Biomedical Engineering Reference
In-Depth Information
of cognitive disabilities. It delivers individualized prompts and procedural information
in a speech, audio, text, checklist, or graphic format. A case study involving two indi-
viduals with brain injury showed improved independence in activities of daily living and
better communication with caregivers as a consequence of ISAAC (Gorman et al. 2003).
Cognitive Orthosis for Assisting aCtivities in the Home (COACH) is a prototype system
designed to support people with dementia in autonomously completing a hand-washing
task. The COACH system provides prerecorded verbal prompts and uses a single video
camera, neural networks, and plan recognition to automatically monitor the execution of
the task. The results from a clinical trial with 10 elders with moderate to severe dementia
showed significant improvements in the completion of hand-washing tasks without care-
giver assistance after the use of the COACH system (Mihailidis et al. 2004).
Another problem associated with cognitive disability that accompanies the early stages
of dementia, especially in the case of Alzheimer's dementia, is disorientation on not only
the temporal level but also on the spatial level. Spatial-temporal disorientation is a threat
to the safety of these patients and increases the apprehension and burden of caregivers.
Global position system (GPS) technology provides some aids that include wrist watches
with a GPS locator (GPS Locator Watch by Verify, and Digital Angel for Senior Wanderers).
An integrated system using a wireless transceiver can detect the exact position of the
older adult and allows caregivers to communicate and monitor the person from a dis-
tance (Parnes 2010). However, these technologies have not yet been widely validated and
require further investigation, including long-term usage tests focused on identifying the
key needs of both elderly people suffering dementia and their caregivers and on seeking
ethical approval.
13.5.2 Technological Devices for elderly People With Motor Disability
Daily activities also require the ability to move and interact with the environment as inde-
pendently as possible. Osteoporosis, one of the most common bone diseases in the elderly
population, and changes in visual and auditory perception can easily lead to a reduced
personal mobility in old age. In this regard, there are several devices that claim to make
life easier for seniors. Assistive technologies for older people with mobility limitations
cover different products and intelligent systems, from bath lifts and rails, powered and
autonomous wheelchairs, and smart walkers to upper/lower limb prosthetics.
The smart walker ”Guido,” the latest evolution of PAM-AID (Personal Adaptive Mobility
Aid), was designed to facilitate the mobility of blind elderly people and focuses on power-
assisted wall or corridor following (Lacey and Dawson-Howe 1998). The PAMM (Personal
Aid for Mobility and Monitoring) device is aimed at supporting the navigation of elderly
people who live independently or in senior assisted living facilities. It provides both guid-
ance to destinations through preprogrammed maps, schedules, user commands, and
sensed obstacles and continuous health monitoring (Yu et al. 2003). Wheelchair-mounted
robotic arms (WMRAs) are devices with a manipulator arm on the wheelchair to provide
assistance throughout the day (Alqasemi et al. 2005). Typical tasks of WRMAs include
manipulating and moving objects, assistance with eating and drinking, and controlling
communication devices and environment control units. Older adults can usually control
the WRMA using a joystick, keypad, voice-command, or other input device.
The assistive robotic manipulator known as MANUS is a commercially available,
WMRA that is able to assist older people with an upper-limb disability. Through a keypad
and a joystick, the older person can drive MANUS manually, deciding the location and ori-
entation to be achieved (Hok Kwee 1998; Driessen et al. 2001). Several studies have tested
