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

Usability in New Contexts: The Case of a Museum

The study of human computer interaction is ultimately a goal driven discipline. This is understandable, as most traditional human computer interactions involve the achievement of a goal or task. However, in the case of a museum visit, the goals of users are marginalized as pleasure and experience often outweigh the completion of a task. Furthermore, the users are far from the traditional workers that HCI often assumes. This presents an interesting situation whereby traditional HCI breaks down and consequently new methods of analysis must be found. This paper discusses the reasons behind the limitations of traditional HCI in a museum situation and briefly discusses the potential for future work.

Introduction

A new wave of museums

When one thinks of a museum, the Louvre in Paris, the National Gallery in London or the Metropolitan in New York are common institutions that come to mind (Ginsburgh & Mairesse 1997). Increasingly, however the idea of a museum is shifting away from this more conservative view to one of interaction and experience. The traditional boundaries of ‘art’ and ‘history’ are blurred to include exhibits that include but are not limited to technology, arboreta, planetariums, science and technology centers. There has been some debate within the museum community as to a strict definition of a museum, however some key similarities have been drawn together to define a museum as an institution that is involved in three fundamental areas: Conservation, Research, and Communication (Ginsburgh & Mairesse 1997). One such institution, located in Melbourne, Australia, is a prime example of this new wave of museums with its technology, arboreta and science exhibits which fits neatly into these three categories as outlined by Ginsburgh & Mairesse (1997).

This modern breed of museum is very receptive to the idea of using technology as a tool to make the visitor experience more fulfilling and rewarding. Several interesting studies have been conducted to determine the role technology can play in this environment and some prototypes produced (Grinter, Aoki, Szymanski, Thornton, Woodruff, & Hurst, 2002; Hsi, 2002). However there are unique challenges associated with applying traditional Human Computer Interaction theories to this novel environment and user base that need to be thoroughly examined before any solid conclusions are drawn regarding the role of technology in a museum.

Museums in general and The Melbourne Museum[1] in particular attracts a wide and diverse range of visitors of all abilities and skills such as tourists, children, families, school groups, students and the elderly that are a far cry from the traditional worker. Essentially, anyone interested in conservation or research on any level is a potential visitor to the museum. Furthermore, unlike traditional goal oriented workers, museum visitors are not usually directed by a clearly defined goal. This poses an interesting and challenging situation when designing technology to serve such unclear or nonexistent goals.

Challenge 1: Designing for a broad user base with blurred user goals

Broad user base

Initial research through group discussions and brainstorming has identified several user groups with special needs and design considerations. These groups need to be carefully considered and understood when designing technology for a Museum.

Blind Individuals	Cannot utilize visual displays. Partially blind individuals may require large font. · Investigate the use of brail. · May enjoy exhibits and technology that provide tactile feedback. · Investigate technology and exhibits that provide auditory information.
Deaf Individuals	Can-not use information presented in audio format. · May need to rely on visual and tactile senses as a basis for information. · Requirement for visual notes to read about exhibits · Visually attractive and informative devices will support this group
Mobility impaired / Very Elderly	Low reaching height Can only use devices that are very ergonomic Arthritic limbs and hands · Any technology will have to be low for wheelchair access and to avoid reaching. · Exhibits and technology will need to be at eye level to avoid unnecessary strain · Any input will need to have simple input and uncomplicated interaction. · Small buttons may pose a challenge to use
Children of all ages	No reading/writing skills yet Limited attention Physically short · Prefer technology and exhibits that present information in pictorial and exciting format. · Will enjoy exciting and intriguing exhibits and technology. · Will require exhibits that are low to the ground and technology that is simple and accessible.
Mentally handicapped	Lower concentration span · May need the exhibits and technology to be fun and simple to understand.
Non-English Speaking Tourists	Cannot understand auditory or visual information presented in English · May require notes about each exhibit to explain what they are about. · Investigate translation, multi language support. · Investigate presenting information in a universal diagrammatic form. · Remain unaware of certain cultural conventions of Australian signs and diagrams.

Table 1: Special user requirements, potential issues and possible solutions

Variable and wide ranging goals

Just as the definition of a museum is hard to define (Ginsburgh & Mairesse 1997) so is the overall goal of a users particular visit. Some individuals may visit a museum for purely social engagement with the community, others may be there for the purposes of research, and others may fall in the middle. Individuals, who visit one particular week for research purposes, may even visit the next week with social intentions. Regardless, any technologies that will be developed will need to take into consideration and overcome this challenge to define a user’s goal and motive, if the technology will be a success.

Technologies have already been incorporated into museums to further enhance user’s visits for some time now (E.g. Grinter, Aoki, Hurst, Szymanski, Thornton, & Woodruff, 2002; Fleck Frid, Kindberg, O'brien-StrainRajani & Spasojevic, 2002; Bederson, 1995). The implementation of electronic devices such as guidebooks, portable computers and Personal Digital Assistants although often viewed as isolating devices, can also be used for social interaction amongst the visitors. For example: shared listening, following a leader and checking in on different individuals (Grinter, Aoki, Hurst, Szymanski, Thornton, and Woodruff, 2002) are all technologies that enable social interaction through a seemingly antisocial personal digital assistant.

This social use of technology such as shared listening would most likely involve audio being emitted from the device, which may be disruptive to other members of the museum. The obvious solution, a pair of headphones, would have negative influence on social interaction as individuals would not be able to hear each other and therefore converse. Therefore, the only feasible use of audio emitting devices would be in place where additional noise would not be a problem (Grinter, Aoki, Hurst, Szymanski, Thornton, and Woodruff, 2002) which is often hard to find in a museum.

The use of devices with audio, such as those mentioned above may also pose other challenges centered around users abilities and disabilities as mentioned in the previous section. Visitors who are auditory disabled may either not be able to hear the audio from the device, or the device may not be compatible with their hearing-aid. A replacement text based device should be made available for individuals with these disabilities. This however, raises another challenge, that the display on these devices may be too small and many of the fine visual details and text many may be rendered unusable by individuals with visual deficiencies. (Reeves, Benford, O’Malley, Fraser, 2005)

Individuals with differing goals will require differing technologies to alter their experience. For example, a social group may be more interested in ‘fun facts’ about exhibits they may use as talking points, while a student may desire hard facts and information to form the basis of a report. One possible solution to this could be through different settings on the technology to present advanced or basic information.

Challenge 2: Evaluating the technological prototype using traditional Human Computer Interaction techniques.

Although it is impossible to tie to a particular date, the field of HCI has been around in some way for at least 25 years (i.e. Shneiderman 1980). During these past two decades, technology and its users have evolved very rapidly (Carroll, 1997). The traditional opinion of technology, as a tool for productivity, work efficiency and strategic advantage has also shifted dramatically over the past years. The idea of a computer as solely a Business Machine, such as an IBM (International Business Machine) almost seems farcical in today’s age of personal computing, mobile computing and user produced content. This shift, partly attributable to the drop in technology cost and decreased software complexity, has allowed home users and small organisations to access almost the same standard of computing available to large corporations with the ability to afford previously expensive infrastructure and training costs.

Along with the shift from the traditional workplace role of technology, a swing in the typical user base has also occurred. The typical user is no longer an employee of an organisation working a 40 hour week to achieve a set goal. A typical user could be a young child researching for a school project at home, an elderly woman emailing her daughter at the local library, a child exploring a museum using a touch-screen, or the typical middle aged able bodied worker we are all so familiar with. It is undeniable that these individuals are all users, yet they have very different goals, motives and abilities.

This convolution of the technology user base has brought with it a shift in many technology related disciplines. Software engineers are no longer solely designing outcome based strategic software, computer manufacturers are no longer only producing beige-boxes or unsightly network routers and mobile phones are no longer exclusively marketed as business tools. However, technological research disciplines such as the field of Human Computer Interaction has been fairly slow to include and produce new methodologies to meet these new users and uses for technology.

Museums in general and The Melbourne Museum in particular attracts a wide and diverse range of visitors of all abilities and skills such as tourists, children, families, school groups, students and the elderly that are a far cry from the traditional worker. Essentially, anyone interested in conservation or research on any level is a potential visitor to the museum. Furthermore, unlike traditional goal oriented workers, museum visitors are not usually directed by a clearly defined goal.

These fundamental differences pose an interesting and challenging problem to curators and designers of museum technology who are required to design exhibits and technologies for this very wide visitor base with often ill-defined goals. The traditional HCI tools and methodologies, usually centered individuals around goals and motives of a worker, break down and produce meaningless results. For example, methodologies such as, Hick’s law (Hick, 1952) and Fitts’ (Fitts, 1954) law; frameworks for predicting interface speed, are no longer relevant to the majority of these non-working museum visitors users, as their motives are not governed by speed and productivity. GOMS model (Card, Moran & Newell, 1983), a methodology that reduces the user's interactions with a computer to its elementary actions, is based upon the premise that the user has a goal, and is repeating the task, which is not relevant in the museum situation.

The Cognitive Walkthrough, a widely used usability inspection method also has limited application in an environment whereby the user is not interested in seeking a predefined goal, such as in a museum. Task analysis, the backbone of a Cognitive Walkthrough (Wharton, 1994), centers around the idea that one can define the tasks of the user and evaluate them according to how they walk through the steps to get to the desired goal. If there is no goal, there can be no task analysis and therefore no cognitive walkthrough.

Any individual, seeking to design a technology to aid the museum experience will therefore have a great deal of trouble applying existing Human Computer Interaction theories to their device. Clearly, an existing methodology needs to modified, or a new one produced.

Design Proposal and future work

The main focus for future work stems from the fact that it is very hard to apply existing goal oriented human computer interaction theories to non goal oriented work. We therefore suggest that a new evaluation method is produced that does not solely rely upon achievement of a predefined goal, but more upon how a user goes about achieving the goal, in effect focusing upon the journey and not the destination.

This could take the form of a modified cognitive walkthrough, with increased focus upon the walking and not the cognition. One such example could be titled the ‘pleasure walkthrough’ and would revolve around the users affective response and pleasure, while placing limited weighting on the outcome.

Conclusion

Environments whereby users are non goal directed and diverse are fairly common and not limited solely to a museum. Amusement Parks, Zoos, Galleries and Shopping centers are also situations in which goal oriented behavior is often second to experience. Traditional HCI theories and methodologies are somewhat challenged in these situations and perhaps need to be modified if they are to remain relevant to these unique and complex environments. Further research should be conducted to find a new angle in which to understand user interaction and experience with technology when there is limited goal oriented behavior and a diverse user base.

REFERENCES

Bederson, B., 1995, ‘Audio Augmented Reality: A
Prototype Automated Tour Guide’, Conference on Human Factors in Computing Systems.

Card, S., Moran, T., & Newell, A., 1983, ‘The Psychology of Human Computer Interaction’, Published 1983 Lawrence Erlbaum Associates

Carrol J.M. 1997, ‘Human-Computer Interaction: Psychology as a Science of Design Annual Review of Psychology’, Vol. 48, 1997

Falk, H., & Dierking.. D., 1992, ‘The Museum Experience’, Howells House.

Fitts P 1954, ‘The information capacity of the human motor system in controlling the amplitude of movement’, Journal of Experimental Psychology, vol. 47, no.6, pp.381-391.

Fleck, M., Frid, M., Kindberg, T., O'brien-Strain, E., Rajani, R., & Spasojevic, M. 2002, ‘Remember: A Tool For Capturing Museum Visits’, Ubiquitous Computing, Vol. 2498/2002, Pp. 48-55

Ginsburgh, V., & Mairesse, F., 1997, ‘Defining a Museum - Suggestions for an alternative approach Museum’ Management and Curatorship’ 16 pp. 15-33

Grinter, E., Aoki, M., Hurst, A., Szymanski, H., Thornton, D. & Woodruff, A., 2002, ‘Revisiting the Visit: Understanding How Technology Can Shape the Museum’, Proceedings of the 2002 ACM conference on Computer Supported Cooperative Work pp.146-155

Hick E., 1952, ‘On the rate of gain of information’, Quarterly Journal of Experimental Psychology, Vol. 4 pp.11-26,

Hsi, S., 2002, ‘The Electronic Guidebook: A study of user experiences using mobile web content in a museum setting’ Wireless and Mobile Technologies in Education’, Proceedings IEEE International Workshop on Wireless and Mobile Technologies in Education.

Melbourne Museum Website, From the World Wide Web at ‘http://melbourne.museum.vic.gov.au/’

Neilson, J., 1994‘Usability inspection methods’ New York : Wiley,.

Reeves, S., Benford, S., O'malley, C. & Fraser, M., 2005, ‘Designing The Spectator Experience’, Proceedings Of The Sigchi Conference On Human Factors In Computing Systems

Shneiderman B, 1980, ‘Software psychology: Human factors in computer and information systems’ Winthrop Publishers