Mounir Mokhtari

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.

Towards useful services for elderly and people with disabilities

This book constitutes the refereed proceedings of the 9th International Conference on Smart Homes and Health Telematics, ICOST 2011, held in Montreal, Canada, in June 2011. The 25 revised full papers presented together with 16 short papers and 8 student papers were carefully reviewed and selected from 94 submissions. The papers are organized in topical sections on smart home and village; health telematics and healthcare technology; wellbeing, ageing friendly and enabling technology; and medical health telematics and healthcare technology.

A distributed approach for assistive service provision in pervasive environment

In this paper, we propose assistive service provision architecture in pervasive environments. This architecture is based on a distributed approach and ensures service design, deployment and discovery aspects. In order to perform those aspects, several constraints are supported by this architecture such as the context of the pervasive environment, the user profile and the terminal profile. Delivered services are dedicated to dependent people (elderly and people with disabilities). Our strategy is based on our previous work on smart home for people with disabilities. We also present the OSGi-based implementation of our architecture. This implementation is a first step to experiment and validate our approach. We are aiming at having evaluations in real conditions The rapid development of information and communication technologies is opening a large variety of new services and aids not only for valid people, but also for dependent people due to physical/cognitive restriction or the elderly. Combining technical aids and mobile technology allows those people to benefit from an independent living in both usual and temporary living environments.

HYCARE: A Hybrid Context-Aware Reminding Framework for Elders with Mild Dementia

Dementia occurs much more frequently in the elders who exhibit impairments of memory, thought and reasoning. In this paper, we present a hybrid context-aware reminding framework intended to help elders with mild dementia improve their level of independence and quality of life. Based on the user study in three different pilot sites, the reminding services are identified and classified into four types according to the nature and urgency. The framework with a novel scheduling mechanism is designed which handles both synchronous time-based and asynchronous event-based reminding services. In order to facilitate the interaction between the caregivers and system, we also provide a simple software tool for caregivers to create and edit the reminding services. Finally, we present some initial implementation results.

New trends to support independence in persons with mild dementia: a mini-review.

Our research was motivated by the growing aging population worldwide and the need to concentrate research efforts on a specific target group; it focuses on elderly persons with physical and cognitive deficiencies. The primary goal is to enable persons with mild dementia to maximize their physical and mental functions through assistive technologies in order to be able to continue to participate in social networks and lead independent and purposeful lives. Persons with mild dementia usually have problems in performing activities of daily living due to episodic memory decline. These can include simple activities, such as bathing, changing clothes and preparing meals. Through extended field test trials involving end users, we have demonstrated that assistive technology that provides timely prompts, alarms and reminders can enable them to preserve their abilities and improve their quality of life. Understanding the user context, especially when targeting demented individuals, and providing the required personalized assistive services is the objective of our research work. Finding the appropriate user interface to interact with the provided services is often a barrier. Thus, we have adopted the approach of a multimodal interactive system with the living environment including a TV set, iPad-like tablets, sensors/actuators, and wireless speakers connected to a reasoning engine that is able to consider the complexity of the users’ profile defined by his/her cognitive abilities. In this paper we will mainly focus on the interaction level with the system as well as on the validation stages performed to meet the users’ requirements. This is the result of several years’ work since 2006 in the frame of two projects (IST-FP6 COGKNOW European completed project and AMUPADH ongoing project in Singapore).

Ambient Assistive Health and Wellness Management in the Heart of the City

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Semantic reasoning in context-aware assistive environments to support ageing with dementia

price are net prices, subject to local VAT. Prices indicated with * include VAT for books; the €(D) includes 7% for Germany, the €(A) includes 10% for Austria. Prices indicated with ** include VAT for electronic products; 19% for Germany, 20% for Austria. All prices exclusive of carriage charges. Prices and other details are subject to change without notice. All errors and omissions excepted. M. Mounir, I. Khalil, J. Bauchet, D. Zhang, C.D. Nugent (Eds.) Ambient Assistive Health and Wellness Management in the Heart of the City

Mild dementia care at home - integrating activity monitoring, user interface plasticity and scenario verification

Robust solutions for ambient assisted living are numerous, yet predominantly specific in their scope of usability. In this paper, we describe the potential contribution of semantic web technologies to building more versatile solutions -- a step towards adaptable context-aware engines and simplified deployments. Our conception and deployment work in hindsight, we highlight some implementation challenges and requirements for semantic web tools that would help to ease the development of context-aware services and thus generalize real-life deployment of semantically driven assistive technologies. We also compare available tools with regard to these requirements and validate our choices by providing some results from a real-life deployment.

Smart Homes and Health Telematics

We discuss an integrated approach towards building systems for monitoring and assisting people with mild dementia in their homes. Our approach differs from existing approaches in three ways. First we improve context acquisition and understanding with the concept of micro-context that takes us beyond existing notions of location and temporal context; second, we incorporate plasticity concept into the human computer interface, in order to provide a natural interaction way and accommodative interface to the user; third we target robust and reliable systems that are easy to scale and deploy in diverse end-user settings, through the use of formal model building tools to specify and verify systems at key stages from requirements generation all the way to deployment and user statistics gathering. In order to address real-life end user requirements we are working closely with geriatric doctors and their staff, so as to get inputs as to precise challenges in caring for mild dementia patients, and how systems targeted at holistic, personalized assistance and care-giving can be built with a view towards scaled up deployment in diverse settings. The main contribution of this paper is an approach for system building that incorporates activity monitoring, user interface plasticity and scenario verification targeting people with cognitive decline in regards to a Singapore initiative called A-Star Home 2015 Phase II. We expect our work to lead to a methodology for systematic development of monitoring and assistive systems for cognitive interventions for mild dementia patients at home. Although the integrated framework is still not completely realized, the three areas mentioned above have each yielded significant results on their own, and these are mentioned in the paper.

Networking and communication in smart home for people with disabilities

With more than one billion people with disabilities worldwide, in addition to the aging population, novice technology users, people with language, learning and literacy challenges, or any individual facing a situational impairment while using a device, the global demand for accessibility has made it a mainstream requirement for governments and businesses around the globe. And, the success of trends such as mobile, social, smart TVs, wearable devices and cognitive technologies will depend on the ongoing integration of adaptive, intuitive and accessible technology capabilities. This means that CIOs and IT leaders need to provide technology solutions to reduce barriers for people with disabilities and realize that these same accessible technologies can increase productivity and improve the overall user experience for the mass market. Attendees will learn how next generation solutions are complementing and supplementing the human senses to better optimize communications and make information more meaningful and consumable to