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

Université de Montréal, CIUSSS South-Central Montreal, Montréal, Canada

Centre Hospitalier Universitaire de Besançon, Centre d'Investigation Clinique, INSERM CIC 1431,

25030, Besançon, France

DOMUS Laboratory, Université de Sherbrooke, Sherbrooke, Canada

Université de Lille, Lille, France

Universidad Politécnica de Madrid, Spain

Univerity of Toronto, Toronto, Canada

HEC Montréal, Montréal, Canada

LIARA Laboratory, Université du Québec à Chicoutimi, Chicoutimi, Canada

Centre de Recherche en Gérontologie Sociale, CIUSSS West Central Montreal, Côte St-Luc, Canada

charles.vallerand}@usherbrooke.ca, {tlihoreau, ttannou}@chu-besancon.fr, sylvia.pelayo@univ-lille.fr,

xavier.ferre@ctb.upm.es, rosalie.wang@utoronto.ca, guy.pare@hec.ca, {Kevin_bouchard, Sebastien_Gaboury}@uqac.ca,

sandra.smele.ccomtl@ssss.gouv.qc.ca

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.

https://orcid.org/0000-0002-2940-694X

https://orcid.org/0000-0002-0088-3865

https://orcid.org/0000-0003-3476-9822

https://orcid.org/0000-0003-2242-8369

https://orcid.org/0000-0001-8417-6609

https://orcid.org/0000-0001-5520-5677

https://orcid.org/0000-0003-2830-2548

https://orcid.org/0000-0003-3474-9784

https://orcid.org/0000-0001-7777-9989

https://orcid.org/0000-0002-5811-2932

https://orcid.org/0000-0001-7425-1994

https://orcid.org/0000-0001-7749-3470

https://orcid.org/0000-0002-5227-6602

https://orcid.org/0000-0002-1995-6307

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

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.

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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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