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Optimizing Assistive
Technologies for Aging
Populations
Yosry S. Morsi
Swinburne University of Technology, Australia
Anupam Shukla
ABV - Indian Institute of Information Technology and Management Gwalior,
India
Chandra Prakash Rathore
Oracle India Private Limited, India
A volume in the Advances in Medical
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Optimizing assistive technologies for aging populations / Yosry S. Morsi, Anupam Shukla, and Chandra Prakash Rathore,
editors.
pages cm
Includes bibliographical references and index.
Summary: “This book focuses on the development and improvement of devices to assist elderly individuals in coping with
various physical limitations and disabilities, highlighting the available tools and technologies for supporting the mobility,
agility, and self-sufficiency of the aging population as well as the challenges associated with the integration of these tech-
nologies into the everyday lives of elderly individuals”-- Provided by publisher.
ISBN 978-1-4666-9530-6 (hardcover) -- ISBN 978-1-4666-9531-3 (ebook) 1. Self-help devices for people with disabili-
ties. 2. Older people with disabilities. I. Morsi, Yosry S., editor. II. Shukla, Anupam, 1965- editor. III. Rathore, Chandra
Prakash, 1982- editor.
HV1569.5.O68 2016
681’.761--dc23
2015032699
This book is published in the IGI Global book series Advances in Medical Technologies and Clinical Practice (AMTCP)
(ISSN: 2327-9354; eISSN: 2327-9370)
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Copyright © 2016, IGI Global. Copying or distributing in print or electronic forms without written permission of IGI Global is prohibited.
Chapter 3
DOI: 10.4018/978-1-4666-9530-6.ch003
ABSTRACT
The technological advances in the robotic and ICT fields represent an effective solution to address specific
societal problems to support ageing and independent life. One of the key factors for these technologies
is the integration of service robotics for optimising social services and improving quality of life of the
elderly population. This chapter aims to underline the barriers of the state of the art, furthermore the
authors present their concrete experiences to overcome these barriers gained at the RoboTown Living
Lab of Scuola Superiore Sant’Anna within past and current projects. They analyse and discuss the re-
sults in order to give recommendations based on their experiences. Furthermore, this work highlights
the trend of development from stand-alone solutions to cloud computing architecture, describing the
future research directions.
Supporting Active and
Healthy Aging with Advanced
Robotics Integrated in
Smart Environment
Raffaele Esposito
Sant’Anna School of Advanced Studies, Italy
Laura Fiorini
Sant’Anna School of Advanced Studies, Italy
Raffaele Limosani
Sant’Anna School of Advanced Studies, Italy
Manuele Bonaccorsi
Sant’Anna School of Advanced Studies, Italya
Alessandro Manzi
Sant’Anna School of Advanced Studies, Italy
Filippo Cavallo
Sant’Anna School of Advanced Studies, Italy
Paolo Dario
Sant’Anna School of Advanced Studies, Italy
47
Supporting Active and Healthy Aging with Advanced Robotics Integrated in Smart Environment
INTRODUCTION
Europe is facing unprecedented demographic changes due to the ageing population and low birth rates.
On one hand, according to the up-to-date statistics, people older than 65 years are the fastest growing
segment of the European population and they will account for a third by 2060. On the other hand, the
number of working-age people is expected to decline steadily and the number of older people to increase,
leading to an increase in the old-age dependency ratio (Eurostat, 2013).
As people age, they become more susceptible to disease and disability; in fact they have at least one
that correlates strongly with the functional decline. However, despite the health problems, the majority
of older adults hope to remain in their own homes as long as possible. Even if this wish could improve
the elderlys’ perceived quality of life, nevertheless it is strongly correlated with the risk of domestic ac-
cidents, such as falls, and social isolation, such as depression and loneliness. The effect of these risks is
the growing emergency admission to hospitals with a not sustainable impact on the healthcare systems.
For these reasons, long-term services and support should be provided in order to promote the ageing
well, but the workforce shortages and financial burdens cannot supply the demand for Nurse Practitioners
(+94% in 2025) (Auerbach, 2012) and Physician Assistants (+72% in 2025) (Hooker, 2011). Furthermore
most European senior citizens live in urban areas (Eurostat, 2013) and services are concentrated there,
to the detriment of persons living in rural areas with a higher risk of social exclusion. For this reason
senior people living in rural areas are highly at risk of isolation. So the ageing population in rural areas
and the lack of access to community services is a challenge (EU Panel, 2007).
Fortunately, many technologies have the potential to help older adults maintain their independence
and health. Technology could support elderly people in mobility inside and outside the house and in daily
activities, encouraging the social relationships and improving the feeling of safety delaying the physical
and mental decline. The validation of this hypothesis is provided on one hand by the rapid development
of smart technologies to improve areas as diverse as healthcare, education and crime prevention, and
on the other hand by their economic accessibility among common people (Mobile Planet, 2014). Ac-
cording to this phenomenon it is estimated that medical electronics equipment production will increase
from $91 billion in 2011 to $119 billion in 2017 with an average rate of 4.6% per year (iNEMI, 2013).
Particularly the EU smart home market is estimated to grow from $1,544.3 million in 2010 to $3,267
million in 2015 (Markets and Markets, 2011). Furthermore, the mHealth market will increase in the next
few years. 63% of users are comfortable with storing their health record in the cloud (63%), and 30% of
them use computers to check medical or diagnosis information (CISCO, 2014).
According to ABI Research (ABI, 2013) a promising market opportunity is also represented by the
use of robots for home healthcare applications, in particular the household robots. ABI Research predicts
that by 2015, robot sales will exceed $15 billion, due in large part to advanced sensor technology and
cheap, powerful cameras. While most robots are currently limited to industrial settings, it is the home
environment that presents the greatest opportunity for robot developers. According to market analysis
carried out by ABI Research, the task robot is the robot with highest revenue (+ 37.5%) between 2010
and 2017. These results confirm the projection made by Robotic Japan Association which shows that
the domestic robot will be the main segment over the global robotic market.
Furthermore the elderly population will benefit from the services, based on the use of Ambient
Assisted Living (AAL) technologies that could contribute to increase their perceived QoL (Moschetti,
2014), as shown in Figure 1.
48
Supporting Active and Healthy Aging with Advanced Robotics Integrated in Smart Environment
The green line represents the standard QoL of an elderly person, which would normally decrease
after a certain age due to cognitive and physical disabilities related to age, as well as decreasing social
interactions. The other lines show how the curve can be modified, introducing service and technologi-
cal tools which aim to prevent, support and enhance the independent living of the elderly population.
In particular, the blue line shows how the decrease of QoL could be delayed when some prevention
activities are undertaken in order to delay or reduce morbidity. The red line highlights how QoL decreases
more slowly in cases where compensation or support actions are engaged in. Similarly, the yellow line
shows how independent living and active ageing can help to maintain high levels of QoL for a longer
period. All of these actions can be supported by an integrated technology solution that can help people
engage in activities that aim at improving perceived QoL.
These concepts provide evidence that by using AAL technologies and exploiting AAL services it is
possible to have a higher QoL at all stages, and to live longer while not being a burden to society and
the welfare system.
Eventually, the aim of this chapter is to describe how demographical and societal challenges related
to the aging population and the increasing demand of nurse practitioners can be addressed and optimised
by the integration of ICT and robotic technologies in a smart environment. In this manner social services
can be enhanced, improving quality of life of the elderly population. Starting from literature evidences
on how integrated solutions could support the active and independent living of aged care (sec. Introduc-
tion and Background), the authors analysed some criticisms related to the proposed technical solutions.
Furthermore they show their concrete experiences of integrated solutions that overcome the criticisms
described and the results achieved. In order to improve future researches in this topic, they conclude
this work with recommendations based on the gathered experiences (sec. Solutions and Recommenda-
tions). Furthermore, the authors highlight the trend of development from stand-alone solutions to cloud
computing architecture, describing the future research directions (sec. Future Research Directions).
BACKGROUND
As stated earlier, AAL technology can meet the elderlys’ main needs improving QoL. So, some possible
services and ICT solutions are shown in Table 1 and described in the following paragraphs.
Figure 1. The model of QoL during ageing and the potential effects of technology solutions related to
the prevention, the support and the independent living of aging society
(Moschetti, 2014)
49
Supporting Active and Healthy Aging with Advanced Robotics Integrated in Smart Environment
Social Interaction
Social participation and communication with friends, family, relatives and neighbours are important elderly
needs. There are several studies which show that robots could be reliable companions for the elderly and
useful tools to quantify and analyse interactions (Sarkey, 2012), indeed. Robots do not necessarily reduce
human contact and socialisation; researchers have demonstrated that robots will address the social and
the emotional needs of the elderly, including reducing depression, loneliness and isolation (Stiehl, 2005).
For instance Huggable (Stieh, 2005) has got sensors to evaluate and quantify the affective component
of touch during a normal interaction with a pet animal in order to capture eventual abnormal behaviour.
Kanamory et al. (Kanamori, 2002) show improvements in aging persons who regularly interact with
AIBO. Babyloid is conceived for robot baby-doll therapy; it encourages the patient to take on an active
care-giving role, helping relieve symptoms of depression in the elderly (Furuta, 2012).
Table 1. Relation between the needs of aging persons with technology solutions
Main Service Area Possible Services Technical Solutions
(Examples)
Social Interaction • Communication with friends and family
• Writing letters via speech control
• Encourage social interaction (gamefication)
• Contact with care staff, doctors etc.
(Furuta, 2012; Kanamori, 2002; Sarkey,
2012; Stiehl, 2005)
Information • Documentaries and news via audio/video
• Speech controlled search function
• Information about places to visit/visited
• Reminding of tasks
(Badii, 2009; Cavallo, 2013; Prakash,
2013; Shiotani, 2006)
Safety • Monitoring risks and giving warning
• Make older users feel safe in and outdoor home
• Emergency calls
• Domestic environment monitoring
(Esposito, 2014; GiraffPlus, 2012; Mileo,
2008; TMSUK, 2014)
Health • Check health status
• Monitored rehabilitation with gesture control
• Documentation of care
• Communication with medical doctors
• Saving and updating patient profile
(Jayawardena, 2010; Matsusaka, 2009;
Tóth, 2010; Werner, 2012)
Leisure • Games that encourage social interaction
• Games for physical and mental training
• Watch movies
(Deterding, 2013; Keizer, 2014; NAO,
2014; Shamsuddin, 2012; Wada, 2006)
Physical support • Collection and distribution of laundry and garbage
• Check of stock amounts & date of expiry
• Order goods to refill stocks / online shopping
• Cleaning works
• Support caregivers lifting patients out of bed
• Support during walking or on stairs
• Transport of heavy objects
• Possibility to locate elderly when outside (e.g. family or care
staffs)
• Navigation
• Providing a seat
• Bringing and moving goods inside house
• Open bottles and food packages
• Controlling devices in smart home
• Translating speech commands to control smart home devices
(Cavallo, 2014a; Farahmand, 2006; Ferri,
2011; Mori, 2010; Secom, 2014)
Mobility • Support in personal mobility inside the house
• Public transportation
(Bogue, 2009; Karlin, 2011; Robosoft,
2014)
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Supporting Active and Healthy Aging with Advanced Robotics Integrated in Smart Environment
Information
Robots can facilitate the access to information such as documentaries and news via audio/video or infor-
mation about places to visit/visited. For instance Wakamaru robot (Shiotani, 2006) and PaPeRo (Osada,
2006) are able to announce the weather report, read the news and communicate predictions (overall
fortune, work fortune etc.) to share with elderly users; while guide robots (Arras, 2003) (Yoshimi, 2006)
are robots conceived for helping people in exhibition events. Through multi-modal interface they inform
about the events, and guide people in the exhibition taking pictures of visitors and entertaining.
Furthermore older persons with cognitive disorders could have problems in remembering appoint-
ments, so robots could help users, acting as a physical support. ICT and robotic technologies should
be able to provide a care environment that supports the day-time management; Companionable (Badii,
2009) and Astromobile (Cavallo, 2013) are able to help users and carers in reminding tasks.
Safety
Older adults who live alone in their own house need to feel safe and often desire to improve the sense of
security and surveillance. They want to monitor the domestic environment and to be aware of risks. The
GiraffPlus system made use of a telepresence robot, a smart environment and smart wearable sensors
to monitor activities in the home using a network of sensors and alerting the user in case of necessity
(GiraffPlus, 2014; Coradeschi, 2013). Mileo in (Mileo, 2008) described a smart home for critical situa-
tion recognition, posture analysis and user localisation. It was specifically designed to support caregivers
in monitoring and providing health assistance to the elderly in their home. Mir-H combines robotics,
internet and mobile technologies in order to provide security, remote monitoring, entertainment and
home networking to users who require them. The robot will guard the home when the user is away and
could inform him of an abnormal presence. Robiorior guards the home, and sends pictures and videos
on a mobile phone alarming in case of necessity (TMSUK, 2014).
Health
Senior citizens often are worried about their health status and need to be in contact with their physician,
therapist and other actors of the care chain. Sometimes these actors don’t have much time to address all
the requests guarantying high level of quality. These solutions could help in checking the health status,
managing the documentation of care, communicating with carers and doctors, monitoring the home
rehabilitation and having a healthy lifestyle. In particular, during the last years researchers have assisted
to the rise of wearable devices to monitor health status and performance (MHN, 2014).
For instance András Tóth et al. (Tóth, 2010) introduced a smart environment for health services. Data
from the wearable device was processed to implement fall detection service and activity monitoring
service, analyse user fitness and monitor vital signs. Taizo is a robot to help senior citizens to lead the
elderly in physical exercise (Matsusaka, 2009). Charlie can monitor vital signs (pulse, blood pressure)
and provide mental stimulation by means of interacting games promoting active aging (Jayawardena,
2010). KSERA system is able to monitor the health and behaviour of an older person by using a sensor
network and humanoid robot (Werner, 2012). Hospi-rimo allows them to talk with other residents and
doctors in a care facility and enables families and friends who live far to virtually visit hospital inpatients
or the elderly living alone (Panasonic, 2011).
51
Supporting Active and Healthy Aging with Advanced Robotics Integrated in Smart Environment
Leisure
In literature there are several works which show the positive involvement of robots with elderly people
for leisure activities and games. For instance, Wada et al. (Wada, 2006) analyse interaction between Paro
and a group of the elderly. They found evidence that the level of social interaction among the elderly
increased, while physiological indicators showed reduced stress levels. Robo-Doc 2 is a companion ro-
bot which is able to teach (encyclopaedia functionality) and entertain people playing chess and Chinese
chess (Lin, 2006). FUWA has an LCD touchscreen which allows users to interact with educational or
entertainment software (Zhang, 2008). Nao (NAO, 2014) is a humanoid robot; it can play soccer, sing
and speak with the user. There are several works which show a positive attitude regarding this robot both
for the elderly and children with autism (Shamsuddin, 2012; Keizer, 2014).
Another important aspect of technologies involved in leisure tasks is related to games for cognitive
training which can provide short-term and long-term benefits to attenuate age-related cognitive decline in
older adults. In particular future researches are required to enhance efficacy of the intervention (Lampit,
2014; Deterding, 2013). Gamification is a recent key concept which involves the use of game techniques
and mechanics to engage and motivate. Future predictions suggest that this interest will continue to grow,
especially in the use of games to change individual behaviour (Schoech, 2013).
Physical Support
Robots are designed to perform a single Activity of Daily Living (ADL) to promote users’ autonomy
managing their activity and their interactions. Older and disabled persons could have some difficulty
in performing activities like feeding, grooming, bathing and housekeeping. For example, aging people
with motor impairments have difficulty with picking up food and bringing it to the mouth; a feeding
robot like My Spoon (Secom, 2014) or Bestic (Bestic, 2014) can support elderly users in eating. The
intelligent Assistive Robotic Manipulator (Farahmand, 2006) is a robotic arm to assist disabled or older
people with a severe handicap in their upper limbs. It can help to pick up and bring objects inside the
house. The Assistant Robot -HAR is a home assistant humanoid robot which could help with household
chores such as wiping the floor, washing and cleaning. RIBA-2 (RIBA, 2014) can lift up or set down a
human from or to a bed, wheelchair and toilet, using its very strong human-like arm and high-accuracy
tactile sensors (Mori, 2010). Whereas Care-o-bot III is a multipurpose robot used to assist people in
household; it can manipulate objects and make teleconferences.
In addition, robots could support older persons also outside of their home, collecting and distributing
laundry and garbage. Dustcart (Ferri, 2011) is a wheeled autonomous robot for door-to-door garbage
collection. DustCart is able to navigate in urban environments avoiding static and dynamic obstacles
and to interact with human users.
Mobility
Another important aspect of AAL technology is that it could try to restore elderly mobility. This can
allow an improvement of quality of life of the elderly. Robots for mobility assistance are classified into
three main groups: Electric wheelchair with a navigation system like HLPR (Bostelman, 2007) and Smart
Wheelchair. There are also mobile robots that support users in order to prevent mishaps and provide
stability like ROAD (Carrera, 2011) which is a robot that carries the weight of the user in order to make
up for the lack of physical strength of the caregiver.
52
Supporting Active and Healthy Aging with Advanced Robotics Integrated in Smart Environment
Smart walkers can support elderly users in movement tasks; they are designed for people with move-
ment residual capabilities (Robosoft, 2014). The exoskeleton robot can enhance users’ movement and
strength (Karlin, 2011).
Public transports are fundamental to independent living of older people. These systems must be acces-
sible and easy to use in different places like city centres, industrial or academic campuses, public parks
or airports. For instance RobuCAB is an electrical cyber car allowing the transportation of four persons
in an automated way. The vehicle works then either in a standalone vehicle or in a fleet vehicle managed
by a supervisor. Another autonomous electric vehicle is robuRide that can transport people from station
to station using pre-learnt routes, either on a shuttle mode or on an on-demand mode (Robosoft, 2014).
LESSION LEARNED
However, according to the literature on technology to promote ageing well in place, some crucial barriers
come out. First, ICT and robotics solutions often are developed without deeply knowing the end-users’
needs and what are the social and infrastructural conditions in which such technology should work.
Second, the design and functionalities of technology are thought up regardless of usability criteria that
are influenced by users’ technology experiences. Third, usually, one user’s need is met by one ICT and
robotic solution and often the developed system is not able to adapt itself efficiently and fast to users’ or
environmental changed conditions. Fourth, the technology solutions are not tested with real end-users
in order to assess the technology acceptance.
Therefore, the RoboTown Living Lab (LL) takes on these challenges in many EU and local projects
(DustBot (Ferri, 2011), AstroMobile (Cavallo, 2014b), RITA (Esposito, 2014), Robot-Era (Cavallo,
2012)), which contribute to implement RoboTown’s services and RoboTown LL infrastructure, in order
to overcome the shown barriers.
RoboTown LL of Scuola Superiore Sant’Anna is located in Peccioli (Tuscany, Italy) and includes
DomoCasaLab and Peccioli’s town centre with its municipality; about 5,000 people live in Peccioli,
with a large percentage of elderly people (25%). The actors involved in the RoboTown LL ecosystem
are Scuola Superiore Sant’Anna, SMEs (RoboTech, TechnoDeal) and the Territory of Alta Valdera. In
this sense, RoboTown LL represents an opportunity to enhance the cross-fertilisation between academy
and industry in order to overcome the gap between service robotics technologies and the current market.
Since 1995 RoboTown LL plays a central and important role by creating a bridge between technological
communities, local administrations and public institutions.
The aim of RoboTown LL is to overcome the barrier related to the flexibility, modularity and continuity
of services. In other words, the services developed have to be functional in heterogeneous environments,
such as private homes or public areas. In this context researches at RoboTown LL defined robot 3D
services (Cavallo, 2012) which implement multiple-users and multiple-robots in multiple-environments
(sec 3). With this new paradigm there is the transition from (one user-one robot) to (n user-one robot)
where a single robotic platform can provide services to different users (for instance a robot which is
able to move in a condominium environment); this concept will be described in the following sections.
Furthermore in order to prevent users from changing their behaviour to accept ICT and robotic solu-
tions; at RoboTown LL a User Centre Design (UCD) (ISO 9241) approach is applied. This approach
consists of different aspects allowing the development of wireless technologies, and home comfort and
robotics services solutions for the elderly population are sustained by a multidisciplinary team in which
53
Supporting Active and Healthy Aging with Advanced Robotics Integrated in Smart Environment
technology developers, designers and end-user representatives collaborate. The shown barriers were
ridden over involving users in all design phases:
1. Analysis Phase (Sec 4): At the beginning users are involved to know full well their needs and at-
titude towards technology in order to develop useful ICT and robotics solutions
2. Design Phase (Sec 5): At the middle users are involved to provide feedback on the technology
design so that it would be accessible. The accessibility also makes technology more acceptable
and usable by people in a wide range of situations
3. Evaluation Phase (Sec 6): At the end, users are involved in active experimentation in order to
validate the usability and acceptability of the developed ICT and robotic solutions
IMPLEMENTATION
The AAL technologies designed and implemented at RoboTown LL provide assistance and healthcare
support, transportation of goods and persons enhancing social inclusion and independent living of se-
nior citizens. The solutions developed are modular, flexible and customisable and are able to help and
support the daily life of users everywhere and at every time, overcoming spatial barriers. Based on past
and on-going projects, infrastructure, robots and service were implemented in order to cooperate and
operate in indoor and outdoor environments (3D service paradigm).
The RoboTown LL is composed of three different environments: the indoor, the condominium and
the outdoor environment.
1. The indoor environment is composed by the DomoCasaLab (Figure 2.A), which reproduces a fully
furnished apartment of 200 mq with a living room, a kitchen, a bathroom and two bedrooms.
2. The condominium area is composed by a main entrance of the building, a hall at the ground floor,
a corridor at the first floor and an automated elevator remotely controlled. The elevator allows to
perform the multi-floor navigation (Figure 2.B).
3. The outdoor environment is around the business incubator and the area is covered by a Wi-Fi net-
work. Also a video surveillance system is installed in order to prevent failures or damages (Figure
2.C).
In these environments AAL technologies are well integrated to provide adequate and continuous
services (see Figure 3).
Hardware
• Robotic Platforms: (Figure 2.B) One of the aims of RoboTown LL is spreading out a set of in-
tegrated AAL services from home to town. For this reason, the use of suitable robotic platforms,
able to act in domestic, condominium and outdoor environments, is essential. The foreseen out-
door robot is developed during the Robot-Era Project. This platform is an autonomous mobile
robot designed to transport objects in an urban environment such as escorting senior citizens,
performing door-to-door garbage collection and providing shopping and drug delivery services.
A condominium robot is designed to act as a concierge and to perform logistics and goods trans-
54
Supporting Active and Healthy Aging with Advanced Robotics Integrated in Smart Environment
Figure 2. The infrastructure and the companion robots developed at RoboTown LL; (A) the DomoCasaLab
(B) the three robotic platforms: the outdoor, the condominium and the domestic one, respectively (C)
the condominium environment with the elevator, on the top, and the outdoor environment, on the bottom
Figure 3. System architecture: the hardware, the software, the planner and the user interface
55
Supporting Active and Healthy Aging with Advanced Robotics Integrated in Smart Environment
portation in the building. It is able to autonomously move inside the building and take the elevator.
It is equipped with a set of rollers to perform tasks of exchanging objects with the outdoor robot.
The domestic robot is a mobile platform equipped with a touch screen tablet, voice recognition
and synthesis, a manipulator and a handle to physically support elderly people. The condominium
and the domestic robot have coloured Light Emitted Diodes (LED) in the eyes for facilitated and
immediate interaction with the user and inertial sensors in the head. They are also endowed with
localisation and obstacle avoidance sensors for autonomously moving in the environment and a
Wi-Fi module to communicate with other agents.
• Wireless Sensor Network: The DomoCasaLab is equipped with four different wireless sensor
networks (WSNs): User Localisation Network, Environmental Sensor Network, Body Sensor
Network and an indoor video surveillance system, in order to monitor the user activity support-
ing the user in the managing of the house. The environmental WSN based on ZigBee technology
is implemented integrating environmental sensors (temperature, humidity, light) with user pres-
ence, water/gas leak and door/window opening. The Body WSN is used to measure physiological
parameters as heart rate, respiration rate, temperature, activity and posture. As regards WSN for
indoor and outdoor localisation a wearable module was developed. The system was composed by
an inertial sensor to monitor motor activity, a GPS receiver and GSM/GPRS module for outdoor
localisation, a ZigBee module for indoor localisation and the GPS and ZigBee antennas. The sys-
tem was able to switch automatically from GPS (outdoor open space) to ZigBee module (indoor
environment). The capability of help request was integrated in the same device.
• Smart Appliances: Sensors are integrated in commercial appliances and furniture. For example,
smart-plugs will collect data on the energy expenditure, and barcode reads and load cells will
provide data to estimate the quantity of food in the smart fridge. The status of appliances like the
oven or bathroom fixtures could be monitored.
Software
• Navigator: The Navigator module is implemented to control the autonomous movement of the
robot and to acquire information from sensors installed on the robot, such as odometry and laser.
Navigator communicates with the robot actuators and sensors by means of the Player framework.
• Environmental Monitoring: An environmental WSN monitors the home status by using several
types of sensors (a switch on the entrance door, PIR, light, humidity, temperature and water leak
sensors). Data acquired from this WSN are collected and processed by this software module. This
software monitors the home status and alerts users and carers in the case of critical situations.
• User Localisation: The system is able to locate users in need of robot support in the continuous
care service. A localisation software acquires data from heterogeneous commercial and ad hoc
sensors, to estimate the position of the user. A sensor fusion approach is investigated to locate
people in a robust and scalable manner. The accuracy and cost of the indoor localisation service
will depend on the typology and number of the installed sensors. In the case of a sensor fault, the
user position is estimated by fusing data from the remaining ones, improving the reliability and
robustness of the service.
• Speech: The speech module represents the natural language interface between the end-user and
the robot by means of appropriate commercial tools of speech recognition and vocal synthesis.
56
Supporting Active and Healthy Aging with Advanced Robotics Integrated in Smart Environment
• Calendar: A calendar tool is integrated into the system, and provides a service to carers and users.
For instance it could be used for medication and care management. In this way, users and carers
are allowed to schedule therapies and medical visits on the calendar. The system automatically ad-
dresses a robotic reminding service at the scheduled time, to remind the user about appointments
or medication. The appointment could be added by means of custom web application or Google
Calendar.
• Database: The database is able to storage data, to retain the data and optimise the searching
procedures. It contains the WSNs outputs and the environment maps for the user localisation
procedures. Furthermore, the database stores the maps for the robot navigation in unknown
environments.
Planner
The heterogeneity of the components involved in the system requires a form of sophisticated reasoning:
the tasks typically required can be accomplished in different ways depending on the specific state of the
environment; they are in general dynamic, which is to say that the human user can post them anytime,
also implying concurrency between multiple goals; and other requirements can even be generated by
the system itself monitoring the state of the system (e.g., a gas sensor could trigger the intervention of a
robot to notify the user). Furthermore, a task execution often requires a set of interconnected (and het-
erogeneous) actions carried out by a multi-robot system in which the access to shared resources (e.g., a
condominium robot supporting the activities related to multiple apartments) must be carefully managed.
This kind of set is called ‘plan’ and it was managed implementing a dedicated planner (Di Rocco
M., 2013).
User Interface
The user can exploit RoboTown services by means of multimodal interface (touch-screen, speech); in
addition custom interfaces have been developed in order to provide more useful service. Web portals are
able to manage different services (garbage, communication, shopping, reminding). Furthermore another
web portal provides home monitoring (mean light, humidity and temperature and entrance door status).
It is connected directly to the database, and the access is restricted to authorised people only. In addition,
the localisation web page reports the room where the users are located.
ANALYSIS PHASE
‘Incomplete understanding of user needs is one of the major sources of system failure’ (ISO 9241); in
fact technology is too often oriented to a young technical target and the ICT solutions designed for el-
derly people and the other involved stakeholders highlight the lack of a specific analysis of their needs
and attitude towards technology.
The RITA Project started from an accurate overview of the situation of elderly assistance on the terri-
tory thanks to the support of public and private socio-medical organisations working with elderly people.
In this study more than 200 elderly people were interviewed about their quality of life and needs, as
well as about the services received by social-medical organisations; also 70 among formal and informal
caregivers expressed their opinions about the quality of services (Figure 4).
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Starting from ADL (Katz, 1963) and IADL (Lawton, 1970) scales, WHOQOL-BREF and WHO-
QOL–OLD (Power, 2005), two investigation questionnaires were designed using both a five-point Likert
scale, for collecting easily information and comparing answers, and also open-ended questions allowing
subjects to express freely their opinions.
The acquired data showed that the 66.5% of participants were alone or together with his/her old part-
ner and had contact with their descendant family mainly via phone calls and one/two visits per week.
Furthermore about 80% of them had some health problems and followed at least a medical therapy but
they met their general doctor one or two times per month. Concerning the daily activities evaluation,
the majority of participants were self-sufficient, however almost all needed help to perform some of
these tasks.
In addition, the health problems and the social isolation risk, due to motor diseases or depression,
were the main factors that influenced the perceived quality of life.
Furthermore older people should be able to access ICT and robotic solutions quickly and easily; for
this reason the elderlys’ attitude towards technology was investigated. The results showed that all involved
people used without problems the TV and the devices connected to it (VHS recorder and DVD player)
and the everyday appliances such as washing machine, vacuum cleaner, dishwasher etc. It should be
noted that many older adults used the MP3 players (40%) and satellite navigation system (50%) and all
participants had a mobile phone and used it without any problems. In addition many interviewed elderly
people were able to use a computer and most of them used internet for entertainment and information.
Finally the encouraging data was that the involved old persons reported willingness to learn of new
technology use in order to be in step with the times.
Investigating the caregivers’ point of view about the introduction of technologies in assistance services
for the elderly, 91% of formal caregivers believed that these new types of interventions could increase
the quality of service. Furthermore technology could improve the security of the elderly and could
consequently have positive effects on elderly quality of life respectively for 82% and 77% of the sample.
In order to meet the elderlys’ and caregivers’ needs identified during the analysis, the following
services were implemented:
• Indoor and Outdoor Localisation: The developed system could help caregivers to know always
where old persons were, especially during their absence. Furthermore the wearable module al-
lowed elderly people that have feelings of vulnerability and insecurity to go out for their activities
in safety because they could be localised with high precision in case of need. The system is com-
Figure 4. Some focus groups with elderly people and caregivers in order to understand user needs
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posed of an inertial sensor, GPS receiver for outdoor localisation and ZigBee module for indoor
localisation (Bonaccorsi, 2014). The caregiver could localise the user by means of user-friendly
interface.
• Help Request: In this way elderly people could maintain their autonomy and independence and
the caregivers could be dismissed from permanent assistance because in case of need an old user
could activate a help request and could be localised in both indoor and outdoor environments
thanks to a wearable module. In particular, this module sends a SMS on the caregiver’s phone
when the user needs help. The sending process may be automatically under certain conditions (i.e.
user fallen). The same wearable device is able to perform the ‘Indoor and outdoor localisation’
and ‘Help request’, improving the usability.
• Domestic Environment Monitoring: Sensor network allowed elderly people to live at home
in security because unexpected environmental changes were detected and alert requests were
promptly sent to the caregiver. These technologies together with the localisation module allowed
to estimate elderly motor and static activities (for example, time in front of TV) and recognise
some activities as sleeping or napping. This information could be useful for caregivers to plan
activities to maintain senior users active from the motor and social points of view.
• General Health Status Monitoring: Thanks to a wearable monitoring device, the main physi-
ological parameters could be monitored, stored and remotely analysed by a medical doctor. In this
way elderly people could receive more attention about their health by clinicians increasing their
safe feeling. Also one formal caregiver could monitor more old persons at the same time improv-
ing the quality of service and reducing the costs.
• Reminder: Technology can support elderly people in reminding tasks. The user, or the family
members, can set up commitments and appointments by means of Google Calendar or a specific
web portal. At a proper time, the system, through the robot, alerts the user; the robot reaches the
user acting as a physical reminder by means of physical presence, voice synthesis and visual re-
minder on the tablet. Furthermore, it can bring and transport objects (i.e. pills, or water bottle) by
means of robotic arm supporting elderly persons with physical disabilities.
• Indoor and Outdoor Mobility: Robots are physical agents with embodiment characteristics, so
they can empower the personal mobility of senior citizens. The domestic robot can help users in
personal transferring inside the house, getting up from the chair or the bed by means of an appro-
priate handle in the back. In order to promote the ageing social inclusion, also the outdoor robot
presents a handle with a joystick, so it can provide physical support during the outdoor walking.
• Communication: In this service elderly persons improve social inclusion, having video confer-
ences with family and friends. By means of robot the user can do phone calls and see far friends
and family. Robots’ multi-modal interfaces can facilitate the use of the services from the users’
points of view.
• Shopping/Garbage Collection: These services provide a complete means of delivering groceries
from the shop to the user’s apartment and garbage collection from the apartment to the collection
point. Using these services, the user can receive continuous support in daily activities by means of
a 3D-service. The services start with a user’s request through a voice command using a wearable
wireless microphone or using the interface running on the robot tablet.
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DESIGN PHASE
After the Analysis Phase, the users were involved in the Design Phase. In the ASTROMOBILE Project
some elderly volunteers were recruited to be involved in the analysis of design criteria and in particular
the study investigated:
• Interfaces to facilitate the interaction between elderly persons and robot
◦Types of interfaces (speech recognition and vocal synthesis, visual interface, touchscreen,
buttons and screen, remote controller etc.);
◦Redundancy;
◦Feedback (coloured lights).
• Appearance of ASTRO robot to be perceived safe, friendly and acceptable by senior citizens
◦Shape (human-like, unhuman-like);
◦Dimensions;
◦Colours;
◦Materials.
Then a focus group with eleven old persons living in the Peccioli area (Pisa, Italy) was carried out to
study what seniors think about the robotic assistant, how they configure it in order to perceive it usable
and acceptable. To collect this information an ad-hoc questionnaire was conceived and used during the
focus group; this tool was made of both multiple-choice questions and free response questions in order
to compare and quantify elderly opinions but at the same time to collect their free motivations.
From the survey with seniors it emerged that most participants chose the vocal interface and the
remote controller because for them speaking is the most natural way for communicating so they would
like that the robot could understand their vocal commands and also reply to them with vocal messages.
Furthermore about the remote controller seniors know well about using a TV remote controller so they
suggested using a similar tool to control also the robot. In addition elderly persons appreciated the idea
to use redundant interfaces (i.e. both visual and vocal messages) because they are free to choose how to
interact with the robot according to the situation and to be sure of having comprehended robot feedback.
Concerning the ASTRO robot appearance most of the elderly pointed out that a human-like shape
would be perceived as more friendly and the robot size should be smaller than a human one in order for
the user to perceive the control on it. Furthermore about the robot colours, the most voted ones are blue
and grey because they are two soft colours that don’t evoke anxiety and they should coordinate well in a
domestic environment. Then during the focus group elderly subjects touched different kinds of materials
(plastic, rubber, metal) having different consistencies (soft, rigid) and textures (smooth, rough). After
asking them to choose the material for the robot cover, most of the elderly preferred the combination of
rigid material with spongy areas.
Results obtained from these surveys were used to address the design of the ASTRO robot’s appear-
ance and the final version of the robot had a human-like shape with a head having some human-like
features (stylised eyes and mouth) (Figure 5). Furthermore the ASTRO cover was made of ABS, a rigid
thermoplastic material, having some spongy trimmings on robot trunk sides and on the head at the level
of ears. Finally the ASTRO cover was coloured grey and the spongy trimmings were blue with two pos-
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sible versions (jeans and patterned). Concerning the human-robot interaction, ASTRO was designed to
support both the touch screen for GUI and a recognition software for the vocal interaction. Furthermore
ASTRO was developed to provide coloured lights feedback related to the task at the level of ASTRO’s eyes.
EVALUATION PHASE
After designing and developing the ICT and robotic solutions, elderly volunteers were invited to DomoCasaLab
to interact with the robots and other devices in order to evaluate the technical effectiveness and acceptability
of the proposed services. The aim of each robotic project is to demonstrate the feasibility and the effectiveness
of robotic services for the user target for which these services are developed. This purpose could be achieved
with intensive experimentations, involving all stakeholders in realistic or real environments. The final objective
is to investigate the acceptability and usability of the system in order to reduce the time-to-market.
The experimentation consists of three phases:
1. Pre-Test Phase: In which the stakeholders are recruited according to the inclusion criteria and
general socio-demographic data are acquired.
2. Test Phase: In which the enrolled stakeholder tests the robotic service.
3. Evaluation Phase: In which the acceptability and usability feedbacks from the user are collected.
Pre-Test Phase
One of the most important issues regarding a successful experimental loop is an adequate selection of
test participants. The recruitment phase is crucial because the reliability of the final results depends
on the enrollment of a suitable sample focussed on the project aims. In our experience more than fifty
elderly people, aged over 65 years old, without severe cognitive impairment, were recruited. After the
subjects’ enrollment, the socio-demographic data needed to be acquired in order to have a description
of the sample.
Figure 5. Preliminary studies of initial concepts and final version of ASTRO robot
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Test Phase
Before the experimentation, the consciousness of technological possibilities is often a little low, dem-
onstrating that end users are unaware of the potential of technology to help them in daily lives. For this
reason, a training phase is indispensable either for elderly people and caregivers.
Before starting, both in RITA and Robot-Era experimentation, an elucidative video about the developed
technology potentiality was shown to test-users in order to increase users’ attitude towards it. Furthermore
the researchers dispelled users’ doubts so elderly people and caregivers participated in a well-aware way.
After the training phase there are many modalities to conduct experimentation with real end-users.
In the RITA Project two focus groups were conducted, one with elderly people and one with formal
caregivers, for testing RITA services and ICT system (see Figure 6). The focus group is a technique for
social research based on discussion among a small group of people invited by one or more moderators
to talk deeply about the topic under investigation. The involved subjects define their position on the
issue, confronting each other. The drawback is that people can influence each other, but the researcher
can limit this problem.
On the other hand in Robot-Era projects elderly persons were invited to interact with robots in a real-
istic condition. The experimental environment was set as real as possible in order for the user to interact
with the robotic system, perceiving the usefulness as in real life. The researcher was present during the
experimentation for security issue.
The future direction will consist of realising a long-term experimentation involving the end-users in
their environments to test the ICT and robotic solutions in real conditions. In this experimental modality
the researcher will be not present and the test-user cannot be influenced.
Evaluation Phase
In this phase the usability and acceptability of the system needed to be investigated in order the design
addresses the whole user experience.
Usability refers to the ‘extent to which a product can be used by specified users to achieve specific
goals with effectiveness, efficiency and satisfaction in a specified context of use’ (ISO 9241). It can be
evaluated with many tools such as ‘Thinking Aloud method’ or ‘Systems Usability Scale’. In the Thinking
Aloud method the participants are urged to describe what they do and think vocally during the accom-
plishment of tasks. This measure is particularly used with test and analysing methods (Ericsson, 1993).
The “Thinking Aloud method” allows the researcher to investigate in detail the overall user experience
because people express their feelings, thoughts and scepticisms directly when using the system. By us-
ing only interviews and questionnaires the data which will be produced spontaneously (like cursing and
swearing) will be lost for documentation and for the data analysis. Furthermore the Systems Usability
Scale (SUS) (Brooke, 1996) is a simple and not highly detailed evaluation method that uses a standardised
form with ten questions to assess the product’s usability. The noted benefits of using SUS include that
1. It is a very easy scale to administer to participants,
2. It can be used on small sample sizes with reliable results, and
3. It is valid because it can effectively differentiate between usable and unusable systems.
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Figure 6. Examples of services implemented at the RoboTown Living Lab; at the bottom are shown on
the left the web portal for the home monitoring and the user localisation, and on the right the sensors
in the DomoCasaLab
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Acceptability is defined as ‘the demonstrable willingness within a user group to employ technology
for the tasks it is designed to support’ (Dillon, 2001). Technology has become an important part of our
everyday lives. Human-computer studies and human-robot studies focus on the interaction between
humans and technological objects. In general, technology acceptance models are used to analyse the
complex relationships between different variables and the acceptance of technological products. In
studies on robot acceptance, this has some drawbacks because robots are more complex than other
technological devices such as computers; in fact their acceptance depends on their shape, functions and
capabilities. The Technology Acceptance Model (TAM) (Davis, 1989) is the most prominent concept. It
was developed to understand expectations about information technology usage and comprises two main
variables that have an impact on acceptance: perceived usefulness and perceived ease of use. Neverthe-
less, the TAM does not take socio-demographic factors into account. Another approach is the Unified
Theory of Acceptance and Use of Technology (UTAUT) (Venkatesh, 2003), which suggests four key
constructs (performance expectancy, effort expectancy, social influence and facilitating conditions) as
direct determinants of usage intention and behaviour. This concept takes into account socio-demographic
factors (gender, age) and individual factors (experience, voluntariness of use), which are deemed to be
influenced by the four key constructs.
In the RITA Project the users’ feedback was collected through an ad-hoc questionnaire based on a
five-point Likert scale (scores on ‘negative’ statements like the ones on Anxiety had reverse scores).
From the survey with seniors it emerged that 72.55% of them had the intention to use the system over
a longer period in time, if this technology would be economically accessible. In confirmation of these
data, most elderly participants (83.62%) perceived the proposal system very useful because they believed
that using the RITA services would enhance their self-assurance (90.20%) and quality of life (47.06%).
Furthermore the usability was well estimated by 67.35% of the older volunteers who didn’t feel anxiety
during the test session.
The results obtained from the surveys with formal caregivers were very positive as shown in Figure
7. Furthermore the technology doesn’t hurt the relationships between caregiver and assisted person ac-
cording to participants’ answers (89%), but all caregivers thought that the use of showed technology and
services could improve the quality of the provided socio-medical services.
In Robot-Era projects the SUS was used to compare the usability of all services in an efficient and
validated way. Regarding the acceptance, an ad-hoc questionnaire, based on the UTAUT core constructs,
was developed. The outcomes of the surveys were elaborated in order to get a Usability and Acceptance
Score range from 0 to 100 and the interpretation of the score is (McLellan, 2012):
• 0-64 Points: Not usable / acceptable.
• 65-84 Points: Usable / acceptable.
• 85-100 Points: Excellent.
The main results on Usability and Acceptability of each Robot-Era service are reported in Figure 8. In
general the Robot-Era services were judged strongly usable, as shown by the number of scores related to
the ‘Excellent’ range (green bar). In particular according to the elderlys’ feedback, the Robot-Era services
were easy to use and the actions performed by the robots were well integrated. However the ‘Shopping
and Drug delivery’ and the ‘Reminder’ services were not usable for some users, because these tasks were
performed using a GUI runnable on a tablet and some of the elderly were not confident with this device.
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The questionnaire on the acceptability of the Robot-Era Services was elaborated considering its
different parts, Attitude, Acceptability attributes, Human-Robot interaction, Graphical interface, Vocal
interface and Effect on the Quality of Life, in order to get a unique score. The main results of the analysis
are reported in Figure 8 and as shown, most of the older persons participating in the experiments pro-
vided positive judgments about the acceptability of the services and the mean values of the score were
in the range ‘Excellent’ (green bar).
The researchers at RoboTown LL learned three lessons from the experimentation conducted with
end-users. First, elderly people prefer to interact with robotic systems using a vocal interface because
they perceive it more natural and easier to use. However observing the conducted tests we can assert
that elderly persons learned quickly to use GUI on a tablet, if the interface was developed according
end-users’ attitude and experience. Second, the obstructiveness of the ICT and robotic solutions should
be minimised to reduce the impact on the user’s environments and lifestyle in order to improve the us-
ability and acceptability. In fact if the technology is integrated in the environment, it is perceived more
Figure 7. The acceptability results gained in the RITA Project; on the top there are the results regarding
the elderly persons, while on the bottom there are the results regarding the caregivers’ part.
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usable and it doesn’t evoke anxiety in the elderly persons. Third, the intention to use a new technology
is strongly related to the perceived usefulness, so in order to improve the acceptability elderly people
should follow a basic training to understand the technological functionalities.
SOLUTIONS AND RECOMMENDATIONS
The experience described in this chapter demonstrated that AAL technologies are nowadays feasible
and effective and can actively be used in assisting senior citizens in their homes. It is evident from
RoboTown LL experiences that these technological challenges require an interdisciplinary approach,
including expertise from the domain of medical science, robotics, engineering and computer science but
also expertise from the domain of architecture, design, psychology, law and ethics. Furthermore robot-
Figure 8. The usability (top) and acceptability (bottom) results gained during robot-era experimentation
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ics and ICT solutions should be distributed and pervasive in order to support the entire population from
home to hospital, from residential facilities to smart quartiers. These solutions should be integrated in
the design of the environment, in order to reach a high level of acceptability and usability for the users.
It is worth mentioning that from the real experimentation, with real users in a realistic environment,
some general recommendations concerning society/users, technical and legal/ethical issues come out
(Figure 9).
In particular, analysing the system from the point of view of end-users and stakeholders, future usable
robotics and ICT solutions should have:
1. Society Centred Design: Since the robotics solutions should be used by users as an active support
of daily living, they should be designed, developed and implemented for the society and around the
society, in a society centred design approach. The future technology should pass from user centred
design to society centred design, where the design phase should be taken into account and also the
society’s need. All the projects described in the previous sections were developed including users
in all the phases, from the analysis of end-users’ needs to the evaluation of the prototypal system
in order to gather useful feedback and comments.
2. Stakeholder Readiness: Since the integrated solution should be usable also from society’s point
of view, it is also important to take into account the time-to-market. That is the degree to which the
people and systems are ready to adopt and diffuse the technology in a reasonable time frame. This
issue is strictly related to the gap between the research and the commercialisation of a product.
3. Low Cost: Since the robotics are intended to be personal, the cost should be compatible with us-
ers’ economic possibility, in order to allow a large service utilisation. The reduction cost of robotic
solutions is a result of a cost-benefit analysis: on one hand, the robotic system is expensive because
of the high technology used; on the other hand it could reduce the cost of hospitalisation. In this
context a new model of business built on cloud robotics solutions could have the potentiality to
offer a new generation of personal robots.
Figure 9. Recommendations come from the experimentation with real users at the RoboTown Living Lab
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4. Customisability, Flexibility, and Modularity: Users’ needs are different and change over time.
As a consequence, it is important to provide a modular service which could adapt to user needs
and capabilities which could change.
5. Robustness, Dependability, Safety, and Security: Since the robotic system should interact with
weak and older persons, it must be safe and reliable.
6. Autonomy: The robotic system should be able to move autonomously and make decisions accord-
ing to need of users, and should recognise mistakes committed by users or itself and self-correct,
when necessary. The robot should also provide for emergency situations and to act independently
to avoid them.
7. Training: The realistic test with real users also demonstrated that the introduction of AAL technolo-
gies in the public and private system of social care services was not easy because of the mistrust
of caregivers regarding these new strategies of care based on technologies that will change their
professional role. Particularly, moving forward in bringing AAL technologies to the home required
dialogue between academia, service providers and patients and their families. For this reason, the
training activities for caregivers focussed on the existence of AAL technologies, and their use was
fundamental to demonstrate to them that AAL technologies can help them in their work without
reducing their importance and role.
From a more technical point of view, the experiences acquired during the experimentations described
before enhanced critical issues that, in the authors’ vision, should be considered as a starting point for
future works.
The key aspect of an autonomous and pervasive system is the integration among its own elements
and with third-part solutions; a robust and effective integration should have the following characteristics:
1. Dependability: One of the most critical problems of a monolithic system (as a stand-alone robot) is
its dependability. Using a distributed approach, a single problem with an agent of the system would
not compromise the whole status. A dependability test should be performed improving safety and
repeatability.
2. Cloud Computing Resources: A future integrated system should be able to be integrated also
with cloud resources in order to increment the quality of service, the storage and the computational
capabilities. In this way also technical solutions could be proposed in a pay-per-use modality,
decrementing the total cost.
3. Intra-Communication: All agents should have the possibility to communicate to each other. In
this way, a simple and local process can be performed with direct communication between involved
agents, without the necessity of a global management performed by the planner.
4. Extra-Communication and Modularity: In order to guarantee future development of the system,
the interface between the system and a possible external application has to be stable and well-
defined. Furthermore, the system has to be modular: in this way, further specialised modules can
be easily defined, developed and integrated. In our experience, the modular approach allowed to
easily integrate the elevator in the Robot-Era system. In conclusion, a complete and easily under-
standable interface and a well-organised modularity are the bases for further development of the
system.
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5. Multimodal and Natural Interface: Generally the users have little or no experience with comput-
ers or other technologies. So, robotic applications need easy interfaces in order to allow natural
interaction with the agents. As a consequence natural and untraditional interfaces should be taken
into account. Following this direction, specific research has been performed implementing natural
language based interfaces and developing an intuitive dialogue manager. Future research will focus
on gesture recognition.
6. Integration with Mobile Technology: Since mobile technology has become an important part of
our daily life, a robotics solution should be integrated with it in order to enhance the acceptability
and usability level.
7. Integration with Social Networks: Since social networks are becoming more common in our
daily life, technological solutions should be integrated with them, avoiding the multiplication of
several user interfaces improving the usability.
Finally, several ethical implications must be taken into account before designing and adopting new
solutions. These considerations generate a set of constraints with respect to the design and conditions
of adoption of a robotic system collected in the European project Senior (SENIOR, 2014) and that were
summarised in (Cavallo, 2012) as the following:
1. Adoption of the System Must Respect the User’s Freedom of Choice: It must not be imposed,
but proposed. It should be presented as an alternative to or an improvement over the existing service
provided to the user, and if the system provides a novel service, care must be taken not to present
such service as an obligation, but as a choice.
2. The System Must Reinforce Personal Autonomy: Functional performance of a robotic system
must not become an incentive for the user to become dependent upon the system.
3. The System Must Safeguard Dignity and Self-Esteem: Functional performance of a system
should not come at the expense of the user’s sense of self-worth and dignity.
4. The System Must Emphasise User Safety: While a priori obvious, this consideration touches an
interesting ethical question insofar as it may require the designers of a given system to voluntarily
limit the control given to the user over that system. The line separating a valid security measure
to an ethically reprehensible hindrance to user freedom may thus become difficult to identify in
some cases.
5. Policy Relevance: The commercialisation of a specific device is strictly correlated with the degree
to which use of a particular technology aligns with currently adopted or emerging policies. On
the other side, the use of a specific integrated technology solution can inspire positive change to
long-term care system policies.
FUTURE RESEARCH DIRECTIONS
In the context of the background depicted, ICT systems and robotics services have been developed in
order to provide a valid solution to support the independence of elderly people and improve a sustainable
healthcare system. Analysing the current state of the art, it is possible to recognise a trend over the use
of ICT and robotic solutions: the first solutions were focussed on the creation of a stand-alone solution,
both a robot or a sensor network or ICT technology. Thereafter, these solutions have been merged and, at
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the same time, the intelligence of the system has been moved from a central actor to a more distributed
architecture. The current direction of development is going towards a cloud design, where resources,
software and information are shared over a network infrastructure.
A service robot is a robotic system that assists people in their daily lives at work, in their house or
leisure and as a part of assistance to the elderly population (Moradi, 2013). Usually, standalone robots
are conceived to perform specific tasks, like cleaning, tele-presence, walk support or escorting (see
background paragraph for details). On the other side, smart environments and ICT services were typically
conceived to monitor the activity of a restricted number of people, and provide personal communications,
energy saving, safety and security services.
As introduced, recently standalone robots have been integrated in smart environments to act as simple
companion robots (Iwata H., 2009; Banks, 2008) or to provide complex assistive services (Badii, 2009;
Cavallo, 2014b). In this new paradigm, called networked robotics (Sanfeliu, 2008), robots provide dedi-
cated services to the users anywhere and anytime, by leveraging the use of wireless communications and
the cooperation between robotic agents. Networked robotics is a trend that envisages the distribution of
robotics application among a set of processors located inside and outside the robots. Robots cooperate
between them and other robotic agents like smart homes and wearable sensors, to improve their sensing
and panning capability, in order to provide more complex, acceptable and dependable assistive services.
As a consequence robots become an active part of a network completely each other. In this way smart
environments and intelligent agents extend the effective sensing range of networked robots improving
their planning and cooperation capability (Cavallo F., 2014b; CompanionAble, 2014; GiraffPlus, 2012).
Nevertheless stand-alone and networked robots present limited computing capabilities and they could
be not sufficient for continuously supporting daily activities (Kamei, 2012).
Some of these constraints can be overcome by integrating robots with cloud computing resources
through the concept of cloud robotics (Goldberg, 2013). This concept leads to more intelligent, efficient
and a cheaper generation of robotic networks. Cloud robotics is not a completely new idea; during the 90s
Prof. Inaba (Inaba, 1997) conceptualised the remote brain paradigm. The big opportunity to develop and
improve this idea is now available (Ferratè, 2013) because of rapid and exponentially growing wireless
communications both outside (3G, LTE) and inside the home (Wi-Fi) and recent innovations in cloud
computing technologies (Lu, 2014). In addition, smartphone penetration is on the rise all over the world,
allowing the possibility to be connected everywhere (Mobile Planet, 2014).
The cloud robotics paradigm extends the concept of multi-robot collaboration, integrating cloud
computing resources (Kuffner, 2010). ‘In this context, robots are connected to cloud infrastructures for
access to distributed computing resources and datasets, and have the ability to share training and labeling
data for robot learning’ (Kehoe, 2013). In (Goldberg, 2013) Ken Goldberg emphasised the benefits of
the great computation capacity and memory allocation of cloud infrastructures, providing a new form
of collective robot intelligence through learning and sharing paradigms. Cloud resources could be used
as a way to improve the robot’s awareness of surrounding objects and environments, implementing a
software repository for everyday objects, images and features, in order to help robots in object recogni-
tion and manipulation tasks (LAAS, 2014).
Recently several researches have focussed their efforts into cloud robotic fields (Goldberg, 2014b).
For instance, the RobotEarth Project aims to implement a World Wide Web for robots (Hunzinker, 2013).
Using RobotEarth architecture robots can store and share information, can offload computational tasks
and can collaborate with other robots. The Software as a Service (SaaS) (NIST, 2014) approach allows
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low cost robots to move computational-intensive data processing to the cloud. In this way, different on-
demand computing resources could be added to improve the computational capability of the robots. Du
et al. (Du Z., 2011) introduced the concept of Robot as a Service (RaaS) which is conceived to resolve
issues on continuity of services. The relationship between users and robotic platforms is mediated by
a robot management system that coordinates and selects the proper hardware platform to fulfill user
needs and provide the required robotic services. In this model, the user is not required to have a robot,
but robots are shared by different users.
The cloud service robotics paradigm extends cloud robotics to AAL fields. In this paradigm, different
agents are integrated in order to achieve an efficient, effective and robust cooperation between robots,
smart environments and humans. In a user centred design vision, a cloud service robotic paradigm aims
to manage different types of robots, in different locations providing tailored and modular services to
older persons in a scalable, affordable and reliable manner.
Eventually, technical cloud robotic challenges mainly focus onto five aspects (Goldberg, 2014a):
1. Big Data: By means of cloud storage, robotic agents, but also other ICT technologies, have access
to a vast amount of data, such as a library of images, maps and object data.
2. Cloud Computing: This technology offers grid computing on demand for statistical learning and
motion planning guarantying the quality of service.
3. Open Source Data and Code: Robotic agents, like humans, will share information and algorithms.
4. Collective Robot Learning: The data collected by different robotic platforms or other agents could
be analysed by means of machine learning algorithms.
5. Crowdsourcing: Robotic agents could access also the vast amount of information available on the
internet and retrieve on demand human guidance for evaluation, learning and error recovery.
Therefore these aspects are mainly related to the technology part. But when researchers design and
implement innovative ICT solutions to support senior citizens, they have to take into account also other
aspects related to society and market. In this way, the acceptability and usability level will increase and,
consequently, the time-to-market of a specific technology will decrease.
The technology should be designed to be pervasive, modular and custom. The user should be im-
mersed in technology, in a transparent way without being invasive, to be supported in each aspect of his/
her daily living. In the near future, in a smart city context, the integrated technology solutions should
support citizens offering different services according to their needs such as energy, traffic and health
management. For instance senior citizens could use this service to be part of the community, promoting
their active social inclusion, to be aware of their health status connecting with other care stakeholders.
These systems should be developed and implemented very close to humans, with some peculiarity
of human beings, in order to achieve the next generation of cloud social robotics. The future service
should be designed passing from user centred design to society centred design, taking into account ac-
ceptability, usability and legal and ethical issues. This integration is not only a matter of technical issues,
but should be the result of synergic action of issues coming from different fields. Cloud social robotics
should cover also aspects related to the friendliness of technology, the communication and integration
between different devices and the integration of common human-machine interfaces to control new ser-
vices in order to reduce the multiplication of multiple interfaces (one interface-multiple technologies).
71
Supporting Active and Healthy Aging with Advanced Robotics Integrated in Smart Environment
CONCLUSION
Eventually, the aim of this chapter was to describe how demographical and societal challenges related to
the aging population and the increasing demand of nurse practitioners can be addressed and optimised
by the integration of ICT and robotic technologies in a smart environment. The concrete experience of
RoboTown Living Lab has been reported and discussed in order to describe how technological barriers
can be overcome. Furthermore, at the end of the chapter, the authors gave some advice and recommen-
dations for future design of new services based on AAL technology.
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KEY TERMS AND DEFINITIONS
3-D Robotic Service: A paradigm where robots are integrated in different smart environments and
coordinated by intelligent agents over the cloud infrastructure to provide continuous services to citizens.
Acceptability: The combination of all factors that influence technology adoption or rejection by society.
Ageing Well: Defined as continued independence with good self, rated health and psychological well
being. Applied to the ageing process, independent living could be called ‘Ageing in place’, insisting on
accompanying the ageing process so persons have not to change drastically their environment or move
from it because of some loss of functions or mobility abilities, or health problems.
Cloud Robotics: Integration of robotics with cloud computing resources. This paradigm led to a new
generation of robotics. Through the cloud, robots can share knowledge, data and algorithms.
Cloud Service Robotics: A paradigm which extends cloud robotics to AAL fields. In this paradigm,
different agents are integrated in order to achieve an efficient, effective and robust cooperation between
robots, smart environments and humans.
Living Lab: A user centred and open-innovation ecosystem to promote social innovation. It operates in
a territorial context where research centres, industries and social organisations active in the area cooperate
together to provide innovative service. Here the citizens can be an active part of the innovation process.
Service Robotics: Robotic systems and services, which proactively act for assisting, monitoring and
providing well-being of elderly or not self-sufficient people in assisted environments.
