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ICT towards elderly independent living

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Andrej Grguric Ericsson Nikola Tesla d.d.

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Due to the current demographic trends and ageing, more and Information and Communications Technology (ICT) has more people are living alone and need proper support in their shown the biggest potential in coping with mentioned daily activities. Important role in overcoming problems of people problems. Information systems offer a vast number of living independently have Ambient Assisted Living (AAL) possibilities in reducing the overall healthcare cost but at the technologies. AAL is related to the use of ICT to increase the same time offer many advantages and benefits that have never quality of life of elderly people and to prolong their before been possible. ICT can help not only professionals independence. A number of research efforts deal with specific dealing with medical systems but also to elderly individuals to challenges of the field. In this paper emergence of AAL as a improve their quality of life and to offer them support in research field is described. Some research challenges are stated everyday living. In order to adequately cope with the specific with special focus on user interaction, adaptation and problems of the elderly people a special requirements have to customization aspects. be met and special technologies used. There is a whole

Keywords -- Ambient Assisted Living (AAL), technology approach tackling with the issues of how the ICT (AmI), user interaction can best support the elderly and enable them to live independently longer and to have better quality of life and it is I. INTRODUCTION called Ambient Assisted Living (AAL). Projections of future demographic trends show that ratio of The following section gives an overview of AAL. Section working-age people per person aged over 65 is reducing and III describes its challenges and research directions while that by 2045 in Europe there will be only two people of section IV focuses on user interaction aspects. Section V working age per person aged over 65. Figure 1 shows concludes and gives insight on future work. population by age class for EU27 where we can see a II. EMERGENCE OF AAL significant increase of older people in recent years. A. Enabling technologies first mentioned “” around 1988 while working as Chief Technologist of the Xerox Palo Alto Research Center. He said that “The most profound technologies are those that disappear.” [2]. A trend towards miniaturization of both sensors and computing technologies makes this vision a reality and enables effective observing of people’s activities. Many believe that after main frame and personal computer ubiquitous computing is the next generation of computing systems. Figure 1 Population by age class, EU-27 [1] As this is an enormous research field many approaches Although we often imagine and wish that older people exist. In Table 1 a simplistic viewpoint on different visions of retire in carefree environments the truth is that in more and the domain is shown where it can be seen that in Europe more cases they retire far from their loved ones and Ambient Intelligence (AmI) phrase is preferred. appropriate care centers. To live independently they need TABLE 1 DIFFERENT VISIONS OF THE DOMAIN appropriate care in their homes. The fact that they often suffer from some illness further emphasizes the need for providing Key phrase Origin Emphasizes them with proper support in everyday life. This ageing Ubiquitous United States Computing/processing aspect process drives social and economic changes since it presents a computing huge burden on national economies and healthcare systems. Ubiquitous Japan and Transmission/bandwidth Cost-reduction and efficiency of the healthcare system thus networking Korea aspect became one of the imperatives of the countries around the Ambient Europe Human interface aspect world. intelligence The next challenge being on proper interpretation and  to promote healthier way of life, utilization of the vast amount of data coming from different  to improve living standards, sources in order to track and predict behaviors of people leads  to prevent social isolation and maintaining social to the Ambient Intelligence paradigm. One of the definitions network around the individual, of AmI is that it is “a digital environment that proactively,  to support informal (family members, friends, etc.) but sensibly, supports people in daily lives” [3]. In a report of and formal (doctors, care organizations, etc.) the Information Society Technologies Advisory Group caregivers, (ISTAG) of the European Commission four scenarios that  to reduce costs in healthcare, illustrate daily life and work around year 2010 [4] are given.  to offer new business models that will facilitate In this report EU charts a path for AmI research. cooperation between device manufacturers, Ambient Intelligence goes beyond aforementioned developers, service providers and other interested ubiquitous (also known as pervasive) computing by parties, addressing the users and their experience and expectations  to offer common (software and hardware) platforms from the devices surrounding them. It provides intelligence in that will fulfill expectations and enable easy computer supported environments. The idea of AmI is that development and deployment of AAL solutions, environment should adapt to the inhabitant(s) and not the  to increase efficiency of resources in ageing society. other way around. The advancements in this area are greatly facilitated by ever increasing number of different networked- C. Europe Support for AAL intelligent devices and progress in the semiconductor The Ambient Assisted Living Joint Program involves 20 industry. Five key technological requirements for AmI EU countries1 and 3 non-EU countries2 and supports: according to ISTAG [4] are: a) technological research, demonstration and 1. Very unobtrusive hardware, dissemination activities of trans-national (short to 2. A seamless mobile/fixed communications medium term) projects, and infrastructure, b) brokerage, programme promotion and networking 3. Dynamic and massively distributed device activities. networks, Planned investments in research and innovation for ageing 4. Natural feeling human interfaces, 3 5. Dependability and security. well are more than 1 billion EUR till year 2013. Additional Many buzzwords and often competing catchphrases contributors in this field are also European Research Council surround AmI evolution: calm technology, (ERC) [23] with its subthemes that cover active ageing issues ubiquitous/pervasive/proactive/ambient computing, smart and national and regional R&D funding programmes. spaces, of things, Internet of devices, , Furthermore, new initiatives such as EU’s European Things that think, invisible/disappearing computer, , Innovation Partnership and its pilot on Active and Healthy to mention only a few. Most frequent Ageing (EIP AHA)4 [20] are continuing to emerge. EU has viewpoint on this (r)evolution refers, however, mainly to even declared 2012 as the European Year on Active Ageing information processing and storage, highlighting the and Solidarity between Generations [21]. importance of distribution. Although European Commission is not part of the implementation structures it contributes with a substantial B. Definition of AAL financial support granted on the basis of article 185 of the EU Term “Ambient Assisted Living” entered the public with Treaty (former article 169). identically named Framework Program (FP) 6 funded support Because of the growing cost of supporting increasingly action that developed scope, procedures and legal basis of the aged population EU’s AAL initiative (under 7th Framework AAL Joint Programme from September 2004 [18]. The scope Program) extending for 2008-2013 period, envisages use of of AAL was further defined within European Action Plan on Ageing Well in the Information Society [22] (adopted by the 1 Namely: Austria, Belgium, Cyprus, Denmark, Finland, France, Germany, European Commission in 2007) which stated: Greece, Hungary, Ireland, Italy, Luxembourg, the Netherlands, Poland,  FP7 as the home for research project funding, Portugal, Romania, Slovenia, Spain, Sweden and the United Kingdom. 2 Namely: Israel, Norway and Switzerland.  AAL Joint Programme for development projects, 3 €600 million in the AAL Joint Programme, an expected €400 million in and FP7 and (till January 2011) more than €50 million on large scale pilot  the ICT Policy Support Programme for funding projects in the EU's ICT Policy Support Programme. deployment activities. 4 EIP AHA emerged in February 2011 aiming to increase average healthy The idea of AAL is: lifespan in the EU by 2 years by 2020. The idea is to bring together  to extend the time older people can live in their (establish a forum of) key stakeholders from demand and supply side (ranging from research to deployment and end users, along with homes by increasing their autonomy and self- standardisation and regulation bodies). confidence,  to support health and functional capability of elderly, AmI technologies and enables older people to live III. CHALLENGES independently as long as possible. The uptake of solutions and platforms developed in AAL One of the FP7 projects from which a lot is expected is projects is still not good enough. Some barriers hindering project universAAL (UNIVERsal open platform and AAL can be identified for different stakeholders [18]: reference Specification for Ambient Assisted Living) [5]  For users and caregivers: which builds upon the results and strengths of the previous o A general reluctance to use technology, projects in the area. o Unclear evidence of real benefits, D. Research directions o An inability to use appropriate technologies.  For service and goods suppliers and providers: Based on technology achievements a number of different o A misunderstanding of requirements, solutions for home and ambient assistance have been o The lack of standards, suggested for the people with special needs. These solutions o Partial broadband coverage. include accessible communication and socialization  For organizations working on legal and economic platforms, dangerous situations alarms, automatic reminders, issues: health status monitoring and other solutions and devices o Diversity of social, welfare and healthcare devoted to support people in their daily activities. In more systems, general way AAL support can be classified in various o Lack of visible value chains, application domains such as: o Heterogeneous target groups,  ageing well at home, o Lack of standards and certification,  ageing well on the move, o Funding.  ageing well in the community, In order to achieve AAL market breakthrough a lot of  ageing well at work. work is still needed. Efforts of researchers around the world R&D activities in AAL cannot leave aside new are thus focused on following directions: experiences and advancements coming from medicine, law, economics, psychology, etc. which means that A. Heterogeneity multidisciplinary approach is often used. Enabling There is a vast number of different technologies that technologies for applications in this domain are sensors and address similar or the same things. Many alternative solutions actuators connected to different reasoning engines and bring even more heterogeneity and complicate development, human-computer interfaces. Many agree that technologies and at the end, integration. The current situation is used for building AAL systems should be: characterized by opposed opinions in several areas that at the  embedded (non-invasive, invisible), same time point towards future developments. Some think, all  distributed throughout environment, should be incorporated in environment while others think  personalized (according to user’s needs), devices should be carried everywhere, one think, that  adaptive to user and user’s environment, dedicated devices are better than all-in-one approach, etc. The  anticipatory (anticipating user’s desires as far as fact is that dedicated devices are still too expensive to the possible). average end user and can only target luxury market. Internet, generic off-the-shelf hardware and open systems are expected It is clear, by now, that many research areas add to and are to close the gap here, lower the cost of integration and related to AAL as depicted in Figure 2. ultimately bring the novel solutions to larger audience. In the software sense this leads to the development of middleware that can hide details of the specific underlying solutions and simplify developments by offering programmers solutions that do not ask for very deep and exact knowledge of the lower layers, thus giving them more time to concentrate to the higher layers and service compositions. Most of architectures proposed in the latest years follow Service Oriented Architecture (SOA) approach allowing decomposition of systems into simpler and well-defined components. One of the most popular SOA applications is OSGi platform [6] which is an industry’s initiative for a standardized open specification increasingly used to deliver services in different environments (also used in previously mentioned project unversAAL).

Figure 2 AAL related research fields B. Interoperability CENELEC5, DATSCG6, etc.) together with their The European Commission's definition for interoperability international counterparts (ISO7, ITU8, HSSP9, etc.) and is: "Interoperability means the capacity with which two other consortiums and initiatives (IETF10, HL711, programmes (a client and a server, for example) are able to 12 13 14 15 exchange and interpret their data properly". Interoperability EPCglobal , CHA , DLNA , AGE platform Europe , is a mechanism used to overcome heterogeneity and it can be EURAG16, OHT17, etc.) addresses really important topic. tackled on many different levels as presented in Table 2. Fragmented efforts, however, slow down the process which is hard but necessary. TABLE 2 INTEROPERABILITY LEVELS, TAKEN FROM [12] International Electrotechnical Commission (IEC), with the Interoperability Relevant to: help from the European standardization bodies, CEN and level CENELEC developed ISO/IEC Guide 71, Guidelines for Technical communication infrastructures standards developers to address the needs of older persons Syntactic standards and format specifications and persons with disabilities, that provides guidance for specifications schemas for exchange of Semantic writers of International Standards as well as users of information and meaning standards. Pragmatic application/service interfaces Dynamic behavioral adaptation and response Examples of standards relevant in the field of AAL are: 18 19 20 Conceptual knowledge presentation and processing KNX , ZigBee , Bluetooth, Wi-Fi, TS 102 690 , Organizational knowledge sharing Agreeing on transport protocols and new traffic patterns 6 Design for All and Assistive Technologies Standardization Co-ordination that derive from new ways of interaction and scenarios of use Group (DATSCG) is a dedicated Working Group of the ICT Standards Board (ICTSB) that addresses the area of eAccessibility. is not at all trivial task. Many solutions deal with different 7 aspects. Together with increased popularity of a cloud based International Organisation for Standardization Activities (ISO) is international standard-setting body composed of representatives from computing some new (cloud-based) solutions also appeared various national standards organizations. on the marked. Example of one such solution is ClareHome 8 ITU is the United Nations specialized agency for information and [10] which is advertised as a first system communication technologies. managed from the cloud and run on a Mac. This cloud-based 9 Healthcare Services Specification Project (HSSP) is a standards portal allows dealers to order, configure, deploy, monitor and development effort to create health industry service oriented architecture service home automation systems. When looking more closely (SOA) standards supportive of the health care market sector. it can be seen that special operating system ClareOS is used 10 Internet Engineering Task Force (IETF) develops and promotes Internet here together with custom built drivers. The question is how standards. 11 this solution can be combined with existing ones and did the HL-7 (Health Level Seven) provides standards for the exchange, management, and integration of data that supports clinical patient care and designers have in mind requirements related to the the management, delivery, and evaluation of healthcare services. interoperability? If an end user wants to buy some component 12 EPCglobal, as a subsidiary of the global non-for-profit standards from some other supplier will this component or service work organisation GS1, works on development of industry-driven standards for together with the existing solution? Those and many more the Electronic Product Code™ (EPC). similar issues (dealing with so called “islands of 13 Continua Health Alliance (CHA) is an open non-profit organization of functionality)” are not easy to tackle, especially since the more than 230 technology and healthcare companies trying to address the standardization, in general, hangs behind industry. interoperability and standardization problems by resolving some gaps and providing guidelines on how to use standards to achieve true interoperability C. Standardization between many different devices and their manufacturers. 14 Digital Living Network Alliance (DLNA) is a non-profit collaborative Standardization in AAL aims at facilitating interoperable trade organization established by Sony in June 2003. In January 2011 it is systems across several domains (not only assistance but also estimated that more than 440 million DLNA-certified devices have been health, social integration, etc.). There are contributions installed in users' homes. coming from all over the world that address different sections 15 AGE Platform Europe is a European network bringing together more than of standardization aspects. European Commission and 160 organisations of people aged 50+, directly representing over 30 million older people in the EU. 5 5 European Standards Organizations (ETSI , CEN , 16 European Federation of the Older Persons (EURAG) is a non profit independent organisation, created in 1962 that represents millions of older 5 The European Committee for Standardization or Comité Européen de people in Europe (through 148 member organisations in 33 European Normalisation (CEN), is the only recognized European organization countries). according to Directive 98/34/EC for the planning, drafting and adoption of 17 Open Health Tools (OHT) is an open source community of healthcare European Standards in all areas of economic activity with the exception of providers, related standardization bodies, and related vendors. electrotechnology (European Committee for Electrotechnical 18 KNX is an open and widely adopted standard for home and building Standardization, or Comité Européen de Normalisation Électrotechnique - controls. CENELEC) and telecommunication (European Telecommunications 19 Standards Institute - ETSI). ZigBee provides wireless low power LAN communica-tion (e.g. between different sensors and home gateway) . ISO/IEEE 11073-1047121. M2M communication is today one protection was more important to interviewees than any of the two most powerful trends in telecommunications and IT potential benefits provided by AmI applications. It is obvious industries (other being cloud computing) [24]. Following that the trade-off between privacy and benefits from using ETSI’s recent (October 2011) first release of M2M Services information about the users is necessary. standard, seven standards development organizations from all F. Legal aspects over the world, including the U.S.(ATIS), Europe (ETSI), Japan (ARIB and TTC), China (CCSA), and Korea (TTA), AmI and its various applications (such as AAL) present have announced (in January 2012) a global initiative to considerable challenge for further development of data and provide global M2M standards [25]. The second (similar) consumer protection. With development of many new announcement came from the ITU, initially looking at the services, which some may be very questionable, new laws and requirements for e-health. Since M2M addresses connected regulations have to keep up. Since many services deal with home, health and other verticals relevant for the area of AAL rather sensitive data and situations that can, if not treated this should really lower the costs, reduce barriers, reduce properly, result even with death of end user it is crucial to time-to-market and homogenize the market. have the proper legislation. Knowing who is responsible for In recent years a wide variety of devices and means of what is very important when dealing with wide range of interaction they enable is yet to be standardized and explored participants who, in general, are prone to responsibility as shows a work on developing a system for coding user diffusion. requirements that has been completed under SNAPI™ project G. Reliability [15] and has now been published as a formal European and British standard EN 1332-4 (Coding of User Requirements Creating reliable and dependable systems with predictable for People with Special Needs). behavior and good ability to diagnose potential errors is one of the most critical areas directly responsible for the D. Security acceptance. Eventhough social aspects of AmI systems The solutions that are being proposed in this field are prevail over technical ones; stability and fault-tolerance still rather vulnerable and lack of proper security mechanisms that remain high on the list of needed system characteristics. Well will convince end users they can cope with different threats. running equipment and systems are a precondition for reliable Although some security mechanisms are being applied in infrastructure that can enable establishment of collaborative existing solutions the more complex security supporting relationships with relevant parties worldwide. In case of mechanisms are still missing. Because AAL solutions deal failure proper warning should be given and ideally with sensitive personal data, security and confidentiality are responsible parties notified to repair the problem. important issues. Proper authentication and data integrity and H. Context-awareness confidentiality support needs are just few of the aspects that need to be adequately addressed. It can be concluded that Context-awareness is a central theme in AAL. Although many aspects of security in the field of AAL are well- context-aware systems are relatively new, trends towards established but unfortunately only seldom applied. including living patterns and user preferences in system design is taking momentum. Large variety of context E. Privacy information sources differ in their semantic level which can Privacy aspect is very important for every individual and also depend on whether information is sensed, provided by is recognized in legislations of all civilized countries. the user or inferred from existing context information. Concerns related to privacy are one of the biggest barriers Efficient access to context information is difficult requirement against the widespread of technologies. These concerns are, to meet so many living labs like Aware Home [7], House_n of course, justified because it has to be insured that every [8], MavHome [9] and iDorm [14] have been established. individual has full control of their personal data. One of the key requirements of context-awareness is Since AmI solutions in most cases need to know where capturing and reasoning upon imprecise and sometimes people or objects reside they can be considered as means of conflicting data so software dealing with that issue must be surveillance. This means that utilization of certain functions able to reason about uncertainty. For this a number of has to be explicitly confirmed by the end user. Although in mechanisms have been proposed and include: fuzzy and general older people’s understanding of what is being probabilistic logic, Bayesian networks, Hidden Markov collected is often incorrect, they have to be properly Models, Dempster-Shafer theory, etc. informed. Survey from 2003 [13] indicated that privacy I. Usability

User’s ability to use a product or a service is most 20 TS 102 690 is a standard produced by ETSI which describes M2M functional architecture. certainly a crucial aspect in minimizing the digital divide. 21 ISO/IEEE 11073-10471 is developed by ISO TC 215 and it defines a Although cost and availability are very important factors common core of communication functionality for independent living activity when considering if some product will be used or not, the hubs. most pivotal criterion for acceptance of the product is the extent to which people feel comfortable using it. This comfortability will again depend on many factors (such as K. Design approaches learnability, accuracy, usefulness, adjustability) and will have Many design techniques have their own advantages and to be adapted according to specific end users’ requirements. disadvantages that prevent them from becoming a definite For example for visually impaired and motor-impaired users, design strategy that can be used under any circumstance and requirements related to information display and requirements for any target group. Some of the approaches here are the related to physical navigation will have to be combined following: together with some other information, such as their age or  User centered design (UCD) places the user at cultural background, if one wants to offer them the product the center and drives the development and design they could use comfortably and easily. Assistive technology22 having in mind user tasks and goals, is, thus, valuable for individuals with disabilities in order to  Design for all (DfA), similar as more recently perform functions that might otherwise be difficult or even coined terms such as Inclusive design or impossible. Universal design, tries to ensure that products Many products and services are currently not designed and interfaces work for people of all ages and with older and disabled people in mind so they should be abilities, involved as much as possible from the start. Capturing user  Accessible design specially considers needs of feedback is very important but traditional evaluation methods people with disabilities. are not adequate for (re)creating the context of use. This  Usable design aims at creating products that are means that the evaluation of usability of those technologies easy and efficient to use. should take place in real-world contexts. The fact that highly Intuitiveness and usability are hard to achieve, especially subjective factors (such as emotion, fun, attention, when dealing with very specific and ever-changing satisfaction) should be taken into account in evaluations requirements of the elderly. Design and implementation of further complicates the whole process. applications are often unsuitable and irrelevant for the ageing J. Trust population [19] but many products that exemplify inclusive design are very successful on the market [17]. It is important Acceptance is one of the main issues when dealing with to note, however, that accessibility of devices is not sufficient technology. Even for younger people who are, in general, condition for the accessibility of overall environment. very familiar with the technology and use it in every part of their lives, some fear may exist. This fear of technology, IV. USER INTERACTION IN AMI ENVIRONMENTS together with a lack of experience, is even worse with elderly and can lead to reluctance to accept these new solutions. Trust Together with ubiquitous computing and ubiquitous and dependability is thus a key issue in the AAL domain. communication intelligent user friendly interfaces represent pillars from which the AmI stems. In the world where we are The benefits must be very obvious for people if they are bombarded with huge amounts of data a human attention is expected to accept the fact that their environments are very precious resource to obtain. Thus, it is very important to monitoring their every move. Furthermore, scientists are have adequate user interfaces. As user-system interfaces are already incorporating some intelligence into clothing and becoming distributed in physical devices throughout the even in our own bodies. Although implants are quite common environment, traditional (single terminal) interaction is for medical reasons here the nonmedical reasons are in focus. becoming obsolete. One of the defining limitations in this new The question is where the line is and should this line be era is most certainly the time of users’ attention. Some call crossed? This topic is also closely related to ethical issues that this new limitation eyewidth. are being largely discussed. As technology is moved to the background it disappears During the Future of the Internet conference in mid-2009 either physically (into the environment) or mentally (devices a big start was made, in the sense of tackling with this issue, are designed in a way they are not perceived as computing when industry partners Gemalto, Microsoft, and Philips devices). Ambient displays follow that trend and move announced the formation of the Trust in Digital Life (TDL) conventional screens into physical environment representing initiative [11]. The idea was to set out a vision for trustworthy the information via changes in sound, light, movement of ICT and to coordinate initiatives in this field in order to objects, smell, taste, etc. Multimodal interfaces become more engage in a broad dialogue with public and private and more important because of the current demands and trends where no single interaction modality can achieve stakeholders. Work started on: a) use cases, b) requirements wanted effect on its own. Multimodal systems are especially and technology, c) law and technology and d) business cases. appropriate for older people who often suffer from reduced sensory, physical and intellectual capabilities [16]. 22 According to ISO 9999:2007 “Assistive products for persons with disability - Classification and terminology”, Assistive Products are A. User modeling understood to be any product (including devices, equipment, instruments, technology and software) specially produced or generally available, for The growing demand for making systems more accessible preventing, compensating for, monitoring, relieving or neutralizing to the user means that user requirements have to be captured impairments, activity limitations and participation restrictions. by more powerful user models. Furthermore, the sole purpose of those systems brings additional demands and enables further refinement of mentioned models. The focus is on C. Customization understanding user goals, needs, preferences and abilities in Personalization refers to the optimization of a system’s order to be able to infer knowledge needed in the design of interface according to the end user’s needs and preferences. It user interaction mechanisms and, at the end, user interfaces. can be: a) user-specified or b) learned by the system. In As systems tend to get smarter good and efficient user contrast to adaptation which is system-initiated and system- modeling becomes increasingly important. If proper model driven (personalization), customization is user-initiated and can be built, it can be used to proactively assist and better user-driven (personalization) process. Although traditional address end user requests. approaches (e.g. keyword based) are extensively used they Information relevant for user model(s) is altered over time fail to represent rich semantic. and can be represented in many different ways, such as: key- Although customization is important feature for systems it value, graphical, markup tags, object-oriented, ontology- is not easy to achieve. There is a challenge how to create based, etc. Many believe that users should be allowed to acceptable customization scenarios and to achieve desired change the user model in the system. This can of course be outcome with the end users who are, more often than not, sometimes very difficult to achieve, especially if some other reluctant to spend their time on customization. With elderly mechanisms rely on the data stored in such model. people there is additional problem with the suitability of the User modeling can act as a good basis for understanding customization. Every user has unique abilities and preferences user needs and identification of most appropriate means of which the customization process should take into interaction. Furthermore, it can be also utilized in knowledge consideration. discovery process. Abilities of a system to learn through user Customization of user interfaces is significant for user interaction and to self-adapt are needed to best meet user’s experience and user satisfaction as it addresses their unique expectations. personal characteristics. For the customization to be effective An increasing number of researchers in the area of user several questions have to be properly answered: What aspects modeling in ubiquitous computing have recently taken into should be made customizable? How should customization account that external context alone cannot determine the most parameters be presented to the user who wants to edit them? appropriate adaptation to the user and have worked on How should customizable options be grouped? What should methods for recognizing user activities, general interests and be configured in system deployment phase and what should current information needs. be left for a user to customize?

B. Adaptation V. CONCLUSION AND FUTURE WORK Adaptive interaction systems draw conclusions from user In this article a short overview of the AAL as a relatively model (as a prerequisite for adaptation) and from monitoring young research area is given. The analysis has been user-system interaction. The idea is to (automatically) make performed not only from technological but also from changes on the that are performed to improve sociological and economical point of view. Apart from the the usability and user satisfaction. Changes can be done on motivation and definition of AAL, challenges and research specific interface elements, their arrangement and/or directions are explained. Special focus is put on user interaction flow (if only graphical interface is considered) or modeling, adaptation and customization aspects. even on combining different modalities (if multimodal User interfaces must support simple, intuitive and natural interfaces are considered). interaction. They prove to be one of the key factors that For automatic extraction of concepts and performing enable elderly users and users with disabilities to overcome specific inferring tasks different data mining and machine their fears and to accept technological aid that is offered to learning approaches have been investigated. Interface agents them. AAL interfaces have to be able to adapt to users. For (computer programs able to learn user’s interests, preferences this to be possible, end user abilities, preferences and and needs) are also used for providing personalized requirements, suitable user models and novel mechanisms for assistance. An agent provided with inference and user interaction adaptation are certainly one of the emerging key modeling capabilities can detect patterns of user behavior and issues that have to be properly addressed in order to make ultimately user intentions. It is important, however, to be adoptable AAL solutions. aware of imperfections of adaptive mechanisms and the cost In user modeling focus is on understanding user goals, of errors alongside the advantages. needs, preferences and abilities in order to be able to infer Some research questions that come from the need to knowledge needed in the design of user interaction anticipate user wishes in the area of human-system interaction mechanisms and, at the end, user interfaces. The drive are: Can user inputs be adequately captured and how (user) towards new interaction paradigms in ubiquitous intent can be inferred? How much information is necessary environments places user modeling in the center of universal for adaptation to be useful and exploitable? How to best design. For that reason, extending the current scope and utilize user model for user interaction adaptation? What level understanding of user model for AAL systems is very of uncertainty can be tolerated when deciding? Which important. Defining which information to include in the user adaptation techniques to use and how? How can the model, how to collect, store and utilize it are not at all trivial (potential) benefit be measured? tasks. Support for user interfaces with adaptation possibilities [20] European Innovation Partnership on Active and Healthy Ageing, web based on adequate user models is necessary when trying to site: http://ec.europa.eu/health/ageing/innovation/index_en.htm deal with very specific and changing requirements of an [Accessed: August 2011] [21] How to promote active ageing in Europe. EU support to local and elderly people. Different levels of adaptation and regional actors, September 2011. customization should adequately reduce the complexity and [22] The Ageing Well in the Information Society Action Plan web site: improve usability of user interfaces. However, the amount of http://ec.europa.eu/information_society/activities/einclusion/policy/age the decisions and suggestions coming from the system has to ing/action_plan/ [Accessed: August 2011] be just right. 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