Implementation of unobtrusive sensing systems for elderly care: Scoping review (Preprint)

BACKGROUND The continuous growth of the elderly population will have implications for the organization of health and social care. Potentially, in-home monitoring unobtrusive sensing systems (USSs) can be used to support (in)formal caregivers of elderlies as they can monitor deviant physical and physiological behavior changes. Most of the existing USSs are not specific to elderly care. Hence, for facilitating the implementation of existing USSs in elderly care, it is important to know which USSs would be more suitable for elderlies. OBJECTIVE Therefore, this scoping review aims to examine the literature a) to identify current unobtrusive sensing systems (USSs) for monitoring human activities and behaviors and b) then assess them for implementation readiness for elderly care. METHODS A structured search was conducted in 'Scopus', 'Web of Science', and 'ACM digital library' databases. Predefined inclusion criteria included studies: on unobtrusive sensor-based technology; experimental in nature; aiming to monitor human social, emotional, physical, and physiological behavior; having potential to be scalable in in-home care; having at least 5 adults as participants. By using these criteria, studies were screened by title, abstract and full-text. A deductive thematic analysis based on the implementation framework of Proctor E. et al. (2011) along with additional outcome ‘external validity’ was applied to the included studies to identify the factors contributing to successful implementation. Lastly, identified factors were used to report the implementation readiness of included studies for elderly care. RESULTS 52 studies were included in the review. Deductive analysis using Proctor’s implementation framework resulted in six factors that can contribute to the successful implementation of USSs in elderly care. They are study settings, age of participants, activities monitored, sensor setup, sensing technology used, and usefulness of USSs. These factors were associated with the implementation outcomes as follows: study settings and age of participants contribute to external validity; sensor setup contributes to acceptability; usefulness of USSs contributes to adoption; activities monitored contributes to appropriateness; sensing technology used contributes to implementation cost. Further, the implementation assessment of included 52 studies showed that none of the studies has addressed all the identified factors. But this assessment was useful in highlighting studies that have addressed multiple factors, thus making such studies a step ahead in the implementation process. CONCLUSIONS This review is the first to scope the state-of-the-art USSs suitable for elderly care. Though included 52 USSs studies fulfills the basic criteria to be suitable for elderly care, but systems leveraging radio frequency technology in no contact sensor setup for monitoring life-risk or health wellness activities appear to be more fit in elderly care. Lastly, this review has extended the discussion on the term ‘unobtrusiveness’ as 'a property of systems which cannot be measured in binary as it varies a lot with user perception and context’.