Enhancing Control and Empowerment for Elders through Assistive Technology

1. Project Goal Studying how assistive technology can be structured, designed, implemented and introduced to most benefit elders to enhance quality of life and ability to remain in control of their environments. Social Science Computer Science Enhancing Control and Empowerment for Elders through Assistive Technology 1. Focus Develop technology consistent with the findings of our social science partners and to suggest potentially relevant technology for further study. 2. Early Key Findings • 7. Preliminary Analysis • an analysis method has been developed using standard open and axial coding, with the tools of diaries, memoing, and concept mapping. • the transcripts will be analyzed in stake holder pairs. Additional observational data from three professionals (two from the Smith team and one from the UMASS team) are also included in the analyses. • as the project focuses upon empowerment of the elders, examples of empowerment, and or lack thereof, are being purposively sought within the analysis in order to address the query implicit in the framework of the study • 8. Early Key Findings • Expectation of enhanced social networks and community • Participants expressed much enthusiasm for the capacity of current computer technology and the potential of video enhanced technology in the future to enrich their social networks. • One elder began a group by describing her encounter with her future husband through the internet: “Seven years ago, my son (introduced me to computers); (I met my husband on line); I was in California and he was in Massachusetts; we dated for two years on the internet (and then married). It changed my life! “ • After seeing an example of videophone technology, one self-defined “very social” participant who struggles with mobility offered “…if such a point and time would come that it would be physically impossible for me [to get out and visit friends], that would be a nice thing to have because I tend to rely a lot on the telephone where I'm calling my friends in CA or GA or AZ or NY and to have the face to face contact along with it would be rather nice.” • Less fear of surveillance and significant fear of threats to safety • Previous literature and other researchers with whom we visited in the past year concurred that elders would be fearful of cameras being used in their homes to assist them. Fears of surveillance, unwanted exposure and loss of privacy concerns, were raised by several researchers. Yet, in our initial analyses, elders became less concerned about cameras in the home when they understood that the data stored on the computer would not be maintained, nor perpetually watched by an unknown observer; instead the computer would analyze the data and alert a pre-selected (by the elder) help source (e.g., Doctor, emergency services, caretaker) if there were a safety threat, such as the detection of a fall. Elder participants had less fear of loss of privacy and more fear of threats to safety than professional participants. • One participant illustrated acceptance and need for such technologies, combined with significant fear of injury and death without such technology, as she stated: “I can see this in a hospital and a nursing home. Actually, there was a woman … who God Bless Her (was living on her own) at age 97. Her sister,…was just approaching her 100th birthday, was in a nursing home, had fallen out of bed, had called for help, no one heard her, she was on the floor all night long, caught pneumonia and died. Her daughter went to an attorney. The response was, ‘Well she was 100 years old.’ But the fact that no one came around to check on people (was frightening); …(with this kind of technology), this woman who was basically a healthy human being might still be alive at 105 or 106 because they have that longevity in their family.” • Another participant clarified that the concern about the cameras as seen by other researchers, may be related to how the video is used and who is doing the monitoring, as he stated “But I think this (dangerous fall) could happen to any one of us in our own home and my thought is: it wouldn't be invasive as long as nobody can see it until it's triggered in some way, and I think that would be the key to make the difference and then you would have elected who would be seeing you, so it would be limited to the police, the fire, yeah, -certainly not your relative out in Washington” • Much concern about equity of access, costs and, user friendliness. • Participants expressed concerns about the costs of technology, whether they and others would have access to it, and user friendliness/technical support that might be needed to support its use. • One participant asked “Now do you have to have this funded by let's say Verizon or AT&T or Comcast or one of those places in order for it to actually be on the market or can it be manufactured and produced by any electronic genius? “ Elder and professional participants engaged with computer scientists to give suggestions about increasing user capacity through overcoming problems from sensory challenges. • 1. Focus The social work team will involve elders, family caregivers, and professionals who serve elders, in a partnership to define the problems and possible technological solutions for empowerment of elders. • 2. Social Science Theory • grounded in an ecosystemic perspective because elderly face challenges of continual adaptation to changing physical and cognitive capacities as, well as constant changes in social relationships and support. • changes in any functional domain may require numerous adjustments, shifting the “fit” between person and environment. • to maintain their capacity, many elders need to be situated within networks (family, formal care givers, informal supports, community) of interdependent parts. • an ecosystemic perspective promotes attention to the dynamics of empowerment with focus on identification of interventions that enhance capacity and generate cascading effects of improved functioning in different domains of life. • 3. Methods • focus group methodology being used for this study. • fits the empowerment focus of the study as participants often feel more empowered in a group than in 1:1 methodologies. • the groups are comprised of three different stake-holder constituencies: elders, caretakers of elders and professionals who work with elders. • although a focus group interview guide was used, the group leaders used a relationally based method of dialectic, focusing upon conversation rather than strictly question-guided narrative responses. This allowed for deeper reflection and synergistic communication among participants. • 4. Focus Group Interview Guide • Reaffirm and discuss the meaning of informed consent, indicate that all participants have the right to discontinue participation at any time. • Explain rationale for focus groups and the need for input from stakeholders to influence potential application of assistive technology. • Ask about success with technology as an icebreaker. • Explain potential range of technology to be used in study and its possible applications. • Ask if anyone in the group has any questions about the technology and what it can do • Ask in what specific ways participants see this technology as potentially enhancing the quality of elders’ lives • Ask if they anticipate any problems or difficulties arising from these technologies; ask for specific issues related to feasibility and utility of the technology for elders • Ask for suggestions re needed changes to the technology in order to increase its utility or feasibility for elders. 5. Focus Group Participants • purposive convenience samples were recruited with the assistance of local social service agencies, comprised of a relatively well educated, mostly middle class group of participants from Massachusetts. • the group was all mobile - none were in wheel chairs although several used canes and similar devices. Additionally and intentionally, none of the group was cognitively impaired. Other group characteristics were not collected to protect the identity of the sample in this small project. • 6. Advisory Group • the team engaged an advisory subset of elders from the community from diverse socioeconomic and professional backgrounds to serve as a pilot group • proved to be invaluable in providing critical feedback to both the UMass and Smith team. Video Phone • Provides live, face-to-face video and voice communication • Based on Skype internet telephony services • Accessible interface customized for elderly needs Researchers: Shichao Ou, Dan Xie Contact Selection Screen Live Video Phone Call Display Feedback Object Finder • Camera-based object locator • Machine learning techniques employed for object detection and recognition • Found object’s location displayed in live video window • Does not require attaching a device to each object Researchers: Dan Xie Displaying the Location of an Object Object Selection Screen Fall Detector • Video-based fall detection • Motion automatically analyzed to detect a fall • Local alert displayed in home • Remote alert and video display sent to emergency contacts • Video phone used to establish contact with fall victim Smith College: Phebe Sessions, Julie Abramson, David Burton, Mary Olson, Lynn Mazur, Alison Pietras, Jordan Crouser University of Massachusetts – Amherst: Edward Riseman, Allen Hanson, Roderic Grupen, Shichao Ou, Adam Williams, Dan Xie, Jessica Krause, Joseph Gallo, Caitlin Bailey Mitsubishi Electric Research Laboratories: Candace Sidner Researchers: Adam Williams Local Alert Display Remote Alert Display Calendar • Information management tuned to the needs of the elderly • Includes appointment/medication alerts and reminders • Clean, simplified interface • Integration with video phone and fall detector Technology Researchers: Jessica Krause, Adam Williams Today’s Schedule Appointment Information Address Book • Keeps all important contact information in one place • Can specify emergency contact list • Accessible interface customized for elderly needs • Integration with calendar, video phone, and fall detector. Researchers: Joseph Gallo Data Entry Screen Entry Display Interdisciplinary Research • 3. Future Work • Additional applications • Robotics for health monitoring, object retrieval, etc. • Face recognition for home security • close communication between the social scientists and computer scientists, each educating and sensitizing the other to each other’s professional language and perspective. “Technospeak” and “Psychospeak” had to give way to communication in universal language. • graduate and undergraduate students in each area receive invaluable training in the other discipline. • learn from each other about the debates within these fields that relate to the project through shared presentations, visits by the social scientists to the research laboratories, participation by computer scientists in the focus groups and regular meetings of the research group as a whole.