Vicious or Virtuous Cycle? The Privacy Implications of Active Assisted Living Technologies for Older People

A variety of technologies are being developed to help older people live healthier, more independent, and safer lives, for longer. While many of these technologies are positively impacting the lives of older adults, they also have the potential to dictate specific behaviours or restrict their autonomy rather than empower them. The vulnerability theory of privacy proposes that vulnerable populations are not only more likely to be susceptible to privacy violations, but are also disproportionately affected by said violations. In this position paper, we adapt the vulnerability theory of privacy to the older adult population, and identify a further potential exacerbatory cycle. The risk of a 'slippery slope' of privacy violation occurs when AAL technologies enable an elevated and quantified visibility of (mis)behaviour and irregular activity that could seem to justify the deployment of further AAL technology. We present ĝ€?FOR VERIFICATION>ratchet-wise rehabilitation' as an alternative vision to the ĝ€?FOR VERIFICATION>slippery slope' and identify research and design challenges throughout the paper

Position paper on ethical, legal and social challenges linked to audio- and video-based AAL solutions

In this position paper, we have used Alan Cooper’s persona technique to illustrate the utility of audio- and video-based AAL technologies. Therefore, two primary examples of potential audio- and video-based AAL users, Anna and Irakli, serve as reference points for describing salient ethical, legal and social challenges related to use of AAL. These challenges are presented on three levels: individual, societal, and regulatory. For each challenge, a set of policy recommendations is suggested

Position paper on ethical, legal and social challenges linked to audio- and video-based AAL solutions

In this position paper, we have used Alan Cooper’s persona technique to illustrate the utility of audio- and video-based AAL technologies. Therefore, two primary examples of potential audio- and video-based AAL users, Anna and Irakli, serve as reference points for describing salient ethical, legal and social challenges related to use of AAL. These challenges are presented on three levels: individual, societal, and regulatory. For each challenge, a set of policy recommendations is suggested

Society in need of transformation. Citizen-Foresight as a method to co-create urban future

The European Commission highlights that creating shared values and democratic citizenship is a today’s requirement to answer challenges of urbanization in Europe. The awareness about the necessity of inclusion of vulnerable groups such as elderly or migrants is still a substantial deficit in research on inclusion. As a matter of principle, future cannot be forecasted. The most effective way to foresee future is to jointly shape it! The Participatory Citizen-Foresight offers a neutral transformation-room and multi-method coordination-framework for detecting accessible and tacit-knowledge for change. In co-creation citizens, experts and Civil-Servants gain insights into complex interdependencies allowing mutual learning and behavior in rehearsal for transition. Society is in need of powerful, collective pictures serving self-confidence and self-responsibility of citizens. First, we describe the specific, participatory-foresight approach. Second, we highlight preconditions for learning and societal change based on constructivism and brain research. Third, we show how this can work in reality by shortly outlining two Citizen-Foresight cases with elderlies and, fourth, we derive selection-criteria for methods aiming at transforming mental images, maps and behaviour.

Conflicting aims and values in the application of smart sensors in geriatric rehabilitation: ethical analysis

BACKGROUND: Smart sensors have been developed as diagnostic tools for rehabilitation to cover an increasing number of geriatric patients. They promise to enable an objective assessment of complex movement patterns. OBJECTIVE: This research aimed to identify and analyze the conflicting ethical values associated with smart sensors in geriatric rehabilitation and provide ethical guidance on the best use of smart sensors to all stakeholders, including technology developers, health professionals, patients, and health authorities. METHODS: On the basis of a systematic literature search of the scientific databases PubMed and ScienceDirect, we conducted a qualitative document analysis to identify evidence-based practical implications of ethical relevance. We included 33 articles in the analysis. The practical implications were extracted inductively. Finally, we carried out an ethical analysis based on the 4 principles of biomedical ethics: autonomy, beneficence, nonmaleficence, and justice. The results are reported in categories based on these 4 principles. RESULTS: We identified 8 conflicting aims for using smart sensors. Gains in autonomy come at the cost of patient privacy. Smart sensors at home increase the independence of patients but may reduce social interactions. Independent measurements performed by patients may result in lower diagnostic accuracy. Although smart sensors could provide cost-effective and high-quality diagnostics for most patients, minorities could end up with suboptimal treatment owing to their underrepresentation in training data and studies. This could lead to algorithmic biases that would not be recognized by medical professionals when treating patients. CONCLUSIONS: The application of smart sensors has the potential to improve the rehabilitation of geriatric patients in several ways. It is important that patients do not have to choose between autonomy and privacy and are well informed about the insights that can be gained from the data. Smart sensors should support and not replace interactions with medical professionals. Patients and medical professionals should be educated about the correct application and the limitations of smart sensors. Smart sensors should include an adequate representation of minorities in their training data and should be covered by health insurance to guarantee fair access

Acceptance and Privacy Perceptions Toward Video-based Active and Assisted Living Technologies: Scoping Review

Background: The aging society posits new socioeconomic challenges to which a potential solution is active and assisted living (AAL) technologies. Visual-based sensing systems are technologically among the most advantageous forms of AAL technologies in providing health and social care; however, they come at the risk of violating rights to privacy. With the immersion of video-based technologies, privacy-preserving smart solutions are being developed; however, the user acceptance research about these developments is not yet being systematized. Objective: With this scoping review, we aimed to gain an overview of existing studies examining the viewpoints of older adults and/or their caregivers on technology acceptance and privacy perceptions, specifically toward video-based AAL technology. Methods: A total of 22 studies were identified with a primary focus on user acceptance and privacy attitudes during a literature search of major databases. Methodological quality assessment and thematic analysis of the selected studies were executed and principal findings are summarized. The PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) guidelines were followed at every step of this scoping review. Results: Acceptance attitudes toward video-based AAL technologies are rather conditional, and are summarized into five main themes seen from the two end-user perspectives: caregiver and care receiver. With privacy being a major barrier to video-based AAL technologies, security and medical safety were identified as the major benefits across the studies. Conclusions: This review reveals a very low methodological quality of the empirical studies assessing user acceptance of video-based AAL technologies. We propose that more specific and more end user– and real life–targeting research is needed to assess the acceptance of proposed solutions.This work is funded by the European Union’s Horizon 2020 research and innovation programme under the Marie Sklodowska-Curie grant agreement number 861091 for the visuAAL project

Using Smart Home Technologies to Promote Physical Activity Among the General and Aging Populations: Scoping Review

BackgroundHealth-monitoring smart homes are becoming popular, with experts arguing that 9-to-5 health care services might soon become a thing of the past. However, no review has explored the landscape of smart home technologies that aim to promote physical activity and independent living among a wide range of age groups. ObjectiveThis review aims to map published studies on smart home technologies aimed at promoting physical activity among the general and aging populations to unveil the state of the art, its potential, and the research gaps and opportunities. MethodsArticles were retrieved from 6 databases (PubMed, CINAHL, Scopus, IEEE Xplore, ACM Library, and Web of Science). The criteria for inclusion were that the articles must be user studies that dealt with smart home or Active Assisted Living technologies and physical activity, were written in English, and were published in peer-reviewed journals. In total, 3 researchers independently and collaboratively assessed the eligibility of the retrieved articles and elicited the relevant data and findings using tables and charts. ResultsThis review synthesized 20 articles that met the inclusion criteria, 70% (14/20) of which were conducted between 2018 and 2020. Three-quarters of the studies (15/20, 75%) were conducted in Western countries, with the United States accounting for 25% (5/20). Activities of daily living were the most studied (9/20, 45%), followed by physical activity (6/20, 30%), therapeutic exercise (4/20, 20%), and bodyweight exercise (1/20, 5%). K-nearest neighbor and naïve Bayes classifier were the most used machine learning algorithms for activity recognition, with at least 10% (2/20) of the studies using either algorithm. Ambient and wearable technologies were equally studied (8/20, 40% each), followed by robots (3/20, 15%). Activity recognition was the most common goal of the evaluated smart home technologies, with 55% (11/20) of the studies reporting it, followed by activity monitoring (7/20, 35%). Most studies (8/20, 40%) were conducted in a laboratory setting. Moreover, 25% (5/20) and 10% (2/20) were conducted in a home and hospital setting, respectively. Finally, 75% (15/20) had a positive outcome, 15% (3/20) had a mixed outcome, and 10% (2/20) had an indeterminate outcome. ConclusionsOur results suggest that smart home technologies, especially digital personal assistants, coaches, and robots, are effective in promoting physical activity among the young population. Although only few studies were identified among the older population, smart home technologies hold bright prospects in assisting and aiding older people to age in place and function independently, especially in Western countries, where there are shortages of long-term care workers. Hence, there is a need to do more work (eg, cross-cultural studies and randomized controlled trials) among the growing aging population on the effectiveness and acceptance of smart home technologies that aim to promote physical activity