GERONTECHNOLOGY Why and How Thomas L. Harrington Marcia K. Harrington Produced by Herman Bouma Foundation for Gerontechnology http://www.gerontechnology.nl Eindhoven, the Netherlands Cover design by: Theo M.J. Raijmakers Produced by: Herman Bouma Foundation for Gerontechnology http://www.gerontechnology.nl Copyright Shaker 2000 All rights reserved. No part of this book may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, without written permission from the publisher. ISBN 90-423-0107-4 Shaker Publishing B.V. St. Maartenslaans 26 NL-6221 AX Maastricht The Netherlands Phone: + 31 43 350 0424 Fax: + 31 43 325 5090 http://www.shaker.nl II Table of contents Preface 1 Chapter 1 Overview of the field 7 H. Bouma, J.L. Fozard, T.L. Harrington and W.G. Koster Chapter 2 Healthy aging 37 T.L. Harrington and C.A. Vermeulen Chapter 3 Housing 59 T.L. Harrington, W.J.M. Heys, W.G. Koster and J. Westra Chapter 4 Lifelong working 85 T.L. Harrington and C.A. Vermeulen Chapter 5 Personal Mobility and Transportation 115 T.L. Harrington, J. Rietsema and M. Vercruyssen Chapter 6 Information and Communication 139 H. Bouma and T.L. Harrington Chapter 7 Mathematical modeling and simulation 165 P. Bidyuk, J.A.M. Graafmans, T.L. Harrington and M.L.J. Hautus Chapter 8 Gerontechnology unfolding 187 H.Bouma, D.G. Bouwhuis and J.E.M.H. van Bronswijk III Bibliography 207 Keyword index 217 Author index 221 Index boxes 223 Index figures 225 IV Preface Imagine yourself when you are 60 years old, or 80. What will your life and your activities be like? Will you do new, exciting things or the same things you like to do now? Will you be able to do simple things such as reading the paper, taking a bath, turning on the stereo, driving a car or taking money from a cash-dispenser? Where will you live, and in what kind of house? Will you be able to enjoy new freedom from a life of work and develop new ambitions? Will you be independent? When asked, older people say that continuing to maintain independence as they grow older is very important to them. Indeed, independence is a quality of adult life in our society that we cherish at any age. Being able to live independently and being able to do what you want partly depends on your health and abilities, but also on the relevant social and physical environment. A supportive environment can help people continue doing what they are accustomed to and doing new things they want to do, even though they may perhaps see or hear somewhat less well, move with more difficulty, or have somewhat poorer memories. The social part of a supportive environment is composed of people (family, friends, or if needed professional caregivers) who provide help. The physical part includes technology that makes living easier and more enjoyable. Throughout life, technology helps persons with products (hardware, software, and services), which provide a large range of possibilities in perception, communication, information processing, and mobility, and in maintaining health. Technology can meet daily needs when it is useful, easy to use, and available at a reasonable cost. 1 What is gerontechnology? The term gerontechnology is a composite of two words, “gerontology,” the scientific study of aging and “technology”: research, development and design of new and improved techniques, products, and services. Gerontology is concerned with research on the biological, psychological, social, and medical aspects of aging. Technology includes all branches of relevant scientific endeavor: physical, chemical, civil, mechanical, electrical, industrial, information, and communication engineering. Gerontechnology refers to technology that fulfills the need of an aging society, i.e. research, development, and design in the engineering disciplines based on scientific knowledge about the aging process. So it is technology in direct contact with insights into ambitions and needs of aging people in their environment and the aging process itself. More formally, gerontechnology is defined as the study of technology and aging for ensuring good health, full social participation, and independent living throughout the entire life span, however much it may lengthen. Five roads are to be paved to address the technological challenges of aging in society both for men and women: First, technology can be used effectively in prevention of age-related diseases and of age-associated losses in strength, endurance, and other physical or cognitive abilities. Technology can play an important role in primary prevention of potential losses and in secondary prevention of unwanted consequences of existing disease or loss. Research has shown that these losses are modifiable through interventions such as improved nutrition, physical exercise, a healthier environment, and modifications of life style. The preventive role of technology includes the design of equipment to facilitate interventions and the design of monitoring equipment that allows feedback about compliance with interventions and their effectiveness. Examples include strength training equipment that is stimulating to use or safety equipment for persons using dangerous tools. Second, gerontechnology can enhance the performance and opportunities of older citizens in new roles that fit their new ambitions. The new roles include changed work, leisure, living, and modified social situations. 2 The potential for technology in these areas has not been developed to a significant degree up to now. An example is the development of user- friendly communication technology to facilitate remote contacts, to make new contacts and to participate in educational activities. The emphasis here is on what older people want to do and can do, rather than on what they cannot, such as running the 100 meter in 10 seconds. Third, it provides technology to compensate for declining capacities, the challenge of aging. This is the most fully developed aspect of gerontechnology and includes products and techniques to compensate for physical, perceptual, and cognitive losses, and for task redesign that takes into account, for example, longer response times. An example here is reading glasses to compensate for diminishing flexibility of the eye’s lens. Fourth, gerontechnology provides technical support that assists caregivers who care for less able older persons. Take for example technology for lifting and transferring persons who are incapable of moving themselves. Many products have been developed for use in hospitals and rehabilitation facilities and some of this technology is currently or potentially available. Fifth, technology aids older persons indirectly by improving research on aging. In many studies on aging, the technological environment and the technological options are not yet taken into account. For example, technology allows imaging organs and tissues, signal processing of neurological events and making other non-invasive measurements, thereby revolutionizing the scientific study of the processes within the aging body. Some central ideas Three concepts are central to gerontechnology: The first concept is that the dynamics of society is driven by technological developments, in particular related to information and communication technology. If older people are to remain integrated into society, technology should explicitly be directed to the fast growing segment of independent older citizens. 3 The second is that age-associated differences in ambitions and in functioning of men and women can be met by improvements in the technological environment. Suitable information and communication tools can for example serve an ambition. A task that may seem very difficult to an older person in one situation may be easily accomplished with suitable environmental modifications. The very idea of age grading of ambitions and of abilities cannot be considered independently of the technological environment. The third concept is that older citizens should remain in control of their technological environment i.e. they should be enabled to decide what they want to be done automatically or by robots. This refers to the concept of the user interface between older users and useful technology. About this book This is the first textbook in gerontechnology. In recent years there has been an explosion of interest and involvement in this new field. Yet there has been no basic text for use in formal and informal education. Specialists in basic and applied technology who might wish to contribute to the quality of life of older people, and gerontologists who see a need to channel more technology to older persons might also benefit from a basic text. And there are potential participants among the general public: the curious, the concerned, those with older friends or relatives, people growing older, which includes us all, and the aged themselves. Our plan for dealing with this complex task was simple. Gerontechnology reaches into every vein of technology, but no one author can know every domain. So we decided to entrain a group of experts for each of the various chapters. We had lengthy discussions and seminars with the experts and with interested older people, who also are experts. So in an interactive process between the editors and the experts, the chapters took shape. Next, because the book could never cover the full scope of gerontechnology, we decided on a few exemplar fields of technology that we could use in the book to epitomize the problems, solutions, cautions, hopes, and dreams of gerontechnology. Accordingly, we focused individual chapters on the relation of older people to the technologies of five principle 4 areas. These were longevity and health, housing, working, mobility and transportation, and informational systems and communication. In addition to these, to exemplify the involvement of the sciences and tie everything together, we included mathematical modeling and simulation. The book begins and ends with general chapters on gerontechnology. The book evolved at the former Institute for Gerontechnology of Eindhoven University of Technology, and was later taken over by the Herman Bouma Foundation for Gerontechnology.