PRE2023 3 Group2

Reserved for Satya, Petar, Alonso, Sander, Gabriel

Group Members

Name	Student ID	Department
Satya Dharmawan	1545892	Electrical Engineering
Petar Rustić	1747924	Applied Physics
Alonso Geeksink Antón	1710508	Computer Science and Engineering
Sander Erbrink	1862146	Industrial Engineering
Gabriël van Dijk	1862081	Industrial Engineering

Problem Statement

The increasing quality of life on a global scale, coupled with the economic conditions in first-world countries where the cost of living per capita is steadily rising, has contributed to a demographic shift characterized by an aging population. Consequently, nations are faced with the imperative of allocating increased resources to elder care, exacerbating an existing shortage of caretakers. Conditions such as loneliness and prevalent health issues, including dementia, accentuate the vulnerability of the aging population, fostering a decline in both mental and physical well-being especially if there is no one to accompany and assist them.

Planning

Week	Task	Name
1	Planning and setting up	Everyone
2	Literature research	Everyone
3	Functional requirements
	First conceptual design
4	Second conceptual design
5	Building prototype
6	Building prototype
7	Testing prototype
	Evaluate results
8	Finish the wiki

Deliverables

• A fully working prototype of the product designed to assist dementia patients in a variety of ways
• A completed Wiki page functioning as a report on the development of the aforementioned product
• A final presentation showcasing the prototype and any relevant parts of it construction and the report

USE

User:

• The main user of this technology will be the elderly that does not have a caretaker assigned to them nor other people to give them assistance. However, this does not limit to just the elderly, but whoever has a medical condition that does not allow them to adhere to the prescribed medication doses along with no one being able to take care of them doing their day to day tasks.

Society:

• Caretakers:
  • This would potentially reduce the burnout rate from caretakers as they have been reported to be burnt out due to low pay in addition to long hours due to the caretaker shortage.
• Government:
  • The main benefit for them would be that they could allocate less resources or subsidies to train/hire more caretakers and potentially increase more spending on healthcare providers as the elderly, especially those with dementia has a lower medication adherence. Thus the likelihood of coming back and using healthcare services would be higher.
• Healthcare services:
  • As mentioned previously, due to potentially having lower intake from the elderly, the burden on the healthcare services would be lower.

Enterprise:

• Given the current socioeconomic state globally, the trend of aging population will continue to increase unless large changes to the economic and social policies are made. Thus, this can be seen as a growing market.
• There will be a lot of business opportunities with AI chatbot companies as they will be the ones advancing the algorithm for the interaction between the robot and the user.

State Of The Art

Caregiver and Clinician Shortages in an Aging Nation

The nursing home industry experiences a higher turnover rate, attributed to comparatively lower wages and benefits, especially when compared to positions in hospitals. This is exacerbated by staffing shortages, leading to increased workloads and often necessitating staff members to take on multiple shifts in a day. Simultaneously, societal values are shifting towards individualism, contributing to the fragmentation of families due to factors like divorce or geographic distance. This trend results in a decline in the availability of "informal care providers," typically family members. The rise in nonmaternal caregivers, such as nannies or day-cares, not only weakens emotional bonds between parents and children but also contributes to a reduction in the pool of accessible informal care providers, further increasing the demand for nursing homes.

Medication Adherence in Older Patients With Dementia: A Systematic Literature Review

This article conducts a thorough analysis of medication adherence among elderly individuals with dementia, encompassing adherence levels, influential factors, and strategies for intervention. The review consistently establishes a link between dementia/cognitive impairment and medication nonadherence in diverse studies. It emphasises factors like patient characteristics, disease conditions, and medication types as contributors to nonadherence. It highlights the necessity for customized interventions to enhance medication adherence in older individuals with dementia, emphasising the crucial role of caregiver support in this context.

The impact of resistance exercise on the cognitive function of the elderly

This research looks into how resistance exercise affects the health of older people, focusing on their physical and mental well-being. The results show that doing resistance exercise, whether at a moderate or high intensity, helps improve muscle strength, lean mass, mood, quality of life, and cognitive function in older individuals. Interestingly, moderate-intensity exercise seems better for boosting mood and certain cognitive aspects. Overall, this study emphasizes the positive impact of resistance exercise on the overall health of older adults, underscoring the importance of personalized exercise plans for this group

The Efficacy of Exercise as a Long-term Antidepressant in Elderly Subjects: A Randomized, Controlled Trial

This study discovered that exercise remains helpful for reducing depression even when people switch from supervised workouts to doing weight lifting on their own at home or in a gym. Even more than two years later, those who exercised were still less depressed than those who didn't. The research also found that people's confidence and mood got better with exercise, even when they did it without supervision for up to 20 weeks. After 26 months, about a third of those who initially exercised were still keeping up with their exercise routine. The study shows that exercise is quite effective, resolving depression in 73% of those who exercised, compared to 36% who didn't. It suggests that doing weight lifting on your own can be a good, long-term way to reduce depression in older adults.

Ability of older people with dementia or cognitive impairment to manage medicine regimens: a narrative review

This review highlights the substantial impact of cognitive impairment and dementia on the medication management skills of older individuals, emphasising the critical importance of evaluating their ability for self-administration through thorough assessments conducted by competent health professionals. Neglecting to address medication management skills in those with cognitive impairment could lead to heightened economic and healthcare burdens. Recognizing this potential consequence, the review urges immediate research into strategies for improving medicine-taking among individuals with cognitive impairment, emphasising the existing limitation in studies focused on this particular area.

The examination of the factors affecting the feeling of loneliness of the elderly

This study investigated the impact of a 12-week intervention program involving interactions with a seal robot on the well-being, mood, and loneliness of elderly residents in a nursing home. The findings indicated a notable reduction in loneliness scores among participants who engaged with the seal robot twice a week, in contrast to a control group. This observation is noteworthy, given that prior research on companion robots, such as Paro and AIBO, primarily emphasized mood enhancement without specifically addressing loneliness. The study suggests that companion robots, serving as substitutes for live animals, can effectively contribute to alleviating loneliness within nursing home environments.

Frontiers | Reducing Loneliness Among Aging Adults: The Roles of Personal Voice Assistants and Anthropomorphic Interactions

The research brings attention to a unique discovery indicating a direct link between anthropomorphism and a reduction in loneliness. Participants experienced a decline in perceived loneliness following the use of Personal Voice Assistants (PVAs), consistent with earlier studies that propose the effectiveness of technology interventions, such as communication tools and virtual pet companions, in addressing loneliness among older adults. The results underscore the significance of anthropomorphism in alleviating loneliness, particularly evident in relational greetings. Notably, baseline loneliness served as a predictor for such interactions, revealing that individuals experiencing higher levels of loneliness were more inclined to engage with the PVA, initiating personal greetings with polite language and adherence to interaction rituals. This behavior suggests a strong desire for connection, highlighting the role of anthropomorphism in fostering meaningful interactions with the device.

The examination of the factors affecting the feeling of loneliness of the elderly

In this study on loneliness among the elderly, age played a significant role, revealing a consistent increase in loneliness among older individuals. Additionally, higher education levels were linked to higher levels of loneliness, likely influenced by socio-economic and cultural factors. Health-related aspects, including self-perceived health and physical functioning, were associated with loneliness, highlighting the complex relationship between health and social isolation. Maintaining strong social networks and regular family contacts were identified as crucial factors in reducing loneliness.

Designing Robots for Elderly from the Perspective of Potential End-Users: A Sociological Approach

This research looks to adress some issues for end-users regarding age-friendly robots. The main issues here were: How robots are envisioned by the elderly, how knowledgeable the elderly are on the robotics development, and how the elderly are involved in robot design. The research uses qualitative methods, notably interviews. Some interesting results were that most elderly rated themselves as capable enough regarding current technologies, or digital competence as the research calls it. However, during interviews most released that they in fact were no able to keep up with the new developments, often also unwilling to try. This study gives a good insight in how the elderly treat and see technology. Therefor it is quite important and interesting for our own research and creation of a product that is aimed at the elderly.

Robots for Elderly Care: Review, Multi-Criteria Optimization Model and Qualitative Case Study

For the first part this paper reviews the current knowledge about robots for the elderly, focusing on service and social robots. The review aims to highlight how robots interact with the elderly in healthcare and social situations. Also events like covid are considered. For the second part it focusses on a conceptual model. As goal it has to maximize efficiency and robot utilization and minimizing the stress for human caregivers. This is a optimisation conceptual model. It first builds on the ever expanding fields and level of robotic presence in society. It then tries to formulate a formula based on gathered data. Finally the study takes a look at the findings of other research papers regarding which needs, requirements and technological adaptations there are in the elderly care. They also used focus groups as part of their data set. Some of the more important findings were that using robots could help loneliness for example. Also that different people had different sets of expectations for robots, even for the robots appearance.

Socially Assistive Robots in Elderly Care: A Systematic Review into Effects and Effectiveness

This research focusses on robot intervention in social assistance for the elderly and its effectiveness. It takes data from previous researches. They took a lot of information from a previous meta study. To improve upon this they conducted thorough quality control on the used sources. They found that from all 2891 found publications, only 17 studies were really relevant to socially assistive robot care for the elderly. These used 5 different robots from which one was undefined. For the results from these different robots, they generally all seem to have various positive influences on the elderly they cared for. The researchers however did not that more intensive studies must be done on a larger scale to give properly confirm these findings.

Robots in Elderly Care

This study looks at robots in the elderly care. They state that longer life expectancy and lower birthrates result in a relatively larger elderly group. This larger group needs more care from less people, which is why robots in elderly care become more important, even more-so considering rising health care costs. First they divide the needs into some categories, such as daily activities, physical, cognitive, psychological and social needs. They then outline different robots for each job, and the rules they must adhere to (Isaac Asimov's Three Laws of Robotics). The researches look at previous studies on these robots and their impact. In their findings the negative effects are prominently discussed, as opposed to many other researches. Noteworthy worries were the huge data collection that could happen trough robots, and how reducing real human contact influences the elderly, for example by thinning the line between the reality and the appearance of robots. They do conclude that further development on care robots for the elderly must be pursued and that it could prove a very useful tool.

Assistive social robots in elderly care: a review.

This paper aims to check how effective assistive social robots are in the care for the elderly. To gather this information, a systematic review of previous literature was done. The robots are divided into two types: assistive robots that do supporting tasks for their patients, and social service robots which try to act more as a companion. They studied the same robots as other provided literatures, partly because there is a small selection to choose from. Studies were once again filtered and resulted in 43 relevant studies. The results are generally positive in all aspects, from mental to physical wellbeing. The researches did note some patterns that limited the significance of the results. For example: most research was done on two robots, Paro and Aibo, thus limiting how varied the use and capabilities of robots was. Also, most research was done in Japan. Furthermore the elderly lived in nursing homes and not on their own, and finally the methodology was lacking, as they had no control over the other studies and how they were performed/measured.

The use of care robots in aged care: A systematic review of argument-based ethics literature

This study explores the effects of resistance exercise on the physical and mental well-being of older individuals. The research findings suggest that engaging in resistance exercise, whether at moderate or high intensity, leads to improvements in muscle strength, lean mass, mood, quality of life, and cognitive function among older adults. Notably, moderate-intensity exercise appears particularly beneficial for enhancing mood and certain cognitive aspects. The study underscores the importance of personalized exercise plans tailored to the needs of older adults to promote their overall health and cognitive function.

Ethical challenges in the use of social service robots for elderly people

The use of socially assistive robots (SARs) for supporting elderly individuals in care and domestic settings raises significant ethical concerns. Key issues include privacy and data protection, safety and responsibility, involvement of vulnerable individuals, and deception. To address these challenges, ethical principles such as nonmaleficience, beneficence, autonomy, and fairness need to be applied to robotics. While clear answers may not yet be available for every ethical dilemma, the development of ethical guidelines for SAR deployment and research is crucial. This article suggests practical measures from a robotics project to navigate these ethical considerations effectively

Granny and the robots: ethical issues in robot care for the elderly

As the elderly population grows and robotics advances, the use of robots in elder care becomes increasingly feasible. They explore various applications of robots in assisting the elderly and their caregivers, monitoring health and safety, and providing companionship. While recognizing potential benefits, they address six primary ethical concerns, including reduced human contact, feelings of objectification, loss of privacy and personal liberty, deception, infantilization, and control over robots. By weighing care benefits against ethical considerations, they conclude that introducing robots with careful planning and guidelines could enhance the lives of the elderly, fostering independence and facilitating social interaction.

Service robots, care ethics, and design

The rapid growth of service robots in various sectors demands ethical attention in their design and implementation. This paper introduces the Care Centered Value Sensitive Design (CCVSD) approach, originally designed for healthcare robots, as a framework for evaluating personal and professional service robots. By integrating care ethics principles, CCVSD aims to systematically incorporate ethical considerations into robot design. The paper discusses the necessity for ethical evaluation of service robots, presents the CCVSD approach, and explores its applicability beyond healthcare. Through examples of current robot prototypes, the paper illustrates how CCVSD can be used to assess service robots based on their integration into care practices. Ultimately, the paper advocates for proactive ethical evaluation in robot design to address the ethical challenges arising from their increasing presence in daily life.

Emotional Attachment to AI Companions and European Law

This paper discusses ethical issues surrounding the use of AI companions for the elderly, and how EU law currently deals with these. It primarily discusses the potential risks of emotional dependence, giving harmful advice/saying harmful things, harming the users relationships, and amplifying problematic social dynamics. The paper contends that EU law currently deals with these risks in 2 major ways: first in a preventative way by establishing a framework of risk from which AI systems are regulated accordingly and secondly through broad liability laws that mean that the maker of one of these companions does not have to be at fault to be considered liable, and that contracts do not invalidate liability. The potential issue of privacy is then discussed and how the EU currently aims to tackle this through the GDPR, although it is considered by the author to have significant limitations due to a lack of informed consent.

AI Companion Robot Data Sharing: Preferences of an Online Cohort and Policy Implications

This article highlights how current policy surrounding AI companions and privacy seldom takes into account the elderly, which is one of the most vulnerable groups, and discusses how future policy could address this. The researchers use surveys to show that old people are less comfortable with the use and storage of their data by these AI companions and that most want more transparency by companies on how their data is being used, as well as heavier enforcement of privacy laws by the government. It is further contended that the elderly are particularly vulnerable due to their lower familiarity with modern technology and higher prevalence of cognitive issues making it easier to obtain consent that was not properly informed.

‘He knows when you are sleeping’ – Privacy and the personal robot companion

This paper examines privacy concerns surrounding personal robot companions by conducting an exploratory study with 12 participants. It aims to understand user attitudes towards data collection and privacy safeguards in personal robot companions. Participants were exposed to scenarios involving interactions with a robot companion, simulating conversations about personal habits. Findings indicate a trade-off between the perceived utility of data collection and concerns about information disclosure. Participants expressed discomfort with the idea of robots storing personal information, citing risks of unintentional disclosure and emphasizing the need for security measures. Cultural backgrounds influenced attitudes towards privacy, with differences noted in perceptions of data ownership and sharing. Overall, the study highlights the importance of addressing privacy concerns in the development of personal robot companions to ensure user acceptance and adoption.