Integration of Ambient Assisted Living Technologies in Older Adults' Care: Lessons Learned from a Longitudinal Study.

Abstract

Background: COVID-19 has added an impetus to an already growing trend around the use of Ambient Assisted Living (AAL) technologies to support frail seniors who live alone. The challenge, however, is that systematic research on the long-term usage of AAL technologies remains in its nascent stages, leaving gaps in understanding of the predictors that contribute to the routine embedding of AAL technologies in seniors' care.

Objective: This viewpoint shares key lessons from a longitudinal study on the routine embedding of AAL technologies in senior care within a hitherto understudied Southeast Asian context. Our objective was to design and deploy an ambient assisted living system termed Ubiquitous Service MAnagement and Reasoning archiTecture (Ubismart), evaluate its impact on older adults' quality of life (QoL), and distill lessons to inform the sustainable and culturally sensitive adoption of AAL technologies in similar settings.

Methods: We conducted an in-depth case study using a mixed-methods design. First, we designed and deployed Ubismart to unobtrusively monitor and visualize older adults' activities of daily living (ADLs). To assess changes in QoL, we administered a simplified, gamified version of the validated OPQoL questionnaire. Finally, we conducted semi-structured interviews with older adults and their caregivers to triangulate the quantitative findings and explore evolving perceptions of the technology and its integration into daily routines.

Results: Quantitative analysis revealed significant improvements in (1) psychological and emotional well-being and (2) leisure and social activities following the AAL intervention. Other QoL dimensions showed no statistically significant change. Qualitative findings reinforced the improvement in psychological and emotional well-being, with many participants describing a heightened sense of safety and peace of mind, often likening the technology to "insurance" or a silent companion. However, the impact on social relationships was paradoxical-some seniors felt more cared for, while others perceived a decline in in-person visits. This paradox highlights the complexities of technology's role in caregiving, as it may simultaneously enhance feelings of safety while unintentionally diminishing social connection for some seniors.

Conclusions: Quantitative analysis revealed significant improvements in (1) psychological and emotional well-being and (2) leisure and social activities following the AAL intervention. Other QoL dimensions showed no statistically significant change. Qualitative findings reinforced the improvement in psychological and emotional well-being, with many participants describing a heightened sense of safety and peace of mind, often likening the technology to "insurance" or a silent companion. However, the impact on social relationships was paradoxical-some seniors felt more cared for, while others perceived a decline in in-person visits. This paradox highlights the complexities of technology's role in caregiving, as it may simultaneously enhance feelings of safety while unintentionally diminishing social connection for some seniors.

Clinicaltrial: ClinicalTrials.gov NCT06486935.