CE: KS QA: Coll: 1 6 11 16 21 26 31 36 41 46 51 56 61 66 71 76 81 86 91 96 101 106 111 116 Techset Composition India (P) Ltd., Bangalore and Chennai, India TBIT816773 Page#: 17 Printed: 3/7/2013 Behaviour & Information Technology, 2013 http://dx.doi.org/10.1080/0144929X.2013.816773 Night optimised care technology for users needing assisted lifestyles J. Augusto a*† , M. Mulvenna a , H. Zheng a , H. Wang a , S. Martin b , P. McCullagh a and J. Wallace a a School of Computer Science and Mathematics, University of Ulster, Newtownabbey BT37 0QB, UK; b School of Health Sciences, University of Ulster, Newtownabbey BT37 0QB, UK (Received 23 October 2012; final version received 11 June 2013 ) There is growing interest in the development of ambient assisted living services to increase the quality of life of the increasing proportion of the older population. We report on the Night Optimised Care Technology for UseRs Needing Assisted Lifestyles project, which provides specialised night time support to people at early stages of dementia. This article explains the technical infrastructure, the intelligent software behind the decision-making driving the system, the software development process followed, the interfaces used to interact with the user, and the findings and lessons of our user-centred approach. Keywords: ambient assisted living; sensing; software engineering; user-centred design 1. Introduction In the countries of the UK, healthcare reforms have placed a renewed emphasis on the delivery of primary care, with a focus on prevention and wellbeing. This updated approach to care has been mirrored in many countries in the developed world. Assisted living systems can support the shift of care from the secondary/tertiary care hospital to the client’s own home. There are clear indicators that the proportion of older adults in the population is increasing: by 2035 the number of people aged 85 and over is projected to be almost 2.5 times larger than in 2010, reaching 3.5 million and accounting for 5% of the total population. The population aged 65 and over will account for 23% of the total population in 2035, whilst the proportion of the population aged between 16 and 64 is due to fall from 65% to 59% (UK National Statis- tics Guide to Older People 2012). As this process unfolds, it is important that such solutions are embraced within the healthcare service delivery pathways. This remains a sig- nificant organisational challenge, in addition there may be a significant market opportunity for suppliers to deliver ambi- ent assisted living (AAL) applications (Augusto et al. 2012). Such applications require technology (both hardware and software) which is reliable, stable, minimally intrusive and easy to use. In 2011, Northern Ireland’s government signed a six year contract for telehealth technology, covering patients with heart and respiratory conditions, diabetes and those who have suffered a stroke (Sade Laja 2012). Health Minis- ter Michael McGimpsey said the pressure on the country’s health budget meant that the service will have to find new ways of ensuring the delivery of a high quality service. He stated: With increasing numbers of people presenting with more and more complex needs and extremely high expectations of the health ser- vice, we must continue to provide the highest possible standard of care. There is no doubt that remote telemonitoring is a prime example of the innovation that will be required going forward. Initial results from the UK’s Telehealth Whole System Demonstrator programme showed that, if delivered prop- erly, telehealth can substantially lower the number of bed days spent in hospital and reduce mortality, the need for admissions to hospital and the time spent in Acci- dent & Emergency Departments (Department of Health Whole System Demonstrator Programme: Headline Find- ings 2011). Indeed, cost saving is a major political and economic driver for telehealth (Limb 2012). In addition to the technology push, there is growing interest in assis- tive technology from the medical community (Daniel et al. 2009). As always, with the introduction of new technology and the resultant changes in the healthcare organisation, timing is a contentious issue. For example, in a recent article in the British Medical Journal, Gornall questioned whether such changes are premature, citing the need for more time for evaluation (Gornall 2012). Whilst telehealth solutions for long-term conditions such as chronic obstructive pulmonary disease and heart dis- ease has received attention (Car 2012), less work has been undertaken in the area of assistive technology for dementia care. This type of assistive technology is normally defined as ‘telecare’. In Kerr et al. (2010) the following definition is provided: ‘Telecare is used to describe the use of equipment * Corresponding author. Email: jc.augusto@ulster.ac.uk; j.augusto@mdx.ac.uk † Current address: Department of Computer Science, Middlesex University, London, UK. © 2013 Taylor & Francis