Attitudes Toward Intelligent Technologies

Nursing homes provide long-term care services and can help preserve the quality of life of elderly people subject to physical and cognitive impairments. In this chapter, we explore the role of intelligent technologies as a supplement to human care-giving and the potential to improve quality of life for both older adults and their caregivers in nursing homes. A study was conducted on elderly people’s and caregivers’ attitudes toward the use of intelligent technologies in nursing homes, with the aim of understanding in which domains of everyday activities the application of intelligent technologies can be more suitable. Results showed that attitude toward the application of intelligent technologies in nursing homes is positive, although multifaceted. Elderly people and caregivers considered intelligent technologies as relevant devices for the improvement of quality of life in different domains. Nonetheless, differences related to the role that technologies played in nursing homes clearly emerged.

A Robotic Arm for Electric Scooters

This chapter describes the mechanical design, manufacture and performance of a three-degree-of-freedom manipulator arm and gripper that can be attached to a mobile vehicle or electric scooter. Known by the acronym “ESRA”, or “Electric Scooter Robot Arm”, this device can be remotely or automatically controlled to pick up and retrieve heavy objects, such as books or grocery products, from high shelves or difficult-to-reach locations. Such tasks are often considered to be arduous or even impossible for the frail elderly and people with disabilities. This chapter describes one example of how the combination of mechanical and electronic engineering technology can be used to perform physically strenuous tasks and enable the frail elderly and people with disabilities to enjoy a greater degree of self-sufficiency, independence and physical productivity. It includes the design process for robotic arm manipulators and actuators. It also provides a brief overview of existing “state of the art” robotic and machine vision technologies, and how these can be used to perform many everyday domestic or household chores.

Meeting the Needs of Diverse User Groups

“Pluggable user interfaces” is a software concept that facilitates adaptation and substitution of user interfaces and their components due to separation of the user interface from backend devices and services. Technically, the concept derives from abstract user interfaces, mainly in the context of device and service control. Abstract user interfaces have been claimed to support benefits such as ease of implementation, support for User Centered Design, seamless user interfaces, and ease of use. This paper reports on experiences in employing pluggable user interfaces in the European project i2home, based on the Universal Remote Console framework, and the Universal Control Hub architecture. In summary, our anecdotal evidence supports the claims on the benefits, but also identifies significant costs. The experience reports also include some hints as to how to mitigate the costs.

The Use of Assistive Technology to Support the Wellbeing and Independence of People with Memory Impairments

This chapter presents the research, results and lessons learned from a project to evaluate currently available assisted living technologies for elderly people with mild to severe memory impairments who want to age in place. During the project a number of households were equipped with assistive technology to enable the end users to better cope with the barriers and problems associated with their forgetfulness. End users were involved in different phases, starting with a problem and needs analysis and ending with an evaluation of the technology installed in their homes. It seemed that technology did have a positive impact on their lives as well as on the lives of the informal caregivers who often live with those who suffer from amnesia. This project gives insight into how we are coming closer to optimizing the positive effects which assistive technology holds for the elderly with memory impairments. Key insights are presented.

Ubiquitous Computing for Independent Living

Ubiquitous computing technology (ICT) shows great potential in supporting the infirm elderly, and others managing complex health issues, to live independently in their own home. While these technologies have great promise, their adoption level is low in Australia. It is suggested that two concurrent strategies are needed to improve the penetration of ICT-based assistive technology in the community. Firstly, significant trials are needed to verify that such systems can provide improved health outcomes and reduce health system costs for suitably targeted patients. Secondly, research in security and privacy, open standards, human-computer interfaces and new models of care driving software specifications is needed, so that these health system benefits can be achieved at a reasonable cost, and with adequate consideration of the needs of clients and carers.

Assistive Technologies as Aids to Family Caregivers in Taiwan

The social structure in Taiwan has changed dramatically in the last twenty years. An increasing population of people aged over 65, a decreasing birth rate and rising numbers of women entering the workforce have led to the need for more aged care services. Research has demonstrated that nursing home placement of older adults in need of advanced care is the most cost effective option for family caregivers. However, filial piety, which entails looking after older parents at home, is one of the core tenets of Chinese society. Placing older parents into nursing homes can lead to conflicts that are detrimental to adult children psychologically. Moreover, the burden of caregiving does not necessarily end for the family once they have placed their parent(s) into nursing homes. It can continue to evoke deep emotional responses in some former family caregivers. This chapter draws on findings from two case studies to illustrate the dilemmas facing Taiwanese families who must cope with changing social conditions and customary filial expectations. The use of assistive technologies as solutions to these dilemmas is outlined. These technologies are argued to be a cost effective way to assist adult caregivers, their charges, and staff in nursing homes. Their use may apply to other Asian countries with similar cultural beliefs and values.

Health Insurance Systems as Models for Managing the Increasing Elderly Populations of Japan and Korea

This chapter looks into the systems and institutions for the elderly population covered by long-term care insurance in Japan and the Republic of Korea (hereafter Korea). It shall discuss the historical changes in policies in these two nations. The Health Care and Welfare Complex elements that make up a single business model for the Health Care and Social Services of the aged in Japan and Korea will also be discussed in this paper. The management environment for medical facilities greatly changed with adjustments in the population structure and the social environment, and this resulted in serious competition between medical facilities for patients. Medical facilities in Japan and Korea showed a rapid increase in comprehensive medical and welfare management. Consequently, there were provisions in both health care and social services through affiliation, chain affiliation and multiplication, before and after the enforcement of long-term care insurance.

Low Usage of Intelligent Technologies by the Aged

Contrary to expectations, assistive technology (AT) usage by the elderly has not increased in proportion to availability and ease of access. This is despite a belief that technology can contribute significantly towards improving their quality-of-life. Our Rehabilitation Mechatronics research group at NTU Singapore is developing a “unified neuro-physio platform”, taking a cue from Eastern philosophies which emphasize that the “internal environment” of the users strongly affects how they interact with the “external environment.” This chapter highlights the need to bridge these two environments meaningfully through “sensitive” technologies which address the mindsets and learning mechanisms of users. The technology platform we propose helps the elderly to understand and enhance their internal environment in order to interact at various levels with AT in their external environment. It provides a fresh approach to understanding and minimizing the persistent “digital divide” between the elderly and high technology.

Telenursing in Aged-Care

The rapidly growing aged population is challenging conventional methods of care provision. Global ageing, combined with other challenges, has compelled health systems to explore new methods for providing health care. Telenursing, providing nursing care at a distance using new technologies, is identified as one alternative. The lack of evidence for the effectiveness of telenursing in aged care is a drawback for its wider use. The aim of this chapter is to review the evidence of randomised controlled trials (RCT) in geriatric telenursing practices. We performed a systematic literature review using the Ovid Medline and Pubmed databases on telenursing. A total of 62 articles were retrieved and 18 studies were selected for comprehensive analysis. The review found that the RCTs were conducted in different areas of geriatric telenursing and various information and communication technologies (ICT) were used in the interventions. Although robust evidence, based on RCTs in aged care telenursing is yet to emerge, the majority of current studies suggest that telenursing is an effective tool.

Preventative Healthcare

Australia’s ageing population has escalated the demand for current health services and the trend could compound to unsustainable levels under the current health system. This chapter proposes a preventative healthcare model based on assistive technology to strengthen wellbeing at the individual and community level. The proposed model could minimise premature and inappropriate admission of Australians to care facilities while enhancing their independence and self care. It could also present a cost effective approach for policy makers by helping to alleviate the escalating costs of the health system. Importantly, this program offers an effective and sustainable alternative for delivering future health services.