ALBERT

Description: Background; With an ever-growing ageing population, dementia is fast becoming the chronic disease of the 21stcentury. Elderly people affected with dementia progressively lose their autonomy as they encounterproblems in their Activities of Daily Living (ADLs). Hence, they need supervision and assistancefrom their family members or professional caregivers, which can often lead to underestimated psychologicaland financial stress for all parties. The use of Ambient Assistive Living (AAL) technologiesaims to empower people with dementia and relieve the burden of their caregivers.The aim of this paper is to present the approach we have adopted to develop and deploy a systemfor ambient assistive living in an operating nursing home, and evaluate its performance and usabilityin real conditions. Based on this approach, we emphasise on the importance of deployments in realworld settings as opposed to prototype testing in laboratories.Methods; We chose to conduct this work in close partnership with end-users (dementia patients) and specialistsin dementia care (professional caregivers). Our trial was conducted during a period of 14 monthswithin three rooms in a nursing home in Singapore, and with the participation of eight dementiapatients and two caregivers. A technical ambient assistive living solution, consisting of a set of sensorsand devices controlled by a software platform, was deployed in the collaborating nursing home. Thetrial was preceded by a pre-deployment period to organise several observation sessions with dementiapatients and focus group discussions with professional caregivers. A process of ground truth andsystem's log data gathering was also planned prior to the trial and a system performance evaluationwas realised during the deployment period with the help of caregivers. An ethical approval wasobtained prior to real life deployment of our solution.Results; Patients' observations and discussions allowed us to gather a set of requirements that a system forelders with mild-dementia should fulfil. In fact, our deployment has exposed more concrete requirementsand problems that need to be addressed, and which cannot be identified in laboratory testing.Issues that were neither forecasted during the design phase nor during the laboratory testing surfacedduring deployment, thus affecting the effectiveness of the proposed solution. Results of the systemperformance evaluation show the evolution of system precision and uptime over the deploymentphases, while data analysis demonstrates the ability to provide early detection of the degradation ofpatients' conditions. A qualitative feedback was collected from caregivers and doctors and a set oflessons learned emerged from this deployment experience.Conclusion; Lessons learned from this study were very useful for our research work and can serve as inspirationfor developers and providers of assistive living services. They confirmed the importance of realdeployment to evaluate assistive solutions especially with the involvement of professional caregivers.They also asserted the need for larger deployments. Larger deployments will allow to conduct surveyson assistive solutions social and health impact, even though they are time and manpower consumingduring their first phases.