Ebook: Technology and Aging

This volume contains an edited selection from more than 260 scientific papers presented at the 2nd International Conference on Technology and Aging (ICTA). The editor's task in compiling selected papers for a post conference publication presents special challenges. Quite apart from the (often delicate) job of deciding which papers are to be included, conference proceedings – whose purpose after all is to document a contemporary perspective of the state of the art in a particular field of science or technology – necessarily offer only a snapshot of an unfolding dynamic plot (the cast members of which periodically return to the limelight at future conferences).

In relatively immature or nascent fields, such as technology and aging, the pace of development is generally swifter than established ones, and conferences snapshots are liable within rather a short time to become as topical as a sepia period portrait. This is no doubt of considerable interest to historians of technology, but probably of dubious value to commercial stakeholders, funding agencies, and policy makers, who demand up-to-the-minute information.

To afford durable relevance to the information the present book contains, we have adopted an alternative approach to the commonly accepted practice of assembling for publication conference papers in the format more or less as originally presented. First, all of the 29 articles contained here are considerably extended versions of selected original conference papers presented at this conference. They have undergone substantial revision compared to the original four-page conference papers, incorporating in most cases new information and results that were unavailable during the conference. Second, we have selected the papers which, not only we editors consider are of significant and enduring scientific interest, but also exemplify best practice in research methodology, particularly in the uniquely multidisciplinary field of technology and aging.

The organization of this book follows roughly that of the thematic sessions at ICTA meeting: Aging-in-Place, Assistive Technology, Monitoring and Telehealth, Transportation and Mobility, and Design.

Since the 1st meeting of the ICTA in 2001, the role of technology in aging-in-place (the topic of this book's first section) has acquired considerably more prominence, capturing the attention of a wide range of scientific and technological disciplines. This is perhaps not that surprising, considering the high prioritization by North American and European governments placed upon aging-in-place solutions as a viable alternative to more costly, and also socially isolating, institutional care. But, necessarily concomitant with successful aging-in-place programs is the implementation of robust and reliable monitoring, assessment and evaluation mechanisms to measure technology efficacy and safety for older people choosing to live independently. In such context, Jakkula and Cook describe how temporal patterns in an older person's daily activities at home, as measured by sensor networks, can be used to predict normal events and identify anomalous ones. Silva, Chau, and Mihailidis in their article share their experience with an experimental automated activity detection system, requiring only a single ceiling mounted camera, which is context-aware regarding unconstrained types of activity in the home. Home sensor networks similarly form the basis of a scalable cognitive and behavioral in-home assessment system developed by Jeffrey Kaye of the Oregon Center for Aging & Technology, and collaborators. Wayne Chung of Carnegie Mellon University and collaborators from Intel Corporation have investigated the influence of various self medication dispensing technologies with respect to compliance among older adults while outside the home. Case studies of basic and instrumental activities of daily living form the subject of articles by Helene Pigot and Axel von Bertoldi and their colleagues concerning cognitive orthotic aids for preparing food with complex ingredients and for hand-washing procedures. Williams, Sabata, and Zolna examine workplace accessibility for older adults with disabilities. Accommodating for agerelated disabilities can significantly improve the effectiveness and productivity of older adults in the workplace, thus influencing employment decisions.

The section on assistive technology (AT) represents arguably the most mature and generic aspect of technology and aging; except that AT can hardly be regarded really as a specific discipline any longer. Assistive devices and systems command an expansive gamut of technological and engineering specialties, drawing upon mechanical engineering and industrial design at one end of the field and cybernetic systems engineering and brain-computer user interfaces at the other. We have chosen three articles for this section whose subject matter and general conclusions relate to a more strategic and general perspective and draw comparisons among disparate technological fields, addressing respectively technical aids for memory, communication, and patient transfer. Massimi and Baecker's investigation into the scope for mobile cellular telephones to function as memory aids for mild cognitively impaired older adults is pertinent for understanding user needs in a market where, currently, people over the age 65 represent one of the fastest growing segments. Keeping with theme of dementia, the efficacy of computer-based aids for initiating and maintaining conversations involving people with Alzheimer's disease has been demonstrated by researchers from the universities of Dundee and St. Andrews, Astell et al., with their CIRCA project. In their comparison of established and novel mechanical hoist sling systems, Dutta, Haliday and Fernie explain that sling design is a critically important issue not only with respect to the patient's welfare, but the caregiver's too. In their paper on peer mentoring of older adults on adoption of new technology, Johanne Mattie and colleagues present a social outcomes perspective. This paper is significant in what it reveals, through extensive focus groups, concerning older people's attitudes to, and order of prioritization of, advanced consumer technology in general and assistive technology in particular. Key pointers have been derived from this project to inform efforts in nurturing awareness among improved take-up by potential users of quality-of-life and autonomy-enhancing technology.

The largest section in the book, on monitoring and telehealth, reveals novel applications of advanced pattern recognition techniques, some of which have, up to now, found roles primarily in the military, process engineering, and financial sectors. Alternative approaches to image processing, to detect posture and gait anomaly, as a diagnostic means for identifying the early presymptomatic stages of Alzheimer's disease and other age-related morbidities, are presented. Edington and Berme apply fractal analysis, while and Prinz et al. are investigating spatio-temporal analysis techniques of Motion Energy and Motion History in image processing. For applications of monitoring for older person support, Meredith Rowe and co-investigators at the University of Florida report on the results of a 12-month pilot of a nighttime safety monitoring system for home use by people with cognitive impairment. The paper by Jimison and Pavel describes their investigation into cognitive health coaching, provided within the context of a general and scalable framework that is independent of particular electronic health record systems. The challenges involved in acquiring continuous data on older subject behavior using home sensor networks is discussed by Hayes et al. The main problem identified by the authors is the interpretation of the very large volumes of data in real time and they propose a solution based on statistical process control. Domestic service robots continue to attract considerable media attention. Michaud et al. report on their application of robots to provide in-home telepresence support to caregivers. Issues of autonomous navigation and obstacle avoidance remain key issues, as well as does acceptance by the older person at home. Sanford and Hoenig present their conclusion following a study into the comparative efficacy of delivering home-based physical and occupational therapy respectively through traditional home visits and telecare services. Kearns and More are exploring how the latest generation of wideband RFID devices can be exploited to study aimless peripatetic behavior, and enhance the environmental safety, of persons with dementia living at home.

Transportation and mobility still represents by far the largest and most commercially lucrative market segment of technology for seniors. There is however a clear trend towards synthesis of information and communication technologies (ICT) and mobility technologies, which is embodied in the latest developments of automatic collision avoidance and full or semi-autonomous navigation functions in powered mobility devices. For interesting approaches to the engineering and design challenges involved see in particular the articles by Viswanathan et al. and Gomi, which recount their respective work on the development of intelligent wheelchairs. Loss of balance and falls, acknowledged epidemic cause of morbidity and fatality among older people, are the subject articles on novel analysis techniques and interventions. Scovil et al. describe an audio-visual cueing system for stair or ramp handrails. Snoek et al. employ motion analysis and event classification algorithms to predict the statistical likelihood that a stair descent pattern is normal or anomalous. Cheng et al. present the results of a parametric analysis of a walking frame's ability to prevent loss of balance, in which the authors compared the perturbation responses in stance and gait for two alternative walker designs. The final article of this section, by Park et al., explores the comparative performance of driving simulators for predicting driving behavior and safety respectively among older and younger adults. The study is underpinned by independent analyses of self reporting and accident/traffic violation citation data.

The last section is dedicated to design issues. Stone and Mather have coined the term ‘Included Design’. They propose that designing for the special needs market before making a design as inclusive as possible to the mainstream market is a viable alternative to the currently accepted notion of inclusive design, provided that aesthetics are appropriately addressed. The contribution by O'Brian, Rogers and Fisk explains how the performance of routine computer tasks by older people is influenced by the design of input devices. A virtual keyboard allowed the authors to independently examine design features shown previously to affect individual task components (namely movement and visual search), assess the text entry task in the target context, and investigate specific design features that might facilitate more natural and effective performance following different levels of practice. Horwitz and Pentland in their article, emphasize the critical importance of user participatory design, especially involving selfcare patients. They introduce the “Cauldron of Thought” technique for achieving optimal and creative design solutions. Finally, Adlam and Orpwood present preliminary conclusions regarding open standardization for off-the-shelf infrastructure components in smart homes designed for older people with dementia. The authors point out that many commercial infrastructures continue to be developed upon proprietary standards, which impedes innovation by third party device manufacturers.

If there is an overall theme connecting the majority of the articles surveyed above, the reader probably will have noticed this to be ‘coping with cognitive decline’, despite there being no section of the book dedicated to this subject. This is the all the more interesting, considering that addressing dementia was never a criterion in selection for the book; and herein lies an apparent trend where the focus for research and development in technology for aging is inexorably converging upon issues of coping with cognitive decline. One might easily conclude that this is because dementia has emerged as the prototypical disability of aging in this century, but it is not actually the case; other age-related morbidities have considerably higher prevalence and incidence. To be sure, as life expectancy increases, there will be people who develop dementia. But what we believe places it so prominently in the sights of gerontechnology researchers and developers is the social shift from institutional to home-based care, in which information communication technology based solutions now afford the possibility of aging-in-place for the many thousands of people having mild to moderate cognitive impairment. This is a salutary lesson for workers in our field to ponder during the years leading up to the next meeting of the ICTA.

Smart homes offer a potential benefit for individuals who want to lead independent lives at home and for loved ones who want to be assured of their safety. We have designed algorithms to detect anomalies and predict events based on sensor data collected in a smart environment. In this paper we explain how representing and reasoning about temporal relations improves the performance of these algorithms and thus enhances the ability of smart homes to monitor the well being of their residents.

We propose an unsupervised learning technique for the automatic classification of activities of daily living (ADL) from video data collected in-place. This technique may be used to develop automated home care systems capable of context-aware interactions with older adults. Data was acquired from a video camera mounted on the ceiling of a simulated bedroom while a subject performed unconstrained activities relevant to this context. A constrained Gaussian model, obtained through Factor Analysis (FA), was later fitted to all frames in the video. The required number of activities to be detected corresponded to the number of latent variables in the constrained model. The mean of the posterior distribution for each previously unseen frame was calculated, and a label corresponding to the factor with the maximum posterior mean for each frame was assigned. As it was naturally expected, the accuracy of our classifier was dependent on the number of activity classes required with a maximum of up to 82.57% of true positives achieved for only two generic activity classes. Sequential arrangements of multiple classifiers may be used to increase the number of activities accurately detected. The simplicity of this method allows for the trivial implementation of real-time, context-aware and interactive home care systems. Current limitations are also discussed.

Cognitive or motor function decline are major causes of loss of independent living among the aged. Several methods employing ubiquitous or unobtrusive technologies have been proposed for application toward in-home assessment to identify clinically meaningful change. Most attempts at multidimensional home monitoring have been on a limited scale. This has been the result of both technical and clinical research challenges in applying and more importantly testing the efficacy of such methods on a community-wide scale. We designed and implemented a system for application to a community based clinical trial of the efficacy of a basic sensor net (motion and contact sensors, RF location systems, and personal home computer interaction) to be studied in 300 homes of independent seniors. In this manuscript we describe a protocol to ensure several key outcomes: facilitation of recruitment and enrollment, customized training of elders for in-home computer use, optimized sensor net installation, tracking of subject status and linkage to study management software to enable on-line, real-time testing and trouble-shooting with seniors. The methodology suggests that large-scale unobtrusive in-home assessment is feasible for research needed to establish the efficacy of such systems for detection of cognitive decline and related conditions of aging.

The World Health Organization cites that compliance to a prescription medicine regimen is one of the most critical issues to the continued health and wellness of elderly people. [1] Extensive data also show that particular elements in the activities of daily living affect compliance. The areas frequently identified for solutions are primarily a result of studying at-home environments and experiences. As people live longer and healthier lives, elders are able to spend more time being active outside of the home. Creating a system to remind and motivate towards medication adherence can be a key factor in keeping an elder safely in his/her home and community. The following paper will describe the collaborative efforts between Intel's Digital Health Group and the Industrial Design program at Georgia Institute of Technology. Qualitative research methods were employed for this project. To better understand the current and future needs of active and mobile elders. The research was conducted in a 12-week time frame by seven industrial design graduate students. A multi-method research approach consisting of questionnaires, photo journals, and collaging exercises were used to understand the problem spaces and offer subsequent solution concepts. Initial findings have shown that participants performing short-term, outside the home activities (<3 hours from home) do not change a person's regimen or require specific products to aid compliance. Understanding these current behaviors also helped uncover latent needs for possible technology and systematic solutions. Prior to the start of this project, a team of researchers at Intel focused on ways to improve the quality of life in elders. [2] In conducting extensive ethnographic research on elders, it was noted that medication compliance is more than just a medical problem. Although it has long been recognized by the medical profession that taking medications is a key marker of the ability to live independently [3], hearing this from many informal interviews emphasized the subjective importance of this activity to elders and family. In addition, noncompliance costs the US healthcare system $100 billion per year. [4] Reports have shown that noncompliance to medication regimens range from 13% to 93%, with an average rate of 50% for long-term therapies. [5] Noncompliance is a particular problem for the older population. It is recognized that compliance itself is not necessarily the problem, but the consequences of noncompliance with the older population typically results in greater health complications and higher risk of adverse health effects. [6] Almost 30% of hospital admissions, and 40% of nursing home admissions for patients older than 65 years are due to noncompliance. [7]

People with an intellectual disability (ID) have difficulties completing their daily tasks, especially complicated ones. Memory and planning deficiencies can significantly impede cooking activities. Having difficulty remembering where the ingredients are located and organizing steps in a recipe can also be quite a challenge. The DOMUS smart home was built to promote functional autonomy. The smart home aims to assist people in activities that are not performed adequately. It prompts information on a touch screen that interacts with the person. The smart home was evaluated with nine people with an ID. The method consists of a two-phase experimentation. The results of the first phase, which involves working with medical staff to select and define an activity to assist, are presented. The second phase, the evaluation of the device with people with ID, is in progress and the topic of a future paper. We conclude by discussing the generalization of smart homes in promoting autonomy in people with dementia.

Dementia is a common affliction in the older adult population and often causes difficulties in remembering the required sequence of steps needed to complete a task. The current solution is to rely on a caregiver to supervise the person with dementia through the task, correcting their actions as necessary. However, maintaining independence from a caregiver is essential in promoting feelings of dignity and reducing caregiver burden. This paper presents the iterative development of a system that autonomously guides people with dementia through the task of handwashing. Clinical trials were used to evaluate each prototype and identify deficiencies that were resolved in subsequent prototypes. This approach has resulted in more effective, robust and unobtrusive task-tracking and subject interaction. The system has reached a point where it is ready to be tested with other activities (e.g. tooth brushing), populations (e.g. children with autism), and integrated ubiquitously into a smart-home.

Overall, 15% of Americans ages 65 and older are currently working or actively seeking work. From 2000–2015 the U.S. labor force of workers over age 54 is anticipated to grow at four times the rate of the rest of the labor force [1]. As people age, they can experience changes in functional abilities such as vision, hearing, and mobility. Workplace accommodations can be used to facilitate job task performance, particularly for people who experience functional difficulties. While workplace accommodations are often considered for persons with disabilities, older workers who have slowly developed functional difficulties over time may not be considered in workplace accommodations. The purpose of this study was to determine differences in the number and types of workplace accommodations received by older workers (65+) and younger workers (<65 years old) with disabilities. Preliminary data analysis revealed that workplace accommodations were provided for access to the individual work environment (71%), for access to the workplace facility (16%) and changes in job set up (13%). People of various age groups, regardless of type of functional limitation often reported receiving no accommodations. For example those with visual impairments ages 18–55, ages 56–64, and ages 65+ reported “no accommodations 12%, 17%, and 50% respectively. The most frequently reported accommodations for visual impairment over all were reading guides (12%), electronic documents (9%), and scanner (9%). However those ages 65+ did not report using any of these accommodations.

This paper presents observations and participatory design meetings to determine desired properties of new mobile phone-based memory aids for seniors. We observed a clinical population of individuals with Mild Cognitive Impairment (MCI) participating in a memory intervention session for a period of six weeks. We then conducted a series of participatory design activities with five normally aging seniors who were concerned about memory loss. Based on these two activities, we contribute evidence that mobile PDA phones contain many of the properties that seniors desire in an external aid; however, they lack appropriate software and hardware. Mobile phone designs should be changed to accommodate seniors, but only in coordination with better user support and without removing desirable memory support functions.

Cognitive prostheses interact with human cognitive abilities to extend an individual's capacity. They have application both with healthy functioning individuals and those who have suffered brain injury. In Alzheimer's disease (AD) patients experience progressive, but inconsistent deterioration across cognitive domains over the course of the illness. Some abilities are relatively well retained in AD and offer the clear potential for developing cognitive prostheses. Here we report the successful development of CIRCA, a system designed for people with AD based on maximizing their retained abilities and working round impaired ones to enable their participation in social interactions with caregivers. Specifically we demonstrate that it is possible to circumvent the working memory problems characteristic of AD and enable people to once more make choices and initiate topics of conversation. Benefits of the current system are temporally linked to contemporaneous use but highlight the potential for future development of prostheses with rehabilitative functions.

Caregivers injure their backs at alarming rates. Some of these injuries are thought to be due to aspects of mechanical lift device use. In particular, the activity of sling insertion is thought to place caregivers at risk of injury. In this paper, we review common practices regarding sling use, conventional techniques for sling insertion, describe the results of our evaluation of the conventional sling insertion activity and describe two novel sling systems. The two novel sling systems are: the single roll sling and the pneumatic lifting strap inserter. We review the designs of these devices and evaluate their potential to reduce the risk of back injury in caregivers.

New technologies have emerged that can enhance the independence and safety of older adults. Research has shown that user acceptance of technology is affected by user awareness, need, experience and the support that is available. This paper discusses a project that aims to develop and pilot a community based education and support program that will teach seniors the benefits of new technologies and how to use the devices most effectively. The program links Community Access Program (CAP) community based internet sites across Canada with regional senior's organizations. Retired volunteers with technical backgrounds deliver introductory courses on new technologies and provide peer to peer support. A series of focus groups and telephone surveys were conducted with seniors in rural and urban sites across Canada to identify barriers that prevent seniors from adopting new technologies and create a prioritized list of which technologies seniors want to learn about. The top technologies identified include cellular telephones, emergency response systems, blood pressure monitors and caller ID. These results were used to develop a curriculum for the peer to peer program that is being piloted in 8 sites across Canada. It is expected that having seniors teach other seniors how to use new technologies will increase the successful adoption of these beneficial technologies and therefore help Canadian seniors live full and independent lives.

To determine the merits of fractal analysis in differentiating health from disease, detrended fluctuation analysis (DFA) was applied to postural sway data of healthy young individuals, healthy elderly individuals, and individuals with compromised balance due to Parkinson's disease. It was found that there were significant differences among the groups. Most notably, those with Parkinson's disease had a significantly more random sway pattern in the M/L direction than the healthy groups, suggesting that quantifying the fractal dimension identified an intrinsic difference between them. Findings also demonstrated differences between healthy young and healthy elderly groups, suggesting an age-related change in postural sway patterns. This study demonstrated that fractal analysis was a useful tool and should be considered as a quantitative way to monitor changes in health.

This paper describes a new computer vision-based method for motion analysis in the context of rehabilitation and orthotics. The proposed approach measures upper-body sway at head level using spatiotemporal templates of motion. Experimental results obtained from video sequences of unaided and aided walking show that the proposed method is able to successfully captur abnormalities in gait, as well as gait improvement due to wearing corrective orthotics.

Persons with dementia often have nighttime activity that can put them at significant risk or injury or death. The most common injuries result from falls in the home, and include fractures and skin injuries. In addition, persons with dementia who are up while the caregiver is sleeping may leave the home unattended and become lost in the community, which can lead to injury or death. Caregivers become overly fatigued by supervising during the night and seek nursing home placement. The purpose of this research was to test a novel technology designed specifically to assist informal caregivers in managing nighttime activity, prevent nighttime injuries and unattended exits. Fifty-three subjects were enrolled in a 12-month randomized pilot study with 26 subjects receiving the system. The system was successfully installed in these subjects' homes and operated correctly throughout the trial. All experimental subjects were very satisfied with the system and used it on a nightly basis. All experimental subjects who completed the study chose to keep and continue to use the system. There were a number of attempted home exits that were prevented due to notification by the system. About twenty percent of subjects in the control group had an event (fall or unattended exit) that was potentially preventable if the system had been in use. This technology represents a novel technology that can significantly reduce the negative consequences of nighttime activity including falls and unattended home exits.

Most health care takes place in the home, especially for people with chronic diseases and conditions of aging. Often the most effective components of the management of these conditions have to do with improving health behaviors, such as exercise, diet and adherence to agreed-upon treatments. With escalating health care costs, it is important to focus on technologies that facilitate home-based care with less expensive personnel, trained to provide coaching for improving health behaviors. The focus of this project is to develop a general-purpose architecture for providing computer-based health interventions for elders in their homes, facilitated by a professional health coach. This architecture incorporates knowledge representations to enable use of known principles of health behavior change. For example, we include modules to assess health behavior goals, motivations, barriers and readiness to change. In addition, based on our needs assessment of stakeholders (elders, family, caregivers, clinicians, service providers, researchers, government, and industry), we have focused on a design to facilitate the participation of family members and low-skilled caregivers as part of the care team. Sophisticated user models and authentication methods are required to determine the appropriate data access and user interface to the system for each user. We use current interoperability standards to anticipate and prepare for linkage with available electronic medical records and personal health records. The primary benefit of this approach is that multiple health behavior interventions can be made available using a common architecture and format that encourages a principled approach to the delivery of care to the home.

Recently, a number of projects have been undertaken to collect continuous behavioral data from elderly individuals using unobtrusive in-home sensors. An important challenge facing these projects is the development of approaches for interpreting these data. One approach, based on statistical process control, is to model each individual's behavior as a random process whose mean and variance may change over time. The sensor data then provide specific measures of the process that can be used to identify changes in patterns of behavior. The approach is presented and applied to measures of sleep hygiene in a group of 14 community-dwelling elders monitored over a six month period. Both acute and slow changes in the patterns of sleep were successfully identified in individuals using this approach.

Assistive technologies for telementoring in homes constitute a very promising avenue to decrease load on the health care system, reduce hospitalization period and improve quality of life. Teleoperated from a distant location, a mobile robot with some autonomous capabilities could become a beneficial tool in telehealth applications. However, design issues related to such systems are broad and mostly unexplored (e.g. locomotion and navigation in home settings, remote interaction and patient acceptability, evaluation of clinical needs and its integration into health care information systems). Mobile robots operating in home environments must deal with constrained space and a great variety of obstacles and situations to handle. This paper presents the interdisciplinary design methodology followed to develop Telerobot, a telepresence assistive mobile robot for home care assistance of elderly people. Using field trials with existing platforms, focus groups and interviews, initial requirements for the new mobile robot platform with its augmented video user interfaces are outlined.

A randomized clinical trial was undertaken to examine the effect of a multi-factorial, individualized, physical/occupational therapy intervention on mobility self-efficacy delivered via teletechnology and traditional in-home visits. Sixty-five community-dwelling adults with new mobility devices were randomized to either the control or usual care group (n=33); or the intervention group (n=32). The intervention included four, one-hour PT/OT sessions, one time per week targeting 3 mobility and 3 transfer tasks. The intervention group (Tele and Trad) had a statistically significant increase in overall self-efficacy over the study period compared to the controls (UCG). Moreover, comparisons of the two treatment delivery methods showed a medium standardized effect size (SES) in both the Tele and Trad Groups compared to UCG, suggesting that a multifactorial, individualized, home-based PT/OT intervention delivered either by teleconference or by traditional in-home therapy can improve self-efficacy in mobility-impaired adults.

Wandering in persons with dementia is meandering, aimless or repetitive locomotion that exposes a person to harm and is incongruent with boundaries, limits or obstacles. Radio Frequency Identification Devices (RFID) are used in alarm systems in nursing homes to differentiate dementia patients from staff and visitors at exitways and to provide selective lockdown. RFID is a well-proven, robust and widely-used technology. Few studies of wandering and wandering-related behavior especially as it occurs in home settings have been attempted, largely because of a lack of suitable measurement tools. Advances in RFID technology present an innovative means to study wandering. Pilot data are presented on the use of a new ultra-wideband RFID technology to precisely monitor wandering behavior in home settings by persons with dementia.

Long-term care (LTC) residents with cognitive impairments are often not permitted to use powered wheelchairs due to safety concerns, which results in a loss of mobility and independence. The authors have developed two prototypes of an anti-collision system for a powered wheelchair; one employs a 3D infrared sensor while the other uses stereovision. Both systems are designed to stop the wheelchair if a collision with an object is imminent and provide verbal prompts to help the user navigate around the obstacle. This paper presents an overview of both designs as well as a comparison of performance testing under controlled lighting conditions. Future work includes more advanced planning and scheduling capabilities, as well as the development of a pervasive network of intelligent wheelchairs.