Developing Independent Living Support for Older Adults Using Internet of Things and AI-Based Systems: Co-Design Study

Background: The number of older people with unmet health care and support needs is increasing substantially due to thechallenges facing health care systems worldwide. There are potentially great benefits to using the Internet of Things coupledwith artificial intelligence to support independent living and the measurement of health risks, thus improving quality of lifefor the older adult population. Taking a co-design approach has the potential to ensure that these technological solutions aredeveloped to address specific user needs and requirements.Objective: The aim of this study was to investigate stakeholders' perceptions of independent living and technology solutions,identify stakeholders' suggestions on how technology could assist older adults to live independently, and explore the accepta-bility and usefulness of a prototype Internet of Things solution called the NEX system to support independent living for anolder adult population.Methods: The development of the NEX system was carried out in 3 key phases with a strong focus on diverse stakeholderinvolvement. The initial predesign exploratory phase recruited 17 stakeholders, including older adults and family caregivers,using fictitious personas and scenarios to explore initial perceptions of independent living and technology solutions. Thesubsequent co-design and testing phase expanded this to include a comprehensive web-based survey completed by 380stakeholders, encompassing older adults, family caregivers, health care professionals, and home care support staff. This phasealso included prototype testing at home by 7 older adults to assess technology needs, requirements, and the initial acceptabilityof the system. Finally, in the postdesign phase, workshops were held between academic and industry partners to analyze datacollected from the earlier stages and to discuss recommendations for the future development of the system.Results: The predesign phase revealed 3 broad themes: loneliness and technology, aging and technology, and adopting andusing technology. The co-design phase highlighted key areas where technology could assist older adults to live independently:home security, falls and loneliness, remote monitoring by family members, and communication with clients. Prototype testingrevealed that the acceptability aspects of the prototype varied across technology types. Ambient sensors and voice-activatedassistants were described as the most acceptable technology by participants. Last, the postdesign analysis process highlightedthat ambient sensors have the potential for automatic detection of activities of daily living, resulting in key recommendationsfor future developments and deployments in this area.Conclusions: This study demonstrates the significance of incorporating diverse stakeholder perspectives in developingsolutions that support independent living. Additionally, it emphasizes the advantages of prototype testing in home environ-ments, offering crucial insights into the real-world experiences of users interacting with technological solutions.