This paper reports on the user requirements analysis, design and evaluation of smart home solutions for people with dementia. In order to be appropriate for people with dementia, smart home technologies should keep interaction with users to a minimum. In the work presented in this paper, discussions with carers, as well as a more formal user-survey, provided a good understanding of the issues that are faced by this group, and useful indications of potential design solutions. This preliminary survey work led to a design approach that used carer emulation, familiarity of appearance, incorporation of verbal prompts and reminders, and careful user-monitoring, to achieve effective devices. This design approach is illustrated through several examples of specific designs. Evaluations of stand-alone systems were carried out prior to smart home installation, and illustrated the complex interface that exists between assistive technology and people with dementia.

Innovative technologies are rapidly emerging that offer caregivers the support and means to assist older adults with cognitive impairment to continue living "at home." Technology research and development efforts applied to older adults with dementia invoke special grant review and institutional review board concerns, to ensure not only safe but also ethically appropriate interventions. Evidence is emerging, however, that tensions are growing between innovators and reviewers. Reviewers with antitechnology biases are in a position to stifle needed innovation. Technology developers who fail to understand the clinical and caregiving aspects of dementia may design applications that are not in alignment with users' capabilities. To bridge this divide, we offer an analysis of the ethical issues surrounding home monitoring, a model framework, and ethical guidelines for technology research and development for persons with Alzheimer's disease and their caregivers.