Unobtrusive Smart Environments for Independent Living and the role of Mixed Methods in Elderly Healthcare Delivery: The USEFIL Approach

Unobtrusive Smart Environments for Independent Living and the role of Mixed Methods in Elderly Healthcare Delivery: The USEFIL Approach

Alexander Astaras (Aristotle University of Thessaloniki, Greece & American College of Thessaloniki, Greece), Hadas Lewy (Maccabi Healthcare, Israel), Christopher James (University of Warwick, UK), Artem Katasonov (VTT Technical Research Center, Finland), Detlef Ruschin (Fraunhofer Heinrich Hertz Institute, Germany) and Panagiotis D. Bamidis (Aristotle University of Thessaloniki, Greece)
DOI: 10.4018/978-1-4666-8234-4.ch015
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In this chapter the authors describe a novel approach to healthcare delivery for the elderly as adopted by USEFIL, a research project which uses unobtrusive, multi-parametric sensor data collection to support seniors. The system is based on everyday devices such as an in-mirror camera, smart TV, wrist-mountable personal communicator and a tablet computer strategically distributed around the house. It exploits sensor data fusion, intelligent decision support for carers, remote alerting, secure data communications and storage. A combined quantitative and qualitative knowledgebase was established and analysed, target groups were established among elderly prospective users and scenarios were built around each group. Use cases have been prioritised according to quantitative functional and non-functional criteria. Our research findings suggest that an unobtrusive system such as USEFIL could potentially make a significant difference in the quality of life of elderly people, improve the focus of provided healthcare and support their daily independent living activities.
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Ageing Population: A European Perspective

Seniors over the age of 65 are the fastest growing demographic group globally, expected to reach 1.5 billion by the year 2050, out of a total of approximately 9 billion people. Statistical data show that three out of the top four most aged populations in the world are the citizens of European countries (Beard J. R et al., 2012). In 2010 Japan had the most aged society with 23% of its population being over 65m while Italy, Germany and Greece follow it in the global ranking. Seniors in these European countries account for 21%, 20% and 19% of the total population, respectively. At the other end of the European spectrum, Slovakia, Cyprus and Ireland are the least aged European countries with an elderly percentage of 13%, 12% and 11% respectively.

By comparison the USA, the world’s largest economy, has a ratio of 13% elderly citizens. The three largest emerging economies, China, India and Brazil, are among the world’s least aged countries: seniors account for 8%, 5% and 7% of the population, respectively. (UK Office for National Statistics, 2011)

The implications of a rapidly ageing population are socioeconomically significant: a proportionally smaller workforce has to sustain increasing numbers of pensioners, while medical and social insurance infrastructures need to adjust towards more emphasis on diseases of old age. Part of the solution to these and future aging-related social challenges will likely involve empowering senior citizens to continue living independently, within the community (Bovenschulte M & Huch M, 2010). Apart from the obvious benefits of better targeted healthcare delivery, the required technological developments and infrastructure changes can be combined to help provide more efficient personalised healthcare for elderly citizens (Codagnone, 2009).

This paper presents the work undertaken so far by the USEFIL project (USEFIL, 2011) specifically following such a service-oriented and technologically innovative approach. The project involves planning, technology development of a novel system and associated services, data collection, as well as final pilot studies validation (USEFIL Consortium, 2011). The three countries selected by the project consortium to host the pilot studies are Greece, the UK and Israel. Elderly citizens in these countries represent a proportion of 19%, 17% and 10%, as compared to an overall European Union average of 16%. Moreover, the EU average is expected to increase by 3% during the 2010-2020 decade, double the rate of increase of the past two decades (UN, 2001).

Comparative research performed by USEFIL scientists based on demographic literature produced the following common observations among the three pilot study host countries:

  • The population in all three countries follows the global trend and is thus ageing.

  • It is ageing at an increasing pace, due to diminishing fertility rates and increasing life expectancy.

  • The difference in the percentages of elderly males and elderly females over the entire population is decreasing.

Key Terms in this Chapter

Ubiquitous Computing: A concept in informatics and engineering where computing can occur everywhere and anywhere. In contrast to desktop computing, ubiquitous computing can occur using any device, based on data obtained by sensors present in any location, in any format.

Elderly: For statistical and public administrative purposes, old age is frequently defined as 65 years of age or older. This is not consistent in international literature: a 60 year threshold is occasionally used.

Smart Environment: A physical world interwoven with invisible sensors, actuators, displays, and computational elements. These computing elements are generally embedded seamlessly in everyday objects and networked to each other and beyond (the internet, usually).

Biomedical Engineering: The application of engineering principles and design concepts to medicine and biology for healthcare purposes (e.g. diagnostic, therapeutic or both).

Unobtrusive Research: Science research based on data collection which does not involve direct elicitation of data from the research subjects. An example would be the extraction of a subject’s sleeping schedule based on examination of a log containing the setting and snoozing times of the mobile phone alarm clock. A counter-example (obtrusive research) would be to directly interview the subject and ask them for this information or to dispatch a researcher to the subject’s residence to monitor and log the occupant’s daily habits.

Decision Support System: A computer-based information system that supports procedural or organizational decision-making activities. Decision support systems are used in healthcare to increase the speed, efficiency and reliability of health-related decisions.

Ageing Population: A global demographic trend according to which the elderly (senior citizens over 65 years of age) constitute a consistently increasing share of the general population.

Independent Living: Living without the need of support from other people or from medical equipment that requires frequent human supervision. In the context of eldercare, independent living is seen as a step in the continuum of care, with assisted living being the next step.

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