Publications

Falls are a major cause of disability, are the leading cause of mortality resulting from injury, and have a huge impact on health-care costs. 33–50% of people older than 65 years fall each year. Thousands of those fall at home, and more than 1000 die after falling down stairs. Falls account for more than 80% of all injury-related admissions to hospital in that age group. The cost to the NHS and Social Services is £981 million, and £600 million of that is for the over 75s.

On 22nd October 2008, an estimated 25,000 people took to the streets of Dublin to protest the government's decision to remove their automatic entitlement to a medical card for those over 70. Emotions ran high on the day with one protestor carrying a placard asking 'why don't you just shoot us?’ Historically those over 70 have been subject to restrictions within Irish Society routinely denied access to borrowing and earning money. Although there have been a number of public campaigns to counter institutionalized ageism in Ireland, older persons are often solely dependent on the state for basic services. So when the entitlement card was first introduced by the Irish government in 2000, it was regarded as a progressive step for Ireland’s increasingly ageing population. Policy-makers hoped that such services would improve the health of older persons in Ireland and help reduce the need for long-term care. In the aftermath of the protest, national opinion and the importance of the older voter swayed the government and the bill was redrafted to only recall the medical cards of wealthy over 70’s for means testing. Now that the dust has settled and most feel the ‘battle was won’, what do older persons really think about their position within Irish Society or their ability to influence social change? At the time many were confused, even hurt, about the medical card debacle but, as one participant in our case study project commented, “sure wasn't there a bit of confusion and my doctor, a great man, said ‘not to be worrying and he'll sort it’”. This paper will explore 'Ageing' in Ireland, not as a condition, but as an understood state shaped by socially and culturally constructed expectations of biology and the meanings attributed to age and ageing. Based on long-term ethnographic research, the authors consider what our informants tell us it means to be ‘old’ in Ireland, not just during the protests, but during quite reflection, speaking about an Ireland in the context of migration, colonisation, the Catholic Church, and nationalism.

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This paper shares ‘user perspective’ insights from the ethnography component of an ongoing Irish interdisciplinary study, Technology Research for Independent Living (TRIL). The research is informed by a shared pool of knowledge, medical and research expertise, engineering resources, design and ethnography and is exploring new technologies that may support older people to live independently in their own homes, even if dealing with age-related illness or injury. To provide theoretical context, we position both our understanding of user perspective and our anthropological ethnographic method of enquiry. We draw on early case study material to illustrate older persons’ understanding and experiences of existing technologies from a life course perspective. We then offer an example from our ongoing ethnographic enquiry, focusing on participants’ experiences of new technology. We consider technology as social and discuss ‘having the know-how’; ‘user-led technology’ and ‘enabling/disabling new technologies’. A critical goal of the research is to achieve user perspective technological design. We argue that it’s important to be clear about what is meant by ‘user perspective’ and how such user perspective is obtained; in our case, through our anthropological ethnographic lens on older persons and their ongoing relationships with existing and new technologies.

Biomedical and clinical research projects have a growing need for innovative technology solutions that are highly flexible, extensible, easy to use, and provide a comprehensive range of capabilities. The technology development overhead that many biomedical researchers must address can detrimentally impact the pace and scope of the research projects. This problem has been compounded in recent years due to the growing interest in translation research i.e. moving from laboratory to home environments. The TRIL Centre [3] has developed a modular, extensible and reusable technology approach based on an open research platform concept called BioMOBIUS® [1] which is freely available for download (www.biomobius.org). BioMOBIUS supports SHIMMER® [2] sensors, USB/IP Camera’s, Tactex® bed & floor sensors and X10 devices. The Continua Health Alliance [4] is dedicated to establishing a system of interoperable personal health solutions. In an effort to enhance interoperability and stimulate further innovation, the TRIL Centre has implemented Continua device connectivity into the platform. The work presented in this paper demonstrates BioMOBIUS’s ability to expand to support new components such as Continua device connectivity standards.

Falls are a major problem in older adults worldwide with an estimated 30% of elderly adults over 65 years of age falling each year [1]. The associated direct and indirect societal costs of falls are enormous [2]. A system that could provide accurate quantitative assessment of falls risk prior to falling would allow timely medical intervention and ease the burden on overstretched healthcare systems worldwide.

Many older pedestrians report inability to complete crossings in the time given by pedestrian lights. Standard times for pedestrian lights in Dublin pelican crossings are specified in the Traffic Management Guidelines (TMG). The TRIL Centre is building a database of gait assessments of Irish community-dwelling older people using GAITRite.

Many factors have an impact on social isolation and loneliness in old age. Connections might be lost due to retirement, relocation or widowhood. Social engagement is also restricted by poor physical health, depression, lack of mobility and demand to care for a significant other (Victor et al., 2000). Evidence suggests that loneliness has a negative impact on mental and physical health, and is associated with problems such as depression, high blood pressure and poor sleep (O’Luanaigh & Lawlor, 2008). Modern technology and the internet offer innovative ways to help older adults remain connected with their peers and family members, if appropriately designed and implemented.