Home Assistance Research Articles

REIMAGINING AGING WITH DISABILITY THROUGH TECHNOLOGY

Abstract Individuals aging with long-term disabilities are likely to require support for managing challenges with everyday activities. To effectively promote independence and aging-in-place for this population, we must consider innovative technology solutions that go beyond traditional direct care services. This symposium will highlight technology research and development efforts from the Rehabilitation Engineering Research Center on Technologies to Support Aging-in-Place for People with Long-Term Disabilities (RERC TechSAge). TechSAge is an interdisciplinary collaboration between Georgia Tech, the University of Illinois Urbana-Champaign, and Georgia State University, dedicated to understanding the needs of, and developing supportive technologies for people aging with long-term vision, hearing, and mobility disabilities. First, Remillard et al., will present interview findings from individuals aging with long-term vision loss on challenges performing instrumental activities of daily living. Next, Mitzner et al., will describe TechSAge research-driven guidelines for designing and delivering wellness classes via video-conferencing to older adults with and without disabilities. Blocker et al., will highlight a field trial evaluating how digital home assistants (e.g., Amazon Echo devices) and smart home devices, along with user-friendly support guides, can support older adults with mobility disabilities at home. Finally, Jones et al., will describe the latest feature of the SmartBathroom laboratory – a SmartBathing Transfer Testbed prototype that will enable us to study of how different bathing environment configurations can impact transfer performance. Margaret Campbell (Retired Senior Scientist for Planning and Policy Support, National Institute on Disability, Independent Living, and Rehabilitation Research) will serve as the discussant for the symposium.

The Effect of Patients’ Understanding of Sling Necessity and Home Assistance on Sling Wear After Shoulder Surgery

Background: Perioperative education and socioeconomic factors influence patient behavior. Recent evidence has suggested that sling compliance is associated with improved outcomes after shoulder surgery; it is important to investigate factors that influence sling compliance. Purpose: To determine the associations between postoperative sling wear and patients’ understanding of sling necessity, postoperative home assistance, and social deprivation. Study Design: Cohort study; Level of evidence, 2. Methods: A total of 66 patients were prospectively enrolled from 2018 to 2020 if they were ≥18 years of age and undergoing shoulder surgery requiring a sling for at least 1 month postoperatively. Sling wear was measured using a temperature-sensing device. At 6 weeks postoperatively, patients’ understanding for sling necessity was determined by their response to a question on the Medical Adherence Measure questionnaire, “Why did you have to wear a shoulder sling?” The Patient Understanding Grading Scale (PUGS) was developed to quantify patient responses. PUGS was graded 1 to 3, with grade 1 corresponding to the least technical knowledge. Patient characteristics, social deprivation (Area Deprivation Index [ADI]), and home assistance were additionally analyzed. Results: There were no significant differences in baseline characteristics between patients when stratified by PUGS grade. Multivariable linear regression analysis for total hours of sling wear per week showed that patients with PUGS grade 2 (β, 48.2 hours; P = .007) and grade 3 (β, 59.5 hours; P = .003) wore their slings significantly more than grade 1 patients. Patients with home assistance had significantly greater day hours (73.5 ± 33.0 vs 44.0 ± 24.5 hours; P = .037) of sling wear per week, but there was no difference in night sling hours. Patients older than 60 years wore their slings significantly more, while men and those with a higher body mass index (BMI) wore their slings significantly less. ADI was not significantly associated with sling wear. Conclusion: This study demonstrates that patients with greater understanding for sling necessity, those with home assistance, and patients >60 years have greater sling wear, while male patients and those with a higher BMI have lower sling compliance. ADI was not a significant contributor.

Model-Driven Development of Service Robot Applications Dealing With Uncertain Human Behavior

In the future, robots will interact with humans in highly variable and unpredictable settings, such as healthcare and home assistance. Frameworks are, therefore, fundamental to analyze and develop interactive robotic applications that can deal by design with the uncertainty of human behavioral and physiological features. Our framework is built upon formal modeling, verification, and learning techniques providing sound mathematical guarantees of human wellbeing preservation throughout the interaction and timely mission completion despite the uncertainties at play. The framework’s workflow makes it accessible to professional figures without expertise in formal methods, and the high degree of automation minimizes the manual effort required throughout the toolchain. The development of toolchain has been tested on use cases from the healthcare setting, in which human behavior is unconstrained, and subjects are often in critical mental or physical conditions.

Building personalized virtual networks of care with the ADel electronic home assistant for older adults

Building personalized virtual networks of care with the ADel electronic home assistant for older adults

Body stakes: an existential ethics of care in living with biometrics and AI

AbstractThis article discusses the key existential stakes of implementing biometrics in human lifeworlds. In this pursuit, we offer a problematization and reinvention of central values often taken for granted within the “ethical turn” of AI development and discourse, such as autonomy, agency, privacy and integrity, as we revisit basic questions about what it means to be human and embodied. Within a framework of existential media studies, we introduce an existential ethics of care—through a conversation between existentialism, virtue ethics, a feminist ethics of care and post-humanist ethics—aiming to deepen and nuance our understanding of the human behind “human-centered” AI directives. The key argument is that biometrics implicates humans through unprecedented forms of objectification, through which the existential body—the relational, intimate and frail human being—is at risk. We interrogate these risks as they become visible at three sites where embodied humans are challenged by biometrics, and thus where the existential body is challenged by the biometric body. This occurs through reductionism (biometric passports nailing bodies to identities, removing human judgment and compromising agency at the AI border), enforced transparency (smart home assistants surveying human intimacies and invading intimate spaces in the bedroom) and the breaching of bodily integrity (chipping bodies to capture sensory data, challenging the very concept of bodily integrity through self-invasive biohacking). Our existential ethics of care is importantly not a solutionist list of principles or suggestions, but a manifesto for a way of thinking about the ethical challenges of living with biometrics in today’s world, by raising the right questions. We argue that a revitalized discussion of the basic existential stakes within human lived experience is needed and should serve as the foundation on which comprehensive frameworks can be built to address the complexities and prospects for ethical machines, responsible biometrics and AI.

On the Use of Assistive Technology during the COVID-19 Outbreak: Results and Lessons Learned from Pilot Studies.

As a consequence of the COVID-19 emergency, frail citizens felt isolated because of social isolation, suspended and/or strongly reduced home assistance, and limited access to hospitals. In this sense, assistive technology could play a pivotal role in empowering frail older adults reducing their isolation, as well as in reinforcing the work of formal caregivers and professionals. In this context, the goal of this paper is to present four pilot studies—conducted from March 2020 to April 2021—to promptly react to COVID-19 by providing assistive technology solutions, aiming to (1) guarantee high-quality service to older adults in-home or in residential facility contexts, (2) promote social inclusion, and (3) reduce the virus transmission. In particular, four services, namely, telepresence service, remote monitoring service, virtual visit, and environmental disinfection, were designed, implemented, and tested in real environments involving 85 end-users to assess the user experience and/or preliminary assess the technical feasibility. The results underlined that all the proposed services were generally accepted by older adults and professionals. Additionally, the results remarked that the use of telepresence robots in private homes and residential facilities increased enjoyment reducing anxiety, whereas the monitoring service supported the clinicians in monitoring the discharged COVID-19 patients. It is also worth mentioning that two new services/products were developed to disinfect the environment and to allow virtual visits within the framework of a hospital information system. The virtual visits service offered the opportunity to expand the portfolio of hospital services. The main barriers were found in education, technology interoperability, and ethical/legal/privacy compliance. It is also worth mentioning the key role played by an appropriate design and customer needs analysis since not all assistive devices were designed for older persons.

Developing an Instructional Suite for the Amazon Echo to Support Novice Older Adults' Use.

Digital home assistants (e.g., Amazon Echo) hold great potential to support older adults across a wide range of abilities to improve or maintain their quality of life. However, these devices and other related environmental control applications are not equipped with sufficient support for successful technology adoption among older adults. Without useful and usable information for guidance during the initial and continued use of these technologies (i.e., facilitating conditions), older adults may not sufficiently learn how to best utilize them, which is a primary barrier to technology adoption among this population. Our goal was to iteratively develop and test an instructional suite to support set up and use of an Amazon Echo Show and related connected technologies by older adults. Our human factors approach provides a roadmap to inform future instructional development for older adults to learn smart and connected technologies.

Influence of the COVID-19 Pandemic on Medication Reconciliation in Frail Elderly People at Hospital Discharge: Perception of Healthcare Professionals.

The current demographic panorama in Spain corresponds to an aging population; this situation is characterized by the need to care for an elderly population, which contains polymedicated and pluripathological individuals. Polymedication is a criterion of frailty in the elderly and a risk factor for mortality and morbidity due to the increased risk of drug interactions and medication errors. There are numerous studies that measure reconciliation at hospital discharge and at admission, and even the methodology of reconciliation, but we have not found many studies that measure reconciliation in the context of the COVID-19 pandemic from the point of view of health professionals regarding difficulties and the strategies carried out, which is essential to begin to glimpse solutions. Methods. This was a qualitative study based on 21 in-depth interviews and two discussion groups, conducted between January and April 2021 (13 nurses and 8 doctors, in rural and urban areas). The discourse was analyzed according to the Taylor–Bodgan model and processed using Atlas.ti software. Results. The areas altered by the health crisis were access to patients, their reconciliation of medication, and changes in the care modality, including the greater use of telephone communication, changes in work organization, and time dedicated to patient care and family work. Difficulties encountered during COVID-19: change in medication format, the specific characteristics of the patient and their pathologies, and difficulties arising from communication with the patient and their family. The strategies applied: the collaboration of home assistants and caregivers, emphasis on patient–health professional communication, and the use of Information and Communication Technologies (ICT). Conclusion. The discharge was interrupted by the health crisis caused by COVID-19, in terms of both the traditional access of patients and by the remote care modalities generated by telemedicine.

Pendampingan Smart Home Anak Pemulung di Sekitar TPA Supit Urang Kota Malang

Supit Urang is a Final Waste Disposal Site (TPA) in the city of Malang. People living around the TPA use the Supit Urang TPA as a place to earn a living. There are children who are lazy every day to help their parents. As a result, children's motivation to learn becomes low to take education, especially school. This Community Service is carried out in the village of Mulyorejo, Malang City. The purpose of this service is to assist elementary school students in learning. This assistance is carried out with the Smart Home concept. The method implemented in this service program is mentoring for elementary school students, totaling 26 students. The results of Smart Home assistance are carried out by providing assistance in learning to read, write, and count. So that assistance provides benefits to improve the cognitive abilities of children around the Supit Urang TPA, Mulyorejo village, Malang City.

Discharge of newborns with risk factors of severe hyperbilirubinemia: description of a hospital at home-based care monitoring and phototherapy.

Neonatal jaundice is common and associated with delay in hospital discharge and risk of neurological sequelae if not treated. The objectives of the study were to report on our experience of the monitoring and treatment of neonatal jaundice in a home care setting and its feasibility and safety for neonates with high risk of severe hyperbilirubinemia. The 2-year study has been led in the greater Paris University Hospital At Home (Assistance Publique-Hôpitaux de Paris). The device of the intervention was the Bilicocoon® Bag, a light-emitting diode sleeping bag worn by the neonate when the total serum bilirubin value exceeds intensive phototherapy threshold, according to the guidelines from the American Academy of Pediatrics. One hundred and thirty-nine neonates had participated in the intervention and 39 (28%) were treated by phototherapy at home, as continuation of inpatient phototherapy or started at home. Seventy-five percent of the sample had more than two risk factors for development of severe hyperbilirubinemia. Twenty five percent of the cohort who received phototherapy at home had lower gestational age (p < 0.014) and had younger age at discharge from maternity (p < 0.09). Median length of stay in hospital at home was 5days. Two patients needed readmission in conventional hospital (1%) for less than 24h. In multivariate model, the length of stay decreased with the higher gestational age (p < 0.001) and increased significantly with the older age at discharge, the birth weight < 10th percentile, and a treatment by phototherapy at home. Conclusion: Hospital at home, which is a whole strategy using an effective and convenient phototherapy device combined with a specialized medical follow-up, could be an alternative to conventional hospitalization for neonates at high risk of severe jaundice. The maternity discharge is facilitated, the mother-infant bonding can be promoted, and the risk of conventional rehospitalization is minimal, while guaranteeing the safety of this specific care. What is Known: • Managing neonatal jaundice is provided in conventional hospital with phototherapy. • Neonatal jaundice increases the risk of prolonged hospitalization or readmission. What is New: • Phototherapy is feasible in hospital at home for neonates with high risk of severe hyperbilirubinemia. •The care pathway of neonates from conventional hospital to hospital at home is described.

Small-Footprint Keyword Spotting for Controlling Smart Home Appliances Using TCN and CRNN Models

Smart homes feature automatic fire/smoke detection, voice-operated assets and appliances etc. More often, smart home appliances like lights, fans, etc., can be controlled through voice commands. Voice-operated devices like Alexa, Siri, and Google Assistant, are not new in the current age concerning voice command execution. However, working with these supports requires a global connection with the internet that costs time and bandwidth. Controlling home appliances need concise commands involving keywords on/off. Further, to operate the home appliances, bandwidth consumption for internet is not a wise idea. Through this paper, models based on Temporal Convolutional Networks (TCN) and Convolutional Recurrent Neural Networks (CRNN) have been studied for Keyword Spotting (KWS) by training models with keywords pronounced in different accents. The performance of these models is compared, and their ability to detect unknown words is studied. Finally, how these models are suitable for building Smart Home assistants to control home utilities with minimum bandwidth consumption is discussed.

Older Adults and Smart Technology: Facilitators and Barriers to Use

Smart technologies (e.g., smartphones, smart security technologies, digital home assistants) have advanced over the years and will continue to do so. There are various benefits to using these technologies in one's life, such as an increase in productivity through automation and self-monitoring one's health. Older adults particularly may benefit from smart technologies to support their everyday activities and compensate for age related changes. In this study, we explored the experiences and attitudes of eighty older adults including those who had prior experience and those who had never used (or perhaps never heard of) smart technologies through an online survey. We assessed their general opinions toward using smart technology and explored what facilitated or hindered their use. Older adults rated the facilitators to use for each smart technology differently, with few commonalities between the order of the most agreed upon facilitators. However, older adults' opinions were consistent across each technology about their ignorance of technological features and cost of the smart technology, which could be potential barriers to use. Among those who had never used one of the smart technologies, privacy was the most commonly endorsed concern. The results from this study support the understanding of key considerations when developing and deploying smart technologies for older adults.

MP20-20 HIGH 30-DAY COMPLICATIONS AFTER BURIED PENIS REPAIR SUGGEST ROLE FOR PREOPERATIVE OPTIMIZATION

You have accessJournal of UrologyCME1 May 2022MP20-20 HIGH 30-DAY COMPLICATIONS AFTER BURIED PENIS REPAIR SUGGEST ROLE FOR PREOPERATIVE OPTIMIZATION Ethan Matz, Rahul Dutta, Nicholas Deebel, Justin Refugia, Kim Thai, and Ryan Terlecki Ethan MatzEthan Matz More articles by this author , Rahul DuttaRahul Dutta More articles by this author , Nicholas DeebelNicholas Deebel More articles by this author , Justin RefugiaJustin Refugia More articles by this author , Kim ThaiKim Thai More articles by this author , and Ryan TerleckiRyan Terlecki More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002553.20AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Buried penis repair (BPR) is typically performed for morbidly obese men with associated comorbidities. Case complexity is variable and often involves penile split thickness skin grafting (STSG) and use of vacuum-assisted closure (VAC). At our institution, BPR is performed with a multidisciplinary team involving urology and plastic surgery. Collectively, we sought to determine the rate of 30-day complications to determine areas for team-based quality improvement and information relevant to preoperative patient counseling and prehabilitation. METHODS: With IRB approval, all cases of BPR from 2012 to 2021 were reviewed. Data was collected for patient demographics, operative case characteristics, and 30-day complications using the Clavien-Dindo classification. RESULTS: Overall, 63 men underwent BPR for the studied interval. Mean age was 55.9±14.4 years and mean BMI was 41.99±9.17 kg/m2. The rate of overall complications was 33% (21/63). Major complications were seen in 8% of patients, classified as Grade IV (4) and Grade III (1). BMI was an independent predictor of complications (p=0.0257). Additionally, patients noted to have preoperative UTI, even when treated, had significantly higher rates of readmission (p=0.006) and unplanned emergency room (ER) visits (p=0.0006). Baseline hypertension (HTN) was independently associated with ER visits (p=0.0148), but not with overall complications. Presence of home assistance, age, history of CAD or PVD, and preoperative A1c values were not associated with overall complication rate. There was no difference in complications with hospital or home negative pressure wound VAC systems. CONCLUSIONS: Short-term complications following BPR were noted in a third of patients, despite multidisciplinary management. Despite all patients having obesity, BMI was a significant predictor of complications. Patients with a history of preoperative urinary tract infection or HTN also appear to be at increased risk. Quality improvement initiatives targeting monitored preoperative weight loss, urinary assessments with test-of-cure and/or prophylaxis, and more aggressive blood-pressure management will be studied prospectively. Patient counseling will also involve setting expectations on the frequency of complicated recovery. Source of Funding: N/A © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e325 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Ethan Matz More articles by this author Rahul Dutta More articles by this author Nicholas Deebel More articles by this author Justin Refugia More articles by this author Kim Thai More articles by this author Ryan Terlecki More articles by this author Expand All Advertisement PDF DownloadLoading ...

Liability issues for the use of artificial intelligence (AI) in health care as a home assistance tool

Liability issues for the use of artificial intelligence (AI) in health care as a home assistance tool Mélanie Bourassa Forcier, LL.L. (summa cum laude, Ottawa), LL.B. (Montreal), M.Sc. (London School of Economics), D.C.L. (McGill), Professor, Faculty

The multiple perspectives of the multipurpose home care service

The Cosi home nursing service (Ssiad), created in 2000, is committed to working in partnership, considering that cooperation and good coordination are at the origin of a sustainable and quality home care. With this in mind, the directors of Ssiad took over the management of a home assistance and support service in 2011 in order to offer personal assistance and care, and thus to provide comprehensive care. Now a multi-purpose home help and care service, Cosi continues to evolve to best meet the needs of users.

PENDAMPINGAN ORANG TUA PADA ANAK SAAT BELAJAR DARI RUMAH DI PAUD MAITREYAWIRA PONTIANAK TENGGARA

AbstractParental assistance when learning from home is an effort made by parents in providing the assistance needed by children while studying from home so that aspects of child development can develop optimally. This study aims to describe parental assistance to children when learning from home at PAUD Maitreyawira, Southeast Pontianak. The research method used is a descriptive method with a qualitative research form. The subjects in the study were the parents of children in class K1 Lucky PAUD Maitreyawira Southeast Pontianak. Data collection techniques used in this study were direct observation, direct communication, and documentary studies. The results of the study show that people have provided learning facilities that children need, supervise the use of children's study time, and supervise children's learning activities while studying from home. Thus, parental assistance to children when studying from home at PAUD Maitreyawira Southeast Pontianak has been carried out well.Keywords: Learning from Home and Parental Assistance

Occupational Therapists' Experience of Using Home Adaptation and Assistive Products as Interventions for Older Individuals and Persons with Disabilities in Thailand

As Thailand becomes an aged society it is important to promote advancements in geriatric medicine to provide the best care for older individuals. The right assistive facilities and household mobility equipment are essential for everyday activities. The use of home adaptations and assistive products can maximize the quality of life for older individuals and make life more convenient for those with disabilities. This study aimed to investigate the experience of occupational therapists, using home adaptations and assistive products. An individual interview was conducted with eight occupational therapists who worked at regional hospitals and centers of excellence throughout Thailand using a qualitative study. The results were interpreted through thematic analysis. Five main themes emerged: (1) empowering independent living at home, (2) accident prevention and safety, (3) family financial constraints and barriers, (4) availability and accessibility of products, and (5) matching products with clients’ capabilities and needs. Based on an occupational therapy approach, this study examines Thailand's needs for home adaptations and assistive products, as well as barriers to accessing those products and services. Through a contribution to knowledge and information based on occupational therapists' experience, the laws and regulations regarding home adaptations and assistive products for people with disabilities can be improved. Additionally, the interdisciplinary team and authorities involved in this issue should also collaborate to formulate guidelines for home adaptations and assistive products for older individuals and persons with disabilities in the future.

A Framework for Rapid Robotic Application Development for Citizen Developers

It is common knowledge among computer scientists and software engineers that ”building robotics systems is hard”: it includes applied and specialized knowledge from various scientific fields, such as mechanical, electrical and computer engineering, computer science and physics, among others. To expedite the development of robots, a significant number of robotics-oriented middleware solutions and frameworks exist that provide high-level functionality for the implementation of the in-robot software stack, such as ready-to-use algorithms and sensor/actuator drivers. While the aforementioned focus is on the implementation of the core functionalities and control layer of robots, these specialized tools still require extensive training, while not providing the envisaged freedom in design choices. In this paper, we discuss most of the robotics software development methodologies and frameworks, analyze the way robotics applications are built and propose a new resource-oriented architecture towards the rapid development of robot-agnostic applications. The contribution of our work is a methodology and a model-based middleware that can be used to provide remote robot-agnostic interfaces. Such interfaces may support robotics application development from citizen developers by reducing hand-coding and technical knowledge requirements. This way, non-robotics experts will be able to integrate and use robotics in a wide range of application domains, such as healthcare, home assistance, home automation and cyber–physical systems in general.

Xiaomi and the Promises of the Good Life? Issues of Security and Risk in the Making of the Smart Home in China

Informed by Foucault’s governmentality, this article examines the making of the smart home in China. Operating within the nexus of security and risk, smart homes foster a discourse of the ‘the good life’ that accelerates AI’s integration into the population’s daily life. Taking Xiaomi (a renowned smart home technology company) as a case study, I trace how commercial practices formulate issues of security and risk in three smart home products: smart door lock, home surveillance camera and virtual home assistant. Drawing on visual and discourse analyses of Xiaomi’s promotional materials, this analysis is structured around three levels of relationships: (a) trust and ontological security; (b) the practices of government and the practices of self (c) and the technologisation of Chinese society. This analysis demonstrates that Xiaomi further advances the state-driven technologisation of Chinese society, in which subjects are guided to embrace the positive dimensions of technology for self-actualisation and self-management. However, the technology that makes domestic life and the physical home more reliable, less prone to risks and more secure has at the same time further eroded social relations and trust.

Introducing a Smart City Component in a Robotic Competition: A Field Report.

In recent years, two fields have become more prominent in our everyday life: smart cities and service robots. In a smart city, information is collected from distributed sensors around the city into centralised data hubs and used to improve the efficiency of the city systems and provide better services to citizens. Exploiting major advances in Computer Vision and Machine Learning, service robots have evolved from performing simple tasks to playing the role of hotel concierges, museum guides, waiters in cafes and restaurants, home assistants, automated delivery drones, and more. As digital agents, robots can be prime members of the smart city vision. On the one hand, smart city data can be accessed by robots to gain information that is relevant to the task in hand. On the other hand, robots can act as mobile sensors and actuators on behalf of the smart city, thus contributing to the data acquisition process. However, the connection between service robots and smart cities is surprisingly under-explored. In an effort to stimulate advances on the integration between robots and smart cities, we turned to robot competitions and hosted the first Smart Cities Robotics Challenge (SciRoc). The contest included activities specifically designed to require cooperation between robots and the MK Data Hub, a Smart City data infrastructure. In this article, we report on the competition held in Milton Keynes (UK) in September 2019, focusing in particular on the role played by the MK Data Hub in simulating a Smart City Data Infrastructure for service robots. Additionally, we discuss the feedback we received from the various people involved in the SciRoc Challenge, including participants, members of the public and organisers, and summarise the lessons learnt from this experience.