Purpose Building services technologies such as home automation systems and remote monitoring are increasingly used to support people in their own homes. In order for these technologies to be fully appreciated by the endusers (mainly older care recipients, informal carers and care professionals), user needs should be understood1,2. In other words, supply and demand should match. Steele et al.3 state that there is a shortage of studies exploring perceptions of older users towards technology and the acceptance or rejection thereof. This paper presents an overview of user needs in relation to ambient assisted living (AAL) projects, which aim to support ageing-in-place in The Netherlands. Method A literature survey was made of Dutch AAL projects, focusing on user needs. A total of 7 projects concerned with older persons, with and without dementia, were included in the overview. Results & Discussion By and large technology is considered to be a great support in enabling people to age-in-place. Technology is, therefore, accepted and even embraced by many of the end-users and their relatives. Technology used for safety, security, and emergency response is most valued. Involvement of end-users improves the successful implementation of ambient technology. This is also true for family involvement in the case of persons with dementia. Privacy is mainly a concern for care professionals. This group is also key to successful implementation, as they need to be able to work with the technology and provide information to the end-users. Ambient technologies should be designed in an unobtrusive way, in keeping with indoor design, and be usable by persons with sensory of physical impairments. In general, user needs, particularly the needs of informal carers and care professionals, are an understudied topic. These latter two groups play an important role in implementation and acceptance among care recipients. They should, therefore, deserve more attention from the research community.
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Although social frailty has been described from a theoretical perspective, the lived experiences of older adults regarding social frailty are yet unknown. In this paper, we aim to (a) gain more in-depth insights into community-dwelling and assisted-living older adults' experiences of social frailty and (b) explore the differences in these experiences between these two groups. We conduct a thematic analysis of 38 interviews with community-dwelling and assisted-living older adults in rural villages the Netherlands. We structure our findings along three overarching themes which highlight different aspects of the social frailty experiences of our participants: (a) present resources and activities to fulfil social needs, (b) resources and activities that have been lost, and (c) how they manage and adapt to changes in resources and activities over time. Loneliness is only reported among the community-dwelling participants, while the loss of mobility and participation in (social) activities is experienced most strongly by the assisted-living participants. These findings challenge the widespread policies and practices of ageing in place. We conclude that for some older adults, living in assisted arrangements is preferred over ageing in place, as doing so can prevent social frailty. The key reason for this is that life in assisted living is likely to bring about new social resources and activities, which may serve to fulfil the social needs of older adults.
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Telemonitoring is regarded as a means to maintain a relatively high quality of life for independently living elderly. This paper discusses a requirements study of a system to, foremost, telemonitor activities of daily living (ADL) of the elderly. The study utilizes literature and in-depth interviews with medical specialists. From the interview results can be concluded that, besides from elderly’s own input, monitoring different aspects of movement, food consumption and sleep pattern are regarded as most beneficial to the medical specialists.
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With population aging and the expected shortage of formal and informal caregivers, emerging technologies for assistive living are on the rise. Focusing on the perspective of the prospective users of these technologies, this study investigates the perceived drivers and barriers that influence AAL adoption. An online survey among 1296 Dutch older adults was conducted. Although loss of privacy was identified as major barrier towards AAL adoption in previous research, the current study provides statistical evidence that these concerns are secondary to the expected benefits of safe and independent living. These findings suggests that older adults consider aging safely in their trusted home environment as a valid trade-off for some loss of privacy. Despite these results, we urge developers to be mindful of privacy aspects when developing AAL applications, as privacy concerns still had a significant negative influence on the attitude towards using AAL.
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Creative arts engagement has been shown to be related to maintaining wellbeing in older adulthood (Tymoszuk et al., 2019). For people living with dementia, music can be engaging and rewarding (Baird & Thompson, 2018), and is often presented as a therapeutic activity. It is theorised that music’s capacity to effect change is due to its engaging, emotional, physical, personal, social and persuasive qualities (Brancatisano et al., 2020). However, music itself is a complex intervention (Loui, 2020) and the ‘creative’ in music activities in the small number of studies with people living with dementia is rarely described or critiqued (Creech et al., 2020). Music is often described as passive (receptive)/active to reflect different listening or playing activities. Only a few studies detail opportunities for people living with dementia to exercise creativity (e.g. Zeilig et al., 2019).Technology to assist these musical interactions in dementia falls under distinct categories of listening to music, or playing music, with very little afforded in the way of agency, choice or control (MacRitchie et al., 2023). A few possible explanations could be: i) the musical activity is valued in terms of pre/post cognitive or social changes (Kontos & Grigorovich, 2018) i.e., the activity itself is not particularly critiqued, ii) creativity is assumed to be embedded in the activity and does not need to be enhanced or supported, iii) the locus of creativity is in cognitive processes occurring in the brain, so people living with dementia are often ascribed a passive role in creative musical interactions (Zeilig et al., 2019). We propose a new way of thinking about musical interactions for people living with dementia, building from the enactive, embodied experience of music (Schiavio et al., 2022), and considering a more relational view. Leaving aside the framing where the person with dementia is limited in what creativity they can offer, we propose instead a framework of design where subtle acts of agency and (mini-C) creativity are afforded, supporting a myriad of musical interactions that sit between listening and performing.
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Technology can assist older adults to remain living in the community. Within the realm of information and communication technologies, smart homes are drifting toward the concept of ambient assisted living (AAL). AAL-systems are more responsive to user needs and patterns of living, fostering physical activity for a healthier lifestyle, and capturing behaviours for prevention and future assistance. This study provides an overview of the design-requirements and expectations towards AAL-technologies that are formulated by the end-users, their relatives and health care workers, with a primary focus on health care in The Netherlands. The results concern the motivation for use of technology, requirements to the design, implementation, privacy and ethics. More research is required in terms of the actual needs of older users without dementia and their carers, and on AAL in general as some of the work included concerns less sophisticated smart home technology
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This paper describes a participatory design-oriented study of an ambient assisted living system for monitoring the daily activities of elderly residents. The work presented addresses these questions 1) What daily activities the elderly participants like to be monitored, 2) With whom they would want to share this monitored data and 3) How a monitoring system for the elderly should be designed. For this purpose, this paper discusses the study results and participatory design techniques used to exemplify and understand desired ambient-assisted living scenarios and information sharing needs. Particularly, an interactive dollhouse is presented as a method for including the elderly in the design and requirements gathering process for residential monitoring. The study results indicate the importance of exemplifying ambient-assisted living scenarios to involve the elderly and so to increase acceptance and utility of such systems. The preliminary studies presented show that the participants were willing to have most of their daily activities monitored. However, they mostly wanted to keep control over their own data and share this information with medical specialists and particularly not with their fellow elderly neighbours.
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OBJECTIVE: To assess the feasibility of conducting a randomised controlled trial to determine the effectiveness of a twenty-week power-assisted exercise intervention in people with profound intellectual and multiple disabilities and to evaluate the potential beneficial effects of this intervention.DESIGN: Pilot randomised controlled trial.SETTING: A large-scale twenty-four-hour residential facility in the Netherlands.SUBJECTS: Thirty-seven persons with profound intellectual and multiple disabilities.INTERVENTION: Participants in the intervention group received a power-assisted exercise intervention three times a week for thirty minutes over a twenty-week period. Participants in the control group received care as usual.MAIN MEASURES: Trial feasibility by recruitment process and outcomes completion rates; intervention feasibility by programme compliance rates; potential outcomes by functional abilities, alertness, body composition, muscle tone, oxygen saturation, cardiovascular fitness and quality of life.RESULTS: Thirty-seven participants were recruited ( M age = 32.1, SD = 14.6) and were randomly allocated to intervention ( n = 19) and control ( n = 18) groups. Programme compliance rates ranged from 54.2% to 97.7% with a mean (SD) of 81.5% (13.4). Oxygen saturation significantly increased in the intervention group. Standardised effect sizes on the difference between groups in outcome varied between 0.02 and 0.62.CONCLUSIONS: The power-assisted exercise intervention and the trial design were feasible and acceptable to people with profound intellectual and multiple disabilities living in a residential facility. This pilot study suggests that the intervention improves oxygen saturation, but further implementation with the aim of improving other outcomes should be considered with caution.
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Wireless sensor networks are becoming popular in the field of ambient assisted living. In this paper we report our study on the relationship between a functional health metric and features derived from the sensor data. Sensor systems are installed in the houses of nine people who are also quarterly visited by an occupational therapist for functional health assessments. Different features are extracted and these are correlated with a metric of functional health (the AMPS). Though the sample is small, the results indicate that some features are better in describing the functional health in the population, but individual differences should also be taken into account when developing a sensor system for functional health assessment.
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In this paper we investigate the precise focus required of a telemonitoring system for the domain of independently living elderly. Particularly, we investigate (1) the needs of telemonitoring for this particular domain, and (2) the requirements for such a telemonitoring system. For our investigation, we performed an extensive study of the literature, as well as performed interviews with 36 individuals active in the field. As a result, we established numerous needs to be considered, being foremost information need on safety, with regard to care response on emergencies (e.g., falling incidents, wandering), as well information need on dependence on care, with regard to inactivity, self-neglect and loneliness. Subsequently, we established numerous requirements to be addressed, being foremost the use of non-wearable sensors, unobtrusiveness, durability, reliability, privacy, and ubiquitousness. In our discussion of the requirements, we detailed specifically the topics of focus, functionality, and form of a telemonitoring system for this domain.
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