Technology for Adaptive Aging (2004) / Chapter Skim
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Part I: Steering Committee Report -- 1 Introduction and Overview
Part I: Steering Committee Report -- 1 Introduction and Overview
Pages 7-40
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Part I Steering Committee Report
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Many experts predict that technology can and will play an important role in supporting the independence of older adults, but to date there has been only modest evidence that this potential is being realized. The Workshop on Technology for Adaptive Aging was held to further understand the reasons why more progress has not been made and to stimulate further advances.
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It is clear that the population of aging (age 65 and older) adults in the United States is entering a period of rapid growth, as baby boomers age and life expectancy increases.
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Many candidate domains were proposed, and we eventually selected six: communication, employment, health, learning, living environments, and transportation. The changes people undergo as they age, specifically cognitive and sensory changes and changes in motor performance, were seen as applicable to all of the domains, so we decided to assign these as "overview" papers, eliminating the need for each domain-specific paper to address
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First we considered a series of potential barriers to acceptance of the technology from the perspective of the aging population themselves. These are issues that could affect potential users' motivation or willingness to try or use a technology, their ability to use it effectively and be satisfied with the results, or other aspects of their interaction with technologies.
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However, there are also individual differences among the aging population that transcend universal design criteria. In the field of aging especially, universal design, while important, is not sufficient because there are many special requirements.
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The factors that influence individual privacy concerns also need to be better understood. Safety It seems obvious that no technology should be made available to seniors if it presents an unreasonable risk of danger or harm to its user, whether in normal operation or as a result of the failure or malfunction of a technology in use.
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Keeping technological supports simple and easy to use should be integral to meeting the needs of the aging population. ISSUES FOR THE SUCCESSFUL INTRODUCTION OF NEW TECHNOLOGIES In addition to potential barriers from the user's perspective, many other considerations can limit the likelihood that new technologies will successfully make the transition from research into marketable products.
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Usability testing is especially important when the market is the aging population. Product testing concludes with a phase of "beta testing," in which the product is released selectively to potential market segments for prerelease evaluation.
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At the same time, we should not lose sight of the fact that future generations will be much more computer savvy than today's older adults, and they may present a considerably larger and more stable market for technological support as they reach senior status. Legal Constraints If there are liability issues associated with the use of a given technology, they will have serious consequences for the willingness of manufacturers to offer the technology, as well as for user acceptance.
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(3) Private health insurance companies may justify reimbursing the cost by demonstrating reduced costs for hospitalization or reduced requirements for medication.
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Overview Papers Changes with Aging The authors of the first two papers provide a summary of what is known about the life-span effects of aging on sensory, perceptual, and motor performance and on cognitive functioning and the ability to operate in a world involving social interaction, in which individual intentions, the demands of multiple external tasks, and feedback come together to produce behavior. The paper on "Cognitive Aging" by K
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We believe that the information garnered from the application of this technology in theoretically driven studies is crucial to the development and extension of the understanding of the impact of current and future technologies on the cognitive vitality of older adults. Methodological and Measurement Considerations A number of questions that focus on ways to develop scientific evidence to support the efficacy of new technologies are addressed in the methodology paper by Christopher Hertzog and Leah Light.
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By extending the range of human performance, they allow older adults to reintegrate into their daily regimens routine tasks that have become too difficult for them. But the promise of independence involves a caution, because dependence is not being eliminated but rather
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The impact of the technology is likely to develop with time, and these developmental processes may proceed at different rates and in many different ways, depending on the purpose of the technology, the individual using it, and the social and environmental context into which it has been placed. Dynamic analyses are more demanding in terms of measurement, data collection, and the skill level of the analyst; they can be more intrusive for the user; and they introduce additional complications into the sifting of information into categories of "error" and "real change." Some adaptive technologies may allow the incorporation of monitoring capability directly into the device itself.
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The potential for technology to provide significant benefits to those with access to it raises ethical questions regarding the role of government in both the development and the distribution of these technologies. Should research into particular adaptive technologies be discouraged because those who need the innovation are a relatively small group, or because a larger group who could benefit from the advance cannot afford to purchase it?
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In addition to basic activities of daily living (e.g., bathing and toileting) , successful independent living requires the capability to carry out instrumental activities of daily living such as managing a medication regimen, maintaining the household, and preparing adequately nutritious meals.
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However, as the authors of the communication paper argue, such changes will be insufficient to ensure the success of communication technologies. Researchers on cognitive aging have shown that there are other important variables that are relevant to the design of speech communication systems, such as prosody, working memory, and the pros and cons of "elderspeak." The practical relevance of these findings must be conveyed to technology designers.
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For the baby boom population weaned on technology, the capacity to ride the crest of change seems particularly evident. Although aspects of this change that is swiftly approaching have been discussed here and elsewhere, the combined effect of multiple factors is significant and has been referred to collectively by steering committee member Scott Bass as the "perfect storm." Like the perfect storm in nature, the entrance of the baby boom generation into later adulthood presents a confluence of independent variables playing off one another in perfect but dramatic harmony.
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Potential labor shortages: Labor shortages are cyclical and are influenced by the overall economy. In times of economic expansion, even nontraditional labor markets are recruited, including retired workers.
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Today's older workers are better prepared for lifelong learning and on-the-job retraining. Consumer activity: The baby boomers have been robust consumers, setting trends and developing habits driven by consumption of quality goods and services.
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Examples of health-related technologies include monitoring devices, decision support systems, emergency response systems, sources of health-related information for consumers, as well as technologies designed to enhance patient and institutional compliance with treatment and lifestyle regimens. Several challenges face those who are developing new technological solutions for health and wellness.
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Moreover, the data reduction and integration will vary for different users. An older person with some functional impairment is likely to need more data reduction and decision support than a family member or a healthcare professional.
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Traditional, highly structured learning is exemplified by the numerous formal courses and training programs available on the World Wide Web. A very different model is the spontaneously organized, nonhierarchical community of learners, who meet virtually or in person to pursue a common interest or problem, often without a designated teacher.
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The first concerns preferences for structure in learning. It may be that many older adults prefer highly structured tasks and environments, so that learner-centered and loosely organized materials are less effective.
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Potentially more intractable expenses arise from the need to customize the technologies to individual users, a requirement that is closely related to the second challenge. Universal design principles do not apply in a straightforward manner to cognitive aids, since by definition these systems must represent the details of their users' daily activities.
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Many of the technologies described in this paper involve extensive monitoring of the routine daily activities of an older adult. Clearly, such monitoring raises important privacy concerns that will need to be addressed by technology designers to ensure that the rights and dignity of the users of the technology are respected.
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The nation's current approach, as it is with many problems, is to "let a thousand flowers bloom." However, in this domain, such an approach has the effect of letting available technology seek its own market, and as discussed above, there are too many reasons, involving both user acceptance and economic reality, why such an approach will facilitate only the most widely applicable technological supports. There are many ways government agencies can play a role in promot
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University faculty could be supported to spend summers or sabbatical leaves on site in industrial settings where potentially relevant technology is being developed. Graduate student training grants could be focused specifically on multidisciplinary training in laboratories conducting aging research, together with internships in industrial and field settings where potential technology interventions are being developed and evaluated.
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Once a product idea has reached the prototype stage, there is a need for the equivalent of what in the software industry is called beta testing -- that is, testing by the intended user population in real-life situations. This beta testing needs to be carried out by an interdisciplinary team that works in the aging user's environment, and it needs to include specialists who understand the aging population and specialists in the conduct of formative evaluation.
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The Americans with Disabilities Act and related legislation are making giant strides in improving physical accessibility in public spaces, but few new homes are being built with wheelchair access in mind and few existing private homes can accommodate even the most fundamental physical access needs without serious renovation. Advanced communications technology was frequently mentioned in the workshop, not just by the speakers on that topic but also in the discussions of living environments, healthcare, and transportation.
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Such tools and techniques include needs analysis to fully understand what the system should do and how it should do it; person analysis to recognize the capabilities and limitations of the target user population; task analysis to detail the components of tasks and ensure that the system functionality is appropriate, the expectations of the user are considered, and that error messages are clear at each point in the process; and in
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There are documented components to usability that provide guidance for design: learnability, efficiency, memorability, error avoidance, and satisfaction. Techniques such as rapid prototyping to develop mock representations of a product can be used to identify critical flaws early in the design process.
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