Volume 18: No. 2, February 2004

Science Briefs
Psychological Science and Intelligent Home Technology: Supporting Functional Independence of Older Adults
by Wendy A. Rogers & Arthur D. Fisk: School of Psychology, Georgia Institute of Technology

Wendy A. Rogers is Professor and Associate Chair in the School of Psychology at Georgia Institute of Technology. She received her B.A. from the University of Massachusetts, and her M. S. (1989) and Ph.D. (1991) from Georgia Institute of Technology. She is a Past-President of Division 21 (Applied Experimental and Engineering Psychology) of APA and is currently President-elect of the Human Factors and Ergonomics Society.

Arthur (Dan) Fisk is Professor and Coordinator of the Engineering Psychology Program at Georgia Institute of Technology. Prior to his academic career, he was Manager, Human Factors Engineering at AT&T. He received his PhD in Experimental Psychology from the University of Illinois in 1982. Fisk is a Past President of the Human Factors and Ergonomics Society and a Past-President of Division 21 (Applied Experimental and Engineering Psychology) of APA. He is currently Secretary-Treasurer-elect of the Human Factors and Ergonomics Society.

They are the Co-Directors of the Human Factors and Aging Laboratory (www.prism.gatech.edu/~wr43/hf_aging). Their research is funded by the National Institutes of Health (National Institute on Aging) as part of the Center for Research and Education on Aging and Technology Enhancement (CREATE), and by a National Science Foundation grant entitled “The Aware Home: Sustaining the Quality of Life for an Aging Population.”


An Aware Home
Imagine if your home were “aware” of your activities so that it might help you remember what it was you went into the kitchen for or whether the visitor at the front door is someone you know or even what the proper procedure is for performing a recently learned home medical procedure. An aware home is not from the world of science fiction – indeed, it is within the realm of science. An innovative research program at Georgia Institute of Technology (Georgia Tech) is focused on developing psychological and computer science to support many home activities. It is the Aware Home Research Initiative (http://www.cc.gatech.edu/fce/ahri).

Wendy A. Rogers and Arthur (Dan) Fisk are the psychologists on the interdisciplinary team involved in the Aware Home Research Initiative that also includes computer scientists, human-computer interaction specialists, and engineers. These researchers are working together to advance science and engineering in support of “aging-in-place.”

There is a growing need in society to enable older adults to remain in an independent living environment. Seventy-five percent of people aged 70 and over live in conventional houses (Shafer, 2000) and many of them live alone, without access to immediate support (Wagnild, 2001). Many older adults fear losing their independence and being required to move to an assisted living environment (e.g., AARP, 2000). Moreover, the initial and long-term economic implications of transitioning to one of these settings are substantial to the individual and to society as a whole. Given current demographics the projection of these costs will exponentially increase.

The Aware Home Residential Laboratory is a fully furnished, state-of-the-art, 5,040 square foot, two-story residence (see Figure 1). The two floors are identical apartments, each consisting of a full kitchen, dining area and living room, two bedrooms, two bathrooms, an office, and laundry room. The apartments facilitate conducting computer science and engineering research on one floor while simultaneously being able to support psychological research on another floor. The Aware Home serves as the focus of research and development efforts to support aging-in-place. State-of-the-art measurement of physical and cognitive impairments can provide critical information to guide development of appropriate and usable technologies for older adults. Most importantly, an understanding the housing needs of older adults serve as the impetus for the research and development efforts. Evaluation studies of monitoring, communication, and smart environment interfaces and technologies will lead to the development of useful and usable interventions to support independence for older adults.

Independent Living Requirements
The independent performance of basic activities of daily living (ADLs), such as eating, bathing and dressing, as well as instrumental activities of daily living (IADLs), such as cooking healthful meals, adequately dealing with medication, and doing the laundry, is a precondition for autonomy and independence in everyday life (Lawton, 1990). Activities aimed at life enrichment and self-fulfillment are also critical aspects of successful aging (Rowe & Kahn, 1998). Such activities that involve the willingness to accept new challenges and to engage in lifelong learning, have been termed enhanced activities of daily living, or EADLs (Rogers, Meyer, Walker, & Fisk, 1998). EADLs imply the adjustment to changes, for example keeping up with technological and communicative developments such as the Internet, and taking advantage of them.

Older adults who are living in their own homes may be faced with situations in which there is a mismatch between the demands in their daily environment and their capabilities. These situations may be the result of both increased demands (e.g., learning to use a new medical device) and deficits in the capabilities of the individual (e.g., age-related changes in cognition, perception, or movement control). To remain fully functional, older adults must find ways to compensate for gaps between task demands required for living and their capabilities. Although numerous perceptual and movement control prostheses are available, the development of cognitive prostheses based on transitioning psychological science into computing and engineering applications has been lacking.

Cognitive Supports for Older Adults
The major cognitive issues that are critical for independent living are captured under the following broad categories: prospective and retrospective memory, demands for attention, working memory, task planning, and strategic approaches to compensate for cognitive changes. There is a promise for psychologically based approaches to address many of the cognitive challenges of daily living. However, currently there are few, if any, efforts to attack these problems from an interdisciplinary perspective. Consequently, there is a disconnect between technology development and psychological theories that can enable older adults to maintain (and in many situations enhance) independence and to sustain their quality of life. Technology has tremendous potential but is relatively uninformed by a realistic assessment of needs and human capabilities. The results of basic psychological science hold out the promise of informing the design and implementation of such technological systems for translation to real world complex environments.

How might an Aware Home support the cognitive functioning of older adults? Consider the following scenarios:
Mr. J. has been having memory problems lately. Sometimes, while preparing dinner, he forgets what he was doing; his memory problems are exacerbated if he is interrupted in the middle of his preparations. Fortunately, Mr. J.’s kitchen is equipped with a reminder system – he simply needs to glance at the visual display mounted by the countertop to see images of his recent actions. By touching the display, he sees and hears additional visual and auditory cues that help him to regain his place. Mrs. Q. has recently been diagnosed with diabetes. She has to use a blood glucose meter daily to monitor her glucose levels. As she sits at her kitchen table to perform the glucose check, an automated system records her activities, recognizes when she has made an error, and provides her with corrective feedback to ensure that she performs the procedure correctly. This automated “coach” will help her to learn to calibrate the device and properly check her glucose levels. The system will also provide her with guidance in interpreting the results and determining whether she should eat, take medicine, or exercise more to regulate her glucose. Mr. K.’s memory problems are typically related to finding something in his house (e.g., his eyeglasses, the cordless telephone, his asthma inhaler). These items are used in different locations throughout the house and he has difficulty remembering where he left them. To assist him, he uses the “object finder” system in his house. Given that the house is instrumented with cameras that can capture activity in all rooms, he can search through various locations on the monitor (without having to walk all over the house) to search for the lost object itself or a cue about where the object is.

Current Projects
The vignettes above represent current research projects underway at the Aware Home. Each project is being investigated by an interdisciplinary team of psychology and computer science faculty and students.

The Memory Surrogates project is investigating the potential benefits of a display that would provide cues about previously performed actions. The prototype system, called the “Cook’s Collage,” provides surrogate memory support for general cooking tasks. Cameras are mounted in unobtrusive locations (beneath a cabinet) and visual snapshots from this angle show the detailed activity of hands and objects. These images are shown on a flat-panel display on the kitchen cabinet. Psychological issues being investigated from the user’s perspective include determining the information display characteristics that are most supportive of memory; the form of information that is most useful; and whether the utility of the information displayed interacts with type of interruption or age of user.

The Technology Coach is designed to support the activities of the older person much like a “virtual assistant.” This project involves developing the computational perception capabilities to recognize what actions are being performed and providing the person with corrective feedback if they perform a step incorrectly or out of order. We are currently testing the system to support the accurate use of a blood glucose meter. Psychological issues that must be addressed in this research include understanding the type of feedback, timing of feedback, form of feedback, and the information display that will best support performance of older adults.

Finding Lost Objects. Developing a system to support finding lost objects in the home must be based on an understanding of the factors that influence the behavior of losing the objects in the first place. What objects are typically lost, by whom, under what circumstances, and how frequently? The nature of the technological support will depend on the answers to these questions. We are addressing these issues via a comprehensive survey of younger and older adults. These data will provide insight for the design of human-centered object-finding services.

Conclusion
Independently living older adults experience cognitive problems, memory problems in particular, that influence their performance of daily activities. Technology has the potential to support the cognitive functioning of older adults in the home if the technology is developed with consideration for the older adults’ needs and capabilities. However, to be successful, we must understand the specific issues with which older adults have difficulties, the source of those difficulties, the contexts in which they occur, and the potential for a cognitive aid to support performance. It is then critical to translate these findings into principles that can guide the development of augmentation systems and to test systems that are designed based on those principles. The system itself may impose certain demands on the user as a function of the design characteristics and hence must be evaluated in the context in which it will be used. The research being conducted at the Aware Home has the potential to enhance the independence of older adults.

References

AARP (2000). Fixing to stay: A national survey on housing and home modification issues - Executive summary. Washington DC: American Association of Retired Persons.

Lawton, M. P. (1990). Aging and performance on home tasks. Human Factors, 32, 527-536.

Rogers, W. A., Meyer, B., Walker, N., & Fisk, A. D. (1998). Functional limitations to daily living tasks in the aged: A focus group analysis. Human Factors, 40, 111-125.

Rowe, J. W., & Kahn, R. L. (1998). Successful aging. NY: Pantheon.

Shafer, R. (2000). Housing America’s Seniors. Executive Summary. Cambridge, MA. Joint Center for Housing Studies, Harvard University.

Wagnild, G. (2001). Growing old at home. In L. A. Pastalan & B. Schwarz (Eds.), Housing choices and well-being of older adults: Proper fit (pp. 71-84). New York: Haworth Press.