Elderly Monitoring and AAL for Independent Living at Home: Human Needs, Technological Issues, and Dependability

Introduction

The demographics are experiencing an elderly population growth. Based on a United Nations study (Department of Economic and Social Affairs United Nations, 2002), the population of elderly aged over 60 is projected to be nearly 2 billion in 2050, more than three times its size in 2000, comprising more than two persons out of five. Population ageing is characterized by attributes like unprecedented, pervasive, and enduring. One of the main concerns, related with this growth, is the cost of elderly care which is rapidly rising. Indeed elderly people are a significant part of the population which is not able to economically sustain itself anymore. Independently from the welfare model, the growth of the elderly population, as pictured by those data, will become not sustainable. Nonetheless, when referring to elderly care costs, it is worth to notice that these problems are not only applicable to elderly patients (and thus to cure and healthcare costs) but also to the non-patient healthy elderly who are losing their autonomy and independence. This fact opens another important perspective: a point of view that includes not only economic costs, but also the social costs and the affective sphere. Thus, picturing this scenario, a target can be identified in smoothing and delaying the transition that leads the person in his old age from the independent to the assisted living (Figure 1).

Figure 1.

Assistance for the elderly paradigms; the top graph represents the currently diffused paradigm, the bottom one the smoother and lower-cost IT-empowered one.

Among all the interventions that could be adopted toward that aim, a significant role can be played by technology, in particular by Information Technology (IT). In these years, Home Automation (HA) and Ambient Assisted Living (AAL), Tele-care and Tele-monitoring, Alternative and Augmentative Communication (AAC) have been interesting topics of innovation in the IT field. Research is currently considering to employ HA not only as a commodity, but also as an empowering tool to provide the elderly with security, independence, communication etc., following the AAL paradigm. Although it cannot be neglected that the criticalities of designing an assistive tool are significantly different from those arising when projecting a commodity. The results of these innovations are leading toward a kind of systems, whose purpose is not only to provide a significant aid, but also to collect information and allow monitoring some aspects of the inhabitant’s life. This monitoring is significantly different from the health related (tele-care, at home follow-up, etc.), raising new challenges. Human and technological aspects get intertwined and must be balanced properly during the design phase to obtain a purposeful tool. Furthermore, the reliability of the designed system has to be considered crucial, since a system failure can cause disastrous consequences, threatening the system purpose and mission.

In this chapter, after detailing the motivation for these assistive technologies, the design and development of newly-defined Ambient Assisted and Monitored Living systems are analyzed, giving particular attention to the fulfillment of the users’ needs while respecting the technological constraints. Moreover, critical aspects of communication are considered, including the delivery and the representation of information. To complete the analysis, dependability for AAML is analyzed, explaining the motivation to provide dependability and the possible approaches in the design phase. Finally, a brief presentation of current research trends in the field ends the chapter.