Table Of ContentIngrid Kollak Editor
Safe at
Home with
Assistive
Technology
Safe at Home with Assistive Technology
Ingrid Kollak
Editor
Safe at Home with Assistive
Technology
123
Editor
Ingrid Kollak
AliceSalomonUniversity of Applied
ScienceBerlin
Berlin
Germany
ISBN978-3-319-42889-5 ISBN978-3-319-42890-1 (eBook)
DOI 10.1007/978-3-319-42890-1
LibraryofCongressControlNumber:2016955303
©TheAuthor(s)2017
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Acknowledgements
As initiator, coordinator, reviewer and (co)author, I cooperated with all people
workingdirectlyorsupportiveofthebook.WithallofthemItalkedinmeetingsor
viamailsandenjoyedthisprivilege.Iwanttothanktheauthorsforthediverseand
well-accomplished chapters reflecting their enormous work and experience. I am
gratefultoStevenKranzforhissupportrevisingthecitationsandbiographicaldata
and improving the graphs as well as for generating the list of literature and
uploadingalltexts.SpecialthanksgotoFionaRintoul(http://weepress.co.uk)who
did some of the translations and many reviews, helping to make this an enjoyable
book to read.
End of August 2016 Ingrid Kollak
v
Contents
1 Prerequisites: Assistive Technologies Between User Centered
Assistance and ‘Technicalization’... .... .... .... .... ..... .... 1
Ingrid Kollak
2 Living Safely and Actively in and Around the Home:
Four Applied Examples from Avatars and Ambient
Cubes to Active Walkers. ..... .... .... .... .... .... ..... .... 5
Martin Biallas, Edith Birrer, Daniel Bolliger, Andreas Rumsch,
Rolf Kistler and Alexander Klapproth
3 Using Gaze Control for Communication and Environment
Control: How to Find a Good Position and Start Working... .... 31
Maxine Saborowski, Claudia Nuß, Anna Lena Grans
and Ingrid Kollak
4 Caring TV—for Older People with Multimorbidity Living
Alone: Positive Feedback from Users in Berlin and Rural
Mecklenburg-West Pomerania. .... .... .... .... .... ..... .... 43
Stefan Schmidt and Anke S. Kampmeier
5 Arm Rehabilitation at Home for People with Stroke:
Staying Safe: Encouraging Results from the Co-designed
LifeCIT Programme .... ..... .... .... .... .... .... ..... .... 59
Ann-Marie Hughes, Claire Meagher and Jane Burridge
6 Telemonitoring in Home Care: Creating the Potential
for a Safer Life at Home. ..... .... .... .... .... .... ..... .... 81
Natalie Jankowski, Laura Schönijahn and Michael Wahl
7 Empowering the Elderly and Promoting Active Ageing
Through the Internet: The Benefit of e-inclusion Programmes .... 95
María Sánchez-Valle, Mónica Vinarás Abad
and Carmen Llorente-Barroso
vii
viii Contents
8 Use and Development of New Technologies in Public Welfare
Services: A User-Centred Approach Using Step by Step
Communication for Problem Solving.... .... .... .... ..... .... 109
JosefM.Huber,HelenSchneider,VerenaPfisterandBarbaraSteiner
9 Parents’ Experiences of Caring for a Ventilator-Dependent
Child: A Review of the Literature.. .... .... .... .... ..... .... 137
Minna Lahtinen and Katja Joronen
10 Evaluation and Outcomes of Assistive Technologies
in an Outpatient Setting: A Technical-Nursing
Science Approach .. .... ..... .... .... .... .... .... ..... .... 153
Ulrike Lindwedel-Reime, Alexander Bejan, Beatrix Kirchhofer
and Peter Koenig
11 Assistive Technology for People with Dementia:
Ethical Considerations .. ..... .... .... .... .... .... ..... .... 173
Hesook Suzie Kim
CVs of Authors.... .... .... ..... .... .... .... .... .... ..... .... 193
Literature .... .... .... .... ..... .... .... .... .... .... ..... .... 217
Chapter 1
Prerequisites: Assistive Technologies
Between User Centered Assistance
‘ ’
and Technicalization
Ingrid Kollak
Interestinhealthhasgrownenormouslyinrecentyears.Thisdevelopmentisdueto
achangeinperspective.Forwhiletheemphasisinthepreviouscenturywasabove
all on medical protection in the case of an illness or accident, today it is on
maintaininghealthintooldage.Thecausesofthischangedunderstandingofhealth
lie in demographic and epidemiological changes; people are living longer and
becoming ill in a different way, which is to say that what were acute illnesses are
today chronic conditions.
Promotion of health, which today takes centre, covers the public as well as the
personal health care sectors. Trading under the label of promoting health are
offerings that range from publicly financed prevention, rehabilitation and care
measures, through corporate health management schemes to privately financed
beauty, fitness and wellness treatments.
Terms such as empowerment, customer focus and participation highlight this
alteredunderstandingofhealthandhealthcare.Theyaresupposedtospelltheend
oftheold,patriarchalwayofdirectingandallocatingmedicalandcareprovision,in
which patients endured their prescribed treatment patiently and uncritically.
Nonetheless, this normative description of active, responsible, self-directed par-
ticipants in a health market makes it clear that contemplation is not rated very
highly, there is no obligation to treat customers equally, an assumption has been
made that this newlywon powerwill be successfullyusedand noone will decline
to participate (Bröckling et al. 2004).
This altered understanding of health has created a continuously growing
healthcare market. In 2011, 12 % of all gainfully employed people worked in the
health care sector—12 times as many as in the chemicals industry. The outpatient
I.Kollak(&)
AliceSalomonUniversityofAppliedSciencesBerlin(D),Berlin,Germany
e-mail:[email protected]
©TheAuthor(s)2017 1
I.Kollak(ed.),SafeatHomewithAssistiveTechnology,
DOI10.1007/978-3-319-42890-1_1
2 I.Kollak
sector, where nearly 44 % of healthcare staff work, predominates (Federal
StatisticalOfficeWiesbaden2016).Healthexpenditureeasilydoubledintheperiod
1992–2014. According to The Information System of the Federal Health
Monitoring (2016), a total of Euro 159 billion was spent on health in Germany in
1992 and a total of Euro 328 billion in 2014. That equated to 9.4 % of gross
domesticproduct(GDP)in1992and11.2 %in2014.ExpenditureperheadofEuro
1,972 in 1992 had risen to Euro 4,050 by 2014.
A characteristic of an expanding, profit-oriented healthcare market is that it
viewseverydayandage-relatedproblemsandmentalhealthproblemsasobjectsof
medical diagnosis and therapy in order to treat everyone and everything with
medicine, operations and cures.
These two tendencies to economise and medicalise the health care markets also
influencethedevelopmentofassistivetechnologyproducts.However,thepotential
for economic gain is widely divergent. As part of the Lower Saxony Research
Network Design of Environments for Ageing (GAL), Erdmann and Schweigert
(2012) asked about 2,000 people in Lower Saxony about their willingness to pay
forAALproducts.TheirresearchresultsalowwillingnesstopayoflessthanEuro
20 a month. Fachinger et al. (2012) took a different perspective on the market for
AAL products under the auspices of the same research network (GAL). They
calculated a sales potential for AAL products correlated to the age of the main
funderofahouseholdthathadadefinedpriceandcomfortlevelaswellasoffering
productsfromtechnicalassistancesystems.Theseassistancesystemscamefromthe
areas of: housekeeping and provisions, security and privacy, communication and
socialcircle,aswellashealthandcare.TheyassumeaplausiblespectrumofEuro
10.1 billion if the main funder is 75 years old or older to 87.2 billion if the main
funder is 50 or older. While Erdmann and Schweigert (2012) established a statis-
ticallysignificantconnectionbetween ahousehold’snetincomeandwillingnessto
pay, Fachinger et al. (2012) assumed a connection between technical affinity and
age (experience with technology throughout the whole of life and access to tech-
nology with increasing age).
Inviewoftheeconomisationandmedicalisationsituation,thequestionarisesas
to which direction further development in the assistive technology industry will
now take.
AlongsidethefloodofallkindsoftechnicalaidscataloguedontheInternetand
offered in newspaper supplements, there is a category of assistive technology
products, which, because of high development costs and a sometimes limited user
group,islookingatthisdevelopmentprocessverycarefully.Fornoteveryproduct
is for the mass market in the way that mobile phones or the Internet are.
In this sector, it can be seen that development is oriented ever more strongly
towardstheuser.Usabilityengineering(Nielsen1994)markedthestartofplanning,
developmentandmanufacturingoftechnicalproductsgearedtowardsanimaginary
user—which actual users first clapped eyes on when they were on the market. In
thisway,the‘ux’oruserexperience(Kuniavsky2003)wasn’ttakenaccountoflate
and couldn’t influence the product until it was redesigned. Greater orientation
towardsactualusersensuedinabidtoshortenthecostlyandtime-consumingpath
1 Prerequisites:AssistiveTechnologies… 3
toanacceptedproduct:user-orienteddesign(Laietal.2006).Usersweresupposed
to test prototype versions in practical situations before a product was finalised.
A more systematic user orientation happens when users are involved in the whole
planning, development and design process: user-centred design (Garrett 2010). In
this approach, a product is tracked from engineering, design and application in
practicethroughtomaintenancetogetherwithusers.Thiswayofworking requires
two things: collaboration between users and their social circle interdisciplinary
teamwork. It is known from existing research and development work that many
assistivesystems need tobeacceptednotjust bytheirusers butalso bythepeople
aroundthem.Forinformalorprofessionalhelpisoftenneededtouseandmaintain
the systems. A good example is gaze control. Equally, it has been shown that
multidisciplinary teams are needed to plan and complete an assistive technology
product.
Thisbooksupportsascomprehensiveaspossibleaninvolvementbyusersinall
phasesofproductdevelopment.Itgathers together chapters fromteamsthatreflect
all steps from needs assessment to planning, through development and design, as
well as daily use and maintenance, to evaluation. These teams bring together
variousperspectivesfromthefieldsofarchitecture,design,(electrical)engineering,
ergonomics, gerontology, health science, informatics, management, nursing,
physiotherapy, rehabilitation and social science.
Our book is aimed at people who use assistive technology products and their
socialcircle. It isalso writtenfor healthprofessionals who introduceand prescribe
assistivetechnology.Thebookalsoaddressesdesignersandengineerswhodevelop
assistive technology and the distributors who sell these products. We want to give
them all an understanding of the range of successful applications, as well as con-
veying a structured procedure whereby clients and products can be successfully
matched.
The book brings together many strands of research and details how elderly,
handicapped and people with short-term illnesses can manage their daily life at
homewiththehelpofassistivetechnology.Itaddressescommonproblems,options
and limitations, as well as common requirements of the above-mentioned group—
including their informal and professional carers. The chapters focus on safety at
home through technological solutions, information and telemedicine as well as
communication and entertainment. The authors discuss solutions from an ethical,
technical and social perspective.
Readers from various disciplines with questions about the different phases of
product development can find useful information in this book. The chapters range
from presentations of successful and outstanding products through evaluation of
different product groups to scientific reflection. All the chapters are focused on
users and provide practical tips. They use photographs to illustrate how users and
technology can work successfully together to ensure safety. The texts present
graphs and tables from recent studies that provide facts and evidence about prob-
lems, requirements and solutions. The book’s reference section provides the
authors’ CVs, lists all references used in the chapters and a comprehensive list of
literature and websites for further reading.
