Types of Technology in Aged Care

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What is artificial intelligence?

Artificial intelligence (AI) refers to the use of technology to mimic human cognitive functions. [3] However, AI can process large amounts of information in ways that people cannot. AI may be used for visual perception, speech or pattern recognition, and decision-making. 

How is AI used in aged care?

Artificial intelligence is increasingly playing a role in the care of older adults. Artificial intelligence is often combined with closed-circuit television (CCTV) or a wearable device and might be used for detecting:

• Falls or requests for help
• Pain levels
• Changes in human behaviour (e.g., wandering)
• Changes in routine that may indicate a health issue (e.g., bathroom trips or eating behaviour). [4]

This information may be used to alert family or aged care services.

How can AI benefit the aged care sector?

AI may improve care and allow older adults to remain in their own home for longer, improve quality of life, and help families feel more comfortable. However, it is important to note that the introduction of AI is often accompanied by fear or concerns over privacy. [5]

Examples of artificial intelligence technology in aged care 

Some artificial intelligence technologies include: 

• PainChek® A universal pain management app that can be used to identify the presence of pain, even when it’s not obvious, using AI technology. 
• HomeGuardian: Uses AI to look at a room/ area and determine what is and what is not normal. it can be used to detect curtains being closed in the afternoon or an oven left on, and is able to make a phone call or activate an alarm in response. 

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What is assistive technology?

Assistive technologies are products or services that enable individual functioning and social participation. [6] Assistive technology can include many different products, including non-digital (e.g., walking frames/sticks, medication packs), or digital (e.g., fall-monitoring technology, mobile apps, GPS phones/watches).

How are assistive technologies used in aged care?

Assistive technologies used in aged care may include smart technology, such as sensors and monitoring systems, mobile devices and apps, mobility aids (such as wheelchairs or lifters), or home modifications such as rails. [7] Assistive technology can be used both by people living at home and those living in residential aged care.

How can assistive technologies benefit the aged care sector?

Potential benefits of using assistive technologies for older adults and their care team may include:

• Increased confidence, autonomy, social participation, and quality of life
• Improved communication
• Decreased anxiety and injury 
• Decreased impact of supporting a loved one for carers and their families 
• Allowing older adults to live in their own home for longer. [6]

Examples of assistive technology in aged care

Some assistive technologies used in Australia include: 

• Accent 1400: A communication-speech generating device that can be used to support older adults communicate using the mouse, head tracking and/or eye gaze. 
• Telstra visual signal alert: A device that provides a visual signal allowing a hearing-impaired user to see that the telephone is ringing. 
• Talking watch: A battery operated talking watch with large numbers/characters that may be suitable for individuals with a vision impairment. The watch’s voice output reports the time and can be activated by pressing a button.

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What are care management system technologies?

Care management systems are technologies used by aged care services to manage relevant information about the people in their care. Whether a person is living in residential aged care or in their own home, up-to-date records can be accessed to manage relevant medical information (e.g., chronic conditions, medication) as well as encourage more personalised interactions and care. Understanding the individual needs of aged care clients can help providers and staff to improve communication, engagement, and quality of care. [8]

How are care management system technologies used in aged care?

Care management systems can be used in both home care and residential aged care. How they are used is likely to differ from workplace to workplace. However, generally they are used to store documents and relevant client information. These systems may also be used for rostering and staff communication. Staff may note information such as appointments or changes in medication/personal care preferences for individual clients. Care management systems might also be used to communicate with the individual’s family/loved ones. For example, families may be updated via an app about their loved ones’ day and activities. These systems may offer the greatest benefit when integrated with other data management platforms such as systems for medication management, clinical assessment data and care plans, and business or administrative systems that record admissions and financial information about the care recipient. [9] Interoperable systems may improve care by:

• Reducing the risk of communication errors
• Saving staff from having to access multiple different systems to input or access the data they need to provide appropriate care to each person 
• Protecting aged care recipients’ privacy if information is accessed from one point
• Providing aged care workers with the most up-to-date data they need to assess an individual’s needs and deliver high quality care. [9]

Interoperability of systems is a pressing problem within aged care that will require a system-wide solution. A major first step will be the ability to integrate data from each person’s My Health Record into the local care management system.

How can care management system technologies benefit the aged care sector?

Digital care systems can help reduce errors and subsequent harm to people receiving aged care. Digital information systems can also allow for better person-centred care, by making sure that individuals’ and families’ preferences are recorded, transparent, and understood by the care team. [8]

Examples of care management system technologies in aged care

• My Health Record: A platform that securely stores an individual’s healthcare information securely in one place where it can be accessed by the individual and the health professionals involved in their care. 
• Service Management System: A service management system that can be used to store records, automate reports, and provide reminders for in-home care delivery. 
• KPMG Community Care: A technology that can be used to support home-care providers and allow communication between care staff and older people with service providers at any time.

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What is gaming?

A game is a system that involves different components such as rules, players, competition, and opponents. Games are traditionally used for entertainment purposes but can also be used for education and healthcare. Gaming can include traditional board games or may involve more advanced electronic devices that can be interacted with (e.g., computer, tablet, gaming console). [10] Aged care services can use gaming technologies to engage older adults in balance and strength training (e.g., Wii Fit Plus).

How is gaming used in aged care?

Most older adults engage in gaming for health-related reasons. Many older Australians believe that playing video games can increase mental stimulation, physical functioning, and improve social connectedness. [11] A common type of electronic gaming used in aged care setting are exercise video games (often referred to as exergames). Games may be used in aged care to provide entertainment, foster social engagement, and promote opportunities for exercise and/or cognitive stimulation. 

How can gaming benefit the aged care sector? 

Gaming can be beneficial for older adults, and may result in improvements in:

• Spatial navigation, perceptions, and memory
• Mobility and balance
• Mental wellbeing
• Social connectedness. [12]

Examples of innovative gaming technology in aged care

Some gaming technologies include:

• Obie: An interactive gaming console designed specifically for older people. The built in projector allows any surface to be used to play and can be used to project games onto the floor to work on balance and stepping skills.
• Wii Fit Plus: An enhanced version of the original Wii Fit software that can be used to tailor exercises, balance games, and fitness activities to an individual.

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What are robots?

A robot is a type of automated machine often designed to carry out tasks performed by humans. They have been used in the manufacturing industry for many years to prevent humans entering hazardous environments. There is now a range of different robots that aim to improve the wellbeing of older adults residing in residential aged care or their own homes. [13]

How are robots used in aged care?

In aged care, robots have several different uses. They can direct exercises, [14] provide emotional support, [15] and encourage social interactions. [16] Examples of robotic technology used in aged care include robopets such as PARO, care robots such as the Care-O-bot or Zora, assistive walking robots, and robots used to manage medication. Socially assistive robots (that assist humans to interact) can be used in aged care to support older adults to interact with others and prevent social isolation and feelings of loneliness. [17]

How can robots benefit the aged care sector?

Robots have the potential to improve quality of life for individuals receiving aged care. Robots can assist with daily functional tasks such as bathing, [18] which can support care workers, and assist older adults to maintain their independence and dignity. Robots can provide mobility support for older adults and can assist individuals to get out of bed or stand up from a chair and walk, reducing the risk of falls. [19] Socially assistive robots that encourage older adults to interact socially with others (e.g., robopets, companions, service robots, or both companion and service), can increase social interactions and reduce depression, loneliness, and agitation for older adults (especially those living with dementia). [17] Robots can assist aged care workers by monitoring the health of older adults and supporting the safe distribution of medications. [20]

Examples of robots in aged care 

Some robotic technologies include:  

• PARO: A robopet that can be used to stimulate interaction and engagement for older adults, especially those living with dementia.
• Care-O-bot: A domestic robot that can be used to carry meals and drinks and enables older adults to mobilise safely with their hands free. 
• Zora: A software solution designed to assist nurses and aged care workers in the support the elderly. It is compatible with the robot Nao (pronounced now). 

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What are sensors and monitoring technology?

Aged care monitoring technologies can include cameras, wearable devices, sensor mats, smartphone apps, and Artificial Intelligence (AI) enabled sensors. These technologies may help in detecting falls, measuring vital signs, GPS tracking and monitoring movement, and behaviour patterns of older people. For example, movement sensors can detect if a fridge or home blinds have been opened or when someone last walked through a door. Pressure sensors might be used to detect a person’s presence or their absence over a period of time. 

How are sensors and monitoring technology used in aged care?

These technologies can be non-intrusive, embedded in the environment, and reliant on infrared or movement detection. They can also be wearable devices tailored to individual’s needs and preferences. The data collected by these technologies can provide real-time information for early intervention and prevention as well as ongoing care and support. The use of sensors and AI technology is increasing in the field of telehealth and telecare.

It is important to recognise that wearable alarms or electronic bracelets that are overly obtrusive can negatively impact a person's dignity, as they may symbolize vulnerability and dependence. [21] This can detract from the individual's sense of self-worth and independence, leading to a decline in their overall wellbeing. Sensors or monitors should enhance, not replace, human care provision. 

How can sensors and monitoring technology benefit the aged care sector?

Sensors and monitoring technology may:

• Increase safety
• Improve medication management
• Allow for 24-hour health monitoring
• Improve communication
• Enhance the quality of care.

Examples of sensors and monitoring technology in aged care 

• Care@Home Bed sensor: A sensor that can fit any bed, be used to monitor movements and detect a fall out of bed.
• REMi: A monitoring system that includes sensors fitted into a mattress cover and can be used to monitor movement and vital signs such as heart rate.
• Smarter Safer Homes: A sensor developed by the CSIRO to support older people to live independently in their own homes. The sensors can be accessed remotely by family members and care workers to support independence. 

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What is a smart home?

A smart home is a place of residence with integrated technology to assist the people who live there to remain independent, safe, and improve their quality of life. [22] Smart homes are set up with sensors, actuators, and intelligent software which can be integrated into furniture, walls, and everyday objects. Using computers, people can then monitor what is going on inside the home even when external to it. This makes it possible to control the internal environment (e.g., adapting the light). If monitoring an occupant’s behaviour, family members can automatically warn an emergency service if the observed behaviour deviates from the normal pattern. [23] Smart homes may include:

• Systems that automate household tasks and optimise homes to suit individuals’ living habits
• Smart locks, doorbells, and security systems
• Motion sensors
• Mobility assistance
• Medication reminders
• Voice-activated smart home assistants (e.g., Alexa, Google Home). 

How is smart home technology used in aged care?

Smart home technology is often used by people who wish to continue living independently. However, not all older people find these technologies useable, and barriers to the introduction of these technologies are sometimes high. [23, 24] Automated functions or smart home assistants may reduce risk of falls or injury (e.g., if a light can be switched off after leaving the room instead of walking through a dimly lit room), [25] and smart locks may be useful if someone from the care team needs to access the home and the older person is unable to let them in. [24]

How can smart home technology benefit the aged care sector?

Smart homes may:

• Enable people to live in their own home for longer
• Increase safety
• Prevent injury
• Allow people to remember, take, and track their medications
• Bring peace of mind to family and loved ones. [22]

Examples of smart home technology in aged care 

Some commonly used, and easily accessible, smart home technologies include:

• Google Home: An app that can be used to support a personalised smart home for older adults, and help with household tasks, such as turning on the lights and setting reminders for medication. 
• Alexa: A voice activated technology that can be used to support smart homes and can provide personalised social interactions. 
• Smart locks: A technology that allows for easy locking and unlocking, it can be used for older adults to control who can access their homes.

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What are smartphones and mobile apps?

Smartphones are mobile devices that can perform many of the functions of a computer, on a smaller scale. They usually have a touchscreen interface, access to the internet, and the capability to run downloaded apps. A mobile app is a software program that has been developed to perform a specific function (e.g., playing games, connecting with loved ones, tracking health, or searching on the internet) and can be downloaded onto a smartphone. [26]

How are smartphones and mobile apps used in aged care?

Smartphones and apps are playing an increased role in promoting people's health and wellbeing. There are many types of apps available to meet different needs of older adults. These may include social apps (e.g., Facebook, WhatsApp), apps to remind people to take medication or drink more water, or health-monitoring apps. The built-in sensors on smartphones, such as accelerometers (to detect movement) and GPS (to detect location) generate real-time data that can be linked to apps for personal health feedback or used by healthcare providers. There are also apps that have been designed for aged care services to improve communication and quality of care. These apps may provide platforms for care staff, older people and their families, and other members of the care team to share relevant information about the person they provide care for (e.g., appointments, medications, changes in care preferences).

How can smartphones and mobile apps benefit the aged care sector?

Potential benefits of smartphones and mobile apps in aged care may include:

• Improved communication (reduced social isolation and feelings of loneliness)
• Increased engagement
• Remote monitoring
• Efficient care management (e.g., medication and appointments)
• Increased independence. [26]

Examples of mobile technology in aged care

Some examples of apps used in aged care include: 

• CareApp: A communication app that can be used to bring providers, residents, care workers, and families together to improve care by increasing transparency and accountability.  
• palliAGED apps: This app can provide nurses and GPs working in aged care with access to palliative care information to help them care for people approaching the end of their life.
• CareKeeper: An app that enables residential aged care staff to be clear on their list of tasks and to document by the resident’s side via a mobile device, providing more opportunity for a personalised connection.

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What are social engagement technologies?

Social engagement technologies support older adults to keep in contact with friends and family. [27] They include social media apps such as video chat products (e.g., WhatsApp) and social networking sites such as Facebook, Instagram, and Twitter. These technologies can also connect older people with people they don’t know who share common interests, thereby expanding their social connections.

How are social engagement technologies used in aged care?

Older people living in residential aged care or alone in the community are at increased risk of social isolation and feelings of loneliness. Technologies that support communication can play an important role in integrating older adults into the wider community and promoting social connectedness. [15] Older people living in residential aged care can be encouraged to use these technologies at any time of the day or night. However, assessment of existing facility infrastructure may be necessary to support increasing levels of online engagement. This may require increasing the range of Wi-Fi access so that it reaches bedrooms and shared living spaces. Other considerations include having reliable and fast broadband speed, providing ample power points for charging devices outside of rooms, and supplying electronic tablets (e.g., iPads) to people who do not have their own. Not all older people will have the skills or knowledge to use mobile devices, or the apps required to connect with others. Therefore, residential aged care facilities and home care services may need to address technology literacy skills to increase the confidence and ability of older adults to use technology safely without the need for ongoing staff support. [28]

How can social engagement technologies benefit the aged care sector?

Social engagement technologies offer many benefits to the age care sector – they can increase socialisation and contact with loved ones for older people and enable them to independently communicate with others. This can increase their sense of autonomy and may improve quality of life and general mental health. [27]

Examples of social engagement technologies in aged care

Some social engagement technologies include:

• Facebook:  An interactive application that can be used to connect with friends and family.
• Words with Friends: An online game where players take turns building words into a crossword-puzzle. This game allows people to play with friends or connect with new people and can provide mental stimulation for all ages.
• WhatsApp: A free, simple, and private messaging and call service designed to keep people connected.

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What is telehealth?

Telehealth refers to the delivery of remote healthcare using telecommunication technology to transmit audio, image, and/or data between a patient and a healthcare provider (such as a general practitioner or a specialist). [29] Many healthcare providers offer these consultations when a physical examination is not needed. [30] The use of telehealth has grown exponentially since the COVID-19 pandemic and is frequently used in residential aged care to allow residents to maintain a relationship with their usual GP who is aware of their medical history, medications, goals of care, and advance care directives. [31]

How is telehealth used in aged care?

In aged care, telehealth can be used to support remote medical consultations with healthcare professionals, provide ongoing remote monitoring with the support of wearable technology, and support mental health and medication management. [32] Telehealth should be used to support and complement face-to-face consultations. However, aged care telehealth technologies should not be used to save costs or purely for convenience as the long-term safety of older adults may be compromised. [33] It should be considered that not all older people will have the sufficient skills to access and use the technology and may need support for telehealth to be successful.

How can telehealth benefit the aged care sector?

Telehealth can improve the access older people have to healthcare by allowing them to access speciality appointments without leaving their usual place of residence. Telehealth technology can reduce travel time for older adults living in the community, and during the COVID-19 pandemic telehealth was used to keep older adults safe and avoid exposure to the virus. [34] The integration of telehealth technologies can reduce healthcare costs by reducing travel costs, appointment frequency, and potentially preventing inappropriate hospital admissions. Telehealth services can prompt increased communication between healthcare providers, aged care workers, older people, and their families, and improve healthcare outcomes for older adults with chronic conditions. [35]

Examples of telehealth in aged care

Technologies that support telehealth include:

• ProEX: The ProEx desktop and mobile device support secure video calls and with multiple users in telehealth video consultations worldwide.
• Skype: A free platform that allows individuals to make phone calls, host or join video conferences, and send and receive instant messages in one-on-one or group chats. 
• Zoom: A free platform that connects people, engages new audiences, and can be used to support telehealth. 

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What is virtual reality?

Virtual reality (VR) involves a computer software system that generates simulations of real or imagined 3D environments that a person can interact with using their own movements. [36]  Virtual reality usually involves the user wearing a headset and holding handheld sensors or wearing gloves to interact with their surroundings. Virtual reality has advantages in the field of health promotion in aged care and is often used to increase engagement and motivation for older adults. Virtual reality may involve interactive games, exercise, or relaxation environments such as a simulated garden. [37]

How is virtual reality used in aged care?

Virtual reality technologies can be used for a range of activities in aged care including pain management; VR can engage an individual to distract them from their pain by guiding them through relaxation exercises, virtual reality games, and even calming scenery. [37] Virtual reality can be used to support reminiscence therapy by recreating historical events, settings and even personal memories which can be a pleasant experience for older adults living with dementia. [38] This technology can also be used to provide interactive physical exercises and supporting social experiences without having to leave home.

How can virtual reality benefit the aged care sector?

Virtual reality has the potential to benefit aged care services and increase quality of life for older adults. It can improve the mood of older adults by allowing them to explore new and exciting environments, revisit familiar places, and socially interact without leaving their home. [39] The use of VR can provide cognitive stimulation for older adults and can be tailored to the individual to improve memory, problem solving skills, and spatial awareness. [40] Virtual reality may also be useful to reduce pain, anxiety, and social isolation by providing a distraction to an individual or guiding them through relaxation exercises, VR games, and even calming scenery. [37]

Examples of virtual reality technology in aged care 

• Virtual Forest™: A peaceful and enjoyable immersive environment designed specifically to improve the quality of life for people living with dementia. 
• Neurons VR: A therapy tool used in aged care to engage older adults in physical activity and allow them to revisit childhood memories and familiar destinations.
• Dementia-friendly home app: An interactive 3D game that can be used to provide carers with ideas to make homes more accessible for people living with dementia.

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What are wearable technologies?

Wearable technologies or ‘wearables’ as they are commonly known are electronic devices worn on the human body in a variety of places (e.g., wrist, hip, or foot). They can take the form of a bracelet (e.g., Fitbit), a smartwatch, or a piece of jewellery such as a ring or pin. Wearables also include artificial intelligence (AI) hearing aids that adapt to a person’s environment, smart glasses, and pieces of clothing that can detect dehydration. All wearables have the ability to monitor in real time, transmitting data elsewhere via the internet, or Bluetooth to applications (or ‘apps’), on laptops and mobile devices.

How are wearables used in aged care?

Wearables can be used in aged care to help track a person’s health and wellbeing. [41] This could include monitoring daily activities such as exercise, sleep duration, food intake, or the amount of energy burned. Other types of wearables record vital signs such as body temperature, heart rate, blood pressure, and glucose levels for clinical purposes. Wearables can also be used to alert people when help is required. [41]

How can wearables benefit the aged care sector?

In aged care settings, wearables can be used to monitor biomarkers such as heart rate and blood oxygenation, allowing clinical staff to detect changes in a person’s health and intervene to prevent an emergency. [42] Devices with inbuilt sensors can be used to sense falls and automatically send out a signal that help is required. People might also manually activate an alarm on a device worn on the body to summon assistance. Some alerts include inbuilt global positioning system (GPS) tracking features and can send a map or tracking beacon indicating where the person in need is located. Geo-fencing alerts that send out warning messages such as an SOS alert when someone steps outside a defined geographic area may be used to monitor the movement of people with dementia. The small size and discreet nature of wearables may make them more acceptable to older people, especially people with dementia, who wish to avoid the stigma associated with overt monitoring. [43]

Examples of wearable technologies in aged care 

Some wearable technologies include:  

• CaT Pin (Bolton Clarke): This pin can be used to track the wearer’s conversations and send alerts to family or care workers if there are signs of social isolation. 
• The mCareWatch: This smartwatch can be used as a personal alarm to contact family members and emergency services when required and support older people to live independently. 
• Oura Ring: This smart ring can be used for continuous health monitoring including heart rate and sleep.
• WearOptimo: This sensor can be used to measure hydration levels in older people, detect dehydration and reduce the need for frequent blood tests

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