“I Don’t Want to Become a Number’’: Examining Different Stakeholder Perspectives on a Video-Based Monitoring System for Senior Care with Inherent Privacy Protection (by Design)

Active and Assisted Living (AAL) technologies aim to enhance the quality of life of older adults and promote successful aging. While video-based AAL solutions offer rich capabilities for better healthcare management in older age, they pose significant privacy risks. To mitigate the risks, we developed a video-based monitoring system that incorporates different privacy-preserving filters. We deployed the system in one assistive technology center and conducted a qualitative study with older adults and other stakeholders involved in care provision. Our study demonstrates diverse users’ perceptions and experiences with video-monitoring technology and offers valuable insights for the system’s further development. The findings unpack the privacy-versus-safety trade-off inherent in video-based technologies and discuss how the privacy-preserving mechanisms within the system mitigate privacy-related concerns. The study also identifies varying stakeholder perspectives towards the system in general and highlights potential avenues for developing video-based monitoring technologies in the AAL context.This work was funded by the European Union’s Horizon 2020 research and innovation programme under the Marie Sklodowska-Curie grant agreement No 861091 for the visuAAL project. This publication is based upon work from COST Action GoodBrother—Network on Privacy-Aware Audio- and Video-Based Applications for Active and Assisted Living (CA19121), supported by COST (European Cooperation in Science and Technology)

What Is Privacy? Perceptions of Older Adults in the South of Spain About the Concept of Privacy and in Terms of Video-Based AAL Technologies

Privacy is a very complex concept that concerns all areas of human activity. Even more so, it has acquired whole new importance and has become a hot-button topic in the era of ubiquitous computing. The emergence of Active and Assisted Living (AAL) technologies is offering the improvement of the quality of life and maintaining the independence of older adults in their preferred environment. Especially with the advancement of computer vision, video-based technological solutions are giving us promising results but bring along significant risks of privacy violation. With this qualitative study, we aim to explore older adults’ understanding of privacy as a construct and their privacy considerations for technology-based monitoring applications in eldercare, for video-based systems among them. Exploratory interview sessions were conducted with 12 older adults 66 and plus of age living in care homes and in private households. Findings indicate that the concept of privacy is indeed difficult to understand and define for older adults. However, the context of video monitoring elicits clear privacy concerns. The nudity aspect of privacy was proved to be the most important among the participants, yet, the attitudinal shift in the perception of nudity was observed in older adults living in care homes. Eight out of 12 interviewed older adults did not like the idea of having a camera-based assistive technology, however, some of their worries were alleviated after explaining to them the possible technology’s inherent privacy-preserving techniques.This work is funded by the European Union’s Horizon 2020 research and innovation programme under the Marie Sklodowska-Curie grant agreement No 861091 for the visuAAL project

Smart homes and their users:a systematic analysis and key challenges

Published research on smart homes and their users is growing exponentially, yet a clear understanding of who these users are and how they might use smart home technologies is missing from a field being overwhelmingly pushed by technology developers. Through a systematic analysis of peer-reviewed literature on smart homes and their users, this paper takes stock of the dominant research themes and the linkages and disconnects between them. Key findings within each of nine themes are analysed, grouped into three: (1) views of the smart home-functional, instrumental, socio-technical; (2) users and the use of the smart home-prospective users, interactions and decisions, using technologies in the home; and (3) challenges for realising the smart home-hardware and software, design, domestication. These themes are integrated into an organising framework for future research that identifies the presence or absence of cross-cutting relationships between different understandings of smart homes and their users. The usefulness of the organising framework is illustrated in relation to two major concerns-privacy and control-that have been narrowly interpreted to date, precluding deeper insights and potential solutions. Future research on smart homes and their users can benefit by exploring and developing cross-cutting relationships between the research themes identified

State of the art in privacy preservation in video data

Active and Assisted Living (AAL) technologies and services are a possible solution to address the crucial challenges regarding health and social care resulting from demographic changes and current economic conditions. AAL systems aim to improve quality of life and support independent and healthy living of older and frail people. AAL monitoring systems are composed of networks of sensors (worn by the users or embedded in their environment) processing elements and actuators that analyse the environment and its occupants to extract knowledge and to detect events, such as anomalous behaviours, launch alarms to tele-care centres, or support activities of daily living, among others. Therefore, innovation in AAL can address healthcare and social demands while generating economic opportunities. Recently, there has been far-reaching advancements in the development of video-based devices with improved processing capabilities, heightened quality, wireless data transfer, and increased interoperability with Internet of Things (IoT) devices. Computer vision gives the possibility to monitor an environment and report on visual information, which is commonly the most straightforward and human-like way of describing an event, a person, an object, interactions and actions. Therefore, cameras can offer more intelligent solutions for AAL but they may be considered intrusive by some end users. The General Data Protection Regulation (GDPR) establishes the obligation for technologies to meet the principles of data protection by design and by default. More specifically, Article 25 of the GDPR requires that organizations must "implement appropriate technical and organizational measures [...] which are designed to implement data protection principles [...] , in an effective manner and to integrate the necessary safeguards into [data] processing.” Thus, AAL solutions must consider privacy-by-design methodologies in order to protect the fundamental rights of those being monitored. Different methods have been proposed in the latest years to preserve visual privacy for identity protection. However, in many AAL applications, where mostly only one person would be present (e.g. an older person living alone), user identification might not be an issue; concerns are more related to the disclosure of appearance (e.g. if the person is dressed/naked) and behaviour, what we called bodily privacy. Visual obfuscation techniques, such as image filters, facial de-identification, body abstraction, and gait anonymization, can be employed to protect privacy and agreed upon by the users ensuring they feel comfortable. Moreover, it is difficult to ensure a high level of security and privacy during the transmission of video data. If data is transmitted over several network domains using different transmission technologies and protocols, and finally processed at a remote location and stored on a server in a data center, it becomes demanding to implement and guarantee the highest level of protection over the entire transmission and storage system and for the whole lifetime of the data. The development of video technologies, increase in data rates and processing speeds, wide use of the Internet and cloud computing as well as highly efficient video compression methods have made video encryption even more challenging. Consequently, efficient and robust encryption of multimedia data together with using efficient compression methods are important prerequisites in achieving secure and efficient video transmission and storage.This publication is based upon work from COST Action GoodBrother - Network on Privacy-Aware Audio- and Video-Based Applications for Active and Assisted Living (CA19121), supported by COST (European Cooperation in Science and Technology). COST (European Cooperation in Science and Technology) is a funding agency for research and innovation networks. Our Actions help connect research initiatives across Europe and enable scientists to grow their ideas by sharing them with their peers. This boosts their research, career and innovation. www.cost.e

Video-based Estimation of Activity Level for Assisted Living

The continual increase in the population of older adults in the next 50 years envisages an increase of dependants on the family and the Government. Assisted Living technologies are information and communication technologies to assist, improve and monitor the daily living of the old and vulnerable population by promoting greater independence and providing a safe and secure environment at a reduced cost. Most of the assisted living technologies are passive sensor-based solutions where a number of embedded or body-worn sensors are employed or connected over a network to recognize activities. Often the sensors are obtrusive and are extremely sensitive to the performance of the sensors. Visual data is contextually richer than sensor triggered firings. Visual data along with being contextual is also extremely sensitive. Since visual data is intrusive, a qualitative study among older adults within the community was carried out to get a context of the privacy concerns of having a camera within an assisted living environment. Building on the outcomes of the focus group discussions, a novel monitoring framework is proposed. Following the framework, Activity Level, as an effective metric to measure the amount of activity undertaken by an individual is proposed. Activity Level is estimated by extracting and classifying pixel-based and phase-based motion features. Experiments reveal that phase-based features perform better than pixel-based features. Experiments are carried out using the novel Sheffield Activities of Daily Living Dataset, which has been developed and made available for further computer vision research for assisted living

Needing smart home technologies: the perspectives of older adults in continuing care retirement communities

Background At present, the vast majority of older adults reside in the community. Though many older adults live in their own homes, increasing numbers are choosing continuing care retirement communities (CCRCs),which range from independent apartments to assisted living and skilled-nursing facilities. With predictions of a large increase in the segment of the population aged 65 and older, a subsequent increase in demand on CCRCs can be anticipated. With these expectations, researchers have begun exploring the use of smart home information-based technologies in these care facilities to enhance resident quality of life and safety, but little evaluation research exists on older adults' acceptance and use of these technologies. Objective This study investigated the factors that influence the willingness of older adults living in independent and assisted living CCRCs to adopt smart home technology. Subjects and setting Participants (n = 14) were recruited from community-dwelling older adults, aged 65 or older, living in one of two mid-western US CCRC facilities (independent living and assisted living type facilities). Methods This study used a qualitative, descriptive approach, guided by principles of grounded theory research. Data saturation (or when no new themes or issues emerged from group sessions) occurred after four focus groups (n = 11 unique respondents) and was confirmed through additional individual interviews (n = 3). Results The findings from this study indicate that although privacy can be a barrier for older adults' adoption of smart home technology their own perception of their need for the technology can override their privacy concerns. Conclusions Factors influencing self-perception of need for smart home technology, including the influence of primary care providers, are presented. Further exploration of the factors influencing older adults' perceptions of smart home technology need and the development of appropriate interventions is necessary

Is big brother watching you? Responding to tagging and tracking in dementia care

The increased availability of assistive technologies, particularly tagging and tracking technology, raises questions for occupational therapists working in dementia care. As experts in environmental adaptation to support participation, occupational therapists need to be clear about what technologies are available to address wandering behaviour, how emerging technologies will be used in their practice, and how they will proactively respond to the ethical issues involved in these technologies. Their use within ethical, person-centred practice will ensure that big brother is not watching, but rather supporting independent functioning in the person’s own home

Wearable device to assist independent living.

Older people increasingly want to remain living independently in their own homes. The aim of the ENABLE project is to develop a wearable device that can be used both within and outside of the home to support older people in their daily lives and which can monitor their health status, detect potential problems, provide activity reminders and offer communication and alarm services. In order to determine the specifications and functionality required for development of the device user surveys and focus groups were undertaken and use case analysis and scenario modeling carried out. The project has resulted in the development of a wrist worn device and mobile phone combination that can support and assist older and vulnerable wearers with a range of activities and services both inside and outside of their homes. The device is currently undergoing pilot trials in five European countries. The aim of this paper is to describe the ENABLE device, its features and services, and the infrastructure within which it operates

Privacy Challenges in Ambient Intelligence Systems

peer reviewedToday, privacy is a key concept. It is also one which is rapidly evolving with technological advances, and there is no consensus on a single definition for it. In fact, the concept of privacy has been defined in many different ways, ranging from the “right to be left alone” to being a “commodity” that can be bought and sold. In the same time, powerful Ambient Intelligence (AmI) systems are being developed, that deploy context-aware, personalised, adaptive and anticipatory services. In such systems personal data is vastly collected, stored, and distributed, making privacy preservation a critical issue. The human- centred focus of AmI systems has prompted the introduction of new kinds of technologies, e.g. Privacy Enhancing Technologies (PET), and methodologies, e.g. Privacy by Design (PbD), whereby privacy concerns are included in the design of the system. One particular application field, where privacy preservation is of critical importance is Ambient Assisted Living (AAL). Emerging from the continuous increase of the ageing population, AAL focuses on intelligent systems of assistance for a better, healthier and safer life in their living environment. In this paper, we first build on our previous work, in which we introduced a new tripartite categorisation of privacy as a right, an enabler, and a commodity. Second, we highlight the specific privacy issues raised in AAL. Third, we review and discuss current approaches for privacy preservation. Finally, drawing on lessons learned from AAL, we provide insights on the challenges and opportunities that lie ahead. Part of our methodology is a statistical analysis performed on the IEEE publications database. We illustrate our work with AAL scenarios elaborated in cooperation with the city of Luxembourg

Designing assisted living technologies 'in the wild' : preliminary experiences with cultural probe methodology

Background There is growing interest in assisted living technologies to support independence at home. Such technologies should ideally be designed ‘in the wild’ i.e. taking account of how real people live in real homes and communities. The ATHENE (Assistive Technologies for Healthy Living in Elders: Needs Assessment by Ethnography) project seeks to illuminate the living needs of older people and facilitate the co-production with older people of technologies and services. This paper describes the development of a cultural probe tool produced as part of the ATHENE project and how it was used to support home visit interviews with elders with a range of ethnic and social backgrounds, family circumstances, health conditions and assisted living needs. Method Thirty one people aged 60 to 98 were visited in their homes on three occasions. Following an initial interview, participants were given a set of cultural probe materials, including a digital camera and the ‘Home and Life Scrapbook’ to complete in their own time for one week. Activities within the Home and Life Scrapbook included maps (indicating their relationships to people, places and objects), lists (e.g. likes, dislikes, things they were concerned about, things they were comfortable with), wishes (things they wanted to change or improve), body outline (indicating symptoms or impairments), home plan (room layouts of their homes to indicate spaces and objects used) and a diary. After one week, the researcher and participant reviewed any digital photos taken and the content of the Home and Life Scrapbook as part of the home visit interview. Findings The cultural probe facilitated collection of visual, narrative and material data by older people, and appeared to generate high levels of engagement from some participants. However, others used the probe minimally or not at all for various reasons including limited literacy, physical problems (e.g. holding a pen), lack of time or energy, limited emotional or psychological resources, life events, and acute illness. Discussions between researchers and participants about the materials collected (and sometimes about what had prevented them completing the tasks) helped elicit further information relevant to assisted living technology design. The probe materials were particularly helpful when having conversations with non-English speaking participants through an interpreter. Conclusions Cultural probe methods can help build a rich picture of the lives and experiences of older people to facilitate the co-production of assisted living technologies. But their application may be constrained by the participant’s physical, mental and emotional capacity. They are most effective when used as a tool to facilitate communication and development of a deeper understanding of older people’s needs