“Smart Homes” for Patients at the End of Life

Abstract

well-documented health related challenges that often come with aging, such as falls, limited mobility, sensory impairment, and isolation. Technological solutions are featured that promote well-being and enable monitoring of one's health status in his or her home; therefore, technology is often perceived as one such tool that can support aging. The number of "smart home" applications has been increasing worldwide in response to rising health care costs, older adults' desire to remain independent and advancing sensor, mobile, and computing technology. The term "smart home" refers to a residence equipped with technology that facilitates monitoring of residents or promotes independence and increases residents' quality of life (Demiris & Hensel, 2008). In this context, the technology is integrated into the infrastructure of the residence and does not require training of or operation by the resident, distinguishing thereby smart home applications from stand alone devices that can be used in the home setting and need to be operated by the end-user (e.g., blood pressure cuffs or web-based applications). This emerging field has also introduced new terms to describe the possibilities of this new era of home based technology. The term "gerontechnology" was coined to describe an interdisciplinary field of scientific research of technological applications (including smart homes) that are directed "towards the aspirations and opportunities for the elderly person" (Bouma, 1998, p. 95). The term "domotics" (combining the words domus, Latin for home, and informatics) describes the study of information technology applications that become part of the residential structure.Smart home applications are designed to support elderly and people with chronic conditions or disabilities and increase their well being and safety in their home. This approach aims to provide a support mechanism as people age and approach the end of their life. Information about residents' activity levels, restlessness at night, or adverse trends, such as dehydration, lack of personal hygiene, or challenges in pain management, can trigger specific interventions that will increase palliation at the end of life.The aim of this article is to explore ethical considerations associated with smart home applications for patients at the end of life and present a framework for the ethical components that need to be investigated in the context of home based assistive technology for the dying. Moran (1993) was one of the first to pose crucial questions about the social impact of smart technologies. She stated the following:The introduction of advanced technology into the home has the potential to change qualitative and quantitative aspects of relationships between household members, as well as the role and function of the home and its relationship with the wider environment. Such technologies consequently have important implications for our health and quality of life. (p. 1) 108 G. Demiris and B. Hensel We define and discuss a series of concepts that constitute ethical ...

Ethics of the health-related internet of things: a narrative review

“…Personal privacy can refer to the right to be left alone or not monitored by a third party (cf. Demiris and Hensel 2009;Dorsten et al 2009;Mittelstadt et al 2011;Pallapa et al 2007;Wilkowska et al 2010). It concerns feelings of intimacy and control over 'private space' (Gaul and Ziefle 2009;Ziefle et al 2011).…”

“…The perceived obtrusiveness and visibility of H-IoT devices affects user acceptance and long-term use (Demiris 2009;Demiris and Hensel 2009;De Bleser et al 2011;Townsend et al 2011). Obtrusiveness has been defined as "a summary evaluation by a person based on characteristics or effects associated with the technology that are perceived as undesirable and physically and/or psychologically prominent" (Hensel et al 2006, p. 430).…”

A Review of Smart House Analysis Methods for Assisting Older People Living Alone

“…Demiris and Hensel [193] stated that "Informed consent is an individual's autonomous authorization of a clinical intervention or research participation" . The user needs to fully understand and be able to give informed consent to install a Smart House system at his/her own home.…”

“…Thus, it is important to clearly identify and seek consent from all the stakeholders. The stakeholders can be direct or indirect, and range from informal caregivers, relatives, or others [193].…”

Visibility of Wearable Sensors as Measured Using Eye Tracking Glasses

“…An important part of dementia care research, then, is to reduce the sources and impact of this stigma. However, assistive technologies may themselves constitute a source of stigma if they are considered obtrusive or even visible by the person with dementia or their caregiver [6,7]. This obtrusiveness is particularly relevant when exploring the potential of wearable sensors to enhance independent living for people with dementia.…”