SHB: Small: Privacy-Enhanced Technologies to Support Underserved Older Adults Age in Place

与人口老龄化相关的人口结构变化需要新的解决方案，以满足美国和世界各地日益增长的老年人的健康需求。由于在辅助生活和长期护理设施中护理个人的成本几乎是非机构护理人员护理成本的两倍，支持就地老龄化的技术被视为解决这一紧迫问题的一种方式。在老年人中，获得广泛护理和服务的风险最高的群体是来自农村地区和城市贫困地区的个人。在这两个群体中，农村个人占老年人口的五分之一，需要长期护理服务和支助的风险最高。同样，居住在低SES社区的城市老年人往往经历更高的功能损失率，以及更差的整体健康结果。除了强调联邦医疗保险的长期护理资源外，这些高需求的老年人往往需要非正式护理人员的支持。非正式的照顾者提供的服务，否则将花费医疗保险系统每年3750亿美元。平均来说，照顾者是有工作的，有孩子，在美国所有非正式照顾者中，66%是女性。这些照顾者通常被称为“三明治一代”，因为除了传统的家庭和工作角色外，他们还必须照顾年长的亲属。因此，迫切需要减轻这些照顾者的负担，以便他们能够继续提供所需的护理，使老年家庭成员远离受助生活。该项目将向社区成员、服务提供商和政府机构提供指导，指导如何利用技术使居住在城市和农村的低社会保障老年人就地老龄化，同时减轻照顾者的负担。具体地说，该项目将对这两个群体进行需求分析，着眼于他们与已经为其设计了老龄化技术的SES较高的老年人有何相似和不同之处。该项目将制定设计指南，以帮助设计师瞄准这一高需求人群，同时考虑到护理人员的接近程度、交通工具、获得医疗服务的机会、技术基础设施和对技术的态度等属性。然后，该项目将利用这些指导方针来定制一套现有技术，以满足这两个群体的特定需求。这些技术将部署在农村和城市老年人的家中，以便该项目能够评估老年人如何使用这些技术，以及这些技术在多大程度上支持他们就地老龄化的能力。结果将展示在其他情况下开发的开创性技术如何被定制，以供低社会经济地位的城市和农村居住的老年人使用。这一项目的更广泛影响包括接触服务不足的社区，培训本科生和研究生，在传统学科之外广泛传播研究成果，以及在学术界、私营公司和政府机构之间建立牢固的联系，所有这些机构都有提高服务不足老年人生活质量的共同目标。最后，社会福利方面的更广泛影响是研究固有的；该项目寻求找到创新的方法，为照顾者和私人和公共付款人提供更有吸引力、侵入性更小、成本更低的选择，同时为服务不足的人提供服务。

The shifting demographics associated with an aging population require novel solutions to meet the health needs of the growing number of older adults in the US and around the world. Since caring for individuals in assisted living and long-term care facilities costs nearly twice what it costs to care for their non-institutionalized counterparts, technologies that support aging in place are seen as one way to address this pressing problem. Among older adults, the groups at the highest risk for extensive care and services are individuals from rural areas, and underprivileged urban areas. Of these two sub-populations, rural individuals make up one fifth of the elderly population and are at highest-risk for requiring long-term care services and support. Similarly, urban-dwelling older adults in low-SES neighborhoods often experience higher rates of functional loss, and poorer overall health outcomes. In addition to stressing the long-term care resources of Medicare, these high-need older adults often require support from informal caregivers. Informal caregivers provide service that would otherwise cost the Medicare system $375 billion dollars a year. The average caregiver is employed, has children, and sixty-six percent of all informal caregivers in the U.S. are women. These caregivers are often called the "sandwich generation" because, in addition to traditional family and work roles, they must also provide care to an older adult relative. Thus, there is a huge need to ease the burden on these caregivers so that they can continue to provide the care required to keep older family members out of assisted living.This project will provide guidance to community members, service providers, and governmental agencies about how to wield technology to enable low-SES, urban- and rural-dwelling older adults to age in place, while simultaneously easing the burden on caregivers. Specifically, the project will perform a needs analysis of these two groups, with an eye to how they are similar to and different from the higher-SES older adults for whom aging in place technologies have already been designed. The project will develop design guidelines to assist designers in targeting this high-need population, taking into account attributes such as proximity of caregivers, access to transportation, access to health services, technology infrastructure and attitudes towards technology. The project will then utilize these guidelines to customize a suite of existing technologies for the specific needs of these two populations. The technologies will be deployed in the homes of older adults in rural and urban settings so that the project can assess how older adults use such technologies and how well these technologies support their ability to age in place. The results will show how pioneering technologies developed in other contexts may be customized for use by low SES, urban- and rural-dwelling older adults. The broader impact of this project include outreach to underserved communities, training of undergraduate and graduate students, broad dissemination of research results beyond traditional disciplinary silos, and building strong connections between academia, private companies, and government agencies, all of whom share the goal of enhancing the quality of life for underserved older adults. Finally, the broader impact in terms of benefits to society is inherent in the research; the project seeks to discover innovative ways of providing more appealing, less invasive, less costly options for caregivers and private and public payers, while simultaneously serving the underserved.