Dissertation: Examining and investigating home modifications and smart home technologies to reduce fall injury among older adults.

Nearly one in six U.S. residents are over the age of 65. The proportion of older adults in the U.S. is anticipated to grow to 22.1% of the total population by 2050. The cost of treating age related conditions and injuries is expensive, government programs including Medicaid paid over $550 Billion in 2017, and makes up between 14-16% of the federal budget each year. With the high cost of treating age related conditions and injuries, and the proportion of older adults continuing to increase every year, it is imperative that researchers and government entities find and invest in preventative measures in order to reduce injury and related healthcare costs. Among the many age-related injuries older adults suffer, falls are arguably the most important to address. It is estimated that one in three older adults has a fall every year. In 2016, falls were the seventh leading cause of death among older adults. Approximately one third of all fallers require medical attention after experiencing a fall. Over 800,000 older adults are hospitalized each year due to fall related injuries. Injuries sustained as a result of a serious fall include various fractures, traumatic brain injuries, and other cuts and bruises.Home modifications, and more recently smart home technologies, can help increase the safety of older adults living in the community. With older adults wanting to “age in place”, installing these modifications and technologies before an accident happens may lower rates of injury. Today, dozens of companies sell various smart home devices for the consumer market. Bud despite the high demand for these technologies by the American consumer, the ability of these devices to keep older adults safe, and how older adults value these technologies, remains uncertain. These home technologies may be particularly beneficial to older adults living in rural areas due to the increased isolation and limited access to healthcare resources. Previous research indicates rural populations have a greater proportion of older adults compared to urban areas, yet lack the infrastructure to provide specialty care to this population. It is estimated that more than 60 million family members provide some sort of informal care to an older adult relative. Of all of these family members, nearly 40% report spending 20 or more hours a week providing this unpaid care. Previous research has failed to examine how these family members feel about home modifications and technologies for their older adult relative. Finding ways to ease the burden of caring for older family members will significantly better the situations of many family relatives.This dissertation aims to cover three areas. 1. Identify people at risk of suffering subsequent fall injuries. Find the average time between an initial fall injury and a subsequent fall injury, and find average time between an initial fall injury and death.2. Examine the preferences of older adults living in a rural area towards various smart home technologies and home modifications.3. Examine the preferences of family members of older adults regarding smart home technologies and home modifications

Fall Prediction and Prevention Systems: Recent Trends, Challenges, and Future Research Directions.

Fall prediction is a multifaceted problem that involves complex interactions between physiological, behavioral, and environmental factors. Existing fall detection and prediction systems mainly focus on physiological factors such as gait, vision, and cognition, and do not address the multifactorial nature of falls. In addition, these systems lack efficient user interfaces and feedback for preventing future falls. Recent advances in internet of things (IoT) and mobile technologies offer ample opportunities for integrating contextual information about patient behavior and environment along with physiological health data for predicting falls. This article reviews the state-of-the-art in fall detection and prediction systems. It also describes the challenges, limitations, and future directions in the design and implementation of effective fall prediction and prevention systems

Fall prevention intervention technologies: A conceptual framework and survey of the state of the art

In recent years, an ever increasing range of technology-based applications have been developed with the goal of assisting in the delivery of more effective and efficient fall prevention interventions. Whilst there have been a number of studies that have surveyed technologies for a particular sub-domain of fall prevention, there is no existing research which surveys the full spectrum of falls prevention interventions and characterises the range of technologies that have augmented this landscape. This study presents a conceptual framework and survey of the state of the art of technology-based fall prevention systems which is derived from a systematic template analysis of studies presented in contemporary research literature. The framework proposes four broad categories of fall prevention intervention system: Pre-fall prevention; Post-fall prevention; Fall injury prevention; Cross-fall prevention. Other categories include, Application type, Technology deployment platform, Information sources, Deployment environment, User interface type, and Collaborative function. After presenting the conceptual framework, a detailed survey of the state of the art is presented as a function of the proposed framework. A number of research challenges emerge as a result of surveying the research literature, which include a need for: new systems that focus on overcoming extrinsic falls risk factors; systems that support the environmental risk assessment process; systems that enable patients and practitioners to develop more collaborative relationships and engage in shared decision making during falls risk assessment and prevention activities. In response to these challenges, recommendations and future research directions are proposed to overcome each respective challenge.The Royal Society, grant Ref: RG13082

A cane-based low cost sensor to implement attention mechanisms in telecare robots

Telepresence robots have been recently used for Comprehensive Geriatric Assessment (CGA). Since the robot can not track a person continuously, there are several strategies to decide when to check them, from cyclic checks to simple requests from users and/or caregivers. In order to adapt to the user needs and condition, it is preferable to perform CGA as soon as regularities appear. However, this requires detection of potential issues in users to offer immediate service. In this work we propose a new low cost force sensor system to detect user’s condition and attract attention of CGA robots, so they can perform a full examination on a need basis. The main advantages of this system are: i) it can be attached to any standard commercial cane; ii) its power consumption is very reduced; and iii) it provides continuous information as long as the user walks. It has been tested with several elderly volunteers in care facilities. Results have proven that the sensor readings are indeed correlated with the users’ condition.Universidad de Málaga. Campus de Excelencia Internacional Andalucía Tec

`Everyone is a winner, help is just a push of a button away. . . ' : the Telecare Plus service in Malta

This paper reports on a research study on the role of assistive technologies in later life. Re- search questions included what is the impact of assistive technologies on the quality of life of older service-users, and to what extent does assistive technology lead to an improved quality of life for subscribers and in- formal carers? The chosen method of enquiry was a case-study of the Telecare Plus service in Malta. A total of 26 semi-structured interviews were held with a convenience sample of 26 people aged 60-plus about their use and experience of this particular telecare system. The Telecare Plus service was found to contribute positively to subscribers' levels of emotional and physical wellbeing, interpersonal relations and personal develop- ment, as well as towards the quality of life of informal carers. However, research also highlighted a range of challenges that stood in the way of increased adoption rates of the Telecare Plus service by older people. The fact that the fi eld of assistive technologies in Malta lacks effi cient and clear business models constitutes another barrier towards the take up of such services.peer-reviewe

Pervasive Technologies and Support for Independent Living

A broad range of pervasive technologies are used in many domains, including healthcare: however, there appears to be little work examining the role of such technologies in the home, or the different wants and needs of elderly users. Additionally, there exist ethical issues surrounding the use of highly personal healthcare-related data, and interface issues centred on the novelty of the technologies and the disabilities experienced by the users. This report examines these areas, before considering the ways in which they might come together to help support independent-living users with disabilities which may be age-related

RFID Localisation For Internet Of Things Smart Homes: A Survey

The Internet of Things (IoT) enables numerous business opportunities in fields as diverse as e-health, smart cities, smart homes, among many others. The IoT incorporates multiple long-range, short-range, and personal area wireless networks and technologies into the designs of IoT applications. Localisation in indoor positioning systems plays an important role in the IoT. Location Based IoT applications range from tracking objects and people in real-time, assets management, agriculture, assisted monitoring technologies for healthcare, and smart homes, to name a few. Radio Frequency based systems for indoor positioning such as Radio Frequency Identification (RFID) is a key enabler technology for the IoT due to its costeffective, high readability rates, automatic identification and, importantly, its energy efficiency characteristic. This paper reviews the state-of-the-art RFID technologies in IoT Smart Homes applications. It presents several comparable studies of RFID based projects in smart homes and discusses the applications, techniques, algorithms, and challenges of adopting RFID technologies in IoT smart home systems.Comment: 18 pages, 2 figures, 3 table