Countries globally have been experiencing an unprecedented increase in the number of older adults. As a result there has been an elevated interest in understanding the factors that may support the maintenance of independent living and quality of life of older adults. Extending the opportunity for older people to age in a place of their choice is a major policy alternative to long term care, thereby enabling older people to stay active, productive and engaged in society and to enjoy a higher quality of life for longer.
There is a large role for innovative technology to support monitoring, early detection and management of health and wellbeing in the home. Most diagnostic and treatment approaches to health are centred in clinical settings, and very few have focused on improving the self-management of wellbeing using novel in-home, ICT (information communication technology)-based intervention systems. Utilising combinations of ambient sensor monitoring, telehealth and ICT, it is possible to predict changes in wellbeing, and to deliver feedback and interventions to support personal wellness management.
The Netwell and CASALA research centres, based at Dundalk Institute of Technology, have as their core goal to ‘Enhance Longer Living in Smarter Places’. Together, these cross-sectoral, multi-disciplinary research centres are developing new ideas that support ageing-in-place and enhance the quality of life and well-being of older people through technology, community and environment-based interventions. Specifically, the Netwell Centre focuses on integrated community-oriented services, more sustainable home and neighbourhood design, and age-friendly initiatives. CASALA is focused on technology development, industrial engagement, commercialisation and market stimulation for innovative systems and services for older people. A large part of the ongoing research at Netwell and CASALA involves Great Northern Haven (GNH)—a demonstration housing project consisting of 16 purpose-built homes, each equipped with a combination of sensor and interactive technology to support independent living for older adults. The apartments at GNH are occupied by older adults, all of whom have been living there since June 2010- Such longitudinal monitoring of residents living in these smart homes provides very powerful information on how older adults live their lives and supports the monitoring of wellness and the promotion of timely interventions to prevent or slow down health decline.
Both Netwell and CASALA employ a person-centred approach to the design of services and technologies for the older population. Technology can often represent a barrier for older adults, acting as an inhibitor to usage rather than a facilitator. There are many reasons for this including unfamiliarity, computer anxiety and inaccessible technology. Furthermore, cognitive disabilities resulting from age degenerative processes can significantly increase the learning curve of older adults, making it more difficult and time consuming for this group to learn new skills, compared to younger adults. Designers of applications that target older adults as a user group must understand this cohort’s attitudes towards technology and communication and ensure applications are designed with their unique needs in mind. It is therefore crucial to involve older adults in the design of technologies that will support them in living independently in their homes. At CASALA and the Netwell Centre, this involves user requirements gathering through interviews and focus groups, involving older adults as co-designers in technologies at each stage of the design and development process and evaluating usability, effectiveness, satisfaction and impact of such technologies with older adults.
CASALA have been involved in the design, development and deployment of various types of technologies to support independent living for older adults. Telehealth is the remote exchange of data between a patient at home and their clinician, to assist in diagnosis and monitoring, typically used to support people with long-term conditions, such as diabetes, chronic heart failure or COPD. Telehealth can provide the person with more control and understanding of their condition. Telecare refers to support and assistance provided at a distance using technology. It is the continuous, automatic and remote monitoring of people by means of sensors, to enable them to continue living in their own home while minimizing risks such as a fall or a gas leak. For a person suffering from dementia, for example, a sensor on a door that detects when it is opened, can alert a carer or family member if a door has opened during the night, which might mean that the person with dementia has left the home.
An important aspect of the use of technology to support health and wellness self-management is that feedback is provided to the appropriate person, be it the person themselves, a clinician or a nominated carer, in a way that is easy to interpret and act upon. Furthermore, technology should only act as an enabler to healthy ageing rather than a replacement for current practice and services.