As of 2020, 7% of Malaysia’s population is over the age of 65, meeting the classification for “ageing society” according to international conventional definitions, reports the World Bank.
By 2044, the percentage is expected to double to 14%, making Malaysia an “aged society”, and by 2056, the country will become a “super-aged society” with over 20% of the population older than 65.
Prof Dr Siti Anom Ahmad, director of the Malaysian Research Institute on Ageing (MyAgeing) at Universiti Putra Malaysia, says an ageing population will pose new challenges to the country, especially to its healthcare and social services.
“The rapid rise in ageing population will overwhelm health facilities, services, and skilled professionals required to cater for the multidimensional needs of older people,” she says.
Older adults will also be burdened with financial issues, she says, and are likely to be left alone as their children may move out to more populated cities.
“Most older Malaysians depend on their children for financial support. “As such, older adults are more likely than the young to be at risk of living in poverty,” she says.
According to Prof Dr Teh Pei Lee of Monash University Malaysia, the issues associated with ageing are not just about treating diseases and degeneration, but also about the quality of life of the aged and their caregivers.
She believes the answer to “How can we age better?” lies in technology.
“It should involve the seamless integration of facilities and activities for better living, using technology-enabled equipment and services,” she says.
Smart solutions
Prof Teh is the director of the Gerontechnology Laboratory at Monash, which aims to translate research into products and services to improve the health and well-being of older people.
“The work we do aims to address as many practical problems as possible within our resources, helping the aged and infirm as well as their caregivers.
“For example, how can we help older adults stay at home and yet assist in monitoring early symptoms for infection or progressions of mild symptoms, and even continue to manage their chronic health issues?” she says.
One potential solution is smart sensor technology powered by artificial intelligence (AI), she says, which can help monitor a person’s activity and vitals.
This would allow family members and clinicians to keep track of the person’s health condition, including their mobility, sleep and diet.
“It is important that older technology users understand how the system works, what kind of information is collected and who has access to that information,” she says.
Prof Teh has designed and developed a smart home system that she believes is more intuitive for people of all ages to use.
The system uses a photo – typically of the interior of the house the person is occupying – that’s embedded with multiple near-field communication (NFC) tags.
When a person taps the lamp in the photo with a smartphone, the embedded NFC relays the information to the phone, and an app will be launched to allow the person to switch on or off the lights.
Similarly, a person can tap on an image of a TV or other device to turn it on or off.
Her impetus for developing such a device was because she believes the conventional smart home systems on the market are not designed for people of all ages.
“Digital assistants that support voice commands, such as Google Assistant and Amazon Echo, are becoming increasingly popular and easy to use.
“However, older adults may face challenges in getting digital assistants to do what they want.
“For instance, both digital assistants are not culturally sensitive and may not understand our Malaysian slang,” she says.
Though new technologies have the potential to support the needs of older people, she says, most also require more study to ensure they meet their needs.
Universiti Kebangsaan Malaysia senior lecturer and chairperson of the Center of Healthy Ageing & Wellness, Prof Dr Devinder Kaur Ajit Singh, says older adults’ needs, perceptions and desired design characteristics as end-users should be prioritised in order to promote technological solutions to them.
“Some older persons may have difficulty in using technology due to age-related changes in vision, hearing, sensory, movement control and memory.
“Hence, these age-related changes must be taken into consideration in the optimal design of technology for older persons,” Prof Devinder says.
When Prof Teh designed her smartphone-enabled solution – which uses a small single-board computer, the Raspberry Pi, with NFC and Bluetooth connectivity – she ensured that it could function without Net access.
“The application does not require an Internet connection, which is regarded as costly and inconvenient to older adults,” Prof Teh says.
She emphasises that it’s important not to assume that all older adults have the same experience and access to technology.
Their socio-economic status and location will also be a factor as to how easily they adopt technology.
To help older women living in rural areas in Malaysia and Thailand seek knowledge and information on technology, Prof Teh has developed the Women-in-tech app.
The app features a chatbot powered by AI for users to tell it about their needs and interests for learning, and a section with videos on various topics, including technology and social communication.
Users can also communicate with others or form communities through the forum section.
She says her reason for kick-starting this project is because the Covid-19 pandemic has affected mostly older women in Asean, especially their employment prospects as they are deemed less tech-savvy.
Benefit of bots
At MyAgeing, Prof Siti Anom and her team worked on a project to minimise contact at nursing homes by automating deliveries using robot carts with remote sensing capabilities for navigation.
The Capacity Building for Caregivers and Older Persons in Elderly Living Institution for Contactless Deliveries using Indoor Autonomous Platform project was funded by the Malaysia One Health University Network.
“We developed an autonomous platform to provide a ‘contactless’ alternative to regular deliveries for institutional living.
“We also provided comprehensive guidelines and instructional material for contactless deliveries in elderly living institutions and conducted on-site training and workshops to strengthen the capacity of aged care operators and caregivers,” she says.
At a workshop, Prof Siti Anom’s team demonstrated how the robots can be used to deliver food and perform basic health screening such as measuring temperatures.
In January, the project received the 2021 Healthy Aging Prize for Asian Innovation from the Japanese government’s Asia Health and Wellbeing Initiative, which aims to promote cooperation in the region for sustainable healthcare systems.
“Inventions should be made simple to operate and affordable. It is also very important to get older people’s feedback on what they need,” she adds.
Meanwhile, Monash’s Gerontechnology Laboratory has developed a Soft Service Robot which Prof Teh describes as a human-sized robot that can retrieve objects with a soft gripper.
The robot can be used to help an older person with mobility issues pick up items such as pill cases, keys and glasses, she says, adding that a study is being conducted on the acceptance of such robots among occupational therapists in Australia.
The lab has also developed an exoskeleton called Ambulate Me to help people, including older adults, who have lost the ability to control their lower limbs.
It’s meant to support the body by sending stimulation signals to the affected muscle group so that the limbs can complete a particular motion.
In the event that the muscles generate a weak contraction and are unable to complete the motion, the exoskeleton will detect this and kick in to complete the intended movement.
Breaking barriers
Though there are a number of robots in the marketplace that were designed to help older adults, they can be very costly, says Prof Teh.
She cited Paro, a therapeutic robot shaped like a baby seal that is meant to bring psychological enrichment to users with dementia, as an example.
Developed by a Britain-based company, the product costs £5,000 (RM28,400).
Meanwhile, the telepresence robot, Giraff, which can be controlled remotely to interact with older people who are living on their own, is priced at US$11,900 (RM49,800).
Despite the benefits that these technologies bring, making them more accessible to older people in Malaysia continues to be a challenge, says Prof Devinder.
“In my opinion, the use of gerontechnology in Malaysia is limited, mainly because it is pricey, especially for older people from lower socioeconomic background,” she says.One possible solution is to focus on local efforts, she adds.
“It will be ideal to innovate, develop, research and manufacture technology locally so that it is more affordable and relevant.
“It is also hoped that by 2030 there will be more demand for technology to enhance independence and longevity, as most older people will be tech-savvy in the future,” Prof Devinder says.
Assoc. Prof Fakhrul Zaman Rokhani, head of the gerontechnology programme at MyAgeing, says there needs to be a more strategic approach to better promote gerontechnology adoption alongside improving digital literacy among older adults.
He recommends taking a three-prong approach, starting with public events such as roadshows to increase awareness about gerontechnology and how it could play a core part in senior care.
Next, it should be followed up with efforts to create more collaborations among relevant stakeholders and government bodies to spur innovation.
Finally, a testbed for new gerontechnology solutions and trials can help expedite the adoption, he says, adding that subsidies can help older adults purchase tech products they need.
Innovation in gerontechnology should also be applied more widely, says Fakhrul Zaman, especially in public places like parks.
It could be used for detecting falls or as a guidance system for older adults suffering from memory loss, he adds.
“We need to convince people that gerontechnology addresses real needs, brings benefits that outweigh the concerns that come with it,” he says.
Meanwhile, Prof Teh says Malaysian seniors are open towards learning and using new technology as long as training and support are available while Prof Devinder stresses the need to plan ahead for successful ageing.
“Home-based assistive and communication technology is beneficial to maintain and improve functional ability, mobility and independence for as long as possible among older people.
“Embracing technology is possible even at an older age and is important for maintaining an optimum quality of life,” Prof Devinder says.
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