Ambient Assisted Living: Passive monitoring of elderly and vulnerable people in their homes
The average life expectancy at birth now exceeds 83 years in Japan, 81 in several other countries, and in East Asia, now exceeds 74 years. Advances in science and medicine mean we are living longer, healthier lives. It also means that there will be more and more of us who’ll outlive our partners, friends, and family – an older population, healthy enough to remain alone in their homes, but facing an everyday risk of accidents, Alzheimer’s, and social isolation.
Figure 1: Data from World Bank, Last updated: Oct 7, 2016
While the dramatic increase in average life expectancy during the 20th century is certainly one of society’s more laudable achievements, the fact that people are living longer (and potentially healthier) lives will inevitably require big changes in social, economic and government policies throughout the world.
A unique and unprecedented demographic phenomenon
Although there are exceptions- in many parts of Africa life expectancy rates have decreased due to deaths cause by the HIV/AIDs epidemic, overall the world’s population is aging. Of particular note, the rising life expectancy within the “oldest old” (people aged 85 or older) in many countries is now the fastest growing part of the total population. 
The US Census Bureau report entitled, An Ageing World, 2015, projects that the growth of the world’s older population will outpace that of a younger population over the next 35 years, with the 65-and-over population expanding in stark contrast to the youth population (under age 20) remaining almost flat.  Meaning for the first time in human history, people aged 65 and over will outnumber children under the age of five.
Figure 2: World population by age group, 2015 – 2050
More significantly, this crossing of two opposing demographics is just around the corner in 2018. After 2018, these two age groups will continue to grow in opposite directions. By 2050, the proportion of the population aged 65 and older (15.6%) will be more than double that of children under age 5 (7.2%), creating a unique and unprecedented demographic phenomenon which comes with significant social and economic impact. 
Figure 3: Young children and aging as a percentage of global population, 1950 – 2050
The huge shift towards not just an aging, but an old population will pose formidable consequences for rich and poor nations alike – with transformational challenges ranging from how to care for older people living alone, to how to pay for unprecedented numbers of pensioners – more than 1 billion of them by 2040. The impact of managing a world with more seniors than juniors will impact everyone – individuals, families, public and private organizations, governments and policymakers.
“We are seeing population aging in every country in every part of the world…Many countries in Europe and Asia are further along in the process, or moving more rapidly, than we are in the United States. Since population aging affects so many aspects of public life — acute and long-term health care needs, pensions, work and retirement, transportation, housing — there is a lot of potential for learning from each other’s experience.” – John Haaga, Acting Director of the NIA’s Division of Behavioral and Social Research 
An evolving definition of care
As the population ages, the definition of care itself will need to evolve from a person’s physical well-being in a hospital or nursing home, to something which is expanded to include an individual feeling the best they can, within their own home. Care will no longer be simply something that happens behind a door in a structured setting, but rather something more integrated into the community involving care providers, policy makers and family. In these situations, the use of unstructured data gathered from multiple sources will combine to provide invaluable insights and actionable recommendations. Suddenly, the ability to keep an eye on daily behaviour patterns becomes central to administering sustainable care, managing recovery process, or even responding to the need for urgent intervention.
Technology designed for a younger demographic can help an aging population
How do we protect those grandmothers, fathers, siblings, and friends, while letting them keep the comfort of their lives, their daily routine? Despite the steady rise of social media by the elderly, research indicates the aging population (your parents and grandparents) experiences difficulties in adapting to technology.  In reality technology is often designed and shaped with a younger demographic in mind. For any of you that have purchased laptops and tablets, or opened email accounts for aging family members, you are not alone when you encounter reticence to adopt technology. Whether it is privacy concerns, techno-phobia, or an inability to make use of a device due to physical limitations such as arthritic hands and fingers, diminished hearing or sight loss, the situation can be frustrating for everyone involved.
Gaining insight from daily routines
What if the solution lay in the routine itself? If the simple objects we interacted with every day were given sensors and Wi-Fi, each step of that routine could be combined to form a picture of a life being lived, in real time. And, if we had that picture, we could know, within moments, if something wasn’t right. A signal could be sent. And help, or simply a familiar face, could arrive.
We often think of the Internet of Things as a system to make life easier. What if could also create a higher quality of life for those in need? Our homes have always provided shelter, comfort, and routine… now they can provide data. Data that can be put into action to save a life or simply allow a life be lived on its own terms. We all find comfort in our routine, now we can find safety as well.
How the connected home can help manage risk
The home has long been the domain of consumer electronics and consumer packaged goods manufacturers, but today’s homes are an increasingly complex web of devices and services delivered by companies across a range of industries using the Internet of Things (IoT). By 2022, an average of 500 smart devices will be present in a typical family home. 
By using IoT technology in the home, people are integrating rooms, devices and services while simplifying the life of residents. Whether in the connected, cognitive kitchen, living room or garage, residents can better manage their home and family life with IoT. For instance, a connected home uses data to provide residents with greater transparency and the ability to analyze their consumption of energy and other home services or resources. The connected home can even make recommendations to help residents conserve resources and manage cost.
By monitoring connected home sensors, data and alerts, it is possible to improve the health and wellness of residents, in addition to equipping caregivers, health providers and concerned family members with the tools they need to monitor and care for residents. Combining capabilities such as video and audio, biometric sensors, presence detectors, leak detectors, and smoke, fire and air quality sensors, it is not difficult to deploy solutions which can reduce the risk of accidents or security problems. For example, a connected home can even alert residents, first responders and insurers if an adverse event does happen.
Creating an Internet of Caring Things
Susann Keohane, Sr. Technologist, IBM, and Nicola Palmarini, Technology Advocate, IBM Research, define The Internet of Caring Things as: “A network of connected objects (devices, sensors) and cognitive systems with a clear mission: to actively care for people – their physical and mental well-being, homes, loved ones…and….when applied to the aging population, to allow family members, doctors, and caregivers to proactively monitor the health and well-being of the world’s aging population.”
By passively monitor elderly and vulnerable people in their homes, IoT connected devices can alert carers and family members when something “unusual” is happening. For example, if John’s ageing mother hasn’t made a cup of tea by 10am, that’s quite unusual, so John receives an SMS message to tell him that Mum might not be up and about yet. Even if she’s fine, she’d love to hear from her son checking she’s okay today!
For wardens in sheltered housing accommodation, insight into which residents may not be going about their normal daily routine would help prioritise their visits during the day. For Health Trusts helping rehabilitate hospital patients back into their homes, being able to keep an eye on their daily behaviour patterns can give valuable insights into the progress of their recovery, or if more urgent intervention may be needed.
Watch the video: Transforming the routine
Advances in science and medicine mean we are living longer lives. How do we protect our aging population while letting them keep the comfort of their lives, their daily routine? Everyday objects with sensors and Wi-Fi can track each step of that routine and form a picture of a life being lived, in real time, to the children and support systems caring for the safety and independence of their loved ones.
Using IoT sensors and data to enable ambient assisted living
CurrentCare, a UK-based IBM Business Partner, has developed a solution for assisted living, using a variety of sensors including energy usage monitors on key appliances such as the kettle, door open/close sensors, temperature monitors, room-level motion detectors, pressure mats in or near the bed, or a toilet flush sensor.
Figure 4: CurrentCare options for ambient assisted living monitoring
Data from these sensors, which come in a low cost, easy to install, set of equipment in the home, is sent over broadband to the IBM Watson IoT Platform, and is analysed by applications hosted on IBM Bluemix. Here, automated rules determine if something “unusual” is happening and in such a case, who to notify by what means, including SMS, email, Twitter, or direct notification to carer or monitoring agencies.
Figure 5: Sensor data is sent to IBM Watson IoT Platform for analysis
For instance, here are examples of some of the rules-based notifications:
If Dad hasn’t had a cup of tea by 10am, TXT me
If he is up and about as normal, send me a tweet
If the front door opens between midnight and 4am
Send me a TXT
Send the friendly neighbour a TXT
If the toilet hasn’t flushed by 10am, send me a TXT
If it’s been flushed more than 15 times a day, email me(!)
If the room temperature drops below 15C
Or, turn on the heating remotely
If the fridge fails, TXT me
If the fridge starts using more power than it used to
Time to buy a new fridge
Time to take your pills… the blue ones that look like this, press here to confirm
Has the home help been today? How long did they stay?
Expanding the IoT portfolio with Watson IoT Platform
CurrentCare offers a prototyping kit, which includes a single Individual Appliance Monitor (IAM) and a Gateway device configured to send data to the Watson IoT QuickStart Platform, with a handy QR code which takes you directly to the page where your published data appears. Each Gateway comes with connection information to enable an application to easily consume the published data, for example using the popular Node-RED IoT wiring tool on IBM’s Bluemix platform.
For deployments of energy monitoring and assisted living applications, the Professional version of the CurrentCare Gateway comes pre-registered to the Watson IoT Platform with a unique device identifier and authentication keys for secure access to the IoT Platform. Each gateway can support up to 10 sensors, from a growing range of energy monitors and environmental sensors including temperature, motion, carbon monoxide, door switch, flood detector and pressure mat.
It was following on from successful energy behaviour monitoring project, Chale Project, which aimed to reduce Energy Poverty in Social Housing on the Isle of Wight in the UK, that CurrentCost realised their energy monitoring product family could be enhanced, with additional sensors, to provide a solution for “Ambient Assisted Living.”
Interesting. The greatest need for my aging relative is some way to get notified when the caretaker doesn’t put her oxygen on in her room or when the oxygen runs out on the tank in her electric chair. Sure there are lots of potential applications.
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