Smart Home Technologies and Services for Geriatric Rehabilitation

Smart Home Technologies and Services for Geriatric Rehabilitation 150 150 IEEE Pulse

Edited by Mohamed-Amine Choukou and Shabbir Syed-Abdul, Academic Press, October 2021, ISBN: 9780323851732, xv +237 pages, $180

Having been the sole, then later primary caregiver for a relative, this reviewer chose to examine this text for potential lessons relating to home care technologies and their applications now and in the near future.

This text consists of nine chapters (really eight), and is the product of 25 contributors, nine reviewers, and two editors. From the web advertisement, this text “provides a toolbox for health care stakeholders involved in decision-making for the design, development, and implementation of smart home solutions.” The readership is seen as: “Rehabilitation students and engineers. Those with research interest on smart homes for geriatric rehabilitation including: biomedical engineers, electrical engineers, computer scientists, software developers.” A brief review of the chapters follows.

Chapter 1, titled “Geriatric smart home technology implementation—Are we really there?,” gives an overview of the growth in the population of geriatric patients, and reviews several of the potential applications of smart home systems, such as environmental control systems, patient monitoring systems, telehealth applications, robotic therapy systems, smart toilets, and potentially smart mirrors (to monitor emotion, stance, and so on). Chapter 2, titled “Smart home technology for geriatric rehabilitation and the Internet of Things,” defines rehabilitation, the Internet of Things (IoT), and IoT systems. Of interest is a three-page table of applications for health monitoring, rehabilitation, fall monitoring and prevention, and gait monitoring. Also of interest is the statement that the literature on the effectiveness of IoT in rehabilitation is scarce.

Chapter 3, titled “Aging population supported by ambient-assisted living in the Kingdom of Saudi Arabia,” reviews, for Saudi Arabia, the forecast growth in their elderly population, and the list of problems that normally come with this process. Most of the chapter then reviews a proposed national website to assist in monitoring and assisting at-home pensioners. It references that a study indicated the cost of retrofitting a home for rehabilitation “was less than US $400, while another stated that the maximum cost of retrofitting a home was $13,500.” No equipment list was offered for either option. Chapter 4, titled “Long-term nursing care at home: Challenges and technology-driven solution approaches: The case of German health care system,” informs us (page 80) “Most people aged 75+ years need round-the-clock nursing care” (not shown in reference) but does do a good review (listing) of items such as caregiver burnout and burdens, needs to be addressed by applied IoT, and quality of life (QoL) indicators. A four-page table lists references relating to health issues of (young) caregivers, and nine pages of the text are devoted to (proposed) “A Smart home automation technology-supported home care” (sic), which outlines the author’s concepts of a system that could assist in home health care. The system as proposed falls short of meeting needs of some patients, such as the need to bathe, dress, move, toilet, clean, entertain, and feed the patient, as has been experienced by this reviewer.

Chapter 5 is a very generic chapter and is titled “Telehealth for the geriatric population: Uses, opportunities, and challenges.” It reviews uses of telehealth, such as for patient screening and diagnosis, consultation, monitoring, rehabilitation and treatment, education, socialization, and motivation, with presumed benefits to the patient, caregivers, and providers. Technical, legal, and human factors elements are touched upon, but again no equipment list or specific recommendations are forthcoming. Chapter 6, titled “Smart home applications for cognitive health of older adults,” largely lists ten generic recommendations for the development of “smart home applications,” one of which is “Recommendation 6.7: User’s conditions, needs, and preferences could be monitored, and the application must be automatically adapted when changes are detected.” A few reports of smart home applications are very briefly touched upon, but none to the extent that a reader could initiate an application.

Chapter 7, titled “From exergames to immersive virtual reality systems: Serious games for supporting older adults,” surveys the literature regarding software that might be of value in the care of older adults. The concepts are covered in generic form. Specific instances in the literature are noted in a 35-page appendix, one that is inserted about midway in the chapter. This appendix is then summarized in a two-page table following it. The domains listed are: useability, virtual reality, game, physical activity/fitness, and cognitive. The reader is advised early that the games exhibit potential, but there are no effective demonstrations of use.

Chapter 8, titled “Big data, big data analytics application to smart home technologies and services for geriatric rehabilitation,” begins, for the fourth time, with the statement that the aged population is increasing in number and need. The reader is given a useful (but incomplete) diagram of “Examples of smart home and AAL devices” (AAL = ambient assisted living), followed by a definition of “big data.” Diagrams and discussions ensue regarding home and neighborhood device layouts and data analysis and reporting. Mention is made of software from Google, Amazon, etc., that may be of use in data analysis and reporting. Chapter 9, “Conclusion and perspectives,” by the editors, consists of 2.5 pages summarizing the prior text (like a forward) and a one-paragraph conclusion that this field will be more technology-enabled (more telemonitoring and telepresence and interactive) in the future.

A few other data points to consider by this reviewer: The body of this text consists of roughly 185 pages (counting all tables and the inserted 35-page appendix 1), and there are an additional 41 pages of references. With less than 130 pages of written text, this book is quite expensive and is primarily a review of the literature, rather than a “toolbox.” Furthermore, in these references, one would expect more than one reference to RESNA, the Rehabilitation Engineering and Assistive Technology Society of North America! One would also expect more than zero attributions to the two editors. It is also the experience of this reviewer that some mention of patient therapy would involve music therapy, but the word “music” does not appear in the text.

Not recommended.

Reviewed by Paul H. King Vanderbilt University