Learning Outcomes
By the end of this session you should be able to:

• Distinguish the different assisted living equipment and tools, and their basic categorization
• Explain the role of AAL in care of older people
• Report the different domains in which Aal can improve communication in care of older people

Introduction

AAL is a subarea of ambient intelligence and can be defined as “an emerging multidisciplinary field aimed at providing an ecosystem of different types of sensors, computers, mobile devices, wireless networks, and software applications for personal health care monitoring and telehealth systems”. AAL was first coined in 2006 by the International Medical Informatics Association in recognition of this emerging technology with the creation of a working group on smart homes and AAL. 

Ambient assisted living (AAL) is an IoT-based service that along with various ICT infrastructure, supports care of elderly or incapacitated patients. These solutions aim primarily to extend the independent life of the individuals in their homes by providing more safety. Connecting users to smart objects, such as blood pressure sensors and motion sensors, it is a common use of this service. AAL not only provides a safer environment but also increases autonomy and stimulates the user to have a more active (both physically and socially) life. 

AAL and smart home environments, often focus on the importance of technology as a way of improving quality of life and/or supporting individuals with cognitive impairments, with the real-time delivery of digital services. ICTs have the potential to improve health care while at the same time alleviating loneliness and social isolation among the elderly. Such health and social impacts are significant. They help to improve, expand, and sustain the older adults’ social contacts, while at the same time improving the emotional well-being of the individuals. Social and emotional contact are critical to psychological and physical health

CATEGORIES OF AMBIENT ASSISTANCE LIVING SERVICES 

The first category is divided into “indoor” and “outdoor” living assistance. Indoor assistance services are the ones presented in a determined space: in apartments, homes, cars, hospitals, and elderly care homes. They can be built upon a well-known hardware/software installation in the specified location, thereby providing a stable environment. 

Outdoor assistance services aim to support persons during activities outside their homes. It is also divided into two classes:  

1. A) firstly at work: to allow an active and productive aging for elderly people and suitable environment for those with physical disabilities in a defined workplace and a stable environment; 
2. B) in community: while shopping, transportation, and during other social activities. These services have to face with highly unstable environmental conditions such as special equipment and technical installations.

There exist three other dimensions that can be used to specify the type of service provided.

1) “Emergency treatment” presents services that aim to predict and react toward critical conditions that might result in an emergency. 

2) “Autonomy enhancement” services increase the independence of the assisted persons.  

3) “Comfort”: These services ease the daily life but are not necessarily required. In addition, they cover all areas that do not fall into the other presented categories.. 

Previous research in the field of perception and acceptance of AAL technologies and systems revealed mainly positive evaluations by diverse user groups with regard to age, aging, and experience with disabilities. At the center of those studies, perceived benefits in terms of a more independent, autonomous, and longer life at the own home environment contrast with perceived barriers, for example, feelings of surveillance, a perceived invasion of privacy, as well as feelings of isolation. In particular, numerous qualitative studies explored perceptions of AAL technologies in people older than 60 years. As key results, the older participants valued the opportunity given by AAL of staying longer at their own home, they understood the crisis in care (lack of caregivers and increasing proportions of people in need of care), as well as the potential of AAL technologies to relieve people in need of care, their caregivers, and the care sector itself. However, they also expressed concerns as they feared a dependency on not easy to control technologies, an invasion of privacy by storage or transfer of personal data, and a substitution of human caregivers by technology. The last is a concern that is inherent to the adoption of any kind of technology based assistive living systems, as despite the fact that AAL and Internet of things systems can facilitate communication of all kinds (either as personalized contact, for information or for health purposes), may also decrease the real face to face interaction and contact. 

In a society where the demographic ageing is constantly increasing, technology can help to improve the quality of life of the older people and extend their independent living. In recent years, AAL and ICT systems have been developed to create better living conditions for older and disabled people, and to support caregivers and medical staff with:  

1. Spotting behavioral problems and providing safe and updated alerting information that can be useful for prevention or timely intervention of risky situations 

1. Promoting older people’s autonomy and ability to share responsibility regarding the health care management 

1. Facilitating communication from a distance either in terms of social contact and social inclusion, or in terms of health and social well being