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1. Advance Planning for Technology Use in Dementia Care: Development, Design, and Feasibility of a Novel Self-administered Decision-Making Tool

   https://doi.org/10.2196/39335  

   Berridge, Clara ; Turner, Natalie R ; Liu, Liu ; Karras, Sierramatice W ; Chen, Amy ; Fredriksen-Goldsen, Karen ; Demiris, George ( January 2022 , JMIR Aging)

   Monitoring technologies are used to collect a range of information, such as one’s location out of the home or movement within the home, and transmit that information to caregivers to support aging in place. Their surveilling nature, however, poses ethical dilemmas and can be experienced as intrusive to people living with Alzheimer disease (AD) and AD-related dementias. These challenges are compounded when older adults are not engaged in decision-making about how they are monitored. Dissemination of these technologies is outpacing our understanding of how to communicate their functions, risks, and benefits to families and older adults. To date, there are no tools to help families understand the functions of monitoring technologies or guide them in balancing their perceived need for ongoing surveillance and the older adult’s dignity and wishes.

   We designed, developed, and piloted a communication and education tool in the form of a web application called Let’s Talk Tech to support family decision-making about diverse technologies used in dementia home care. The knowledge base about how to design online interventions for people living with mild dementia is still in development, and dyadic interventions used in dementia care remain rare. We describe the intervention’s motivation and development process, and the feasibility of using this self-administered web application intervention in a pilot sample of people living with mild AD and their family care partners.

   We surveyed 29 mild AD dementia care dyads living together before and after they completed the web application intervention and interviewed each dyad about their experiences with it. We report postintervention measures of feasibility (recruitment, enrollment, and retention) and acceptability (satisfaction, quality, and usability). Descriptive statistics were calculated for survey items, and thematic analysis was used with interview transcripts to illuminate participants’ experiences and recommendations to improve the intervention.

   The study enrolled 33 people living with AD and their care partners, and 29 (88%) dyads completed the study (all but one were spousal dyads). Participants were asked to complete 4 technology modules, and all completed them. The majority of participants rated the tool as having the right length (>90%), having the right amount of information (>84%), being very clearly worded (>74%), and presenting information in a balanced way (>90%). Most felt the tool was easy to use and helpful, and would likely recommend it to others.

   This study demonstrated that our intervention to educate and facilitate conversation and documentation of preferences is preliminarily feasible and acceptable to mild AD care dyads. Effectively involving older adults in these decisions and informing care partners of their preferences could enable families to avoid conflicts or risks associated with uninformed or disempowered use and to personalize use so both members of the dyad can experience benefits.

    

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2. Aging in Flood-Prone Coastal Areas: Discerning the Health and Well-Being Risk for Older Residents

   https://doi.org/10.3390/ijerph15122900  

   Bukvic, Anamaria ; Gohlke, Julia ; Borate, Aishwarya ; Suggs, Jessica ( December 2018 , International Journal of Environmental Research and Public Health)

   Coastal communities are increasingly exposed to more intense and frequent hurricanes, accelerated sea-level rise, and prolonged tidal inundation, yet they are often a preferred retirement destination for older adults vulnerable to flooding and extreme weather events. The unique physical and psychosocial challenges of older population age 65 and over may affect their level of preparedness, capacity to cope with, and ability to respond and recover from a hazard event. Despite the clear vulnerabilities of older residents living in high-risk areas when compared to younger coastal populations, there is a lack of empirical research on the integrated flood risks to this population group in the coastal context. This paper provides a holistic assessment of this emerging problem along the U.S. East Coast by measuring the exposure of older population to sea level rise and storm surge in coastal counties. It further evaluates how age-related vulnerabilities differ between rural and urban settings using the case study approach and geospatial and statistical analysis the paper also conducts a review of scientific literature to identify gaps in the current understanding of health and well-being risks to aging populations in coastal communities. The results show that older populations are unevenly distributed along the U.S. East Coast with some states and counties having significantly higher percent of residents age 65 and older living along the shoreline. Many places with larger older populations have other attributes that further shape the vulnerability of this age group such as older housing stock, disabilities, and lower income and that often differ between rural and urban settings. Lastly, our study found that vast majority of research on aging in high-risk coastal locations has been conducted in relation to major disasters and almost none on the recurrent nuisance flooding that is already affecting many coastal communities. 

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3. Social Robotics to Address Isolation and Depression Among the Aging During and After COVID-19

   https://doi.org/10.1007/978-3-030-78642-7_22  

   Miller, Jordan ; McDaniel, Troy ( July 2021 , 23rd International Conference on Human-Computer Interaction (HCII 2021))

   COVID-19 is exacerbating isolation issues faced by older adults, which may lead to increased risk for depression and other mental health issues. Social robots are being explored for their potential to alleviate these challenges through conversational therapy, companionship, and connectedness regardless of where older adults chose to age in place—from home to long-term care facilities. This is a discussion piece with the objective of raising awareness to the topic of social isolation within older adults and current limitations in the field of social robotics. We discuss the state of the art in social robotics for aging in place and bring attention to remaining challenges for addressing isolation and mental health especially during and after COVID-19. This paper provides a discussion on critical differences between environments where older individuals age, and how designs should account for these variations. Lastly, this paper highlights the physical and mental health issues of caregivers and provides a discussion of challenges that remain toward using social robotics to assist those who take care of the aging population. 

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4. Taking Stock of the Present and Future of Smart Technologies for Older Adults and Caregivers

   Harrington, Christina N ; Jelen, Ben ; Lazar, Amanda ; Martin-Hammon, Aqueasha ; Pradhan, Alisha ; Reeder, Blaine ; Siek, Katie ( March 2021 , A Computing Community Consortium (CCC) Quadrennial Paper)

   null (Ed.)

   Technology has the opportunity to assist older adults as they age in place, coordinate caregiving resources, and meet unmet needs through access to resources. Currently, older adults use consumer technologies to support everyday life, however these technologies are not always accessible or as useful as they can be. Indeed, industry has attempted to create smart home technologies (e.g., Microsoft HomeOS, Intel CareNet) with older adults as a target user group, however these solutions are oftenmore focused on the technical aspects and are short lived. In this paper, we advocate for older adults being involved in the design process - from initial ideation to product development to deployment. We encourage federally funded researchers and industry to create compensated, diverse older adult advisory boards to address stereotypes about aging while ensuring their needs are considered. We envision artificial intelligence (AI) systems that augment resources instead of replacing them - especially in under-resourced communities. Older adults rely on their caregiver networks and community organizations for social, emotional, and physical support; thus, AI should be used to coordinate resources better and lower the burden of connecting with these resources. Although sociotechnical smart systems can help identify needs of older adults, the lack of affordable research infrastructure and translation of findings into consumer technology perpetuates inequities in designing for diverse older adults. In addition, there is a disconnect between the creation of smart sensing systems and creating understandable, actionable data for older adults and caregivers to utilize. We ultimately advocate for a well-coordinated research effort across the United States that connects older adults, caregivers, community organizations, and researchers together to catalyze innovative and practical research for all stakeholders. 

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5. CAL: A Smart Home Environment for Monitoring Cognitive Decline

   Fredericks, Erik M. ; Bowers, Kate M. ; Price, Katey A. ; Hariri, Reihaneh H. ( July 2018 , Proceedings of the International Conference on Distributed Computing Systems)

   The increased growth of the aging population (i.e., 65 years or older) has led to emerging technologies in health care that provide in-home support to patients using devices throughout the household. Such smart home environments can monitor and interact with patients and their doctors/caregivers to augment patient medical data for diagnosis than can be generated via traditional doctor visits. Moreover, smart homes are enabling older adults to stay at home longer as opposed to permanent moves to assisted living or nursing facilities, increasing health and well-being and decreasing overall costs to the individual and society at large. This paper proposes Cognitive Assisted Living (CAL), a cyber-physical system comprising a network of embedded devices for collecting and analyzing patient speech patterns over time for monitoring cognitive function beginning in the early stages of Alzheimer’s disease. Specifically, CAL will analyze patient speech patterns and spatial abilities, via a set of daily interactions, to provide a longitudinal analysis of speech deterioration, a significant indicator of cognitive decline resulting from Alzheimer’s disease. Understanding the rate of cognitive decline can enable caregivers and health care professionals to better manage the patient’s daily care and medical requirements. Additionally, the patient’s cognitive state can be shared across household devices to increase the patient’s comfort and better accommodate lifestyle changes. To these ends, we describe the architecture of the proposed system, the methods to which we will detect cognitive decline, and specify how the system will provide continuing fault tolerance and data security at run time. 

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