Smart Environments in Support of Fragile and Isolated Older
Adults: Protocol for the City of Côte Saint-Luc’s Living Lab
Nathalie Bier
1 a
, Mélanie Couture
9 b
, Thomas Tannou
1,2 c
, Carolina Bottari
1 d
,
Thomas Lihoreau
2 e
, Hélène Pigot
3 f
, Sylvia Pelayo
4 g
, Xavier Ferrer
5 h
, Rosalie Wang
6 i
,
Charles Gouin-Vallerand
3 j
, Guy Paré
7 k
, Sébastien Gaboury
8 l
, Kevin Bouchard
8 m
,
Sandra Smele
9 n
and Sylvain Giroux
3 o
1
Université de Montréal, CIUSSS South-Central Montreal, Montréal, Canada
2
Centre Hospitalier Universitaire de Besançon, Centre d'Investigation Clinique, INSERM CIC 1431,
25030, Besançon, France
3
DOMUS Laboratory, Université de Sherbrooke, Sherbrooke, Canada
4
Université de Lille, Lille, France
5
Universidad Politécnica de Madrid, Spain
6
Univerity of Toronto, Toronto, Canada
7
HEC Montréal, Montréal, Canada
8
LIARA Laboratory, Université du Québec à Chicoutimi, Chicoutimi, Canada
9
Centre de Recherche en Gérontologie Sociale, CIUSSS West Central Montreal, Côte St-Luc, Canada
Keywords: Smart Environment, Older Adults, Frailty, Social Isolation, Welfare Mix, Living Lab, Smart Cities, Action
Design Research, Mixed Data.
Abstract: In the context of an aging population, 5.6 million people in Canada are suffering from social isolation and this
is a key factor contributing to frailty because it promotes the onset of cognitive impairment, depression, and
dependency in older adults. The COVID-19 pandemic and the demands of social distancing have particularly
affected older adults by increasing their exposure to social isolation and medical complications. In addition,
the pandemic has highlighted the vulnerability of the health and social services system and the importance of
exploring community involvement and telehealth solutions – such as telemonitoring activities of daily living
(ADLs). This paper presents the protocol of a living lab project that aims to co-develop a support model
around the telemonitoring of ADLs at the scale of a city, Côte Saint-Luc. In particular, the project seeks to
optimize older adults’ identification and use of resources available in the community. These resources include
services from the city, the health and social services system, and community organizations, and support from
families and community volunteers. With the support of telemonitoring, this ecosystem could enable seniors
to live at home for longer.
a
https://orcid.org/0000-0002-2940-694X
b
https://orcid.org/0000-0002-0088-3865
c
https://orcid.org/0000-0003-3476-9822
d
https://orcid.org/0000-0003-2242-8369
e
https://orcid.org/0000-0001-8417-6609
f
https://orcid.org/0000-0001-5520-5677
g
https://orcid.org/0000-0003-2830-2548
h
https://orcid.org/0000-0003-3474-9784
i
https://orcid.org/0000-0001-7777-9989
j
https://orcid.org/0000-0002-5811-2932
k
https://orcid.org/0000-0001-7425-1994
l
https://orcid.org/0000-0001-7749-3470
m
https://orcid.org/0000-0002-5227-6602
n
https://orcid.org/0000-0002-1995-6307
o
https://orcid.org/0000-0003-0602-5957
Bier, N., Couture, M., Tannou, T., Bottari, C., Lihoreau, T., Pigot, H., Pelayo, S., Ferrer, X., Wang, R., Gouin-Vallerand, C., Paré, G., Gaboury, S., Bouchard, K., Smele, S. and Giroux, S.
Smart Environments in Support of Fragile and Isolated Older Adults: Protocol for the City of Côte Saint-Luc’s Living Lab.
DOI: 10.5220/0010970900003123
In Proceedings of the 15th International Joint Conference on Biomedical Engineering Systems and Technologies (BIOSTEC 2022) - Volume 5: HEALTHINF, pages 883-891
ISBN: 978-989-758-552-4; ISSN: 2184-4305
Copyright
c
 2022 by SCITEPRESS – Science and Technology Publications, Lda. All rights reserved
883

1 INTRODUCTION
As the population ages, the long-term sustainability of
the health and social services system is becoming more
precarious because chronic illness and functional loss
usually lead to increased use of services. The health
and social services system is struggling to meet
demand and one in five older adults who use both
formal and informal home care report unmet needs
(Turcotte & Grant, 2006). In addition, the current
COVID-19 pandemic has further strained the already
limited resources, reducing access to health and social
services. Indeed, day programs, ambulatory and home-
based services were put on hold as professionals were
deployed to other care roles deemed to be of higher
priority (Koeberle et al., 2020).
The pandemic also exposed older adults to social
isolation due to the lockdown and social distancing
rules. Social isolation is a major problem in Western
societies, with 5.6 million Canadians suffering from
it (Angus Reid, 2019). This phenomenon is
experienced as an objective and/or subjective
reduction in the number and quality of interpersonal
contacts which leads to a loss of an individual's social
roles (Fakoya, McCorry & Donnelly, 2020). Social
isolation is a key factor contributing to frailty, as it
promotes the development of cognitive impairment,
depression, and dependency, thereby creating a spiral
that increases frailty status (Gobbens, 2016). Frailty
is a condition of vulnerability that exposes older
adults to incidental adverse events which leads to an
increase in their use of health and social services
(Abell & Steptoe, 2021; Andrew et al., 2018).
How can we help frail and isolated older adults
better meet their needs to remain at home? The
pandemic has highlighted the vulnerability of the
health and social services system and the importance
of better exploring both community involvement
(Ministères des solidarités et de la santé, 2020) and
telehealth solutions (Smith et al., 2020). Furthermore,
the pandemic has exposed great deficiencies in the
services provided to older adults in long-term
residential care. This means that a more robust,
system of home-based care provision is critical
moving forward. More diverse partners need to be
involved to put in place an ecosystem of support that
is adapted to, and provided in close proximity to older
adults, i.e., in their neighborhoods. It has become
increasingly urgent to mobilize cities, community
organizations, citizens, families, and older adults
themselves in a process of reflection and co-
construction of an ecosystem of support that will have
a significant impact on the home support and older
adults’ quality of life.
In addition to having exacerbated social isolation,
the pandemic led to the growth of telehealth, though
some of its possibilities have yet been exploited.
Among these possibilities, is the telemonitoring of
activities of daily living (ADLs) to collect data
remotely via smart environments in order to detect
and analyze patterns of engagement in ADLs in a
person’s home over a long period of time; for
example, detecting patterns of sleep, personal
hygiene, meal preparation and outings. Our team has
shown that these patterns, and their deviations when
compared to the person’s normal routine, can be used
to better understand home service needs and to detect,
and even predict, adverse events that could lead to
hospitalizations or changes in living environments
(Lussier et al., 2020a, 2020b). However, to our
knowledge, this form of telemonitoring has not yet
been tested on a large scale or integrated into a
complex ecosystem that allows for interactions
between multiple partners (health system,
municipalities, community organizations, etc.).
This paper presents an ongoing, living lab project
taking place in Côte Saint-Luc, a city located on the
island of Montreal in Canada. The project uses a
model of support grounded in telemonitoring of
ADLs to optimize the identification and use of
available community resources by frail and isolated
older adults. These resources include city services,
health and social services, and community
organizations, and support from families and
community volunteers. The paper will present the
rationale of this study, including our past
collaboration with the city of Côte Saint-Luc, as well
as the potential of telemonitoring of ADLs to support
older adults. It will also present our past studies on
the topic. The paper concludes with a presentation of
the protocol of the project that started in 2021 and will
end in 2024.
1.1 History of Partnership with the
City of Côte Saint-Luc
In 2017, Infrastructure Canada launched the Smart
Cities Challenge competition, which challenged
municipalities and Indigenous communities across
Canada to use a smart city approach to address local
issues for their residents. The City of Côte-Saint-Luc
(34,066 residents) submitted a proposal that was
selected as one of 10 finalists in the category of cities
with 30,000 to 500,000 residents. With the help of our
research team, the city wanted to ensure that its
citizens were better connected to their community, to
municipal services, and were more socially engaged
through connected technologies. The Mayor, his team
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of councilors, and the City Manager were actively
involved in this project. For eight months, the City led
a broad community engagement campaign and, with
our research team, conducted a pilot project to assess
the feasibility of such an approach. In the fall of 2018,
our team conducted eight focus groups with all of the
City's stakeholders: city councilors, staff, frail older
citizens, engaged older adults, families and
caregivers, etc. In the homes of five older citizens, we
also deployed assistive technologies, alongside an
ADLs telemonitoring system that we developed
through a previous research project (Ngankam et al.,
2019), over a 4-month period. Ours results indicate
that older citizens are isolated and are not able to
obtain all the services they need to remain in their
homes and that city services are not being used to
their full potential. In addition, stakeholders noted
that there is no systematic effort to screen or assess
the needs of older citizens. Older citizens who
received the technology found the experience very
positive, experienced an increased sense of security,
and expressed interest in obtaining information about
their lifestyle via telemonitoring.
While the final proposal was unfortunately not
selected by Infrastructure Canada, it laid the
groundwork for a living lab, identified, and mobilized
the necessary resources, and established a
collaborative network to build on. Since this
competition, the City of Côte Saint-Luc, which has
one of the oldest populations in Canada, has been
particularly affected by the COVID-19 pandemic.
Thus, it seems more relevant and timelier than ever to
set up a living lab in this City. With this project, the
City and our team wish to continue the extraordinary
mobilization of this community and to set up a Living
Lab that meets the needs, expectations, and
dynamism of this ecosystem. This project goes
beyond the pilot project, which focused on
monitoring ADLs, because it will contribute to a
reassessment of the concept of frailty and will
produce a complete analysis of the ecosystem of
support in order to better address social isolation.
1.2 The Potential of Smart Homes for
Home Support of Older Adults
Smart environments used in telemonitoring can play
a key role in the provision of adequate home support
services. In the context of this proposal, smart
environments refer to "environments that adopt ICT
to collect and share information, analyze and monitor
residents' behavioral patterns, and improve their
quality of life" (Lee & Kim, 2020). An "environment"
in this proposal refers to a single house, apartment or
other type of living situation that is not integrated into
a care facility (such as an intermediate residence or a
long-term care facility).
When integrated into a human chain of support, the
smart environment can be more effective and focused
on the needs of older adults. The social network of the
older adult becomes an important part of this system
and both systems (smart environment and social
support) have the potential to decrease social isolation,
prevent adverse events and thus promote care at the
right time, and for the right person (Ngankam, Pigot,
Frappier, Oliveira, & Giroux, 2017; Lussier et al.,
2020a, 2020b). To achieve this, smart environments
must be integrated into a complete ecosystem of
services and care, supporting older adults according to
their needs and preferences. Smart environments can,
therefore, help develop a comprehensive support
system for frail and isolated older adults at critical
times; for example, if the telemonitoring system
detects that the person has not been out of home for a
certain amount of time, it can alert a neighbor, a
member of the family or a person from the City
services to go and verify that the older adult is well.
Over the years, several advances have been made
in the field of telemonitoring of ADLs. Studies have
shown the possibility of detecting mild cognitive
impairment or even Alzheimer's disease based on
simple markers such as walking speed (Akl, Taati, &
Mihailidis, 2015; Kaye et al., 2012; Sperling et al.,
2011) or time spent performing ADLs (Dawadi,
Cook, Schmitter-Edgecombe, & Parsey, 2013;
Lussier et al., 2019; Wu et al., 2021). In this regard,
our recent review showed that cognitive deficits could
be detected by the telemonitoring of general activity,
outings, sleep patterns, and computer use (Lussier et
al., 2019). Our team has further shown that social and
health care providers can adapt their intervention plan
according to detected events in daily life, such as time
spent in inactivity, use of kitchen appliances, etc.
[(Lussier et al., 2020; Lussier et al., 2020). Older
adults can thus be offered more, or fewer, services
depending on the needs detected.
Telemonitoring via smart environments holds
great potential to optimize home support services
(Lussier et al., 2020a; 2020b). In fact, in the last ten
years, an increasing number of studies have been
devoted to the development of such systems but have
mainly been oriented towards the development and
conceptualization of technological components. Very
few of them go as far as including small-scale testing
in a living laboratory context. In fact, recent literature
reviews on the subject (e.g. Marikyan, Papagiannidis,
& Alamanos, 2019; Queirós, Silva, Alvarelhão,
Rocha, & Teixeira, 2015) indicate that less than 10%
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of current studies include usability testing, and even
fewer include field testing. As a result, little has been
published on the implementation processes required
to integrate telemonitoring into the social and health
care system or the community (notably, in cities) via
smart environments, including the facilitators and
barriers to such implementation.
1.3 Past Work of Our Team
Our team developed NEARS, a telemonitoring
platform of ADLs that is currently being tested in the
health and social services system in Canada and in a
residence for older adults. NEARS is based on
environmental sensors and on a secure web-based
platform that receives data from these sensors,
processes it via activity recognition (AI) algorithms,
represents this data in various forms (tables, figures) to
users, and sends alerts as needed (Ngankam et al.,
2017, 2019; Lussier et al., 2020a; 2020b). NEARS
makes it possible to adjust the extent to which users
need to interact with the system and the information
they are given access to, according to their abilities. For
example, it may be decided that an older adult should
not need to interact at all with the system due to a
limited ability to do so, in which instance the system
would be used by his or her support ecosystem; or
alternately a healthier older adult may want to interact
with the system if he or she is comfortable with the
technology. NEARS has been validated and deployed
in accordance with the Québec Ministry of Health and
Social Services’ rules and regulations regarding data
security and protection.
However, in these projects, the NEARS platform
is used with only one type of actor at a time. The
present project therefore aims to connect several
actors of the ecosystem of support to the platform to
avoid working in silos. In this project, the older
citizens' ecosystem is thus conceptualized as a
dynamic interaction between families, health and
social service providers, community volunteers (e.g.,
neighbors), municipal services, community-based
organizations, and research partners; entities that all
have the well-being of frail older adults at the heart of
their mission, but do not frequently work as an
organized system in the city of Côte Saint-Luc, or
most other cities. They will all collaborate in the co-
design of the services surrounding the system.
1.4 Objectives of the City of Côte St-
Luc's Living Lab
The general objective of this living lab is to reduce
social isolation, improve safety and support aging-in-
place using a smart environment installed in the home
of older adults and integrated into a human
ecosystem. The specific objectives are as follows: (1)
To co-construct a social infrastructure composed of a
close network established between the different
partners, namely the City, health and social services,
neighborhood organizations, research community,
older citizens and their families; (2) To develop an in-
depth understanding of the interactions between the
different actors of the older adults' ecosystem in order
to conceptualize a support model articulated around
sustainable smart environments that are adapted to the
needs of all partners; (3) To co-develop the support
ecosystem and determine the best ways of
implementing it; (4) To deploy a citywide project and
evaluate its usability; (5) To identify the facilitators
and obstacles to implementation of the system, in
order to make necessary changes that ensure its
sustainability in the neighborhood and enable the
reproduction of the initiative on a larger scale.
2 METHODS
2.1 Study Design
For this project, a living lab is defined as an
ecosystem made up of numerous stakeholders of
differing perspectives, all of whom contribute
towards a shared objective through their co-
construction of a social and technological innovation
(Dubé et al., 2014). The living lab approach has the
best fit to this project. Indeed, the social isolation of
older adults is a complex and multidetermined
problem, and the person's entire ecosystem is
responsible for putting in place conditions to promote
home care services. In addition, a project in close
collaboration with the community makes it possible
to observe phenomena that are difficult to recreate or
study in a controlled research laboratory context, such
as real interactions between stakeholders. The living
lab approach also allows us to go beyond the
traditional one-way approaches to knowledge
transfer; it favors the development of innovations by
and for the community so that these innovations have
real and long-term impacts.
Considering the relationships established with the
community and the objectives pursued by the
program, an action design research method (Sein,
Henfridsson, Purao, Rossi, & Lindgren, 2011) is used
within the living lab. This method is the most
relevant, since the project's objectives require a major
commitment from the main stakeholders, the co-
development and co-planning of a social and
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technological innovation, as well as the need to follow
an iterative process, i.e., a cyclical improvement of the
innovations as they are implemented in collaboration
with all the stakeholders involved (Koshy, Koshy, &
Waterman, 2010). In this method, collaborators are
actively involved in decision-making, with power
shared between community stakeholders and the
research team (Darses & Reuzeau, 2004). The aim of
this method is to develop innovations "with" people,
not "for" people.
Action design research includes six steps (Sein et
al., 2011): 1) formulation of the problem and its
clarification; 2) co-development of the innovation
with a user-centered design approach; 3)
implementation of the solution; 4) evaluation; 5)
reflection on the process; and 6) sharing of the results
with all stakeholders.
2.2 Setting
2.2.1 Preliminary Step: Setting up the
Living Lab Governance Structure
Before starting the project, the organizational
structure of the living lab and how it will function
(Dubé et al., 2014) must be set up in a collaborative
manner with representatives of all stakeholders. This
step consists of setting up various committees and
working groups, each with a specific mission in the
living lab. Each stakeholder can play the desired role
according to his or her availability and skills. This
step was started in June 2021 and should be
completed by the end of January 202e.
As this project is an action design research
project, all stakeholders are involved in all the
important stages of the project. The team is composed
of both researchers and community partners, ensuring
a two-way knowledge transfer throughout the project
and the successful implementation of the digital
solution. These partners are currently the City of Côte
Saint-Luc, represented by the Mayor of the City.
However, City Councilors and the General Director,
all of whom have been involved in all discussions on
this project since 2018, will continue to be involved
during the deployment of the project through an
advisory committee composed of a representative of
all partners. This involvement will be complemented
by other members of the administration, according to
their field of expertise (e.g., the person in charge of
emergency services). Thus, depending on the
committees and working groups set up (e.g., working
group on the co-design of the service, working group
on usability tests, working group on the recruitment
of isolated older adults, etc.), the City will be able to
delegate the best person to contribute to the
discussions and ensure a harmonious implementation
of the system in the municipal services. We also have
a close partnership with the CIUSSS West Central
Montreal (a health and social services institution),
whose territory includes the City of Côte-Saint-Luc.
Stakeholders will take part in the activities according
to their expertise, within the relevant working groups
(e.g., co-design of the service).
2.2.2 Step 1: Clarify the Problem
The problem clarification stage aims to better
understand the role of each actor, including the smart
environment, and to make it explicit through co-
design workshops with the following key players:
older citizens and their family, community
organizations working with older adults, municipal
employees and councilors, and health and social
services professionals and their managers. The co-
design workshops will consist of two to five activity
sessions and will include a care mapping technique.
These sessions will make it possible to clarify and
map the relationships between stakeholders in an
interactive and dynamic way, the role they play and
wish to play in the digital environments, the potential
facilitators and barriers to the implementation of
smart environments, etc. An analysis of the data from
each workshop will be carried out using mapping
(Miles, Huberman, & Saldana, 2014).
2.2.3 Step 2: Co-development of the
Innovations
This stage aims to co-develop the ecosystem of
support to include smart environments. The
collaborative approach will allow us to: 1) develop an
innovation that fits harmoniously with the services
and know-how already in place; and 2) meet the
specific needs of all identified users to ensure its
maximum adoption. The collaborative approach thus
makes it possible to create a user-centered service. In
this stage, 2 to 3 co-design workshops are planned.
The form of these workshops is to be specified with
the partners of the living lab. The deliverable of this
step is the identification and formalization of who
will play what role at what time, who will receive
what information, and who will respond in what way.
Ethical and privacy issues will be addressed in this
step and will be treated as requiring careful address
throughout the project. For example, ethical concerns
impacting adoption and use of smart homes such as
privacy, informed and supported decision-making,
stigma, discrimination, and equity of access will be
addressed.
Smart Environments in Support of Fragile and Isolated Older Adults: Protocol for the City of Côte Saint-Luc’s Living Lab
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For telemonitoring, we will use NEARS. The co-
design workshops will determine the level of
interaction or investment expected from each type of
user. The co-developed support ecosystem around the
telemonitoring will be pre-tested in a research lab
setting with the various stakeholders to determine its
clarity and usability (effectiveness, efficiency, and
user satisfaction) as well as its acceptability.
Participants will be asked to perform various tasks
with the prototype, including receiving and
responding to alerts. Different questionnaires will be
used to measure satisfaction (system usability scale
(Brooke, 1996) and user experience (Schrepp,
Hinderks, & Thomaschewski, 2014), and a
personalized questionnaire will be used to document
general impressions of the developed service will also
be employed. Objective measures will be taken to
evaluate effectiveness and efficiency (degree of task
completion, connectivity of the self-help network,
number of interventions and contacts, etc.). Notes
will be taken on user comments and feedback, and all
of this data will be used to identify problems with the
use of the prototype being tested. Acceptability will
be measured by means of questionnaires [TAM2;
Venkatesh, Morris, Davis, & Davis, 2003), UMUX
(Finstad, 2010)].
Following the laboratory pretest, a validation of
the acceptability and feasibility of the support service
will be done. In this part of our usability test, we will
evaluate how the formal and informal networks react
to various immersive situations simulated in the
homes of older adults and in organizations. Without
being in a real situation, this task will be used to get
as close as possible to a situation of real use of the
system from the point of view of the different
stakeholders.
2.2.4 Steps 3 and 4: Implementation and
Evaluation of the Service
Implementation refers to the process used to integrate
the co-developed service in the community. The
implementation phase makes it possible to measure
the barriers and facilitators to ensure that the
implementation is successful. Implementation
strategies will be planned within the working groups,
including the identification and recruitment of frail
and isolated older adults.
The project will collect mixed data, integrating a
pragmatic pretest/posttest and an embedded single-
case study (Yin, 2011). The main single case being
the City of Côte Saint-Luc and sub-cases each
household receiving the technology. We aim to
recruit 20 older citizens who live alone, have a limited
social network, low mobility, and come from
different cultural communities. There will be no
control group given the exploratory nature of the
project and its complexity. The older adults will be
recruited through the project partners. Quantitative
impact measures will be identified with stakeholders,
but could include the following measures: Social
isolation measured with the Medical Outcome Study
Support Survey (MOS-SS) score (Sherbourne &
Stewart, 1991), and number of visitors, supplemented
by semi-structured interviews of approximately 45
minutes; overall frailty status [e.g. mild, moderate,
severe; Clinical Frailty Scale (Rockwood et al.,
2005)], health-related quality of life (EuroQoL52)
(Brooks & De Charro, 1996) and number and nature
of adverse events encountered, such as
hospitalization and change in living situation.
For the qualitative part of the project (embedded
case study), we will comprehensively and
integratively describe "how" and "why" (Yin, 2011)
the support network is integrated around the
telemonitoring and how it impacts social isolation and
safety at both a macro (sites) and micro level (20
older citizens and their ecosystem). The City of Côte
Saint-Luc will serve as the macro-level case. At the
micro level, we will recruit 20 quartets consisting of
1) an older citizen, 2) their family caregiver, if
possible, 3) the designated social and health care
provider, and 4) a designated alert responder (e.g.,
workers from community organizations or
volunteers); for a total of 80 participants. These
quartets are considered the integrated subunits of
analysis in the case. The quartet will be interviewed
at three-time points before, during, and three months
after service implementation. We may need to make
iterative changes to the service over the course of the
project to better align with the needs of the
community. As for the results of the questionnaires,
depending on the type of scale, these results will be
analyzed with non-parametric or parametric
statistical tests such as ANOVA.
2.2.5 Steps 5 and 6: Reflecting on the
Process and Sharing Results
At the end of the pilot, we will meet again with all the
partners involved, to complete a process evaluation.
This postmortem will allow us to identify the
effective and ineffective implementation strategies as
well as facilitators and barriers to the implementation
of a service around telemonitoring of ADL and the
living lab as a whole, the strengths and limitations of
the approach used, and the elements that could be
addressed in the future. We aim to create an
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implementation guide to facilitate future deployment
in other municipalities.
3 RESULTS
This project was funded by the Fonds de la recherche
du Québec – Santé in June 2021. The Ethical Review
Board (ERB) of the CIUSSS West-Central Montreal
reviewed the protocol and provided approval for step
1. The ERB will review the other steps in a next round
of evaluation, before their implementation. No
research will be conducted without the proper ethical
approval.
4 DISCUSSION AND
CONCLUSION
This project aims to address two important problems
encountered worldwide in western societies: older
adults' home care - often approached in a reductionist
and siloed manner - and social isolation, which is
sometimes reduced to its social determinants. By
addressing social isolation in interaction with health
and novel technologies, this project is particularly
innovative. Also, developing a living lab on a city
scale is an exciting approach that will develop new
methods of engagement between communities and
research. It is essential, in this type of project, that
local knowledge be recognized and integrated at all
stages, allowing this project to go beyond the simple
model of scientific experts (the researchers) to a
partnership model (research experts and local experts
- i.e., the community and its knowledge of the
environment and its reality). As the community has
been involved since the project’s inception, we hope
to have a rapid and direct impact on the relationships
between the various stakeholders in the community
capable of triggering a "snowball effect", i.e., the
organizations working closely through the project
will want to continue the collaboration and continue
to be involved in activities that have a strong potential
to decrease the social isolation of older adults in the
long-term.
The creation of a living lab will allow for the
development of new social and technological
innovations because they will be carried out in close
collaboration with local people. The meeting of these
two milieus (research and field) will also make it
possible to document the entire process surrounding
this type of project and thus facilitate the transfer of
the knowledge and methods developed through this
partnership. This program will also be able to
highlight new knowledge on the various factors
involved in social isolation and their
interrelationships, along with the junction of
approaches used in health, human and social sciences,
and technology. This will lead to a more accurate
understanding of these multiple determinants.
In conclusion, we hope that the project will lead
the citizens of the City of Côte Saint-Luc and its
organizations to mobilize to change their vision of
home care and social isolation of older adults, by
working in an integrated manner. Future work will
allow for a more large-scale deployment of the
technological solution, evaluation of its cost-
effectiveness metrics and regulatory approvals.
ACKNOWLEDGEMENTS
This project is funded by the Fonds de la recherche
du Québec – Santé. NB is supported by a salary award
from the same organization. The authors wish to
thank Dida Burku, Tanya Abramovitch and Mitch
Brownstein, from the City of Côte-St-Luc, for their
enthusiasm for the project and their genuine concern
for the care and quality of life of their citizens.
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