Chapter 5: Imagined futures for digital AT
As part of focus groups with UK-based disabled people conducted for this report, participants were asked to come up with new ideas for transformative digital AT and inspire innovative thinking in this space (). These ideas were focused on applications which have the capacity to interpret their experience of the world or to complete tasks that would otherwise be difficult or impossible for them to complete independently. A selection of these ideas is presented below.
Body language interpretation glasses
“Body language is such an important part of language and quite often I don’t understand from looking at someone if they are angry or joking and some kind of body translator for people with autism would be incredibly helpful… some kind of smart glasses.”
Participant with a cognitive impairment.
British Sign Language (BSL) and closed-captions hologram
“My dream would be to have a sort of hologram both in BSL interpreters and captions that was 100% accurate and it would just be available everywhere at any time of day. It would change my life.”
Participant with a sensory impairment.
Robot assistant
“For me it would have to be a robot that could do all of my personal care. I just wish there was a robot I could say help me go to the loo or help me to get in the shower – that’s all I’d like to see.”
Participant with a mobility and cognitive impairment.
Texting support tool
“If you’re sending a text to someone, it can be so easily misconstrued. It’s so easy to want to put something into writing and the other person at the other end takes it the wrong way. If there was something to interfere and say you put so and so which could be misconstrued – that would be a very good help.”
Participant with a cognitive, mobility and dexterity impairment.
Incorporating information about accessibility into wayfinding apps
“For the Google Street view to expand…if there was a little robot that would go into the entrance of every single business you go to on the high street that would take 360 degree images of the ramps, access, what it’s like inside…you can view the accessibility whenever you are planning a trip.”
Participant with a cognitive, hearing, visual and mobility impairment.
Improved connectivity between devices and systems
“I have multiple carers each day, somebody different and when you’ve got anxiety and you’re quite vulnerable anyway, having this constant stream of strangers coming into your house that you don’t know. It ends up being more stressful than helpful so having that permanent fixture in your house that could do all of those things and connect to all your devices, call for assistance if needed.”
Participant with a cognitive and physical impairment.
Case study 5: digital AT for social care and independent living
Many disabled and older adults report needing support with everyday tasks and issues accessing social care (). Digital AT in adult social care can support people to live independently in their own homes for longer. This case study draws on a workshop jointly organised with Policy Connect conducted for this report in April 2024.
Opportunities
The use of digital AT has the potential to provide disabled and older adults with tools to independently control their home environments to better meet their needs. Mainstream smart home devices, such as Amazon Alexa and Google Home, can give people with mobility issues new ways to control lights and heating, ask for information, set reminders, access entertainment and keep in touch with friends and family using voice commands or a smartphone (). Other forms of home automation, such as robot vacuum cleaners and voice-operated doorbell intercom systems, are used by Blind or partially-sighted people to perform everyday tasks (). These technologies could reduce the cost of in-home care and the workload of carers ().
Many local authorities and social care providers have been experimenting with digital sensors and AI systems aiming to support monitoring for care and wellbeing (). For example, local authorities have piloted remote monitoring technology systems, where sensors installed in homes or wearable devices collect and analyse information on daily routines, such as sleep patterns and meal preparation and notify carers if there is concerning activity deviating from normal routines (). This could lead to health benefits and allow earlier interventions in emergencies (). Workshop participants suggested AI systems could be a potential tool to reduce the administrative burden on caregivers, allowing them to focus more on direct care (). ‘Social robots’, such as the robotic baby seal PARO developed in Japan, have been used to reduce agitation and increase social engagement for people with advanced dementia ().
Challenges
Privacy is a significant concern for users of digital AT in social care. Open-source technologies, such as Home Assistant, offer better privacy controls but require significant technical knowledge. Data minimisation, on-device processing and the use of zero-knowledge proofs which allow systems to confirm a user meets certain criteria without revealing additional personal information, can offer privacy-preserving alternatives. However, social challenges remain, such as users feeling coerced into accepting technologies presented as the only option for receiving care, diminishing disabled and older users of their agency and right to privacy ().
One of the key challenges with the use of digital AT for social care is the difficulty of integrating technologies into the social care system. Local authorities responsible for social care struggle with the high costs and time needed to implement new systems, especially in resource-poor settings or areas with poor digital infrastructure. Integrating digital costs into overall care costs when providing funding could ensure smart home technologies are more widely accessible. There are also challenges with the lack of training for users and the social care workforce, where there is a recognised digital skills gap ().
Ensuring uniform training is difficult due to the mix of providers in the social care sector and varying levels of digital literacy. Smaller providers, already lacking in resources, often struggle to see the value in investing in digital training. Knowledge-sharing resources could assist organisations struggling with how to proceed with decisions to deploy new technologies (). Effective onboarding processes and tailored training for digital AT is important, especially for initial setup with new technologies, where users may be less confident.
Despite high interest in digital AT, its efficacy in social care is unclear, exacerbating challenges in securing funding. Research has found mixed results on the efficacy of digital AT for improving health and quality of life for disabled people and challenged claims digital AT reduce care costs with some evidence that digital AT, such as social robots, increase carer workload (), ().
Concerns around how digital AT impact jobs could lead to resistance from both caregivers and care recipients. Many social care providers approach technology deployment through the lens of efficiency and savings rather than focusing on user needs, which could compound social isolation ().
Technical challenges in inclusive design hinder the use of mainstream devices, such as smart home technologies, for specialised needs. For example, mainstream speech recognition technologies struggle with speech disfluencies. Ensuring thorough user research before product development and incorporating feedback throughout the process can help create digital AT that are both functional and responsive to the diverse needs of users.
Example: Smart home devices for independent living
In Scotland, the Blackwood group, a specialist housing and care provider for disabled people, has introduced the CleverCogs™ digital system into its housing facilities. CleverCogs™ is accessed through a touchscreen tablet and provides simplified internet access for those typically digitally excluded for home automation, social interaction and health planning ().
Conclusion
Digital AT, especially mainstream smart home devices, are already used to support independent living for disabled people and older adults. However, there are several challenges hindering wider integration into social care systems due to issues with funding, demonstrating efficacy of technologies, privacy concerns and the need for digital skills and training.
