Introduction - Web viewMOBISERV – FP7 248434. An Integrated Intelligent Home Environment for the Provision of Health, Nutrition and Mobility Services to the Elderly

MOBISERV – FP7 248434An Integrated Intelligent Home Environment for the Provision of Health, Nutrition and Mobility Services to the Elderly

Deliverable

D2.3: MOBISERV System Requirements Specification Volume II

Date of delivery:

Contributing Partners: UWE, SMH, ANNADate: 4 Jan-11 Version: Vol II v4.1

D2.3: MOBISERV System Requirements Specification, VOLUME II 2/86

Document Control

Title: D2.3: MOBISERV Initial System Requirements Specification

Project: MOBISERV (FP7 248434)

Nature: Report Dissemination Level: Restricted

Authors: UWE, SMH, ANNA

Origin: UWE

Doc ID: document.docx

Amendment HistoryVersion Date Author Description/Comments

V1 2010-07-5 UWE Draft – literature review

V2 2010-09-13 UWE Draft - ILAEXP summary

V2.1 2010-10-11 UWE, SMH Draft - Function Process Specifications

V2.2 2010-11- 22 UWE, SMH Draft – Data Analysis

V3 2010-12-6 UWE, SMH Draft – Detailed use-cases

V4 2010-12-20 UWE, SMH Draft – Policy Context

V5 2010-1-07 UWE, SMH Final version

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The information contained in this report is subject to change without notice and should not be construed as a commitment by any members of the MOBISERV Consortium. The MOBISERV Consortium assumes no responsibility for the use or inability to use any software or algorithms, which might be described in this report. The information is provided without any warranty of any kind and the MOBISERV Consortium expressly disclaims all implied warranties, including but not limited to the implied warranties of merchantability and fitness for a particular use.


Table of contentsEXECUTIVE SUMMARY........................................................................................................8

GLOSSARY...............................................................................................................................9

1 INTRODUCTION..............................................................................................................10

1.1 OBJECTIVES OF THIS DOCUMENT..............................................................................101.2 STRUCTURE OF THIS REPORT.....................................................................................10

2 LITERATURE REVIEW...................................................................................................11

2.1 CONSTRAINTS TO IMPLEMENTATION OF ASSISTIVE TECHNOLOGY.........................112.1.1 Barriers and exclusion at home.............................................................................112.1.2 Attitudes towards technology................................................................................12

2.2 COPING STRATEGIES AND COMPENSATORY BEHAVIOUR.........................................122.3 PSYCHOLOGICAL AND SOCIAL ASPECTS OF AGEING................................................132.4 CRITERIA FOR ACCEPTANCE OF TECHNOLOGY........................................................14

2.4.1 Response to companion and service robots...........................................................152.5 TRAINING NEEDS FOR LEARNING TO USE TECHNOLOGY........................................162.6 OVERVIEW OF EXISTING ASSISTIVE TECHNOLOGY AND SERVICE ROBOTICS SYSTEMS...............................................................................................................................172.7 CONCLUSIONS.............................................................................................................25

3 FURTHER ANALYSIS OF THE DATA GATHERED...................................................26

3.1 MECHANISMS USED TO TRANSLATE USER NEEDS INTO SYSTEM SPECIFICATIONS..263.2 CODING AND INTERPRETATION..................................................................................27

3.2.1 User Characteristics..............................................................................................273.2.2 Key Themes............................................................................................................27

3.2.2.1 Nutrition......................................................................................................................................................273.2.2.2 Health and Well-Being...............................................................................................................................283.2.2.3 Safety............................................................................................................................................................283.2.2.4 Comfort........................................................................................................................................................28

3.2.3 Clustered feedback to the concepts.......................................................................293.3 CONCLUSION...............................................................................................................30

4 DETAILED FUNCTIONAL AND NON-FUNCTIONAL REQUIREMENTS...............31

4.1 REQUIREMENTS PRIORITISATION AND SELECTION – SUMMARY OF EXPERT COMMITTEE DISCUSSION AND RESULTS..............................................................................314.2 SUMMARY OF HIGH LEVEL FUNCTIONS AND DISCUSSION POINTS..........................324.3 DETAILED FUNCTIONAL REQUIREMENTS.................................................................36

4.3.1 Function for reminder and encouragement to eat (Nutritional Assistance).........364.3.1.1 Use cases......................................................................................................................................................364.3.1.2 Function specification and assumptions...................................................................................................364.3.1.3 Content Requirements:..............................................................................................................................374.3.1.4 Sub-Function Requirements......................................................................................................................374.3.1.5 Process Specification..................................................................................................................................37

4.3.2 Function for Reminder and Encouragement to drink (Dehydration Prevention). 394.3.2.1 Use cases......................................................................................................................................................394.3.2.2 Function specification and assumptions...................................................................................................394.3.2.3 Content Requirements...............................................................................................................................394.3.2.4 Sub-Functions Requirements....................................................................................................................404.3.2.5 Process Specification..................................................................................................................................41

4.3.3 Function for Reporting to health professionals.....................................................424.3.3.1 Use cases......................................................................................................................................................424.3.3.2 Function specification and assumptions...................................................................................................424.3.3.3 Content Requirements...............................................................................................................................424.3.3.4 Sub-Function Requirements......................................................................................................................424.3.3.5 Process Specification..................................................................................................................................43

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4.3.4 Function for a tele-medicine/self-check................................................................444.3.4.1 Use cases......................................................................................................................................................444.3.4.2 Function specification and assumptions...................................................................................................444.3.4.3 Content Requirements...............................................................................................................................444.3.4.4 Sub-Function Requirements......................................................................................................................444.3.4.5 Process Specification..................................................................................................................................45

4.3.5 Function for Games for Social and Cognitive Stimulation...................................464.3.5.1 Use cases......................................................................................................................................................464.3.5.2 Function specification and assumptions...................................................................................................464.3.5.3 Content Requirements...............................................................................................................................464.3.5.4 Sub-Function Requirements......................................................................................................................464.3.5.5 Process Specification..................................................................................................................................47

4.3.6 Function for Voice/Video/SMS via robot communication with friends and relatives.............................................................................................................................48

4.3.6.1 Use cases......................................................................................................................................................484.3.6.2 Function specification and assumptions...................................................................................................484.3.6.3 Content Requirements...............................................................................................................................494.3.6.4 Sub-Function Requirements......................................................................................................................494.3.6.5 Process Specification..................................................................................................................................50

4.3.7 Function for a mobile intercom for enabling front door entry..............................524.3.7.1 Use cases......................................................................................................................................................524.3.7.2 Function specification and assumptions...................................................................................................524.3.7.3 Content Requirements...............................................................................................................................524.3.7.4 Sub-Function Requirements......................................................................................................................524.3.7.5 Process Specification..................................................................................................................................53

4.3.8 Function for responding to call for help from the user.........................................544.3.8.1 Use cases......................................................................................................................................................544.3.8.2 Function specification and assumptions...................................................................................................544.3.8.3 Content Requirements...............................................................................................................................544.3.8.4 Sub-Function Requirements......................................................................................................................544.3.8.5 Process Specification..................................................................................................................................55

4.3.9 Function for Encouragement for exercising..........................................................564.3.9.1 Use cases......................................................................................................................................................564.3.9.2 Function specification and assumptions...................................................................................................564.3.9.3 Content Requirements...............................................................................................................................564.3.9.4 Sub-Function Requirements......................................................................................................................574.3.9.5 Process Specification..................................................................................................................................58

4.4 NON-FUNCTIONAL REQUIREMENTS...........................................................................594.4.1 User Acceptability.................................................................................................594.4.2 Environmental and Operational............................................................................594.4.3 Training Needs and Support..................................................................................604.4.4 Usability and accessibility.....................................................................................604.4.5 Comfort..................................................................................................................614.4.6 Help and documentation........................................................................................624.4.7 Performance..........................................................................................................624.4.8 Maintainability and Support..................................................................................624.4.9 Security and privacy..............................................................................................634.4.10 Cultural and Political..........................................................................................63

4.5 FINAL CONCLUSIONS..................................................................................................63

5 CONTENT RECOMMENDATIONS FOR FUNCTIONS...............................................64

5.1 ADVICE ON NUTRITION..............................................................................................645.2 ADVICE ON EXERCISE.................................................................................................65

6 POLICY CONTEXT AND EXISTING PRACTICE FOR PROVISION OF SUPPORT SERVICES FOR OLDER ADULTS.......................................................................................66

6.1 IN THE UK...................................................................................................................666.1.1 Prevention policy...................................................................................................67

6.1.1.1 Prevention and early intervention.............................................................................................................676.1.1.2 Joint strategic needs assessment (JSNA)..................................................................................................686.1.1.3 World class commissioning........................................................................................................................68

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6.1.1.4 Personalisation............................................................................................................................................686.1.1.5 Market development...................................................................................................................................696.1.1.6 Partnership and whole system approaches..............................................................................................696.1.1.7 Involving older people and carers.............................................................................................................69

6.1.2 Provision of support services for older adults in the UK......................................706.1.2.1 Background Statistics.................................................................................................................................70

7 APPENDICES....................................................................................................................72

7.1 NL QUESTIONNAIRE RESPONSES...............................................................................727.1.1 Setting A – Residential...........................................................................................72

7.1.1.1 Care staff.....................................................................................................................................................727.1.2 Setting C – Independently living............................................................................78

7.1.2.1 End-Users....................................................................................................................................................78

8 REFERENCES...................................................................................................................84

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Table of Figures

Figure 1 MOBISERV’s user-centred design approach............................................................26Figure 2 Methods used to translate user needs into system requirements and specifications..27Figure 3. Process specification for the Nutritional Assistance Function.................................38Figure 4 Process specification for the Dehydration Prevention function................................41Figure 5 Process specification for reporting to health professionals.......................................43Figure 6 Process specification for tele-medicine.....................................................................45Figure 7 Process specification for games function..................................................................47Figure 8 Process specification for video/voice/SMS Outgoing communication.....................50Figure 9 Process specification for video/voice/SMS Incoming communication.....................51Figure 10 Process specification for mobile intercom...............................................................53Figure 11 Process specification for responding to call for help...............................................55Figure 12 Process specification for encouragement for exercising.........................................58Figure 13. The eatwell plate, FSA...........................................................................................64Figure 14 Brightly coloured pictures from www.ageuk.org.uk...............................................65Figure 15 Demographic data, current and projected from the National Statistics Office UK. 66

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List of Tables

Table 1. Summary of recent and current assistive technology.................................................24Table 2 Summary of prioritisation discussion for the High Level Functions..........................35Table 3 Sub-Functions for F_1................................................................................................37Table 4 Sub-Functions for F_2................................................................................................40Table 5 Sub-Functions for F_19..............................................................................................42Table 6 Sub-Functions for F_17..............................................................................................45Table 7 Sub-Functions for F_18..............................................................................................47Table 8 Sub-Functions for F_11..............................................................................................49Table 9 Sub-Functions for F_14..............................................................................................53Table 10 Sub-Functions for F_6..............................................................................................55Table 11 Sub-Functions for F_8..............................................................................................57

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Executive Summary

This document, D2.3: MOBISERV Initial System Requirements Specification, Volume II presents further analysis and investigation of stakeholder issues, following on from the last submitted deliverable – MOBISERV D2.3 v8.

This report is seen as a continuation of the previous deliverable, which will be referred to as Volume I, and as such, is seen a living document with a new volume being compiled for each review, which will build on and extend the previous findings as more issues are identified. The findings reported in these Volumes I and II should assist in bringing the lifestyles of the older persons and other stakeholders closer to the engineers. This will help to ensure that the MOBISERV technologies are centred on a solid appreciation of user needs and contexts.

Investigating the people, activities and their contexts continues to be achieved through a series of primary research as well as secondary research – valuable information from other similar studies. This information will continue to provide guidance on how the MOBISERV components should be designed to ensure user acceptance, usability and utility.

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Glossary

Term ExplanationMOBISERV An Integrated Intelligent Home Environment for the Provision of Health,

Nutrition and Mobility Services to the ElderlyF_x Function id (Original ids retained)F_x.y Sub-Function Requirements id (Original ids retained)ILAEXP Independent Living & Ageing & cross-industrial committee of expertsProspagnosia

Facial perception disorder which inhibits the ability to recognise facesi

Aphasia Also known as Anomic aphasia, inability and difficulty with recalling words and namesii

Agnosia Neurological illness or consequence of a severe brain injury which results with a loss of the ability to recognise people, objects, shapes, sounds despite no defect in a specific sense or major memory lossiii

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1 Introduction

1.1Objectives of this Document

This document has the following objectives:

1. To review current and previous research in the areas of understanding the context within which assistive technology will be used for older adults.

2. To present the outcomes of a deeper analysis of the data gathered as part of Task 2.3.3. To provide a refined corpus of scenarios to be used to inform the design and

evaluation of the MOBISERV technology4. To identify a refined set of functional and non-functional requirements5. To identify appropriate content for realising the implementation of the functional

requirements6. To understand the policy context and existing practice for provision of support

services for older adults in the UK

1.2 Structure of this report

In Section 2 there is a state of the art review of requirements based on a comprehensive secondary literature review. Section 3 provides the outcome of further analysis of the data gathered as part of task 2.3. Section 4 provides a refined set of functional and non-functional requirements, as well as use-cases and process flow specifications. Section 5 provides content that can be incorporated within the functions to ensure validity of the information. In Section 6 there is a review of policy context and existing practice for provision of support services for older adults in the UK which will ensure contextualisation and grounding for the services being developed within MOBISERV. This will assure that the design and development is taking place within an existing framework, evolving with reference to it, rather than outside it.

The Appendices contain further user data from the NL site, extracted from questionnaires and cultural probes with end users and direct stakeholders such as professional caretakers.

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2 Literature Review

A secondary literature review has been conducted to find out what issues have been elicited for contexts similar to the MOBISERV system. The issues are discussed in relation to the following themes that have emerged: Constraints to implementation of assistive technology, barriers and exclusion at home, attitudes towards technology, coping strategies, criteria for acceptance for technology and response to companion and service robots. These issues provide a comprehensive understanding of the contexts within which we need to design our systems as well as providing useful guidance for conducting our trials.

2.1Constraints to implementation of assistive technology

2.1.1 Barriers and exclusion at home

Barriers to the use of digital technologiesA qualitative report by Age Concern UK and Help the Agediv, supported by the BT British Telecom has revealed and distinguished barriers that older people must overcome if or when using modern digital technologies. In the UK, 64% of people over 65 have never used Internet technologies. Large portion of this group comes from lower social-economic background and higher ages. In this report four key barriers have been identified in relation to internet use: 1. Lack of un-derstanding of and confidence with ‘how it works’, fears and anxieties about ‘doing some-thing wrong’ as well as internet security 2. Digital technologies dismissal, people who have a means of accessing the Internet but choose not to, either because they are against the idea, or a way to justify their lack of confidence 3. A perception that it will be too hard to learn, 4. Affordability for people with a low income.

Outcome for MOBISERV requirements: A common feature is a lack of understanding and confidence when using digital media which is a barrier, therefore ensuring the provision of a support and training framework as part of the system will be important to consider.

Barriers to aging at home and mobility One of main objectives of the MOBISERV project is to allow older people to maintain a good quality of living in their home environment. As the aging process advances, the existing home environment poses increasing number of challenges. Sixsmith et al.v report barriers at home that have been investigated through a series of interviews. The findings have shown that physical aspects of houses (stairs, steps) present a fundamental problem often requiring significant investments to be adjusted for physical impairments. Another problem arises from the fact that elderly, fragile people are sometimes reluctant to modify their environments for aesthetic reasons or because of simple refusal to face their own physical decline. Often people are unable to accept their physical and cognitive decline, choosing to conceal their in-creasing frailty.External barriers are by and large related to transport difficulties. For elderly people living outside city centres, travelling can be essential for socialising, shopping or health visits. A good proportion of over 70s is not able to drive anymore and have to rely on public transport. This brings problems like waiting on bus stops in severe weather conditions. Reduced mobil-ity typically affects socialising, which consequently provokes loneliness and isolation.

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Outcomes for MOBISERV requirements – It will be important to ensure sensitivity towards any modifications that might need to be made, eliciting issues in a supportive manner to enable appropriate customisation of the system, as well as flexibility in relation to aesthetic preferences.

2.1.2 Attitudes towards technology

In a comprehensive study by Mitzer et al.vi where 113 older adults participated in focus groups in the USA to discuss their use and attitudes about technology in the context of their home, work and healthcare, it was found that positive attitudes outnumbered negative attitudes suggesting that older adults perceive the benefits of technology use to outweigh the cost of such use. Positive attitudes were most frequently related to how the technology supported activities, enhanced convenience, and contained useful features. These included speed of response, the technology’s ability to perform operations quickly, such as to access, store and retrieve information. Also the portability and small size of devices were positively viewed. Negative attitudes that were most frequently associated with technology included creating inconveniences such as interruptions – phones ringing at inconvenient times, and physical and mental effort required to use devices. In this study, physical inconvenience was a complaint specific to healthcare technologies. The researchers stated that this could be due to the fact that many measures of physical health status rely on some sort of physical intrusion or discomfort. Another negative attitude was expressed when technologies had too many or too few features or programming options and the researchers suggest that customisation or adjustability or features may be a preferable case where it is possible. Security and reliability concerns are also a source of negativity towards technology. Safety concerns include worries of physical danger and health risks. Reliability issues include experience of technology performing inaccurately or undependably.

Outcome for MOBISERV requirements: The scope of each of the features will have to an adequate level of customisation to ensuring a match with physical and cognitive abilities, as well as personal and social requirements of the individual.

2.2 Coping strategies and compensatory behaviour

Dickinson et al.vii conducted observations in users homes as part of the UTOPIA Usable Technology for Older People: Inclusive and Appropriate) project which gave them an insight into observing how people cope with everyday issues and their use of artefacts around them. Observing an older adult retrieving her phone with her walking stick and hitting it several times suggests a phone must be robust enough to withstand such treatment.

Forlizzi et al.viii describe an ecology of aging, comprised of people, products and activities which take place in their home and surrounding community. The components of the ecology of aging are part of a system and are interconnected. They state that these components are adaptive, illustrating this by means of the following example: If one part of an older person’s life breaks down (e.g. the person is no longer able to drive safely), another part must change (the person will rely on family and make less frequent trips, or hire a community taxi service). They also find that the flow of information among components can be complex and have unexpected consequences, such as sources of information and information channels between the older person and the health care provider. Another aspect of the components within the ecology is that they are dynamic and evolving, and the experience of the person

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depends on the choices made, for example choice of assistance after breaking a hip, ranging from home to institutional. Forlizzi et al. also state that the ecology has a potential to break down, for instance opting for a particular option can have a detrimental impact on certain aspects of the person’s quality of life and well-being. Having an appreciation of this balance of this ecology and ensuring adaptability and flexibility of the MOBISERV system to respond to the changes will be an important part of the system’s ultimate success. Changes in physical and cognitive ability over time will contribute to fundamental changes in the interactivity with the system, as well as the level of reliance on the system that need to be considered. They examined how perceived status can affect their social interactions, why they want certain products, how they use those products, how they operate in their environment and the activities and experiences that they engage in at home or in their community. They found that for older adults new products can meet emerging needs, but they can also serve as a source of frustration and hardship. For example a Zimmer frame offers a chance to retain autonomy, but if it is too heavy or cumbersome then it may prompt further reliance on others. Objects and experiences present new meanings in the ecology of aging and it is up to the researchers to identify these issues and address them accordingly. Longitudinal studies are suggested as a means of studying how users lives unfold, for example as they make the transition from independent living to institution.

Outcome for MOBISERV requirements: It will be important to take a holistic view of individuals’ environment and lifestyle, not as a one off assessment, but a more in depth consideration of routine and social activities, within and outside the home over a period of time. This will help to ensure that the system truly integrates to the personal behaviours and circumstances.

2.3Psychological and social aspects of ageing

Loss of close companionship, resulting in loneliness and depression is often something that has been found to accompany growing oldix, ii. Risk factors for depression, as a clinical condition, include self-perceived health, functional limitations and smaller network size, which can have differing impacts depending on biological factorsx. Aguirre et al.xi have considered making older people and their relatives aware of a possible presence of depression through monitoring patterns of communication, loss or gain of weight and variations in sleep patterns and encourage frequent social contact by suggesting social activities.

Outcome for MOBISERV requirements: The MOBISERV components have the potential of also monitoring some of these risk factors through the Wearable Health Status Monitoring Unit and analysis could provide deviations from individual basal patterns established at the start. Therefore keeping a long-term record of appropriate data with the consent of the users could result in the capability of incorporating this functionality in the future. However Bharucha et al.xii point out that there are a number of critical research gaps in the efficient collection and storage of voluminous real-time continuous data from multi-modal sources, as well as the need to develop automated data reduction and mining techniques to identify clinically meaningful events and deviations from a prior baseline. These are opportunities that can be also be addressed by the MOBISERV consortium.

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2.4Criteria for acceptance of technology

Heerink et al.xiii explored the concept of enjoyment as a possible factor, which might influence acceptance of robotic technology by older adults. They conducted an experiment with a conversational robot, iCatxiv, on 30 users, which incorporated both a test session with an interactive robot and a long-term user study. Ages ranged from 65 to 94 with 22 female and 8 male. Data was gathered using questionnaires and observation sessions. This study confirmed the role of enjoyment as a positive factor influencing robotic technology acceptance by older adults and that the model of technology acceptance that implies that intention to use reflects the user’s actual use is also applicable to specific technology used by older adults. Users who indicated that they were not interested in participating with the robot were all observed interacting with the robot in the tearooms, as soon as the room was empty, implying that just because someone does not wish to participate in a test, this does not mean they are not interested in (or curious about) the system. The authors suggest that these users may have been prevented from participating because they felt embarrassed. They are interested in finding ways to tempt these users to participate and avoid creating the impression that test subjects will ultimately encounter some form of embarrassment. They suggest it may be valuable to encourage these potential users to participate in different ways.The study implies that non-functional aspects could be an important factor in raising the levels of enjoyment for older adults who use a system and the fact that a social robot is not just for assistance, but also a welcome companion.

In a more recent study, Heerink et al.xv describe a UTAUT (Unified Theory of Acceptance and Use of Technology) Toolkit they have developed to assist in the evaluation of a user’s acceptance of social robots. Previous results have shown that a more extravert robot was perceived as more socially intelligent and was more likely to be accepted by the user than a more introvert version.The researchers felt it was necessary to develop the model because this type of research is multidisciplinary and requires some formalisation of method of interpretation. UTAUT constructs that were applicable were Anxiety, Attitude, Facilitating Conditions, Social Influences and the ‘classic TAM (Technology Acceptance Model) constructs which are Perceived Ease of Use and Perceived Usefulness. These constructs are shown to have a degree of interrelations. Although used in this study to measure technology acceptance it could perhaps be used to measure a user or carers anticipated level of technology acceptance when eliciting non-functional requirements for the system.

Forlizzi et al.xvi found that older people generally want products that match their aesthetic desires and use products that support their functional needs and abandon those that don’t. Also the most important products are the ones that support their values of personal identity, dignity and independence.

Outcome for MOBISERV requirements: Considering ways of making the interaction with the system enjoyable and engaging as well as ensuring utility of the functionality will be important. It will also be vital to investigate whether assistive service robots and technology are better presented as aids rather than carers, and to what extent the image of being “cared for” by a machine affects a person’s concept of dignity and independence. The findings will have an impact on the embodiment of the Portable Robotic Unit.

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2.4.1 Response to companion and service robots

Wada et al.xvii used questionnaires read to participants to evaluate the effects of a seal robot, Paroxviii, on older adults in a nursing home. They used a Profile of Mood States (POMS) scale (McNair et al, 1992)xix and the social readjustment rating scale (Homes and Rahes, 1967)xx to investigate subject’s mood before and after introduction to the robot. They conducted experiments over three weeks and participants were exposed to the robots in 2 groups for an hour a day, 4 days a week. The robot was passed between the participants in turn and they all spent an equal amount of time with it. They found that the robot increased happiness in those that used it and that they interacted with it willingly. It also encouraged them to communicate with each other and the nursing staff. One resident who was not sociable with others or staff sang to the robot and made the rest of the group laugh, another made up a song about the robot and sang it to the robot. Two robots were used in the study - one with interactive skills and a placebo, the authors noted that both had positive effects on the users, as determined by post session questionnaires. Their stress levels were reduced. Interestingly the subjects did not notice that the placebo Paro's actions were following a pattern rather than in reaction to their actions. Also participants interpreted their own meaning from the actions of the robot.

Another study involving the Paro seal robot, by Kidd et al.xxi, also conducted in a social community setting where the robot was introduced as a shared artefact, belonging to the group. Here it was found that the robot stimulated social interaction between residents, giving them something to talk about and allowing them to share an interesting social experience, which raised their esteem.

Ezer et al.xxii sent questionnaires through the post in order to investigate the types and characteristics of tasks that younger and older individuals would be willing to let a robot perform. They mailed questionnaire packets to 2500 younger adults (aged 18-28) and 2500 older adults (aged 65-86). A total of 310 packets were mailed back from respondents. Of these, 177 were completed and answered by individuals in the targeted age groups – 60 younger adult respondents (M = 22.7 years) and 117 older adult respondents (M = 72.2 yrs) – thus the effect rate of return was just 5.6%. They found that respondents from both groups would prefer a robot to perform infrequent but important tasks that require little interaction, such as emergency notification, rather than service - type chores that require recurrent interactions. Older adults reported more willingness than younger adults in having a robot perform critical tasks in their home and results suggest that both younger and older individuals are more interested in the benefits that a robot would provide than in their interactive abilities. The results contradict the belief that older adults are less willing to have a robot in their home than younger adults.

Outcome for MOBISERV requirements: The above supports many of the envisioned MOBISERV use-cases and functionalities, by stating that a robotic system should support “infrequent but important tasks that require little interaction”. Many of the MOBISERV functionalities, such as the ‘nutrition assistant’, the ‘dehydration prevention’, the ‘panic responder’ and the ‘physical exercise encouragements’ will run in the background, and show up only when absolutely necessary.

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2.5Training Needs for Learning to Use Technology

Mitzner et al.xxiii explored training preferences for learning to use technology and found that older adults definitely had a desire for additional training for technology items they used in the home. Their training needs varied depending on their goals and they expressed an interest in training particularly for specific tasks rather than general or basic training. Older adults benefit from procedural training to a greater extent than conceptual training. People also generally preferred the training to be conducted by themselves, family and peers, and domain professionals. Czaja et al.xxiv has also noted that a negative attitude and low perceived self-efficacy are likely to impact learning proficiency.

Mitzner et al.’s findings also suggest that older adults have a strong preference for self-training by reading manuals and other printed instructions and by hands-on learning through trial and error.

Outcome for MOBISERV requirements: Training methods for learning to use technology is something we will definitely explore more within MOBISERV; how to introduce the robot and associated MOBISERV system and components to the end users. We will start from the findings above, and explore ways to let the robot introduce itself to the end users, and teach the end users the specific functionalities by hands-on learning and trial and error.

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2.6Overview of existing assistive technology and service robotics systems

A review was conducted to understand the scope and potential of existing developments in the area of assistive and service robotics, which provides strategic underpinning for technology being developed as part of MOBISERV.

Type of AT Name of AT Target Audience

Research or Commercial

Description Status

Cognitive Prospective Memory aid

Memory Glassxxv Amnesia sufferers, mild Alzheimer’s disease, dementia, prosopagnosia, normal aging, mild cognitive impairment

Research Context-aware eyeglasses which can be used to manage anomia and agnosias. Reminder system.

Evaluations conducted with healthy participantsNo evaluations have taken place with less healthy participants


MemoClip xxvi Amnesia sufferers, mild Alzheimer’s disease, dementia, normal aging

Research Wearable badge attached to users clothes which is associated with task information such as time, location and context



Friedman xxvii Normal aging, mild cognitive impairment, mild Alzheimer’s disease or other dementia

Research Wearable microcomputer which uses both radio and ultrasound to determine user’s location and provides task based information. Voice prompts are only issued when required which reduced the user’s dependence this aid


Cognitive AutoMinder xxviii Normal aging, Research Cognitive orthotic device which Early prototype has not been

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Description Status

Prospective Memory aid

mild cognitive impairment, mild to moderate Alzheimer’s disease, or other dementia

can model user’s daily activities and issue reminders accordingly

evaluated with intended target audience

Cognitive aphasia

VERA (Visually Enhanced Recipe Application) xxix

Normal aging, aphasia

Research Sound and text based interface which mainly provides visual displays for cooking instructions that can be customised for aphasic users

It has not been determined whether text or sound is more suited for issuing cooking reminders

Cognitive aphasia

Cooks Collage xxx Normal aging, aphasia

Research Video reminder system which displays the various stages for preparing a meal using previous six stages taken on a monitor

Evaluations are currently in progress

Environmental PlaceLabxxxi Research Detects motion and activities with a combination of sensing devices integrated into the architecture of the house as well as on devices and wearable sensors

Effective in association of usage with other similar environment sensing aids which can be used to detect and monitor user activities

Physiological Bedwetting alarms xxxii

Anyone regardless of cognitive impairment

Commercial Pads detects moisture Various bedwetting alarms are commercially available

Physiological GlucoMON xxxiii Anyone who requires their blood sugar levels to be monitored

Commercial Monitors blood sugar level Can be operated with existing blood sugar level monitoring devices

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Description Status

Physiological Fall detector xxxiv Vulnerable to falls

Commercial This Wireless sensor is worn on a belt or in a pouch with an elastic belt can automatically detect serious falls and raise an alert to the monitoring centre or designated carer.

A button on the front can also be used to call for assistance which could be used to replace the Amie or Gem Pendant.

Physiological University of Virginia floor vibration based fall detector xxxv

Vulnerable to falls

Research Piezoelectric sensor joined to the floor monitors floor vibration patterns

Very successful lab tests (100% accurate detection 0% false alarms),

Physiological Vibrating gel insoles xxxvi

Vulnerable to falls

Research Viscoelastic silicone gel insoles with embedded vibrating components to assist and improve balance

Sensor is lightweight and so can easily be embedded in shoes

Advanced integrated sensor set

BodyMedia xxxvii Anyone who requires monitoring of metabolic and physiological data

Commercial Wearable upper arm band that monitors user’s metabolic and physiological information. Armband maybe uncomfortable and or intrusive for some older people

Available for general public


Garmin Forerunner xxxviii

Anyone who requires

monitoring of metabolic and physiological

data

Commercial Wearable wrist GPS device which monitors heart rate, distance covered and calories burned

Mainly designed for use by athletes

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Description Status


CareWatch xxxix Mild cognitive impairment, mild to moderate Alzheimer’s disease or other dementia

Research Multisensory system which informs carer whether user is moving within the home, attempting to open a door or in bed

Published data of clinical trials is now available


CareMedia xl Mild to severe Alzheimer’s disease or other dementia

Research Automated system which uses video and sensor to monitor behaviour, activity and social interaction

Feasibility study and follow up comprehensive study has taken place in a dementia ward


COACH (Cognitive Orthosis for Assisting Activities in the Home)xli

Mild cognitive impairment, mild to moderate Alzheimer’s disease or other dementia

Research Computer vision system that can interpret hand positions with stages of hand washing

Tested with 10 moderately to severely demented users who were able to complete 25% more stages correctly without carer assistance

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Description Status


Radio frequency (RF) transmitter home monitoring system xlii

Anyone at risk from dementia

Research Motion detection sensors and wireless network is installed at the users home and user is required to wear a watch so that the system is able to monitor their motion within their home

The feasibility of the research prototype has only been demonstrated in a single home using a 3-week longitudinal record of RF transmission data as part of a larger study of persons at risk for dementia


PROACT (Proactive activity toolkit) xliii

Mild cognitive impairment, mild to moderate Alzheimer’s disease or other dementia

Research Computer based system which uses RF technology to recognise activities of daily living and performance of these activities. User wears a glove which detects RF signals placed on objects within the users home

Tested on a group of participants aged 25 to 63, results showed the system recognised 14 activities of daily living and detected 88% occurrence, 73% of which were correct


European Commission on SmartFarbrics Project (WEALTHY garment, MyHeart) xliv

Research Wearable vest which monitors EKG, breathing, EMG and physical activity

Tested with 5 cardiac and 7 healthy participants (none over the age of 64)

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Description Status


BioHarnessBTxlv Anyone who requires

monitoring of metabolic and physiological

data

Research and Commercial

Wearable device which monitors heart rate, EKG, breathing, temperature and other vital signs

SDK available for research


Microsoft Sensecam xlvi

Memory loss Research Wearable neck device that consists of a passive digital camera, sensors and 3 axes accelerometer.

Case reports with older persons with limbic encephalitis and mild to moderate AD suggest improved recall of autobiographical events. Poor resolution images may not be suitable for memory report

Assistive robot Gecko Systems CareBot xlvii

Older people, chronically ill and children

Research Mobile service robot platform which can act as a nurse’s aide responding to commands from medical personnel. Carebot can also perform various carer related tasks such as replacing bed pans and other mundane or undesirable tasks allowing the carer to focus on patients. Carebot can carry over 200lbs and also provides Telemedicinal functions.

Cost effective monitoring, virtual visits, automatic reminders, companionship, automatic emergency notification and trials of this robot have taken place

Assistive robot Intouch health RP-7 xlviii

Medical professionals, stroke victims, hospital patients

Commercial Mobile robotic platform which provides the means for a medical professional to provide rapid assessment of stroke patients in emergency rooms

Has been tested on both stroke and oncology wards in the USA and has also been demonstrated with assisting health professionals with teaching students

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Description Status

Therapeutic robot

Paro (National Institute of Advanced Industrial Science and Technology Japan) xlix

Older people, hospital patients and the sick

Commercial Therapeutic robotic seal which uses tactile sensors to respond to being stroked, petted, speech and sounds.

Research conducted with dementia patients in Japan resulted with half the patients showing an improvement in brain activity after spending time with the robot

Assistive robot Ri-man (Riken bio-mimetic control research centre) l

Bedridden patients

Research Soft humanoid interactive robot which has the skill and ability to carry out human care and welfare tasks. Soft areal contact sensors measure magnitude and position of contact force. Body is covered with soft material for physical safety with human robot contact and mechanical

Under development

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Description Status

joints are isolated

Assistive robot Twendy-One li Older people Research Human symbiotic robot designed to assist with nursing care and housekeeping. Outer shell is overlaid with silicone skins and force sensors which detect physical contact

Passive impedance mechanism allows the robot to adapt to unexpected external forces Projected cost to supply the robot may exceed current cost of human care

Assistive robot Companionable lii Older people suffering from dementia prone to social exclusion

Research Integrated cognitive assistive and domotic companion robotic system for ability and security

Graceful, scalable cost effective integration

Table 1. Summary of recent and current assistive technology

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2.7Conclusions

This literature review has provided a number of insights into integration and interaction issues that need to be addressed as part of the MOBISERV project, particularly in relation to providing a system which will be relevant and thus valued and used.

The recent and current systems identified provide useful background information for the development of the different MOBISERV components that the consortium can build upon.

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3 Further analysis of the data gathered

This chapter presents further analysis of all the primary data gathered in the first year of the project. The focus of this analysis was to explore in more depth the themes identified in the first release of this document as well as any relationships between the themes. The ensuing coding helps to translate emerging issues clearly into functional and non-functional requirements.

3.1Mechanisms used to translate user needs into system specifications

Incorporating a broad user-centred design approach, we used several data gathering, concept generation, and user counselling iterations, designed to result in a deeper and more informed understanding of issues with each succeeding approach. The foci of the subsequent stages were refined depending on the outcome of the previous stages.

As depicted in the figure below, we started with observations in older people’s homes and living environments. Based on what we experienced and learned here, we started interviewing the end-users, their carers, their family and secondary stakeholders, to get a deeper understanding of the older people’s lives, their habits, problems and needs. Based on these outcomes, cultural probes were designed to focus on specific aspects of older people’s daily lives, and very early concept ideas were generated and discussed in focus group workshops with a mixture of end-users and other stakeholders.

Figure 1 MOBISERV’s user-centred design approach

During, and right after the initial user requirements elicitation phase of the project, the ex-tensive data from all stages of the user-centred design approach was thoroughly analysed and coded. As shown in the figure below, key themes including their many details were extracted and end user characteristics were analysed and grouped in several personas. Using the perso-nas scenarios were developed addressing the emerging key themes. These scenarios and use cases form the basis for the envisioned MOBISERV system and its functionalities.

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Qualitative & Quantitative Data Analysis

Key Themes Scenarios / Use Cases

PersonasEnd User Characteristics

Function Requirements

MOBISERV functions

Observations, Interviews, Questionnaires, Cultural

Probes, Focus Groups


Figure 2 Methods used to translate user needs into system requirements and specifications.

3.2Coding and interpretation

Previously coded data fragments extracted from the results of the initial user requirements elicitation phase (appendices of deliverable 2.3 Volume I) and subsequently gather data were reanalysed in more depth. A very short summary will be given here.

3.2.1 User Characteristics

A large variability in the data was noted: Age between 59 to 95 Gender ratio male/female between 1:7 to 1:15 Most live alone, on their own or in a residential home Most are not graduated Type and level of handicap:

o mild dementiao limited mobility, they can’t do what they want to doo severe somatic handicaps, that is physical, not mentalo incontinenceo social isolation, lonelinesso malnutrition, do not eat and drink enougho falling o exhaustion caused by restlessness

Variety in technology use, most have a TV, some have a cell phone, few have a computer, very few use internet or email

3.2.2 Key Themes3.2.2.1 Nutrition

The data gathered has illustrated different ways in which older people regulate themselves in order to ensure they are eating and drinking enough. This provides a valuable insight into how these functions may be implemented. Suggestions from participants for content for

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encouragement included showing images of food and drink, as well as using cooking sounds and smells to encourage an older person to eat or drink. We will be conducting further research into evaluating different approaches that have been identified by older people regulate themselves and methods that are used by carers, friends and family. The findings will provide a valuable insight into how these aspects of the system can be implemented successfully. Once this has been established and can be explained to older people, this may increase perceived usefulness of these functions and therefore improve acceptability amongst older people of the system as a whole.

3.2.2.2 Health and Well-Being

Our findings show that older people regulate themselves not just in regards to their diet, but also to ensure they are taking their medication correctly (correct dosage, correct time, managing prescriptions, etc.) and as well as exercise. This has provided useful insight into how these actions can be supported by the functions of MOBISERV. Continuing investigations will reveal which methods are found to be most effective, with long-term benefits. This information will prove useful when designing the various encouragement features while also increasing acceptability amongst older people who want to develop an established routine in regards to ensuring a healthy lifestyle.

Utilising strategies that carers actively use to encourage a healthier lifestyle for older people will also prove useful when designing and implementing functions related to health such as nutrition monitoring and encouragement to exercise. For example, some users may be more receptive to particular suggestions in regards to encouragement to exercise compared to others. Increasing acceptability in regards to these functions may be achieved by considering established guidelines, methods and activities are used to promote and encourage a healthy lifestyle for older people. Consideration of attributes that are successfully applied to older people within specific categories such as similar level of handicap, age, gender etc. suggest options for customisation to suit individual needs.

A review of various organised activities, and methods to encourage participation within care homes and residential villages with older adults, has highlighted the effectiveness of different approaches towards encouraging participation in social activities. One example is the possible use of the video conferencing to enable older people to see others exercising with them which will be further investigated. Combining features of the system such as video conferencing to achieve one function could be applied to others such as encouragement to exercise related to encouragement to drink.

3.2.2.3 Safety

Our findings show that many older people are aware that they may be susceptible to injury caused by a fall or other type of accident. However some older adults are reluctant to discuss this with researchers on the grounds that they perceive the researcher suggesting that they are somewhat more vulnerable than what they believe they are. This reluctance to admit frailty and loss of functionality will be important to be aware of when customising and individualising the system to an individual. Concealment could lead to inappropriately or incorrectly configured systems that are not suit to the individual’s real condition.

3.2.2.4 Comfort

Physical comfort in relation to any devices that must be worn, and psychological comfort associated with the perceived usability and reliability of technology are key areas of concern

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that have emerged throughout. These are also found linked to acceptability in regards to computer anxiety. Identifying specific issues in relation to the MOBISERV system will only be possible when all the prototypes being to be evaluated as part of the field trials.

3.2.3 Clustered feedback to the concepts

This section covers issues arising in relation to the selected functions selected by the ILAEXP.

Nutrition MonitoringMalnutrition Many older people do not eat or drink enough.

Especially people living (semi-) independently. Many older people are dehydrated and do not understand the importance of drinking

enough.

Monitoring The majority of the carers agreed that nutrition monitoring is very important Carers suggested that nutrition monitoring may be of use to users suffering from

dementia, as some have no understanding of what food is what and often need to be told what to eat.

The majority of the end users were very negative towards nutrition monitoring. The majority of end users were against having cameras in their home and felt that it

would invade their privacy.Eating / drinking Monitoring the amount that people drink was suggested as more important than

eating.Locations Most end users sit in the same place to eat all their meals, either at the table or sat in

a comfy chair.

Assistant RobotInput All agreed that voice recognition is the best way to communicate with the robot.

The issue of voice recognition of multiple users was also raised. Some suggest that a graphical interface would be useful for people who had had a

stroke and were unable to speak.Voice The majority thought that it would be important to personalize the robot by selecting

gender and accent. Most did not like the American accent and would prefer an English one. The style of the interaction on the demonstration video was found “cold” and lacking

emotion.Embodiment Some thought that a humanoid robot might be best and would like it to have some

kind of facial expression to make it seem more human. While some thought that it looked cute, others found thought it looked very scary. A few thought that it didn’t need to have a form at all and just needed the base. Some were open to the idea of it being a pet but that fur might not be practical.

Control A number of participants pointed out the importance of being able to turn the robot off and to put it away, for example in a cupboard.

Functionality Many suggested that it would be very useful if the Robot had an arm or grabber so it would be able to pick things up for the user.

The participants were positive about the camera on the robot if it is used for video conferencing only, but reiterated the importance of being able to switch it off.

Smart TextilesClothes The majority is very positive about smart clothing.

Some participants suggested it would be better as a separate device, so they would know they were wearing it and it would not need to be washed as frequently as

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underwear. A number of participants and carers suggested that it might be necessary to have a

front fastening on the vest as many older people struggle to get into tighter clothing.Monitoring Some wonder who will be monitoring the signal.

Carers suggested it would be particularly useful if it could detect when a user had fallen.

Several carers do not see the benefit for their clients, but think such smart clothes would be more beneficial in a hospital.

Health MonitoringMonitoring The end users were generally negative about being monitored and information being

passed onto their doctor or carer. Falls and strokes were seen as important issues by carers and end users.

Reporting Few of the participants understand the use or importance of the system being able to produce reports.

Carers think that when users might think they are not ill enough to 'trouble' the doctor, the system can help to identify their illness and choose to contact the doctor if needed.

Emergencies Most end users felt that in an emergency a carer or doctor should be contacted straight away.

A number suggested that the system should ask the user first and if there was no response should then contact someone.

An 'override' function was suggested for certain situations - programmed to suit the needs of the individual.

Emotions Some carers could see the benefit of facial recognition but felt that end users may feel that it was an invasion of their privacy.

Video communicationSocial interaction Social isolation was identified as a very important issue.

Video communication can be very helpful. Some people still prefer using the telephone, which they feel most comfortable with.

Virtual contact with carers

Some staff have experience with video communication, but think it could be much improved and then be very helpful.

Several clients and social carers mention that they would be very happy with a video communication system.

3.3Conclusion

The findings summarised here and presented in Vol I have enabled the consolidation of specific functional and non-functional requirements that are presented in the next chapters.

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4 Detailed Functional and Non-Functional Requirements

4.1 Requirements prioritisation and selection – Summary of expert committee discussion and results

From the scenarios and functions identified in Volume I of the requirements specification, nine of them gained high ranking in the Independent Living & Ageing & cross-industrial committee of experts (ILAEXP) workshop (on prioritising MOBISERV requirements) held on September 21, 2010 in Paris, France. The committee used the following criteria to support their decision:

Strategic Value: Does this feature address the project’s objectives (DoW) in promot-ing health and well-being and independence for an individual?

Utility - Secondary stakeholders: How useful is this feature for secondary stake-holders? (By usefulness we mean, the secondary stakeholders are able to provide bet-ter services and improve the utilisation of their existing resources)

Utility - Tertiary stakeholders: How useful is this feature for tertiary stakeholders? (By usefulness we mean, the tertiary stakeholders are able to provide better services and improve the utilisation of their existing resources)

Technical Feasibility: Is there any technical or other risk associated with this require-ment/ feature (keeping in mind correspondence with the proposed technical solution in the DoW)?Scale of 1 (there are serious concerns about feasibility, the availability of staff with the needed expertise and/or resources, or the use of unproven or unfamiliar tools and technologies, within the scope and lifetime of MOBISERV) to 5 (no risk, the feature can be very easily implemented).

Market exploitation potential: Is this function exploitable from a financial perspect-ive?

Innovation: Is this function new? Does it significantly contribute to an increase in scientific research on AAL, and is it not already part of many other research projects?

The process of prioritisation involved a discussion of the scenario and use-case related to a particular function followed by independent voting. Each member of the committee then read out their score and explained the rationale behind their score and this was noted. Using a weighted average, the overall score was calculated and noted. On ranking the scores in order and applying a cut-off threshold, 11 functions were selected, with four being combined into two, resulting in a total of nine functions.

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4.2Summary of High Level Functions and discussion points

Proposed Function-ality

Score Discussion

Encouragement to drink

36.5 It was recommended that this function be merged with Reminder to Drink. The research would be in the area of developing effective persuasion tech-niques from a psychological level and this would have to be an aspect that was customisable.

Encouragement to eat 35.5 It was recommended that this function be merged with Reminder to Eat. Again there was a lot of scope for researching persuasive methods. From a psy-chological perspective this was very important.

Reminder to drink 35 It was discussed that while this was a challenging function from a technical and practical perspective good results had been achieved in a laboratory set-ting. As such, the experts deemed the market poten-tial important. A name change to Dehydration Pre-vention was recommended to clarify functionality. This function was seems to have a high innovation aspect. Further evidence for supporting this function can be found in the Dutch national task force annual reportliii of 2010 on malnutrition shows that currently 17% of people receiving care at their home suffer from malnutrition. This is 21% for people living in care homes. Dehydration numbers are expected to be even higher, up to 25% of people living at home)

Reminder to eat 32.5 This function was deemed particularly important on strategic value. It was suggested that this function could be linked with the encouragement function. Some issues discussed included - thinking about what measures could be taken if the person did not give an accurate response - this could be by validat-ing user response by using information from sources. It could be also useful to consider help in relation to unhealthy eating- offering people healthy options as suggestions and tracking dietary intake when self de-clared and advising appropriately. Interactivity should include asking the person what was eaten and logging the information appropriately should be con-sidered. It was recommended that the wording of the function be altered for clarity. How the act of eating is detected needs to be communicated, as this is an innovative aspect of the project. Nutritional Assist-ance was one suggestion made. The discussion also included what information would be communicated to the secondary and tertiary stakeholders and the utility of the information for them. It is also import-ant to consider how the reminder would be personal-ised.

Reporting and com- 31.5 The utility and role of tertiary stakeholders needs to

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Score Discussion

municating to health professionals

be considered in more depth, in relation to their roles and commitments and how this could fit in with ex-isting service models. The utility for healthcare staff will also have to be clearly defined.

A tele-medicine/self check platform. (Finding out if everything is okay - in cases of detection of irregular patterns)

31 Clear provision of protocols and process will need to be considered and defined.

Games for Social and Cognitive Stimulation

30 This was seen as a very good and useful feature that could also have a positive impact on overall usage of the system. It was also recommended that exercises could be encouraged through games as well so there was potential to consider linking with encourage-ment to exercise functionality. With the potential ability to have an affective response during game play, by recognition of facial expressions for in-stance, was seen as an innovative development. Seri-ous considerations need to be given to the types of games available and the development costs associ-ated with this.

Voice/Video/SMS via Robot communication with friends and relat-ives

29 There will be overlap between this function and the one involving communication to health profession-als. The two-way communication could be initiated by care-givers to remotely communicate with the person in case of not being able to visit, alleviating social isolation and loneliness. As there are products already available for this purpose, it is important to define clearly the added value that MOBISERV can bring in terms of usability and accessibility for the target user groups.

A mobile screen con-nected to the front door

28.5 Combining this function with the other proposed features will enhance the overall utility of the MO-BISERV system giving it added value. The utility of the MOBISERV proposal for this functionality is that it is mobile, the person does not need to go to a fixed point, but the portable robotic unit can come to the person.

Response to call for help from the user.(Panic responder – Being able to call someone in an emer-gency)

28 Considerations were given to the technical aspects of enabling this functionality effectively. Suggestions were made in regards to embedding microphones in the environment or person. False positives would be important to consider avoiding overloading the response team who might be contacted. This is a risk of failure from a number of issues due to real life complexity and it was recommended that further careful consideration should be given to the risk factors to ensure reliability.

Encouragement for 28 There was potential for this to be developed into a

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Score Discussion

exercising very innovative function by considering ways of re-liably recognising inactivity/activity levels and mak-ing appropriate suggestions that are customisable to suit individual issues and circumstances. The inter-face should be given careful consideration - as with other functions. If an emotion centric element were considered for the nature of the encouragement, this would have a high innovation potential.Identifying the potential of incorporating a social element to this feature as well as linking to the games could be explored. A review of existing tech-nology, such as the Nintendo WiiFit was advised.

THRESHOLDReminder to take medication

27.5 There are a number of competing products which already exist in regards this function. As such there was a consensus over the low score on all criteria.

Allow user to check a particular medication

27.5 There was potential for combining this with the re-minder for taking medication, however an automated process is fraught with complexities relating to safety and reliability issues, as medication is not al-ways retained in its original packaging, which also varies considerably. At its simplest level, this could be achieved as part of the first-person telecommu-nication with medical personnel.

Food inventory 26.5 The committee members agreed that carers and rel-atives would be checking the contents of the fridge and pantry on an intermittent basis anyway. While providing this information to people with dementia is important, the technical feasibility of this would be quite complex - particularly managing leftovers etc. and non-pre-packaged meals and food. There is a possibility of enabling the users to interactively in-form the system, but that somewhat defeats the ob-jective of automation. Additionally it was noted that there has been quite a lot of research in this area already with no significant success.

A mobile remote for the house (lights, heating, curtains, locks)

26.5 This was viewed as having low market potential and innovation and outside the scope of the project as envisaged requiring a high level of external integra-tion.

Reminder for per-sonal hygiene

25 This was viewed as having low market potential and innovation and outside the scope of the project as envisaged and could requiring a high level of monit-oring. If required, this could be made part of the dairy scheduler.

Diary reminder/man-agement (Being reminded of social engagements

24.5 Extremely low scores in relation to the innovation criteria. Already implemented by Robosoft as part of their existing platform.

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Score Discussion

and other diary ap-pointments)Facility for carrying things from one room to the next

23.5 While this could help people with mobility issues, people with mobility difficulties already have carry-ing facilities as part of their ambulatory assistants. There would be little overall benefit in relation to re-sources for redesign. Low score on innovation cri-teria.

Automated checking of gas, water, win-dows, doors

23 This was defined as being outside the scope of the project required excessive integration with external elements.

Responding to re-quests for Weather In-formation/News

19.5 Information is available via other media channels already in use. This is also part of the existing functionality implemented by Robosoft on their mobile platform.

Table 2 Summary of prioritisation discussion for the High Level Functions

4.3Detailed Functional Requirements

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4.3.1 Function for reminder and encouragement to eat (Nutritional Assistance)

This function will serve to prevent malnutrition for people that tend to forget to eat or do not feel like eating, and tend to skip meals.

4.3.1.1 Use cases

Use-Case 1: As Brenda has diabetes, her doctor has advised her to eat regularly. She is also prescribed some medication for her diabetes, which needs to be taken after meals, so it is important that she eats on time. Brenda’s daughter has setup meal-time periods using the MOBISERV touch screen interface. When the intelligent monitoring system in the environment and robot has not observed any eating activity around such a timeslot, the system will ask Brenda if she has eaten. If she replies that she has not, it gently suggests that she should have something to eat. On the occasions when Brenda is out, the system knows that she is not in, so the reminder will not be issued. Later, the MOBSIERV system confirms whether she has eaten when she returns by politely inquiring.

Use-Case 2: Aalbert lives on his own and often feels depressed and lonely. He has never been very good at cooking and consumes very little nutritious food, mainly relying on packaged food. Often he does not eat at all.When the monitoring system has not observed any eating activity for a pre-set period of time (set-up in consultation with Aalbert) or has received a negative response in response to the reminders, the system recommends to Aalbert that he eats something by a persuasive (to be determined by research and customisable to individual preferences) encouragement. It suggests meal options (based on the contents of his refrigerator or larder if these are known) or items that it has recorded as being Aalbert's favourite nutritional snack. It also lets him know of the benefits of eating regular healthy meals, and suggests that doing so will make him feel better. The system has a set of ways of proposing nutrition and does not repeat the same information every day.

4.3.1.2 Function specification and assumptions

The function is activated using the Graphical User Interface (GUI):When user deac-tivates the function a warning will be issued and an e-mail will be sent to the caretaker or a relative. Meal types and eating periods are pre-specified by a health-care expert or relative using the GUI (remotely and locally). The person responsible for this should set a realistic interval because the EatingDetection system will be switched ON at the start of those eating periods and will be running just for the duration of the meal periods. (AUTH should specify if the monitoring system will is going to be running continuously or not. In case the EatingDetection system runs continuously then Eat-ingDetection Initialisation and termination are unnecessary)

It is assumed that the user is at home. Otherwise the function must not start. When the user comes back home the robot should ask for information about the user’s eating activities while he was out.

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“No response” function (see flowchart): this function will first check for technical problems (e.g. low volume) and repeat the notification. If this fails again, an e-mail should be send to the care-taker/doctor/relative.

4.3.1.3 Content Requirements:

Nature of information and presented format - Pictures/Video on screen, speech, sound

Timing specifications: default values of how long after the meal time will the first encouragement occur and after that how often will it be repeated (Z). These values will be determined by the carer/relative in consultation with the end-user.

4.3.1.4 Sub-Function Requirements

Sub-Function ID

Sub-Functions Requirement

F_1.1 Ability to turn function ON or OFF

It should be clear to the user and others whether this function is in the ON or OFF mode

F_1.2 Setup meal timeslots and periods of eating for each meal

Touch screen interface for carer or user

F_1.3 Detect a missed meal Camera monitoring status should be visible to the user

F_1.4 Locate the person Option of actions to take if the person can’t be located within a pre-set time limit

F_1.5 Issue a missed meal reminder to the person

Voice or melody or screen (Allow for selec-tion by user or carer)

F_1.6 Detect an acknowledgement of meal reminder by the user

If the reminder has not been acknowledged within 10 minutes (for example), reissue x number of times, after which take a pre-de-termined course of action

F_1.7 Detect the action by the user in response to the reminder

Request verbal response if no action is iden-tified.

F_1.8 Issue a highly persuasive encour-agement to eat to the person, after not responding to a reminder.

Voice / on screen, persuade for instance by showing favourite food, or available food.

F_1.9 Log a missed meal Log date and time. Take pre-set action when a pre-set number of meals are missed.

Table 3 Sub-Functions for F_1

4.3.1.5 Process Specification

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Figure 3. Process specification for the Nutritional Assistance Function

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Reminder

Encouragement

Start serviceGoogle

CalendarPRU loads

Data

End service

Alternatives: Internal database, text file, intranet, other web-based

database etc

Initiate EatingDetection

Eating activity detected

Log meal data

YES

NO

PRU Locates user

Issue a reminder

PRU asks user if he has

eaten

If user has eaten

If eating activity detected NO

Encourage user to eat

If Z minutes have passed

If eating activity

detectedYES

Using Dialogue and/or a GUI

Log missed

meal data

YES

HOW?

Using Dialogue and/or a GUI

Trigger separate

“No response” function

Log acknowledgement

User responds question

Terminate EatingDetection

Notify user that he is being monitored

No

Yes

No

Yes

Within the pre-Specified timeinterval

No

Yes


4.3.2 Function for Reminder and Encouragement to drink (Dehydration Prevention)

This function will serve to prevent dehydration for people that do not drink enough, or tend to forget to drink.

4.3.2.1 Use cases

Use-Case 1: Brenda often forgets to drink enough during the day. Brenda’s assistive robot will remind her to drink in combination with the other reminders or at moments where she is eating or taking her medicines. These reminders and triggers can be set-up by Brenda’s daughter through the GUI on the PRU. Only when more than a pre-set number of hours pass by, without any drinking events, the robot will suggest to have a cup of tea, coffee or water. To detect this, intelligent sensors in the environment will be combined with the sensors of the robotic assistant.

John, who will also find having this reminder useful, might potentially have problems with interpreting and recognising the reminder because of his memory problems. Therefore, the system will be fully customizable in terms of the interface mode used for the reminders, as well as the appearance of these reminders.

Use-Case 2When Dafne is at home, her assistant robot provides gentle encouragements to drink, by proposing many varying fluids, on varying times of the day. Think about water, milk, coffee, tea, orange juice, wine, etc. The system learns what Dafne likes and what not, and adjusts the schedule to this, but every now and then, it will still propose new or other drinks.

For Brenda, her weak eye-sight has to be taken into consideration, so the information should not only be presented on the screen. For John, there might be potential problems with being able to interpret, recognise and respond to the encouragement because of his dementia. So for him, the messages should be very easy to understand and structured.


ON/OFF Setting on GUI should issue warning when switching off and send e-mail to a relative or when ON user should be notified that they are being monitoredGUI should also provide settings setup for:

the interval the robot should wait until issues a reminder again If reminders should be issued when user is taking medication or is having a meal (if

this is the case, the best way to accomplish this is to integrate this function with the eating and medicine functions)

Drink preferences should also be taken into consideration.

4.3.2.3 Content Requirements

Nature of information and presentation format - Pictures/Video on screen, speech, sound

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Timing specifications: default values when the first encouragement occurs and after that how often will it be repeated (Z). These values will be determined by the carer/relative in consultation with the end-user.

4.3.2.4 Sub-Functions Requirements

Sub-Function ID


F_2.1 Ability to turn function ON or OFF It should be clear to the user and others whether this function is in the ON or OFF mode

F_2.2 Detect lack of drinking activityF_2.3 Issue a reminder to drink, together with a eat-

ing reminderF_2.4 Detect drinking activityF_2.5 Issue a reminder to drink, when detecting an

eating activityF_2.6 Detect and log the user’s response to the re-

minderF_2.7 Keep a list of drinks, and preferences of the

userF_2.8 Issue a highly persuasive encouragement to

drink to the person, after not responding to a reminder.

Voice / on screen, persuade for instance by showing favourite drinks.


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Figure 4 Process specification for the Dehydration Prevention function

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Start service

Load data

Google Documents/databaseTime of consumption of

last drink,Preferred drinks etc

DrinkingDetection

Ask user when did he last drink something and get

response

NO

If user last drank something > X hours

ago

YES

Issue Reminder and log acknowledgement

YES

If drinking activity detected

Log drink Data

YES

End service

Within a pre-specified time interval

Log missed

drink data

Encourage user to drink

If Z minutes

have passed

DrinkingDetection

NO

Locate user

No

No Yes

Yes


4.3.3Function for Reporting to health professionals

This function will facilitate easy, reliable and frequent communication between the user and certain carers (social and/or professional).

4.3.3.1 Use cases

Use-Case 1:Dafne has some physical problems, related to her age. Every now and then, she feels pain somewhere, or she does not feel as well as usual. She always wonders whether this is all related to her age, or that there is something more. She does not want to go to the doctor everytime as it is quite cumbersome to get to the clinic. With MOBISERV, Dafne can ask for a very quick but effective tele-consultation. This means that through an audio and video link, she can hear and see the doctor, and the doctor can hear and see her. She has to make an initial request to see the doctor via the system and then when there is a free slot the doctor calls her. The doctor has some standard questions, and Dafne can ask about her specific complaints. If needed, this tele-consultation can be followed up by a real consultation.


Medical personal will hold complete records for the person with information regard-ing any changes or variations to conditions and treatments.


Need to log the problem the older person is experiencing clearly in a pre-defined format.

Enable user to define the mode of initial communication depending on the nature of their query - use email as the default. The user has the option to also use the emer-gency services (e.g. 999) via traditional means.

Need to receive acknowledgment to the query/appointment request.


Sub-Function ID



F_19.2 Ability to easily add / remove contacts like family, carers and doctors

F_19.3 Ability to setup a audio and/or video connec-tion to a remote party

The user should be asked for audio, or audio and video

F_19.4 Ability to follow the user with the webcam For small movementsF_19.5 Ability to follow the user with the robot For big movementsF_19.6 Ability for the user to focus on a body part

which is not the faceShould be intuitive and simple, maybe using the touch screen

F_19.7 Ability to mute the audio and/or videoTable 5 Sub-Functions for F_19

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Figure 5 Process specification for reporting to health professionals

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Start Service

User requests tele-consultation

Email doctor/

carer

Request problem

information from user

If doctor / carer calls

Locate and go to user

Notify user

If user responds

Setup audio/video call

Call Social carer/

Remote Call

Centre

NO

Mute optionNotify/show outgoing video so the user knows that camera is activeRemote control of webcam & videoVoice or on-screen command for call termination

If real consultation

required

Make appointment

End service

NO

End Service

Start Service

No


4.3.4 Function for a tele-medicine/self-check

This function will facilitate easy and non-intrusive health check-ups, and/or long-term health monitoring, and/or advice to improve the users general health and well-being.

4.3.4.1 Use cases

Use-Case 1Brenda has mobility issues and has been prescribed with an exercise regime to improve her walking, balance and general fitness. She also has a heart problem, so her breathing and heart rate have to be monitored at the same time. Mobiserv system monitors the most important vital functions using smart garments and activity sensors, which Brenda puts on before the exercise sessions. The smart garment can follow her activities and issue an alarm to her to slow down or stop, for instance when her breathing and pulse functions become too high or irregular. All the readings during her exercise session are recorded and emailed to her doctor at the end of the week.

Use-Case 2Aalbert does not eat much and is prone to hypothermia due to low body weight, particularly at night in the winter.Aalbert puts on the MOBISERV smart garment night wear (or has smart sheets on his bed) that monitor his body temperature while he sleeps. If his temperature falls below a certain threshold, the system takes remedial actions – such as issuing an alarm to Aalbert, issuing an alarm to a neighbour, controlling the heating, or sending an email to the doctor.


Baseline measures will be made, recorded and stored on an individual basis prior to monitoring as part of a calibration process.


ON/OFF Setting on GUI When ON user should be notified that he is being monitored. Instructions about how to put on/operate the smart garments and smart sheets should

be available in a variety of formats – text and photos, video, audio


Sub-Function ID



F_17.2 Display the steps of how to put on the smart garments

F_17.3 Detect certain exercises User can indicate to the system if they

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are about to embark on an exercise routine or some particular activity which they want monitored.

F_17.4 Give feedback based on the analysis of the exercises

Video or sensor data can be used if available

F_17.5 Detect vital functions through the smart garment or smart bed sheets

F_17.6 Give feedback based on the analysis of the data from the vital functions

F_17.7 Issue an alarm based on the analysis of the data from the vital functions

F_17.8 Log all the data recordedF_17.9 Mail a summary of the data to a carer

/ doctorEnsure the summary is formatted and structured to enable readability



Figure 6 Process specification for tele-medicine

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Start Service

If function is ON

Monitor and log

user’s vitals

YES

Vitals’ analysis OK?

Definition of OK:Manual: setup on GUIAutomatic: software

Issue alarm to user and /

or carer

Google documents, intranet, database?

NO

YES

Alarm based on analysis of vitals

If certain time has passed since last

email

Setup on GUIAfter each session/day/week

Send email to carer / doctor

YES

End ServiceNO

Summary of logged data since last email

NO


4.3.5Function for Games for Social and Cognitive Stimulation

This function will improve the acceptance and increase the usage of the overall system, making the system more fun and affording a higher level of engagement through affective computing.

4.3.5.1 Use cases

Use-Case 1

Although John has dementia, he really enjoys playing games such as Scrabble with his son. Sometimes he needs a little bit of guidance but for the most part he plays very well and enjoys the challenge of the game. The MOBISERV system will have inbuilt gaming functionality to stimulate users and also promote acceptance of the system. Users will be able to play against the machine and also against friends who have the same system or via a special website. John can play Scrabble and cards with his friends at the day centre from his own home, or play against the machine.

Use-Case 2

Lilian likes to play board games with her husband when she can, particularly Othello. No one at the care home knows how to play Othello so Lilian has to wait until the weekend to play her favourite game.Lilian can also play Othello with her husband when she is in the home or play against the machine.


Users will be provided training in playing the games and understand the scope of the game play.


Provide access to a range of games with animated instructions on how to play. When monitoring facial expressions, only processed data should be available. Access

to this should be determined and secured.


Sub-Function ID


F_18.1 Ability to turn function ON or OFF

It should be clear to the user and others whether this function is in the ON or OFF mode

F_18.2 The system offers games for different cognitive levels

Card games, or word games which are com-monly played by participants currently could be used. While the efficacy of “Brain Training” games has not been conclusively established, games remain an important mechanism to keep

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people engaged and alert.F_18.3 The robot offers social engage-

ment during periods of phys-ical inactivity or on request by the user.

A future enhancement could involve enabling the robot to function as a social companion in playing games with the user using affective computing.



Figure 7 Process specification for games function

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Start service

If function is ON

If game selected

YES

Play game

YES

GUIVoice recognition: “Start …”Select against:Robot/friend/website

GUISettings setup for levels

Monitor face for expression recognition

Readjust game structure or

level

New game? YES

End service

NO

NO

NO


4.3.6 Function for Voice/Video/SMS via robot communication with friends and relatives

This function will support and increase the frequency of social interaction with friends and family.

4.3.6.1 Use cases

Use-Case 1

Terry really misses his friends. He moved to the residential home from his hometown 250 miles away to be nearer to his children. His mobility issues prevent him from leaving the home very often to visit his family, and he misses things like the grandchildren's birthday parties as he is too frail to attend. The MOBISERV screen enables Terry to use video calling or hand free telephone calling (voice only) to his friends and family. Video calling helps Terry to feel like his distant friends are in the room with him. It also enables him to remotely attend birthday parties or family events with two-way interaction. Terry's family can also use the system to upload photos or videos of their activities to share with Terry at any time. Terry is able to select whether or not he wants the audio visual calling or voice only calling options with a one-step interaction, and it is clear to Terry when the camera is on and what the other person is able to see.

Use Case 2Because Aalbert’s sons and daughter live quite far away, they cannot come by every day or every week. Still, they do want to know about how their father is doing, and sometimes worry about his health and his loneliness.With the MOBISERV system, they found a solution for this. Every morning, one of the children checks in on their father through the robot’s audio and video connection. This can be done from a computer, laptop or smart phone. They can see their father, find out how he is doing, and have a chat. Because of the mobile robot, this can be done in any room and in any location in their father’s apartment. Aalbert has the option of setting a do not disturb option if he does not wish to be contacted at any time, or turn the camera off and use voice only.


Outgoing callsThe function is activated using the Graphical User Interface (GUI):When user deactivates the function a warning will be issued.When function is activated the robot should inform the user for the operation of this function (i.e. special commands like “Call <contact>” or “Text <contact>”). A database holds contact details (usernames, phone numbers, pictures etc)When the robot interacts with the user there should be a detection of a “no response” function that will firstly check for technical problems (e.g. low volume) and repeat the notification. If this fails again, an e-mail should be send to the care-taker/doctor/relative.

Incoming CallsThe function is activated on the Graphical User Interface (GUI):When user deactivates the function a warning will be issued.When function is activated the robot should inform the user for the operation of this function (i.e. special commands like “Answer call” or “Open SMS”). A database holds contact details (usernames, phone numbers, pictures etc)

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If the user is not at home the system should function log the call. When the user comes back home the robot should notify the user if he has any missed calls or unread SMS.When the robot interacts with the user there should be a detection of a “no response” function which will firstly check for technical problems (e.g. low volume) and repeat the notification. If this fails again, an e-mail should be send to the care-taker/doctor/relative.


Allow GUI/Speech commands (e.g. “Call <contact>”, “Text <contact>”) in regards to ac-cessibility regarding the function

Enable Create, Read Update, Delete with access available for Google contacts or MS Outlook format

During the call the robot should be put into silent mode and recognise only specific com-mands like: “Camera ON/OFF”, “Mute”, “End Call”.


Sub-Function ID



F_11.2 Ability to select the mode of the communica-tion (including synchronous and asynchron-ous)

It should be clear to the user which mode of communication is currently selected and what is its status - receiving/transmit-ted/both

F_11.3 Configuration of contacts - Ability to easily add / remove contacts

Usability of the contacts config-uration should be straightfor-ward to use.Open Source software available for friends and family members to install locally.

F_11.4 Check current availability/status of contacts If the friend or relative is cur-rently unavailable it should be possible to contact them to re-quest communication in immin-ent future via an alternative means.

F_11.5 Ability to setup a connection to a remote party

Voice or touch screen com-mand.

F_11.6 Ability to mute the audio and/or video Voice or touch screen commandTable 8 Sub-Functions for F_11

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Figure 8 Process specification for video/voice/SMS Outgoing communication

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Start Service

Contacts

Load Data

Dial contact

Notify user and ask if he wants to leave message/

send SMS instead

If contact respondsNO

Audio/Video call

YES

If user responds positively

Record Video/audio message or write SMS

and send

YES

Message composition

Send message

Confirm recording or

message to user

Notify user

End service

NO

User specifies the type of communication and

person

SMS Audio/Video Call

Load Data

SHACU

Verify message

PRU: GUI/Speech (dictation)

Repeat the message to user and confirm


Figure 9 Process specification for video/voice/SMS Incoming communication

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Start service

Notify user

Contacts

If user answers

Locate user

Audio/Video call

YES

Missed call notification

NO

End service

Notify user

If user wants to open the SMS

Display/Say SMS

YESSMS

Notification

NO

Load data

SMS Audio/Video call

User reply NO

Send new SMS

YES

SHACU

Show caller’s photo and display name/announce who is calling.

This will send contact’s details to a function similar to this Function’s Part I

Icon on screen or reminder after a

while

Icon on screen or reminder after a while

Locate user


4.3.7 Function for a mobile intercom for enabling front door entry

This function will support people with mobility problems to increase control over safety.

4.3.7.1 Use cases

Use Case 1Aalbert is at home, in his apartment on the 7th floor. He sits in his favourite chair, and is watching television. The doorbell rings. There is a visitor outside, in front of the main entrance of the building. Due to his impaired mobility, he misses quite some visitors; they leave before he reaches the intercom in his hallway. Sometimes Aalbert is also nervous about answering the door when he is not expecting anyone and does not know who is calling.With the MOBISERV system, combining the smart environment with the robot assistant, the robot comes up to Aalbert’s chair when the doorbell rings. On the robot’s display, it will show a live video of his visitor standing in front of the door. Aalbert can easily see who is there, then start an audio connection with the visitor if he wants to, or let her/him in right away, by telling the robot to open the door, or by pressing a button on the robot’s touch screen.

When Aalbert is not at home, the system will know this, and a short video will be record showing the visitor in front of the door. When Aalbert comes home, the robot will show a message with the option to see this video.


The person can set the system to a do not disturb mode to avoid unwanted interruption which could be communicated to the caller without the need for interaction.


Log audio/video clip => so the video should start recording once the visitor pushes the button. Other option that can be included: take a picture

Automatic adjustment of image quality


Sub-Function ID



F_14.2 Recognise the door-bell Either by direct integration with the door-bell system or sound recognition.

F_14.3 Locate and move to the userF_14.4 Enable the user to select mode of communica-

tion, voice or videoF_14.5 Start link

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F_14.6 Ability for the user to initiate desired action, open an electronic lock, call for help



Figure 10 Process specification for mobile intercom

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Start service

If doorbell rings

Locate and go to user

YES

Notify user

On-screen video

Open door?

Open electronic

lock

YES

Talk to visitor?NO

Start audio/video

intercom

YES

Call for help?NO

Call remote call-centre

YES

Log missed visitor

NO

End service

User at home?

NO

YES

Audio/Video Call => Locate and go to user


4.3.8 Function for responding to call for help from the user

This function will increase safety at home and the feeling of being not being left isolated in an emergency for people that live alone.

4.3.8.1 Use cases

Use Case 1John enjoys being at the day care centre, and likes the carers and nurses very much. He sometimes forgets where he is and what time it is, and starts to panic. At the day care centre, they know how to help him relax. Sometimes, this also happens at his home, even in the middle of the night. Once, he ran out of his bedroom, shouting for the nurse.John’s MOBISERV system is able to detect loud voices, such as shouting or screaming. The system will locate the person in panic, and the robot will to him/here, and setup an audio and video connection with the care call centre. The person in the call centre can immediately talk to John, to help him relax and set him at rest. John has memory problems, so the response will have to be appropriate for this. In the intelligent environment, panic or falls could also be detected or corroborated by monitoring sensors in smart clothing or smart bed sheets.

Use Case 2For Aalbert, Brenda, Carol, Dafne, Lilian and Terry, the system will have the ability to trigger a call to the care call centre in response to a fall or a voice call for “help” from the person, informing the centre of the nature of the alarm, resulting in appropriate action. Brenda has poor eyesight and a pre-existing medical condition which should be known by the system and also communicated. Lilian’s loss of hearing means that she might need alternative modes interaction with the call centre.


There should be a defined protocol for transferring services to alternative components when the PRU is being charged.


Detect a range of pre-defined incidents such as falls, loud noises, yells, screams, etc. Provide information about the nature of alarm / identity and conditions of user resulting to

appropriate response from caretaker In regards to feedback to the user: Investigate alternative methods according to person’s

conditions: visual (text messages on screen), tactile (vibrating bracelet) Settings for feedback available on GUI


Sub-Function ID


F_6.1 Detect loud noises, yells, screams, etc.

This should be tested and validated, for every room in the houseMicrophones might be installed in every room and linked to

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F_6.2 Detect fallsF_6.3 Locate the user, and go thereF_6.4 Call and connect with a remote

call centreAudio and/or video

F_6.5 Focus the camera on the user Reliable recognition Table 10 Sub-Functions for F_6


Figure 11 Process specification for responding to call for help

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Start service

Emergency detected?

Locate and go to

user

YES

Call remote call centre

Video conference

Focus camera on user

End Service

NO

Contacts

Detect falls/loud noises, screams...


4.3.9Function for Encouragement for exercising

This function will support and encourage physical activity in order to stay healthy, stay in good condition and stay independent for as long as possible.

4.3.9.1 Use cases

Use Case 1Aalbert, like many older people, suffers from very stiff muscles, especially in his hands, arms and legs. He does not engage in much physical activity during the day, so therefore the doctor told him to do some exercises, preferably every day. Aalbert knows the benefits, but still does not really like to do these exercises, and tends to skip them most of time.The MOBISERV system functions as a persuasive agent in this case. First, it detects when Aalbert is sitting still for long, by sensors in the environment, and by interaction through the robot. The system will try to find a pattern in Aalbert’s daily activities, to find out the best or most preferred opportunity to propose and do some exercises. The system knows many exercises to offer diversity, and will ask for feedback after each exercise. This way it learns what Aalbert likes, when he likes to do exercises, and how many time he wants to spend per session. Among other things, Aalbert is encouraged by feedback on his exercises, showing his progress and describing the benefits of regular gentle exercises, such as promoting a good night's sleep.

Use Case 2For people with mobility problems, such as Brenda, Dafne, John and Lilian, the activities will have to be specifically designed by a medical practitioner or physiotherapist. If needed, data from the exercises, for instance from the intelligent clothes or from the robot’s video camera, can be recorded and analysed by a caretaker, for safety reasons, or for feedback or adjustments on the execution of the exercises.


The function is activated using the Graphical User Interface (GUI):When user deactivates the function, a warning will be issuedFunction will monitor activity levels during daytime only and based the outcome of the user’s baseline measure.Exercises and initial schedule (will be later modified according to the user’s response) should be added by via a web interface. Exercises should be tailored to each user’s needs, taking into consideration each user’s situation. Messages should be persuasive describing the benefits of regular gentle exercises, such as promoting a good night's sleep.It is assumed that the user is at home. Otherwise the function must not start.


Instructions and guide available throughout the exercises in a variety of formats The exercises are selected and specified by a qualified therapist based on the specific

user’s conditional and ability.

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Sub-Function ID



F_8.2 Detect and rate physical activityF_8.3 Enable a carer or doctor to insert new exer-

cises.F_8.4 Issue persuading messages to do an exercise. Ensure persuasiveness and

credibilityF_8.5 Detect patterns in the user’s response to the

persuading messagesF_8.6 Adjust the schedule of messages to the user’s

pattern and his other activitiesF_8.7 Keep a basic log of the exercises done.


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Figure 12 Process specification for encouragement for exercising

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Start service

Detect Activity levels

If long period of inactivity detected

NO

PRU checks

Scheduler

YES

If it’s time for new messageNO

PRU loads Exercises

YES

PRU informs user that he’s

inactive for very long and suggests an

exercise

Log acknowledgement

PRU guides user through the exercise

When exercise is finished PRU

asks for feedback

Log exercise data, feedback and adjust

scheduler and exercise accordingly

DataLogger: SensorsInteractionManager

For time of last persuading message and ideal times

Modification of Scheduler

Monitoring user’s vitals and adapting, showing progress and describing the benefits to keep use going etc

Time, difficulty and duration of exercise


4.4 Non-functional Requirements

Analysis of the data gathered from across the different locations and the secondary literature review has helped to identify the following non-functional requirements which will be vital to consider in the context of the MOBISERV system.

4.4.1 User Acceptability

o The system should enable the user to maintain their current routine as much as possible

Older people tend to like to sit in the same place to watch TV, or to eat dinner. They like routine and familiarity in their everyday lives. So the MOBISERV system needs to be able to map onto existing patterns of behaviour, existing meal times, place that meals are eaten, nap times, hours of retiring to bed and awaking, and recognition of other leisure activities and not force people to modify their routines and habits in unfamiliar ways.

o The user should have the ability of enable or disable all aspects of the sys-tem functionality

It will be important to allow users to switch off specific functions if they so desire. This is essential both from an ethical perspective, as well as in response to the concerns expressed by some of the older persons regarding some of the proposed features of the MOBISERV systems that could be viewed as an invasion of privacy in particular contexts. Empowering users to have control over the functionality will be a vital part of gaining their trust.

o The status of all monitoring functions should be clearly visible to the user The status of the cameras, both for the monitoring of activity and for

the video conferencing functions should be clearly visible to the user. The display of the status should be prominently displayed and not hid-den or accessed via other interface elements. The ability to switch these on or off should be directly accessible in one step.

o The system should comply with the users’ aesthetics as much as possible The ability to alter the voice of the speech synthesis The look and feel of the system should be alterable It might be desirable to change characteristics of the embodiment of

the portable robotic unit.

4.4.2 Environmental and Operational

All system interfaces and controls should be clearly visible and accessible in different lighting conditions Some of the living areas, such as conservatories are very bright during the day,

in comparison with internal rooms that can be poorly lit, particularly on cloudy days if the lights are not switched on.

MOBISERV FP7 248434


An automated brightness and contrast control based on ambient light will be desirable.

The system must be able identify if an internal doors is closed and have an appropriate response protocol People often like to keep internal doors shut, particularly in the winter to

prevent heat loss. This can pose a problem to ensuring that the robot has free access to all areas of the house. The mapping should be able to identify doors as being different to other obstacles and issue an alert as pre-determined.

The system should to able to detect the background noise level so as to ensure clarity and detection of messages and sounds

o Adapt the volume of system messages and sound taking into consideration background noise level.

The system should be capable of operating at a high level of humidity

4.4.3 Training Needs and Support

A structured and phased illustration of each of the functions, sub-divided into coherent step-by-step tasks should be provided

The illustrations should be provided through a range of media and formats The different formats should take into consideration users’ goals, abilities and

experience levels. An individual needs assessment to ensure that the system is customised for op-

timal and satisfactory use should be conducted A person-centred planning model with pre-specified metrics should be created.

4.4.4 Usability and accessibility

The limitations in mobility, eyesight, hearing and sometimes memory, which are a result of the natural aging process, should be considered in regards to the usab-ility and accessibility of the technology.

The following design principles should be adhered for the graphical user inter-face:

o Feedback – The results of all actions should be clearly displayedo Consistency – The location of items should be the same across screens

and similar functions should behave the same throughout the system. This also applies to error messages and system status information.

o Error recovery – Provide an undo option or an easy way to recover from unintentional interactions with meaningful error messages.

o Individualisation – Allow the user to customise the look and feel of the system and tailor the system to individual capabilities and preferences. Ensure flexibility of the display characteristics such as size of icons and fonts and provide more than one option/mode to perform a task.

MOBISERV FP7 248434


o Memory load – Avoid memory overload by reducing the number of steps to complete tasks and providing suitable memory aids such as clear and meaningful status information and labels for icons.

o Structure – Provide a clear visual map of the system structure and keep the structure as simple as possible.

o Cognitive load – reduce information process requirements of the user by organising the display into clear sections and providing highlighting for critical information. Use Gestalts laws of perception to guide the design.

o Minimalistic design – Avoid visual and auditory clutter by minimising the number of items displayed in one location and the number of sounds and voice responses.

Memorability and learnability – It should be ensured that voice commands are easy to remember by keeping them short and customising them to suit the user’s vocabulary. The user should have access for the configuration of these.

Natural Ageing Factorso Audition – Age related decline could effect hearing of high-frequency

sounds. The design should take into consideration that changes in hearing capability influence older adults’ ability to detect tones and other sounds as well the ability to comprehend speech. As such there should be limited reliance on tones and a mechanism to easily adjust the volume of the sys-tem should be provided.

o Vision – Visual acuity is affected by age and as such the system should provide for a high contrast accessibility mode where the user can change the size of interface elements and text. The speed with which visual in-formation is process increases with age and as such information shown on the screen should have a longer level of persistence – particularly in re-gards to status information and error messages. Glare can be more prob-lematic for older adults and care should be taken to ensure screens are anti-glare.

o Cognition – age related decline could affect memory, attention, spatial cognition and language comprehension (both verbal and written) and clear instructions and feedback should be available to ameliorate this.

4.4.5 Comfort

Ergonomic factors – the touch screen should be easy to operate with minimal effort. The screen should allow for adjustment of positioning for suitable viewing angle and operation.

Physical comfort - the wearable devices should be easy to put on and remove, with fastenings that can be done and undone without help, with fabric that is soft against the skin over long periods of time. The material should be allergy tested with information of composition available.

MOBISERV FP7 248434


4.4.6 Help and documentation

The instructions should be presented in a variety of formats – video, audio and text-based with appropriate graphics.

The language used should be simple with no jargon and the terms should be used consistently throughout.

There should be a single step access to the help and support and it should be context sensitive.

Aide de memoires should be easily accessible. A training protocol should be devised which allows introduction of the system

to the user in a phased manner over a phased period of time.

4.4.7 Performance

Efficiency – operations should be completed in a minimal number of steps without an undue number of screens or commands.

Error prevention - To minimise errors due to the user issuing incorrect voice commands, the verification process should be transparent and robust, provid-ing pre-emptive and targeted feedback in a clear manner. As much as possible, through the use of clear formatting and automated checking, the user should not be allowed to enter data that will be erroneous or ambiguous, such as dates and times etc.

Confirmation options should be available, and undo and redo should be avail-able as appropriate.

Error recovery - It should be clear to the user if the system needs to recover from an error state, providing the user with clear information on the status of the system and the time that will be taken for error recovery.

If the user has chosen an option or function by mistake, it should be easy for them to leave the unwanted state without having to go through an extended dialogue or lose previously entered information.

4.4.8 Maintainability and Support

Charging procedure – the user should be aware of the status of the battery levels and knows when the system will be docking for charging.

The user should be made aware of the reasons for any lags or non-responsiveness during the interaction process so that they know that it is the system that has an issue and don’t feel uncertain about the status of the interaction at any point.

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Updates – The update process should be transparent to the user and should not change the currently setup system settings and parameters.

4.4.9 Security and privacy

Telecare users and their carers should be informed about what information will be collected and how it will be used.

Privacy of the recorded data should be ensured through secured storage and transmis-sion. Data encryption and passwords need to be set-up.

Levels of access to change crucial system setting should be identified.

All changes made to the system or system settings should be traceable through system logs.

4.4.10Cultural and Political

Language support – There has to be support for Dutch. The language and images used should reflect and respect local cultural norms and preferences.

Access rights – It should be clear to the user as to who has access to system settings and data, and these should be definable and changeable.

4.5Final Conclusions

As stated earlier, gathering requirements is an iterative activity that we will be continuing, particularly in relation to tasks 2.2, 2.5 and 2.6 and will continue to generate results as the concepts and technology begin to evolve and take shape. As we conduct evaluation studies and field trials, clarifications to these requirement specification will start to emerge and be refined as end users and stakeholders gain a clearer understanding and experience of the scope of the technology and the consortium sees how the technology needs to be further adapted to suit needs.

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5 Content Recommendations for Functions

5.1Advice on Nutrition

A range of guidance is available from http://www.ageuk.org.uk/health-wellbeing/healthy-eating-landing/ that could be incorporated into the Nutritional assistance function when offering advice and encouragement to the user regarding meals.This website provides information on Healthy eating, illustrating The eatwell plate from the Food Standards Agency (food.gov.uk) is shown in Figure 13. The eatwell plate, FSA

Figure 13. The eatwell plate, FSA

This graphical representation could be used as part of the touch screen interface to seek information from the user in regards to their dietary intake and help them to keep track of their daily intake – clearly identifying food groups covered and those not covered.

The AgeUK website also offers more targeted advice on Foods to improve digestion, improve immunity, for a healthy heart and vitamins, minerals and supplements.

Brightly coloured pictures can be used to whet peoples’ appetites.

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http://www.ageuk.org.uk/health-wellbeing/healthy-eating-landing/


Figure 14 Brightly coloured pictures from www.ageuk.org.uk

5.2Advice on Exercise

Age UK provide exercise DVDs designed to help strengthen muscles, increase flexibility, improve balance and endurance - http://www.ageuk.org.uk/health-wellbeing/keeping-fit/exercise-materials/ It could be possible to link guidance and excerpts from these DVDs to the encouragement for exercise function.

The “fit as a fiddle” national programme will be producing a range of educational resources over a five year period, as well as providing links to local community initiatives and schemes to promote exercise.http://www.ageuk.org.uk/Documents/EN-GB/FAAF_booklet.pdf (Fit as a Fiddle Booklet)

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http://www.ageuk.org.uk/Documents/EN-GB/FAAF_booklet.pdf

http://www.ageuk.org.uk/health-wellbeing/keeping-fit/exercise-materials/

http://www.ageuk.org.uk/


6 Policy context and existing practice for provision of support services for older adults

6.1In the UK

Figure 15 Demographic data, current and projected from the National Statistics Office UK

According to figures published by the National Statistics officeliv, UK, over

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the last 25 years the percentage of the population aged 65 and over increased from 15 per cent in 1984 to 16 per cent in 2009, an increase of 1.7 million people in this age group. Over the same period, the percentage of the population aged under 16 decreased from 21 per cent to 19 per cent. This ageing of the population is projected to continue. By 2034, 23 per cent of the population is projected to be aged 65 and over compared with 18 per cent aged under 16. The fastest population increase has been in the number of those aged 85 and over, the ‘oldest old’. In 1984, there were around 660,000 people in the UK aged 85 and over. Since then the numbers have more than doubled reaching 1.4 million in 2009. By 2034 the number of people aged 85 and over is projected to be 2.5 times larger than in 2009, reaching 3.5 million and accounting for 5 per cent of the total population.The old-age support ratio (OASR) represents the number of people of working age to the number of people of state pension age (SPA) and over. In 2009 the IASR was about 3.2. It is projected that by 2034 the OASR will have fallen to about 2.8 people of working age for each person of SPA and above; without the increases in SPA, the OASR would have been projected to drop further to about 2.2 by 2034. The old age support ratio is a demographic ratio and does not take into account possible future activity rates. Inactivity owing to factors such as early retirement, health problems, disability and caring responsibilities may prevent people from working; on the other hand, some people of SPA will choose to extend their working lives into later life.In 2008/09, pensioner couples received an average gross income of £564 per week, single male pensioners received £304 per week and single female pensioners £264. In 2008, the average weekly expenditure of households headed by someone aged 65 to 74 was £354, of which 32 per cent was spent on food and non-alcoholic drink, domestic energy bills, housing and council tax. For households headed by someone aged 75 or over, average expenditure was £217 per week, of which 40 per cent was spent on food, energy bills, housing and council tax.

6.1.1 Prevention policy

The prevention package aims to raise the focus on older people’s prevention services and encourage their use, and, in the longer term, to improve older people’s health, well-being and independence. Developing services included in the prevention package takes place within a wider policy context. This briefing outlines some of the relevant policy areas and levers for implementation.

6.1.1.1 Prevention and early intervention

It has been government policy since the 1988 Griffiths Report for local authorities to find ways that support older people to live in their own homes and to prevent unnecessary admissions to residential care. The NHS Next Stage Review points out that because people are living longer, there is a need proactively to identify and mitigate health risks. This includes supporting people to take responsibility for their own health and helping them to live independent and fulfilling lives. The Government’s strategy for all ages concentrates on cultural change, preparation for later life, providing the right support and delivering it effectively.

As health is a major priority for people in later years, the prevention package contribution is a key component of the strategy.

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6.1.1.2 Joint strategic needs assessment (JSNA)

The JSNA is designed to help build the stronger partnerships between communities, local government and the NHS that are required to develop effective prevention strategies locally. It should be informed and shaped by local community views as well as evidence of effectiveness, efficiency and equity to shape the future priorities for investment in services. Behind the JSNA is a process that identifies current and future needs in relation to health, care and well-being. It compares these needs with the pattern of existing services to inform future service planning. It is essential needs assessment include future projections. Modeling spending on prevention and intervention will enable a commissioning community to put in place long-term plans to manage the projected increase in demand for older people’s services as the ageing population grows. For further information, see the DH web pages on JSNA http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_081097

6.1.1.3 World class commissioning

The World Class Commissioning (WCC) framework of competences aims to help public sector commissioners achieve three outcomes for local populations: better health and well-being for all

better care for all

better value for all

WCC guidance says commissioners should promote services that encourage early intervention, to avoid unnecessary unplanned admissions. Resources within the prevention package are linked to WCC competencies and structured around the commissioning cycle. For more information, see the DH pages on World Class Commissioning http://www.dh.gov.uk/en/Managingyourorganisation/Commissioning/ Worldclasscommissioning/index.htm

6.1.1.4 Personalisation

The White Paper Our Health, Our Care, Our Say (2006) aimed to shift towards a more personalised service, a greater focus on prevention and addressing inequality effectively. The local authority guidance LAC1 2008 stated: “The direction is clear: to make personalisation, including a strategic shift towards early intervention and prevention, the cornerstone of public services.” Putting People First (2007) introduced a vision for adult social care that is personalised for individuals, with prevention, early intervention and enablement at its core. It contains a commitment that local areas have a sustainable community strategy, utilising all relevant community services, especially the voluntary sector, to achieve this. Personalisation can only start to be delivered where councils have a strong focus on both the well-being of their communities and a recognition that people should be helped in a way that may reduce or prevent their need for social care support where that is possible. Prevention, early intervention, building social capital and universal services are all at the centre of Putting People First.

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http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_081097

http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_081097


The Darzi report NHS Next Stage Review: What it means for the third sector, contains the vision that: “Every primary care trust will commission comprehensive well-being and prevention services, in partnership with local authorities, with the services offered personalised to meet the specific needs of their local populations.”

A number of services in the prevention package may be commissioned by older people themselves through personal budgets, individual budgets or direct payments. For example, they may pay for a personal assistant to carry out personal care and support services such as footcare, or purchase telecare devices. Commissioners still have a role to play in ensuring that people have a diverse range of options upon which to spend their budget allocation. For more information, see the DH web pages on personalisation. http://www.dh.gov.uk/en/SocialCare/Socialcarereform/Personalisation/index.htm

6.1.1.5 Market development

World Class Commissioning guidance says that market building means commissioners will develop formal and informal relationships with existing and potential providers. Prevention services and interventions to promote older people’s independence and well-being may be particularly suited to provision by local organisations and community groups, including the voluntary sector. According to WCC guidance, commissioners should develop an understanding of the third sector’s ability to deliver services.

6.1.1.6 Partnership and whole system approaches

A whole system approach is crucial to prevention. Many social care interventions produce reductions in the usage of health services; many health interventions can have an impact on reducing the use of social care services. Jointly planning and explicitly sharing the risks and benefits have the potential to produce the greatest improvement for all. Other public services are crucial to promoting independence and well-being – housing, transport, community safety, leisure services and public health, for example.

6.1.1.7 Involving older people and carers

Involving older and disabled people in the planning and monitoring of services is crucial to ensuring that they are developed appropriately. Public and patient involvement is vital at every stage of the World Class Commissioning cycle to understand needs, populations and desired outcomes, and to design flexible and responsive services that can achieve real outcomes for the local ageing population. A constitution for the NHS in England, published in January 2009, set out the core principles and values for the NHS, including patient and family involvement in decisions and partnership with other organisations.

The carers’ strategy Carers at the heart of 21st century families and communities (DH, 2008) includes a more integrated and personalised support service for carers. The Mental Capacity Act (2005) provides a framework to protect vulnerable people who are unable to make their own decisions and sets out a single standard test for assessing whether a person lacks capacity. It includes provision for an independent mental capacity advocate (IMCA) to support people who have no one to speak for them. The National Dementia Strategy, Living Well with Dementia (DH February 2009), aims to provide early intervention services to help people with dementia remain independent for as

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long as possible. It looks specifically at making services, including intermediate care, more accessible to people with dementia. The 2009 strategy Be active, be healthy: A plan for getting the nation moving highlights the value of physical activities like walking and dancing to encourage older people to be more active, which can help preserve their mobility and independence. Currently only 17% of men and 13% of women aged 65 to 74 meet the Chief Medical Officer’s recommendations for physical activity, and these figures drop considerably among over-75s.

6.1.2 Provision of support services for older adults in the UK

6.1.2.1 Background Statistics

Councils have reported an increase in Adult Social Service spend from £16.1 billion in 2008-09 to £16.7 billion in 2009-10, this is approximately a 4 per cent rise in cash terms and 2 per cent in real terms. Over a longer term, this represents a real term increase of 9 per cent since 2004-05 and 46 per cent over the 10 years from 1999-00. Expenditure on Older People (aged 65 and over) continues to make up the majority of the total adult expenditure although the percentage has decreased from 59 per cent in 2004-05 to 56 per cent in 2009-10. This is unchanged from 2008-09. This represents an increase from £9.1 billion in 2008-09 to £9.3 billion in 2009-10 (3% in cash terms and 1% in real terms). Expenditure on adults aged 18-64 with a Learning Disability has increased from £3.8 billion in 2008-09 to £4.0 billion in 2009-10 (4% in cash terms and 3% in real terms). Expenditure on Residential Care has increased slightly by £60,000 from £7.59 billion in 2008-09 to £7.65 billion in 2009-10 in cash terms (1%), but has fallen in real terms by 1 per cent. Expenditure on Day/Domiciliary (non-Residential) care spend has increased from £6.5 billion in 2008-09 to £7.0 billion in 2009-10 (8% in cash terms and 6% in real terms). This is in line with Government policy to improve independence, choice and promote people's ability to live at home. The expenditure on Direct Payments for adults was £812 million in 2009-10. This is an increase of 33 per cent in cash terms and 31 per cent in real terms from 2008-09. The percentage of gross expenditure used for direct payments for adults is increasing and equates to 5 per cent of the overall gross current expenditure in 2009-10 compared to 4 per cent in 2008-09 Overall, 12 per cent of people aged 16 or over in England in 2009/10 were looking after or giving special help to a sick, disabled or elderly person. This represents around 5 million adults in England. Six per cent of adults in England were caring for someone who was living with them, and 6 per cent were caring for someone living elsewhere only. In 2009/10 15 per cent of households in England contained a carer. This represents around 3 million households in England. In 2008 10% of UK residents aged 65 or over were living in residential care options including care homes, sheltered housing and extra care housing. Over the period April 2009 to March 2010 over half a million service users received community equipment and minor adaptations to their home as part of a care package following an assessment and over £233 million was spent on equipment.

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Information SourcesAge UK http://www.ageuk.org.uk/home-and-care/ and the NHS information centre http://www.ic.nhs.uk/ provide lots of information for older people and their family carers about care and support services that are available. Social Care Institute for Excellence (SCIE): http://www.scie.org.uk/adults/index.aspSCIE focuses on dissemination of good practice to the large and diverse social care workforce and support the delivery of transformed, personalised social care services. Aimed at social care professionals but there is much information here that will be of interest to end users. The Alzheimer’s Society website is a good source of information and support for people looking after someone with dementia http://alzheimers.org.uk/The Princess Royal Trust for Carers provide information and support, including a searchable help directory and local contacts, at www.carers.org/

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http://www.carers.org/

http://alzheimers.org.uk/

http://www.scie.org.uk/adults/index.asp

http://www.ic.nhs.uk/

http://www.ageuk.org.uk/home-and-care/


7 Appendices

7.1NL Questionnaire Responses

7.1.1 Setting A – Residential

7.1.1.1 Care staff

N=10, all female

Care coordinator 1

Carer 7

Care support 2

How well do you feel that your establishment is able to manage or monitor the needs of the old people in its care with regards to the following medical issues or problems:

well managed

fairly well managed

Not sure

need a little more support

need a lot more support

Monitoring and prevention of heart problems 2 6 1 1 0

falling 1 8 0 1 0

incontinence 7 2 0 1 0

loneliness 1 1 5 3 0

social isolation 1 4 3 2 0

physical limitations or impairments 3 3 2 2 0

Cognitive limitations or impairments 1 6 1 2 0

Diet and nutrition 2 7 1 0 0

Diabetes 3 6 0 1 0

What do you feel could be done to improve the management or monitoring of the issues or problems mentioned in the previous question?More time for the clients. More education and expertise.

We should be able to directly respond / reply to the needs of people. Now people have to wait quite often, because there is no personnel.

Observing.

A better analysis of the problems a patient has, so he/she will end up at the right department. More personnel on holidays and in weekends.

More clinical training for carers on specific topics. More personnel. More activity coaching.

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What do you feel the quality of life is like for the average older person in your care?I feel very well supported 0 0%

I feel supported 6 60%

Neither good nor bad 4 40%

I would like more support 0 0%

I would like much more support 0 0%

What sort of things do they enjoy doing that you think they would like to do more of, to improve their quality of life?Going outsideSocial contacts in apartment (one on one)

Drink a cup of coffee with the carer, have a chat. Go shopping. Spontaneously go for a walk.

More walking when the weather is good. More attention for the clients like a chat.

Activities that fully address their needs.

Activities during the evening and weekends.

Cooking club, eating together with family, talking to staff.

Eating activities, open stage activities, music activities.

Personal hobbies.

How frequently do you feel unable to assist the people in your care?very often 0 0%

often 1 10%

sometimes 5 50%

occasionally 3 30%

never 1 10%

What type of things are you unable to assist with and why?Handling clients with psychological issues; they tend to be in a certain atmosphere, which I cannot always handle well.

Psychological issues, not enough education. When multiple things happen at the same time, not enough staff.

More personal attention, due to time constraints. Giving the right care to clients with psychological issues.

When multiple requests come in at the same time. For instance, when 3 people have to go to the toilet.

People that cannot speak, and try to say something to you. People with heavy pain, for which nothing helps.

Physical complaints.

People on the wrong department, for instance a person with dementia on the somatic department.

With the anger and frustration of clients suffering from dementia.

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What do you need to be able to support older people better?Time 10 100%

More staff 10 100%

More training 3 30%

Better Equipment 3 30%

Better monitoring systems 3 30%

Better nutrition 1 10%

Greater physical strength 0 0%

Better entertainment facilities 4 40%

More facilities for individual clients that cannot participate in group activities.

Volunteers.

Do you feel that the average resident has enough social interaction with the following:too much interaction

plenty of interaction

some interaction

a little interaction

no interaction

care staff 0 7 2 0 0

social/housing workers 0 7 2 1 0

medical staff 0 5 4 1 0

friends 0 2 5 3 0

family 0 5 5 0 0

What technology do your residents HAVE ACCESS TO?TV 10 100%

DVD player 9 90%

Landline Telephone 10 100%

Own mobile phone 6 60%

Computer 7 70%

Internet 7 70%

Interactive TV 0 0%

Electronic games 0 0%

Online shopping 0 0%

What technology do your residents regularly USE or CONTROL?TV 10 100%

DVD player 7 70%

Landline Telephone 8 80%

Own mobile phone 3 30%

Computer 1 10%

Internet 1 10%

Interactive TV 0 0%

Electronic games 0 0%

Online shopping 0 0%

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If they do not have access to some of these technologies, have any of them expressed a desire to use them – if so, which ones?We often here that people would like to have a TV on their own room.

No.

How would you rate your residents attitude to technology in general?1 positive/open minded 0 0%

2 fairly positive 0 0%

3 neither positive nor negative 8 80%

4 fairly negative 1 10%

5 very negative/dismissive 0 0%

6 Don't know 1 10%

If technology was developed to assist you in caring for your residents, which of the following items would you find most useful?

Very useful

Useful

A little bit useful

Not useful

Don’t know

Reporting what they eat 2 2 4 1 1

Reporting the amount of food consumed per meal 2 3 4 0 1

Reporting the amount of times they eat 0 3 4 1 2

Reporting the amount of times they drink 2 7 0 0 1

Reporting their facial expressions to denote issues 3 1 3 1 2

Reporting if they consuming the wrong kinds of food or drink 0 7 2 0 1

Reporting how active they are 2 3 3 1 1

What other types of easily accessible information would you find useful for monitoring or assessing a resident's wellbeing?When they go to the toilet, intercom system to answer questions over a distance.

When people tend to faint.

With restless clients; a signal when they get restless and want to get out of their chair. When people have to go to the toilet.

Unrest.Warnings when people tend to faint.

How accepting do you think your residents would feel about certain types of monitoring device if it was for their own benefit?

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Accepting Tolerant Indifferent Intoleran

tWould not allow

Don’t know

Cameras 0 1 8 1 0 0

Wearable sensors embedded in clothing 0 2 4 3 0 1

Food monitoring system 0 4 2 3 0 1

Activity monitoring system 0 3 2 3 0 2

Environmental Hazard monitoring system (e.g. trip hazard) 0 8 1 0 0 1

Facial recognition technology 0 3 4 1 0 2

Speech recognition technology 0 6 3 0 0 1

“Smart clothing” monitors things like blood pressure, temperature and heart rate with tiny sensors embedded in clothing – do you think your residents would be happy to wear this technology embedded in some type of light underwear such as a vest?Yes.

Yes, if we can clearly explain what the purpose is.

Yes, if they do not feel it, and if other people cannot see it.

Yes, probably.

I think so. Most people do not like it when we have to measure their blood pressure or temperature, so this would be very helpful.

No.

Could you foresee any practical problems getting your residents to wear or use “smart clothing”?Are these clothes washable? Who will wash them?

Too tight clothes, irritation.

Do not know.

I think it will be uncomfortable.

Damage to the sensors?

Damage to sensors, because of wearing and pulling it.

Might be hard to put on with certain clients. Will it give the right values?

What if people spill fluids on it?

What happens for instance when a person tends to have a low blood pressure all the time?

How long do you think they would be happy to wear smart clothing for?1 day.

During the day.

Max 12 hours?

During the day, so about 12 hours.

10 to 14 hours.

During the day, about 8 hours.

1 hour

Do not know.

How do you think most residents would feel about interacting with a robot?

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Positive/open minded 0 0%

Fairly positive 0 0%

Neither positive nor negative 4 40%

Fairly negative 4 40%

Very negative/dismissive 0 0%

Don’t know 2 20%

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Would they like it if the robot did the followingYes No Don't know

Followed them around 0 8 2

Was equipped with a camera 1 6 3

Was like a person (humanoid) 5 3 2

Spoke to them 5 2 3

Listened to them 5 1 4

Had an interactive computer screen 3 2 5

Reminded them to do things (take medication etc.) 7 1 2

Reported to a control centre if it saw a problem 9 0 1

Monitored what they ate 1 5 4

How would you feel about working alongside the following types of assistive technology:

Fine OK indifferent

A bit worried

I wouldn't do it Don't know

Monitoring Cameras 0 1 3 3 3 0

Wearable sensors embedded in clothing

0 1 5 1 1 2

Food monitoring system 2 3 3 0 1 1

Activity monitoring system 1 3 4 0 1 1

Environment-al Hazard monitoring system (e.g. trip hazard) 5 4 0 0 0 1

Facial recognition technology 1 4 2 0 1 2

Speech recognition technology 2 3 2 0 1 2

Interactive robots 1 2 2 3 1 1

Do you have any further concerns or comments regarding the use of technology to assist or monitor your clients?Let the client choose. I think current clients are not ready to make this step.

Do not know.

I do not think that everyone will like these technologies.

Especially for people with dementia, I think a robot will mostly cause unrest. Technology that detects dangers is very welcome.

7.1.2 Setting C – Independently living

7.1.2.1 End-Users

N=4, 1 male, age between 67 and 81

How important is it to you that you live independently in your own home?

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Really Important 3 75%

Important 1 25%

I don't mind 0 0%

Not very important 0 0%

I would rather not live at home 0 0%

How well do you feel that you cope with living at home?Very well 2 50%

Well 2 50%

Neither good nor bad 0 0%

I struggle a bit 0 0%

I struggle a lot 0 0%

How often do you see the following people?Every day More than once a week Once a

week Seldom Never

Doctor or nurse 0 0 0 2 1

Social worker 0 0 1 1 1

Housing worker 1 1 0 1 0

friends 0 0 2 0 1

Family 0 1 2 0 0

How often do you speak on the telephone with the following peopleEvery day

More than once a week Once a week Seldom Never

Medical staff 0 0 0 3 0

7.2 Social worker 0 0 0 2 1

Housing worker 0 0 0 2 1

Friends 1 0 1 1 0

Family 0 1 1 1 0

Which of the following activities do you take part in and how often?

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Several times a day

Every day

More than once a week

Once a week Seldom Never

Talking to friends or family 0 2 1 0 0 0

Gardening 0 0 0 1 0 2

Taking medication 1 1 0 0 1 0

craft/hobby activities 0 0 2 0 1 0

Watching TV 0 3 0 0 0 0

Walking 0 2 1 0 0 0

Taking a nap 0 1 0 0 2 0

Shopping 0 0 3 0 0 0

visiting friends or family 0 0 0 2 1 0

Excursions or day trips 0 0 0 0 3 0

Cimema or similar leisure activities 0 0 0 0 1 2

Excercise class 0 0 0 2 0 1

Is there anything not mentioned in the list that you enjoy doing that you would like to do more often?Going on a holiday.

Are there any things that you struggle with in terms of your independence and what do you feel might help you overcome this?Help with household issues.

Walking with a wheeled walker.

Has a wheeled walker to walk with.

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Which of the following technology do you use at home?TV 4

DVD Player 3

Landline telephone 4

Mobile phone 3

Computer 0

Internet 0

Interactive TV 0

Electronic games 0

Online shopping 0

Is there any technology that you don't use that you would like to?A laptop.

Is there anything stopping you from using technology?It is hard to program phone numbers, hard to use a phone, and I do not want to ask help from others.

No.

No.

How would you rate your attitude towards technology in general?Positive/open minded 1 33%

Fairy positive 0 0%


Fairy negative 1 33%


“Smart clothing” monitors things like blood pressure, temperature and heart rate with tiny sensors embedded in clothing. Do you think you would be happy to wear this technology embedded in some type of light underwear?Yes 1 33%

No 2 67%

How would you feel about using certain types of monitoring technology in your home if it were for your own benefit?

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Accepting Tolerant Indifferent Intolerant Would not

allow

Monitoring cameras 0 0 0 0 4

wearable sensors embedded in your clothing 0 1 0 0 3

technology that monitors what you eat 0 0 0 0 4

Technology tghat monitors how active you are 0 1 0 0 3

Technology that looks out for dangerous things in your home and alerts you 0 0 0 0 2

Technology which tells how you are feeling by looking at your face 1 0 0 0 2

Technology that understands what you are saying 0 1 0 0 2

Technology that monitors you and alerts other people if you are in danger 0 0 0 0 3

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How would you feel about living with a helpful robot?Positive/open minded 1 33%

fairy positive 0 0%


Fairy negative 0 0%


Don't know 1 33%

Would you like it if the robot did the following:Question Yes No

Followed you around 1 2

Was equipped with a camera 1 2

Was like a person (humanoid) 1 1

Spoke to you 1 2

Listened to you 1 2

Was operated by a computer screen 1 2

Reminded you to do things 1 2

Reported to a helpdesk if you were having a problem 1 2

Monitored what you ate 1 2

Do you have any further concerns or comments regarding the use of technology to assist or monitor you in your home?If I needed help or care, I would say yes to the above things a robot could do.

The robot should not walk in my way.

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8 References

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