As issue 2 of Lychnos pointed out, by 2050 the over-65s will make up over 30% of Spain’s population, and there will be more than four million over-80s. The trend is similar in the rest of the western world, and it poses a serious challenge for today’s societies’ HIGHLIGHTSProfile: Mario Piattini Velthuis
human and economic resources, given the inexorable decline older people experience in their visual, auditory, motor and cognitive capacities.
At the same time, information and communications technologies (ICTs) continue to made great strides, and now form part of our lives, being present in all our everyday devices, vehicles, management systems, art, leisure and entertainment. On another positive note, research is also showing how ICTs can be applied to assist people with different needs and capabilities, and so make an important contribution to elderly people’s quality of life.
Indeed, numerous studies suggest that R&D and innovation in relation to ageing has an important role to play. Along these lines, the Research Agenda on Ageing for the 21st Century, a joint project by the United National Ageing Programme and the International Gerontology and Geriatrics Association published in 2007, highlighted several critical areas for research in which ICTs can play an important role: social participation and integration, healthy ageing, physical and mental functioning, quality of life, etc. The Fundación General CSIC’s report on ageing-related R&D (Informe de la I+d+i sobre envejecimiento
) published in November 2010, which analyses the main lines of interest on the subject, points out the need to stimulate research into technology aspects in order to combat, correct or alleviate the effects of human ageing.
Numerous studies suggest that R&D in the field of ageing has an important role to play.
At the European level, FP7 proposes ICT Challenge 5: ICT for Health, Ageing Well, Inclusion and Governance, which includes research on intelligent services and environments for the elderly, and research for personalised inclusion. The European Commission is also promoting the Ambient Assisted Living (AAL) Joint Programme, the object of which is precisely to carry out R&D projects looking at “ICT-based Solutions for Advancement of Older Persons’ Mobility,” and it is backing the Joint Programming Initiative (JPI) “More Years, Better Lives: The Potential and Challenges of Demographic Change.” The vision paper published by the JPI secretariat in February 2011, set out the “big challenges for society.” These included the adaptation of space (to increase elderly people’s independence and allow them to live at home), mobility for the elderly, and “senior tourism” (a specific feature of active ageing). This document also highlighted the importance of giving security to people who need help, achieving “age-friendly” environments that enable efficient and nearby access to everyday services, and the promotion of family and social networks.
In December 2007 Spain’s eVIA technology platform for health, welfare and social cohesion (Plataforma Tecnológica Española para la Salud, el Bienestar y la Cohesión Social
) was set up. The platform’s goals include its having a positive impact on public and private investments in R&D and innovation in technologies applied to health, welfare and social cohesion, an area which includes health-care technology, facilitating independent living for disabled people, and boosting the quality of life and independence of the elderly. Moreover, in recent years dozens of national projects involving both basic and applied research have been carried out (TIN, TSI, CENIT, Avanza, CDTI, etc.), which apply ICTs to various different aspects of ageing.
Advances in technology
As Robert X. Cringley said: “if the automobile had followed the same development cycle as the computer, a Rolls-Royce would today cost $100, [and] get a million miles per gallon.” Indeed, ICT has evolved at a dizzying speed, one only needs to recall the rate at which we have gone from mainframes to PCs (which brought IT within everyone’s reach) and mobile devices (telephones, tablets, etc.) and, today, what we could call ubiquitous and pervasive computing. That is to say, computers that are available in any environment and embedded in all the objects around us. Urban automation systems will offer the same monitoring and remote assistance services as domestic automation does in the home, but in the street
Another major IT revolution is today’s trend towards connecting everything to the Internet (the so-called “Internet of things”). What is more, having connected everything to everything else, we have now also managed to enable systems to recognise their context and process knowledge, and even to exploit the semantics of systems, services and interactions.
Also, devices are not only getting smaller, more powerful and easier to use (consider, for example, today’s smart phones), they are also sprouting sensors of all kinds (light, sound, temperature, etc.) and have more reliable communications, and better security, range and features (think of WiFi, Bluetooth, Zigbee, RFID, etc.), transmitting large volumes of multimedia information rapidly, which can be stored in the “cloud.”
Another area that has progressed rapidly has been human-computer interactions, with intelligent user interfaces, augmented and virtual reality, and further developments in natural language processing technology. Despite this progress, the special issue of ERCIM News (European Research Consortium for Informatics and Mathematics) in October 2011, on the subject of Ambient Assisted Living (AAL), highlighted the following challenges: understanding user requirements (above all, regarding old people’s interaction with complex technology environments); architectural frameworks that support integration and the management of accessibility solutions; and tools for the development of accessible AAL environments.
Another field that has made big strides is that of artificial intelligence, with new types of techniques for data mining, knowledge discovery and representation, or decision-making (neuronal networks, genetic algorithms, semantic networks, case-based reasoning, agents, etc.) applicable to the detection or treatment of diseases.
There is a multitude of areas in which ICTs can contribute to improving quality of life for old people and enhance ageing. Thus, for example, one innovation to help overcome mobility problems is the development of intelligent wheelchairs designed to avoid collisions by using sensors to detect obstacles. “Chairs” that can climb stairs or adapt to different types of terrain automatically are also being designed, amplifying user’s strength under microprocessor control. Along similar lines, wearable robots that replicate the kinematic structure of human limbs are also being developed.
To tackle visual problems, audible and vibrotactile signals for pedestrians are now being augmented with systems able to tell people where they are, what dangers they may face on their route, and what is around them. Intelligent systems can help people take the right medication by reading the information on the label and giving extra information. Similarly, for people with hearing difficulties, there are numerous systems to translate voice to text, or which convert and reproduce sign language.
To alleviate cognitive problems, which affect 10% of the over-65s, there are devices that can guide the elderly through their everyday tasks. Hypermedia systems can be used to present material from the past to stimulate long-term memory in dementia sufferers for whom the loss of short term memory has degraded the ability to communicate. Rehabilitation systems, and video games to enhance cognitive functions, have also been developed.
As regards what has come to be called “online ageing,” the web can play an important role in improving quality of life through social interaction. Indeed, many elderly people’s first contact with ICTs was with their using e-mail or videoconferencing to communicate with relatives. Moreover, according to a number of studies, they tend to use the Internet for travel, information about public bodies, or on-line banking. But we have to take into account all the problems they have to overcome when interacting with a computer: their limited ability to focus on a task on a computer screen, poor colour sensitivity and perception, loss of contrast, a reduced visual field; or problems such as arthritis or Parkinson’s disease, which can make it difficult to use a mouse; or mental problems caused by dementia or Alzheimer’s disease. Fortunately, users can now move the cursor without having to use their hands (with eye movements or by looking in a particular direction), or control a computer with their voice or via a touch screen. Also, accessibility has been taken further, with a huge range of recommendations on website design regarding interaction, information architecture, visual design, information design, etc. which make sites friendlier for the elderly.
Independent living has also been given a boost, particularly in the home or old people’s home, monitoring the elderly as they go about their daily lives, with the implementation of chips or sensors that gather various vital signs, weight, health indicators, etc. (so-called “healthware”) in order to prevent health risks, falls, etc. and alert relatives or carers. However, these measures raise important safety and privacy issues. These systems make it possible, for example, to use actuators to light up the way to the bathroom, or record the time an old person has been awake, to produce an alert when the individual needs help, starts to get disorientated or is sleeping badly. Sensors can also be used to create “trainers” supervising physical therapies, recording body movements and making appropriate suggestions.
ICTs can also be used to help coordinate the activities of old-people’s carers. In a similar way to “Computer Supported Cooperative Work” (CSCW), one can talk of “Computer-Supported Coordinated Care” (CSCC) which aims to keep people in good shape, by improving communication and coordination between all stakeholders: old people, friends, relatives, doctors, nursing staff, etc.
Technology can help preserve and augment human capacities and experience.
Although, as Niehls Bohr pointed out “Prediction is very difficult, especially about the future,” we can, nevertheless, make some predictions based on the work of research groups at today’s cutting edge to see how future developments in ICTs could help improve quality of life for old people. After all, as Alan Kay said: “the best way to predict the future is to invent it.”
The foresight study on “Technologies for Active Ageing” by Fundación OPTI (Industrial Technology Foresight Observatory) and FENIN (Spanish Federation of Healthcare Technology Companies) in November 2011, listed the hypothesis over various time horizons (short, medium and long term) that received most backing from experts in the field. Thus, the study indicates that in the short term there will be an emphasis on personalisation and adaptation of systems, with particular attention to their usability, accessibility, reliability and safety; in mobility and ubiquitous alert systems; the use of the cloud to store clinical information, and the use of virtual reality and videogames for rehabilitation.
Personally, I think that we will go from home automation systems or building automation systems to genuine urban automation systems, that will offer the same monitoring and remote assistance services in the street as are currently available in the home. This will allow old people to stroll around town at ease rather than having to live shut away in their homes. Adding ICTs to “analogue” solutions that are already being installed in almost all cities (such as tactile paving to guide the visually impaired), and turning into genuine “digital cities,” will make a reality what Fundación COTEC called the major urban challenge of creating the “city of knowledge”: guaranteeing the least favoured or most vulnerable groups (such as old people) non-discrimination and full participation by eliminating barriers and improving accessibility (in terms of architecture, urban planning, transport and communications).
Over the medium-term (6-10 years) the OPTI foresight study stressed customisation and flexibilty, and device interoperability. The use of remote monitoring systems will become more widespread and the ethical and legal aspects of handling personal information will need to be resolved. Progress will also be made in robotics, with more flexible and delicate movements, more degrees of freedom and computing power, adding built-in perception, cognition, communication and awareness. In short, robots with a new mind (“mindware”) and body (“bodyware”) will emerge, to which will be added the capacity to detect emotions and thus react appropriately which will allow more lasting relations to be created (social relations with empathy, trust, etc.) between old people and their “robot companions” or “guardian angels.” Doing so will mean incorporate specific cultural themes, emotional aspects (from literature, drama, cinema, etc.) and some of the features of pets.
Over the longer term, it is difficult to predict what technology might offer, bearing in mind the integration of areas such as synthetic biology, artificial cells, micro-electro-mechanical systems, nanotechnology, or artificial intelligence; it seems that we will have chip-brain interfaces that can connect the nervous system with bionic prostheses, replace brain circuits, etc. Moreover, silicon based information will be complemented or replaced by quantum or molecular information, which will open up new doors to technology development. In short, a totally multidisciplinary future that will no doubt radically change how old people are looked after.
In this evolution it should not be forgotten that the level of maturity of the various different technologies may be measured on three planes: scientific, that is to say the progress in research; industrial, the development of products in the business sphere; and commercial, i.e. the acceptance by the market and uptake by users. A technology that is scientifically mature will not always be used or always commercialised. It has to be borne in mind that the maturation of a technology generally requires longer than expected and there is the risk of creating expectations that are not met in the short term, which can cause a sense of frustration, leading to a good technology’s being discarded before it is fully mature.
In any event, it seems that technology will help preserve and enhance human experience and capabilities (although it inexorably ends up modifying them), benefiting everyone, not only because we all aspire to grow old, but because in the end it brings benefits to all groups, in the same way that the ramps installed to help people with reduced mobility have ended up being used by everyone with a suitcase or shopping trolley.