Smart Speakers: can they make life of the elderly easier?

In an article from 2017, the MIT Technology Review reported the story of a community of octogenarian near San Diego who fell in love with Amazon’s Alexa, following a study aimed at showing how voice services and home automation technology impact the wellbeing of older adults.

The story is based on a six-month pilot project conducted by a non-profit organisation named Front Porch and it was started after the residents of the community, all between 79 and 100 years old, expressed interest in Alexa and asked for it. The project was so successful that the participant-base quickly grew from 15 to 90 households, with 75% of participants using their smart devices at least once a day. In the surveys, all the respondents felt that their device made their life easier and 70% of them felt more connected with their families, friends and the community than before starting using Alexa.

The key reasons for using the devices varied between residents: many used it to check the weather in the morning; most to set alarms, timers and reminders; some to listen to music; others to check the news and search information. All participants went through training and workshops to learn how to use the devices, and in most cases, after learning initial basic tasks, they expanded the functions that they used.

On the other hand, we probably all have seen the “Hey Goo Goo” video of an Italian grandmother struggling with the Google Home Assistant her son bought her. After watching that video the conclusion that this kind of technology is not adequate for older people might be tempting, but it is not true for all of them.

Even for those who are not digitally native and did not grow up with technology, a key element plays in favour of smart speakers: their voice-first user interface. People age in different ways, and while many elderly people have problems with vision, standing up and moving, many are able to talk and listen until their later years. Of course, challenges with dementia and other cognitive impairments exist, but for many elderly people the conversational interface of smart speakers offers a natural and intuitive way to retrieve information and perform tasks through digital assistants.

One barrier for them to engage with voice assistants (that was also raised by some of the community residents of the study) regards the fact that their voice does not always sound natural. But technology is evolving very fast and tech companies are filling the gap quickly. Google introduced the first two English accents (British and Australian) in 2018 to make its assistant sound more familiar, and after that the number of languages and dialects that are supported by all voice assistants is continuing to grow exponentially.

Also, just a couple of weeks ago, Amazon introduced a new feature that enables Alexa to imitate human emotions and speaking styles so that it can seem even more human. At the moment the emotions are limited only to “excitement” and “deception”, and the speaking styles to “TV anchor” and “Radio Host”, but the potential for implementations in healthcare and emotional support is simply fascinating. Just imagine if a solution like Woebot, the chatbot that helps to reduce symptoms of depression and anxiety using Cognitive Behavior Therapy methods, could be delivered through a smart speaker with a voice that can imitate human emotions.

Today, it is estimated that there are over 70 million Americans who own at least one voice-activated smart speaker, with Amazon’s Echo and Google Home leading the market, and Apple’s HomePod and Microsoft Cortana following. In Europe, the UK leads the way with 12,6 million users, followed by Germany (11,7 m) and France (7,6).

Unfortunately, voice assistants and smart speakers started entering in non-English speaking countries only recently, so it is still too early to have data about their adoption among older people in Europe. However if we look at the United States, the situation looks promising.

Looking at voice assistants more in general (eMarketer, 2019), it is interesting to see that in the U.S. one person out of five who is aged older than 65 uses a voice assistant at least once a month, reflecting a good adoption by some segments of that population.

Like the “tech savvy seniors” for instance, a particular group of seniors described in the Deloitte 2018 Survey of US Healthcare Consumers that is comprising people who are older than 75, who are comfortable going online to shop, book travel, and manage personal finances, and who are interested in using technology for their healthcare needs: 44% of these seniors declared to have used a digital assistant (in any form, not only smart speakers) to monitor their health issues, and 57% to receive alerts for medications.

Until this year Smart Speakers could not be used to transfer patient health information or access medical records because they were not HIPAA compliant, but in April Alexa has launched its first HIPAA-compliant medical skill and opened access to its Alexa Kit to enable HIPAA-compliant companies to build skills that transmit and receive protected health information as part of an invite only program. Also, smart speakers and voice assistants developed by Google, Apple and Microsoft are being used in medical environments and at hospitals.

So, we may not have to wait too long before proper clinical services will become available on smart speakers, including to help older people. Nevertheless, smart speakers are already helping them to live better in many other ways:

By simplifying daily tasks, routines, and managing their home for them. Switching on and off all lights, turning on the heating, or browsing the internet; all these activities can be very simple but become a real challenge when we start having movement or dexterity problems.

By providing trustworthy health information from reliable sources like the NHS when people search for medical questions about symptoms, causes and treatments.

By helping them to connect with their families and friends and reducing their sense of isolation. Solutions like Ask My Buddy or Ask Marvee help older people sending “Good morning, I am ok” messages to their loved ones, they help them to send relatives and friends requests to call back for checking, and they can also help them receive news from the rest of the family or friends.

By supporting their caregivers to help and monitor them even when they cannot meet them frequently or they live a long distance away. Life Pod, for instance, is a solution focused on a medical reminder for the elderly that can also send daily reports and personalised alerts to their family members or professional caregivers.

By preserving their health and wellbeing longer: detecting falls, preventing accidents and diagnosing some diseases. Totemic, for instance, is a solution for smart speakers that can detect falls without the need of wearable devices on the person, and it also helps elderly people call for support when they have fallen and cannot reach a phone. Also, scientific research is advancing and finding ways to support the diagnosis of, for instance, Parkinson’s and Cardiovascular30030-2/abstract) diseases through voice assistants and smart speakers.

So, even though human presence and interactions remain central for the life of elderly populations, all these aspects seem to indicate an important role in the future for Smart Speakers in helping elderly people to live independently for longer, reducing their sense of isolation, and relieving some of the pressure that is on family members and caregivers who provide long term care for them.