Mobile Devices to Aid the Elderly

As the population ages, especially in the western world, society is witnessing a rising proportion of elderly individuals (Jorge, 2001; Abascal & Civit, 2001). It has been estimated that by 2020, one in four Europeans will be over 60 years of age (Mikkonen, Vayrynen, Ikonen, & Heikkila, 2002) and the global rate of elderly individuals to be one billion in 2020 (Mikkonen et. al, 2002). These individuals are not, as often assumed, confined to their dwellings or nursing homes, but are in fact active social members of the community (Jorge, 2001), living healthy lives past the ages of 70 (Mikkonen et. al, 2002). Daily life however, is often a challenge for individuals with age induced problems such as motor, vision and auditory disabilities. Furthermore, as the proportion of elderly individuals increases, the rate of age induced cognitive disabilities such as Alzheimer's disease are also rising (Jorge, 2001). Like other elderly citizens, these individuals have friends, hobbies, family and friends, travel around their community and carry out daily activities such as cooking and taking medication (Jorge, 2001). Unlike the rest of the population however, these people often require the support of a care giver.

Technological development is already being shaped to accommodate elderly users’ special requirements, and many devices and services are on offer to help them cope with everyday activities (Mikkonen et. al, 2002) generally within the home. However, as technology becomes increasingly sophisticated, the idea of mobile services to support the elderly in a wide variety of situations is becoming more feasible and attractive as a tool to increase the autonomy of elderly people (Abascal & Civit, 2001)

Both mobile devices and elderly individuals pose very interesting and challenging interaction-design issues that need to be carefully understood for widespread adoption, acceptance and use. This literature review will examine three research papers in depth with the goal of developing a wider understanding of mobile devices, what they have to offer elderly people, and the associated challenges with this technology and this particular user demographic.

Three papers have been carefully selected, not only for their varying methodologies and angles, but for their similarities, which are manifested in a variety of different ways, some intentional and some not. Jorge (2001) focuses upon the issues and methodologies required in the development of situation aware mobile devices for elderly citizens. He argues that due to varying illnesses, disabilities and personality traits, it is almost impossible to design for each individuals unique needs. The solution, according to Jorge (2001), is the use of adaptive social assistants that change intelligently to the needs of elder users based upon information such as context and location. Abascal and Civit (2001) examine five self-described contexts that form the basis of a requirements analysis and subsequent discussion. Finally, Mikkonen, Väyrynen, Ikonen & Heikkilä (2002) conduct a participative two part study and determine four concepts that are analyzed in a participative manner by elderly citizens.

User centered design and participative design research methodologies were widely used and discussed in all three papers. It seems that Abascal & Civit's (2001) primary objective was almost to urge the “incorporation of older people’s needs to the design process”. They argue that the technology will only be successful if older people’s opinions are taken into consideration throughout the whole design process. They propose five situations in which to examine in order to identify elderly users requirements for mobile telecommunication. It is unclear as to how Abascal & Civit determine these five situations, and the article would be far more polished if the logic behind this was described. While in agreement with Abascal & Civit (2001), Mikkonen et. al. (2002) go one step further, by actually conducting an participatory ideation session with an elderly study group. The study consisted of five predefined phases based upon the OPERA framework: Own Suggestions, Pairs suggestions, Explanation, Ranking and Arranging. This resulted in the construction of four user produced technological concepts which were in turn evaluated on various levels by another elderly cohort. This was self titled a “User and Usages Study”. Although the Jorge (2001) article focused more closely upon the technical design aspects of mobile devices and elderly individuals, he too states that one needs to build on user centered design methodologies that combine task analysis with participatory design. He further states that careful studies of how the target population actually lives is critical in the success of this technology.

Surprisingly, as each paper was partly selected for its different angle, there were some very similar themes evident in the findings and discussions throughout all three papers. Of the four concepts produced and examined by Mikkonen et. al. (2002), a reminder device, that kept track of bills, medication and other information was the most technically feasible and received strong support from the elderly respondents. This is in line with Jorge (2001) who found that a key function a mobile assistant should perform would be to support daily routines that may suffer as a symptom of short term memory loss. Titled 'Memory Prosthesis', this hypothetical device would use location aware contextual information to provide unobtrusive reminders common to specific situations, reminiscent of the device elderly users outlined in the Mikkonen et. al. (2002) study.

The most popular, although currently unfeasible, device constructed by the participants in the Mikkonen et. al. (2002) study was a location aware Bluetooth-enabled security bracelet, titled “Mobile Wrist Care”. The device, already used within the home from a base station, would work through the mobile network and consequently outside the home. A panic button on the bracelet would connect through a Bluetooth connection to a larger device carried on the person or in the handbag. In the event of an emergency and the press of the panic button, coordinates of the individuals location, obtained from GPS positioning would be sent. Abascal & Civit (2001) discuss a very similar device with an inbuilt panic button, yet delve deeper and examine the situation in which the individual is too incapacitated to physically press the panic button. They outline a hypothetical device that could monitor vital health statistics such as heart rate, blood pressure and breathing rate, with the ability of notifying authorities if certain statistics reach a particular level.

Although phrased differently throughout each paper, way-finding was another finding that consistently echoed throughout the papers. Jorge (2001) outlined the case of how a blind individual could benefit from an adaptive tracking device. Although essentially based upon a standard GPS system, the adaptive social assistant would not only direct individuals, but it would use intelligent data to alert a caregiver if an individual strayed off a predefined route. The author also describes a particular case of boarding the correct bus and leaving it at the correct time. This directly aligns to the Mikkonen et. al. (2002) participative user study which results in the construction of a hypothetical service concept that enables elderly individuals to travel more independently on public transport. They describe a location aware portable terminal that informs the user when the correct bus arrives at the bus stop, even when the user cannot read the bus number. During the journey the mobile device informs the driver of the particular stop the passenger wishes to leave.

The prevalent theme throughout all the articles was one of aiding individual autonomy for as long as possible in an individual’s life. Each paper, with its different methods, goals and motives seemed to be touching upon this overall goal. While this is more obvious in some papers, such as the Abascal & Civit (2001) article titled “Universal Access to Mobile Telephone as a Way to Enhance the Autonomy of Elderly People” the other two papers suggested that having a society in which elderly individuals remain autonomous for as long as possible, it is not only better for the individual it is also better for the community.

Another theme of the papers was one of optimism of the future. Each paper was very optimistic of the role mobile technology will play in the future support of elderly individuals. The Mikkonen (2002) study, for example develops four different hypothetical technologies, of which three are currently technically infeasible. The Jorge (2001) paper revolves around the central idea that current static technologies are not suitable enough for the wide variety of elderly users and their particular uses. He proposes that “we should look to a not-so-distant future in which a variety of devices, such as wearable computers, intelligent environments and robots, monitor our medical status” and that an adaptive social assistant, currently not developed, could fill this user-service void. The Abascal & Civit (2001) paper also outlines several 'mixed technologies for future wireless telecommunications' such as a Mobile Text Telephony – a form of mobile Instant Message chat and Light Terminals – A mobile device capable of accessing the Internet. The article, currently 6 years old, is clearly showing its age with the current environment of relatively fast 3G mobile bandwidth. Nevertheless, the idea of widespread mobile Internet use by the elderly remains as futuristic as ever.

This brief literature synthesis, consisting of only three articles, just scrapes the surface as to the current state of research into mobile devices to aid the elderly, yet reflects the reoccurring themes that seem to resonate throughout most of the current research within this area. Some themes discussed and highlighted within this three paper literature review were:

1. User centered design to understand the very complex user base.
2. Aiding memory and supporting daily routines
3. Contributing to personal security inside and outside the home
4. Way-finding
5. Autonomy for the elderly
6. Looking towards the future.

Clearly, the potential benefits of mobile technology for the elderly are very high. However we are yet to see widespread adoption, use or even development of these aforementioned devices within the community. It is both heartening for the author to see the potential of future technology to help the elderly, yet somewhat disheartening to know that many of these individuals will not be around to take advantage of these devices in the future when they eventually become widely used.

References

Abascal, J., & Civit, A., 2001 Universal access to mobile telephony as a way to enhance the autonomy of elderly people, Proceedings of the 2001 EC/NSF workshop on Universal accessibility of ubiquitous computing: providing for the elderly pp 93-993

Jorge, J., 2001 Adaptive tools for the elderly: new devices to cope with age-induced cognitive disabilities Proceedings of the 2001 EC/NSF workshop on Universal accessibility of ubiquitous computing: providing for the elderly pp 66-70

Mikkonen, M., Vayrynen, S., Ikonen, V., and Heikkila, M. O., 2002 User and Concept Studies as Tools in Developing Mobile Communication Services for the Elderly Personal and Ubiquitous Computing 6:113-124