Help at Home: Use of assistive technology for older people
More people are living longer with complex conditions and needs. Technology can help people to stay living well and safely at home as they get older. But technology is changing rapidly and it can be challenging to get the right technology for the right person with the right support. There has been considerable investment recently in developing and evaluating assistive technologies for older people. But this is a relatively new field and there are important gaps in what we know.
This review presents a selection of recent research on assistive technology for older people funded by The National Institute for Health Research (NIHR) and other government funders.
This has been selected with help from an expert steering group. In this review we focus on research around the use of technology in the home, remote monitoring systems and designing better environments for older people.
We need to understand more about how technology is used by older people in their home. We know that many devices are never used and more are not used fully or as intended. Research helps to understand the reasons for this. Insights include the timing of introducing new technology – often too late, at the point of crisis or advanced illness. The health of older people is often unpredictable and demands of technology may be too much at times. Research also shows real ways in which people use devices and services, including workarounds and adaptations. Under-investment in training to support longer term use of technologies in the home is an issue, and the human element of support is essential. Studies also highlight the need to motivate staff such as community nurses in the benefits of telecare and other initiatives. Based on research, a toolkit has been developed to guide those designing and implementing telecare systems.
A number of studies have explored integrated monitoring and response systems to check the health, wellbeing and safety of older people living at home. Some of these are focused on particular groups, like those with dementia. They range from systems using sensors, alarms or wearable technology to cameras, smart televisions and service robots. Some collect data on health status, movement or eating and drinking. Other systems are more interactive. A selection of studies also looks at the use of home technology, from telephone to social networking devices, to combat social isolation in older people. Much of the research to date has focused on developing prototypes and systems. There is little real-life testing or evaluations showing impact on falls, hospital admissions or quality of life.
Designing better environments
Occupational therapists play a crucial role in assessing the home and adapting the environment for older people. Research includes developing smart solutions for bathrooms, where many falls happen. There is also research to inform design of future kitchens to make it easier to cook with limited function. Other studies have focused on the wider neighbourhood, with teams involving clinical and public health researchers working with engineering, housing, architects and urban planning experts. These include better design for those with mobility issues or confusion. There has also been more basic research, for instance on navigation issues for people with dementia, which should inform design of future homes and care homes.
This review gives a flavour of recent research which has tested and developed technology to help older people live longer at home. There are challenges in doing this research, from recruiting older people into studies to the rapid pace at which technologies change. Research has focused more on high-end digital technology than evaluation of more basic devices to help toileting, mobility, vision and everyday tasks. In terms of systems and technologies featured in this report, there has been more research effort in developing prototypes than real-world testing in the home. Little is known about actual use of technologies over time and their impact in preventing falls, reducing isolation, or anticipating health crises or emergencies. More research is needed using mixed methods to evaluate technologies in use and share learning across sectors.