Technology for Ageing in Place

by Ms. Grace Chan
from Global Newsletter - April 2017

Population ageing is an important phenomenon that generates economic, social and personal challenges for societies. The associated demographic changes also call for developing new products and services designed to meet the needs of an increasing number of older adults. We expect technological innovations to enhance the effectiveness of our health and long-term care systems, improve the quality of life of the older population and, at the same time, create a new page for the associated societal changes.

In order to put the proper role for the technology for ageing in place, it is necessary first to consider the initial objectives of such innovations. This article provides a brief highlight of some remarks on ageing-in-place technologies, with an outlook to future possibilities.

Ageing in Place, which seeks to enable older people to stay at home in their community and avoid institutional care for as long as possible, has been the dominant model for positive ageing over the past decade. Meeting the challenges of ageing requires an integrated approach to care, which implies better care management and shared responsibility among health and social-service systems.

Preventing Falls among Older Persons
An effective ageing-in-place arrangement must include protocols to address the risk of falls by senior persons and its prevention. The technology-based interventions that have been deployed in a wide range of fall- prevention contexts include assessing, diagnosing and treating fall risk, increasing adherence to intervention, detecting falls and alerting helpers in the event of a fall. These range from the appropriate design of the built and home environment, as well as smart devices that provide biofeedback or assistive mechanical compensation to support better balance or adjust the center of gravity of a person.

However, notwithstanding a very detailed understanding of the complex home or community environmental, physiological and biomechanical processes involved, very few of these solutions have yet been statistically demonstrated to be useful, i.e. in reducing the risk of falling. Moving to outcome-based ageing-in-place arrangements and actively seeking data-driven strategies to make fall prevention more efficient and responsive to person’s needs are a priority. As the development practitioners start to urge field workers to engage in population health- management techniques such as risk stratification, disease-management screenings, and healthy living coaching, fall prevention specialists become more interested in adopting big-data analysis tools to deliver the insights.

Smart Home Technologies
The “smart home" environment has been widely promoted as the critical solution enabling older persons to live independently. That is facilitated by advances in information and communication technologies, demonstrated by smart-sensor networks that are responsive to a wide range of measured environmental, physiological, and emotional parameters. The combination of these features into the home living environment is essentially what constitutes the concept of a ‘smart home’.

In reality, smart-home technologies go well with the assisted care for ageing-in-place. The recognized goal of the smart home in the ageing-in-place context is to enable older person to age in place with independence, safety, dignity, and quality of life, whereby the person’s medical and social care is monitored and functional support for home management and personal motility is provided as needed. Examples may include activity monitoring and the provision of emergency assistance when an imminent harmful situation is detected; environmental controls responsive to the person’s health status; the control of home appliances aimed at providing networked assistive-technology support for basic ADL and IADL; and robotic homes systems, including supervised environments for people with mild cognitive impairment. The degree of success of smart-home applications eventually relies upon the extent to which their design and implementation makes it possible to tackle the challenges faced by older persons, making them active participants in the health and social-care decision and in the monitoring of their conditions.

Needless to say, smart-home technology applications also encompass cultural difference. In a recent survey, GFK (2016) online interviewed over 1,000 adults in Germany, UK, USA, Brazil, South Korea, China and Japan. The key differences in the impact of smart-home technology across China, Japan and South Korea were found interesting. The majority of consumers in China believed smart-home technology would make an impact on their lives in the near future, almost equaling their hopes for wearable technology. However, in Japan, only one in five people considered smart-home technology would impact them, and mobile payment won notably higher votes. For South Korea, it was revealed that opinions were divided at around half. In the findings, the key barriers to adoption of smart-home technology were cost, with around a third of the people citing that factor, and privacy and the danger of hacking. The high cost of smart-home technology was of most concern in South Korea (30 %) and China (29 %), with slightly fewer Japanese consumers seeing that as a barrier, at 25 %. Privacy concerns were most common in China (27%), with South Korea standing at 24% and Japan at 18%. In a smart-home ageing-in-place environment, robots with affective-response ability and responsive to voice, eye-gaze, and gesture have recently entered the Hong Kong market. Japan pioneered this arena a decade ago through the development of companion robots and further research in this direction has taken place in Europe. It is foreseeable that the practical research on ageing-in-place robot technology can be enriched in the Chinese community.

The objective of technological intervention for ageing in place is to enable older people to live and socially engage with a maximum degree of independence, safety and dignity. Although technology has the potential of being a powerful solution for successful independent living, we should carefully look into the application in the local context. Looking to the future, the application of technological advances should be carefully studied. The establishment of the baselines upon which to benchmark the social and functional value of new ageing-in-place support-technology- based systems and services is highly recommended.