Older Adults Health Monitoring

Yu Cheng Hsu

Learning outcomes

Understand the challenges and opportunities of health monitoring for older adults
Learn about different types of health monitoring technologies and their applications
Explore the ethical considerations and future perspectives of health monitoring for older adults

Aging Society

Population aging

Aging is a global issue, especially in developed countries
Definition
- More than 7% of population aged 65 or more
Reason
- Longevity
- Lower fertility rate

Challenges - physical frailty

A practical challenges is decline of function along with aging

Physical
- Reduce muscle mass
- Lower bone density
Cognitive
- Reduce processing speed
- Reduce working memory
- Reduce execution speed
Consequence
- Prone to injury

Challenges - caregiver burnout

Taking care of a people could result in

Physical burnout
- Physical exhaustion
- Somatic symptoms
Mental burnout
- Stress
- Depression

Healthy aging

Definition: Developing and maintaining functional ability

Functional ability
- Meet basic needs
- Learn,grow, and make decision
- mobility
- Build and maintain relationship
- Contribute to society

Health monitoring of older adults

Technology could help
- Extend healthy aging duration
- Lowered threshold to achieve functional ability

Older adults health monitoring

Health monitoring assist older adults life in

Older adult health

Continuous monitoring leads to
- Early prevention
- Chronic condition management

Caregiver perspective

Reduced caring burden
Easier health information management
Remote management

Wearable devices

Wearable devices monitoring

Cardiovascular health
- Heart rate
- Blood pressure
- Electrocardiogram (ECG)
Respiratory health
- Blood oxygen level
- Respiratory rate
Activities
- Exercise
- Sleep

Sensor technology

Photoplethysmography
Accelerometer
ECG

Domestic health monitoring machines for targeted purpose

Spirometry

Pulmonary functional test
Monitoring chronic pulmonary disease (COPD, asthma)

Continuous glucose monitor (CGM)

Glucose monitoring for diabete patients

Consideration of using wearable devices

Data formatting
Interpretation of measured data
Integration of different data modality
- Android Health connect
- Apple Health

Ambient assisted living

The other type of older adults monitoring is environmental monitoring

Camera
- Fall
Gas
- Smoke
- Air Quality
Humidity
Light
Temperature

Ambient sensors image from Alkhomsan et al. (2017)

AI-enabled monitoring

The problem of the simply monitoring is that we don’t take further steps.

Rule-based automation

Popular options include IFTTT (if this, then that) or Apple/Google Home built-in rule-based automation

Example
- IF “Temperature > 26”
- Then “Turn on Air con”

LLM-enabled home automation

Incorporate personal records, behavior to execute actions
Lowered coding requirements for automation

Online-offline collaboration

The other type of monitor-to-action is connecting to offline supports

Healthcare systems

Reporting health monitoring records for clinician as extra evidence
Emergency calling for stroke, fall events

Social support

Connecting to social services
Emergency call service (平安鐘)

Implementation aspects

Accepting new technology

Older adults are usually less accepting of new technology

Factors affect older adults’ attitude toward new technology

Perceived usefulness
Perceived ease of use

The actual usefulness is not the key. The key is to facilitate older adults perceive its usefulness

Implementation

Some useful way to increase adoption rate of health monitoring technology

Active communication with older adults
Incentives
Peer / authoritative engagement

User interface design

Simple and intuitive interface for older adults
Clear and concise information display

In-class reading: FDA issues safety alert on Trividia blood glucose monitors

Guided questions:

What are the difference between original instruction and revised instruction
What are the potential consequences of the original instruction?
Regulatory strategy for health monitoring devices, is the safety of the device is the only concern?
Business perspectives: What are other ways to fix the error, and what are the potential costs?

Ethical consideration

Privacy vs. Safety Trade-off
- How much privacy are we willing to sacrifice for safety?
Data ownership
- Who owns the health data
  - Older adults
  - Caregiver
  - Child
  - Device company

Future perspective

LLM integration
Mental health
More non-intrusive monitoring devices

Design your own scenario

The other type of monitor-to-action is connecting to offline supports

Profile: Mrs. Lin, 78 years old
Living situation: living alone in an apartment
- Two adult children live overseas
Mobility: Walking slow, need to use a cane
Cognition: Occasionally forget things
Health: Managed hypertension and diabetes, early-stage hearing loss

Problem

Her children are increasingly anxious. After the recent slip in the kitchen, they want to hire a full-time domestic helper, but Mrs. Lin refuses.

What are the potential biological signs could be monitored
What are the potential house sensor could be installed to increase home safety
After installing 1. and 2. what are the potential action we can do if something happens?

Bibliography

Alkhomsan, Mashail N, M Anwar Hossain, Sk Md Mizanur Rahman, and Mehedi Masud. 2017. “Situation Awareness in Ambient Assisted Living for Smart Healthcare.” IEEE Access 5: 20716–25.