The Assisted Living Project et HiOA-prosjekt

Background

Both EU and Norwegian authorities consider technological development to be an answer to the growing care burden caused by the enormous increase in people with cognitive impairments or dementia. Nearly 36 million people currently suffer from dementia globally, a number that is projected to rise to 100 million by 2050. In Norway, approximately 70,000 persons suffer from dementia syndrome, a number estimated to increase to 140,000 within the next 35 years. Technological developments are presumed to assist in the daily living of adults with MCI/D, as well as prevent and postpone institutionalisation. The goal is to confront the future lack of labour to carry out the care and to underpin integrity, autonomy, independency, dignity and quality of life (QoL).

Assisted living technology (ALT) is a generic term for a heterogeneous group of technologies, involving for example videophones, robotics, GPS technology and monitoring systems to enhance security and safety and enable people to live an independent everyday life at home and in the community. Such solutions typically feature i) sensors with corresponding alarms, e.g. fall sensors, fire sensors and movement sensors including GPS positioning; ii) timer-based monitoring and switch automation solutions, such as light switch controls, oven switches and electronic door locks; iii) calendar-type assistance to help people remember tasks; iv) communication solutions connecting both devices and the person with the outside world, e.g. alarm centrals, health personnel, relatives and other care providers. In addition, other features have been investigated in a number of research studies.

Only a few studies have researched the need for technological solutions from the perspective of persons living with MCI/D. In translating these often broadly defined needs into actual and usable compensatory technological solutions, this group is too often left out, even though studies have demonstrated that persons with MCI are indeed capable of giving their opinions on the user-friendliness and usefulness of assistive technology. In the Assisted Living project approximately 300 elderly will be included in a study of their needs for and use of technology.

Responsible research and innovation

The public interest in ALT has been more pronounced than the actual use of these technologies, because of factors related to organisational culture among care providers, technological alienation among elderly, and a lack of anchoring of the technologies with the relatives of the persons with MCI/D. Within a Responsible Research and Innovation (RRI) line of thought innovations should not be pushed on society, but rather be developed with society, to meet the needs of society.

RRI has been interpreted as a comprehensive approach of proceeding in research and innovation in ways that allow all stakeholders at an early stage (A) to obtain relevant knowledge on the consequences of the outcomes of their actions and on the range of options open to them and (B) to effectively evaluate both outcomes and options in terms of societal needs and moral values and (C) to use these considerations (under A and B) as functional requirements for design and development of new research, products and services (European Commission 2013a: 3, see also Owen et al. 2013 and von Schomberg 2012). RRI is implemented as a cross-cutting concept throughout the whole of the new European research programme Horizon 2020, involving six key dimensions: engagement of citizens, gender equality, science education, open access, ethics and governance.

In this project two main aspects of RRI will be further developed: RRI as a process of participatory technology development, and RRI dimensions integrated in an approach for technology appraisal.

 

The contribution of the project

Building on this state-of-the-art, the Assisted Living project will engage in development of tech­nological solutions to needs defined by persons with MCI/D themselves in an RRI process specifi­cal­ly adapted to the capacities of such user groups. The project is designed to be both an important contribution in the process of ALT innovation in Norway in line with the strategic priority in Innovation in Caring (NOU 2011), and to enrich and inform RRI in both concept and practice.

Most current home automation or mobile applications perform individual tasks and often generate alarms based on a set of fixed rules, e.g. high temperature at the electric cooker. Few holistic systems exist that manage decision-making at an integrated level, adapted to each user. The technological approach in this project is to develop self-adapting and self-learning systems. The characteristic of a self-learning system is that it evaluates its own performance according to a set of goals and improves its algorithms automatically based on what works best in each case. The system learns by experience and employs the best learned strategy next time a similar situation arises, hence it evolves to be better suited for the tasks at hand. In addition, such a system is self-regulating and tailors itself automatically, for example in accordance with user preferences and needs.

The technology development in the project will be done in cooperation with the Skøyen Omsorg + center in Oslo. It must be stressed that the exact nature of these solutions cannot yet be described as they will be the result of an RRI design process.

It must be clear that all these tasks and research questions may change as the learning process in the project unfolds.

 

Dialogue, reflection and learning in the project

Reflection and learning is a basic element in RRI and there will be several reflective learning loops in the project.

Integration and learning within the project team:

The ProjectSTEP group: This group will function as a combination of steering group and sounding board. The group will consist of a broad range of experts and stakeholders. An important function of the group is to discuss the situation analysis in the project and critically reflect on the framing of the issues and the plans and methods for developing and assessing the ALT solutions in the project.

The dialogue conferences: There will be at least three conferences: before, during and after the technology development.

Conferences: Broader learning will be generated in two conferences at the end of the project; one focused on foresight and one on presenting and discussing the project’s main learning points.

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