with Multimorbidity: A Multi-Stakeholder Study

Background nFor persons with multimorbidity (PwMs), self-management is a complex process that involves integration of knowledge and tasks for multiple, and often interacting, chronic diseases [1]. Patients are frequently required to prioritise conditions, and to reconcile conflicting information and clinical advice [2]. The current study aimed to understand experiences related to self-management of multimorbidity for older patients (aged over 65), and for key stakeholders in their care network. The data presented was collected as part of an extensive requirements gathering exercise to inform the design of a digital health ecosystem that aims to support self-management and improve integration of care for older PwMs. n nMethods nSemi-structured qualitative interviews and focus groups were conducted with 19 older PwMs, 7 informal carers, 16 formal care workers, 6 general practitioners, 4 pharmacists, and 15 other healthcare professionals. Interviews and focus groups were transcribed and analysed using thematic analysis. n nResults nA number of themes associated with self-management of multimorbidity emerged during the interviews and focus groups, including “symptom recognition”, “symptom monitoring”, “appointments”, “information for self-management”, “motivators for self-management” and “barriers to self-management”. n nConclusion nThe findings from this rich, multi-stakeholder dataset highlight a number of key motivating factors and barriers to effective self-management for older PwMs in Ireland. This study highlights the importance of providing sufficient information, education and support to empower older PwMs to play a more active role in the management of their conditions.

Designing stress management interventions for older adults to improve wellbeing

We are experiencing an increase in the number of older adults. This presents both challenges and opportunities in the field of HCI research in terms of health self-management technology. This paper presents on-going work to design a mobile application that supports older adults in managing stress and sleep. The aim is to explore if sensor technology and a tablet application can be used to present intuitive feedback on stress levels and sleeping patterns with a view to reducing stress, improving sleep quality and increasing health and well-being overall.

Independent Living Applications

Countries globally have been experiencing an unprecedented increase in the number of older adults. As a result there has been an elevated interest in understanding the factors that may support the maintenance of independent living and quality of life of older adults. There is a large role for innovative technology to support monitoring, early detection and management of health and wellbeing in the home. Most diagnostic and treatment approaches to health are centered in clinical settings, and very few have focused on improving the self-management of wellbeing using novel in-home, ICT (information communication technology) based intervention systems. Utilizing combinations of ambient sensor data acquisition, telehealth and ICT it is possible to predict changes in wellbeing, and to deliver feedback and interventions to support personal wellness management.