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Assistive Technology for the Elderly

Assistive Technology for the Elderly

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Assistive Technology for the Elderly

645 Seiten
4 Stunden
Mar 11, 2020


Assistive Technology for the Elderly addresses the intricacies involved in the design and development of assisted technologies for the elderly, covering smart systems such as magnifying book contents, speaking electronic devices, alarms for doors and windows, smart alert bands, panic buttons, medication dispensers and reminders, Wander Gard, physiological parameters monitoring systems and smart home monitoring systems. This book is aimed at those who are responsible for designing assistive technology intended to be used by the elderly. It lays out the technology that is already available and covers user needs and state-of-the-art technologies and methodologies.

  • Focuses on practical devices and technology for engineers
  • Offers deep coverage of sensor based assistive technologies that are elderly for people with dementia, physical disabilities and people living alone
  • Covers assistive technology ecosystems and offers case studies for practical application
Mar 11, 2020

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Assistive Technology for the Elderly - Academic Press



Access control for Internet of Things—enabled assistive technologies: an architecture, challenges and requirements

Shantanu Pal¹, Michael Hitchens¹ and Vijay Varadharajan²,    ¹Department of Computing, Macquarie University, Sydney, NSW, Australia,    ²Advanced Cyber Security Engineering Research Centre, University of Newcastle, Callaghan, NSW, Australia


There has been a tremendous growth in the use of the Internet of Things (IoT) in recent years. One important application area for the IoT is in the area of assistive technologies. Assistive technology can improve the functional capabilities of persons with disabilities by, for example, improved mobility and accessibility. IoT technologies, by virtue of their ubiquity and edge intelligence, can significantly enhance the provision of such services. IoT systems may deal with large amounts of data. In the assistive technologies context, this data can be particularly sensitive, as it may include health, location, and other highly personal information. Security then becomes a pressing concern in IoT-enabled assistive technology. In the IoT, security and privacy are major challenges due the characteristics of such systems (e.g., resource-constrained nature of the devices and high mobility). Given the large amount of personal data involved, and the potential reliance on IoT devices in the home and in users’ lives, access to data and resources is an important aspect of security in such systems. This chapter provides a discussion of the critical issue of security in IoT-enabled assistive technologies, particularly addressing access control. After identifying the requirements for such a mechanism and detailing a number of use cases, we present a fine-grained access control architecture for use in IoT-enabled assistive technology based on a combination of attributes, roles, and capabilities. We then discuss the issue of access right delegation for such systems. This will allow flexible and dynamic propagation of access rights in a manner suited to the characteristics of these systems. Finally, we outline a set of challenges that are significant when considering issues for security in IoT-enabled assistive technologies and demonstrate how our design satisfies the identified requirements.


Internet of Things; assistive technology; access control; delegation; security

1.1 Introduction

The Internet of Things (IoT) enhances the connection between the digital and the physical. This paradigm shift enables us to transform everyday objects into smart objects that are able to sense, process, and act autonomously, fostering the communication between people and things and between the things themselves [1]. We consider things as a set of applications, services, users and their associations. The IoT has a large and growing role to play in many aspects of everyday life.

One of the most important application areas for the IoT is smart health care [2,3]. This seeks to address a myriad of challenges from the rising cost of health-care systems to the development of new applications, infrastructures, technologies, and protocols to assist both patients and caregivers. Personal (portable and mobile) devices have a huge potential to provide better lives for people with disabilities [4–6]. For instance, BlindeDroid is an information tracking system that uses smartphones and wireless sensors for building an indoor navigation system for real-time guidance of blind people [7]. This is just one example of how the development of IoT-enabled assistive technologies can improve life for people with disabilities. Other possible application areas include hearing aids, alternative and augmentative communication devices, and mobility assistance [8]. Assistive technologies consist of both hardware and software and can be defined as a device or system that provides people with practical solutions to everyday life activities [9]. While there is a growing demand for such systems designing, developing and deploying such assistive technologies at the required scale is challenging, especially when the issues of large systems, for example, heterogeneity and multiple domains of authority, are considered. The IoT has the potential to provide improved services for people with special needs, but the design of such systems will need to take into account contextual requirements, for example, ease of use, privacy, and flexibility [10].

According to the World Bank, 15% of world’s total population is experiencing some form of disability and disability prevalence is higher in developing countries [11]. The World Health Organization (WHO) reports that among these 15% of people, 2%–4% are experiencing a significant amount of difficulties in functioning [12]. We argue that with the increasing stress on global health-care systems, the IoT has the potential to provide better services to people with a disability by providing an emphasis on proactive health monitoring and self-management. IoT-enabled assistive technologies are seen to be powerful tools to help in achieving a better quality of life by increasing independence and improved participation of disabled people in social and economic life [13]. The development of the IoT should enable the seamless integration of service delivery with the specific needs of users. To achieve this will require addressing the technical challenges of providing improved IoT-enabled assistive technology in the specific context of people with special needs. One of these challenges is to provide proper security measure for those devices and the associated data. People with disabilities are likely to place significant value on their data while at the same time being potentially restricted in how they can interact with technology. The provision of security is complicated by the nature of the resource-constrained nature of the devices (e.g., limited battery power, processing capability or even memory storage) as well as the characteristics of such IoT systems (e.g., high mobility and dynamic interaction).

The security needs of IoT-supported assistive technology are myriad and we do not intend to address them all in a single chapter. Instead, we select one area, access control, and use it to illuminate how security can be provided in such systems. Access control is an important issue for IoT assistive technology due to the need to control access to devices and the integrity and confidentiality of patient-critical sensitive data. More significantly, we consider that security in such systems must be provided in a way that is comprehensible to end users—the people requiring the services of assistive technology. Access control includes the specification and enforcement of policies that authorize and authenticate a legitimate user and then ensure that proper access is given to those users for certain resources [14].

In order to address such issues, in this chapter, we first examine the need for access control for IoT-enabled assistive technologies. To demonstrate its practicality, we introduce a policy-based access control architecture that can address access control issues in IoT-enabled assistive technologies. To the best of our knowledge, this is the first research that discusses the access control issues for IoT-enabled assistive technologies. The major contributions of this chapter can be summarized as follows:

• We examine the potential of IoT-enabled assistive technology and survey some existing proposals.

• We present a comprehensive discussion of the requirements for IoT-enabled assistive technologies, including the security requirements of such systems.

• We discuss an access control architecture for IoT-enabled assistive technology. In our architecture, we employ attributes for authenticating a legitimate entity within the system, rather than depending upon a concrete identity of an entity.

• We outline the need for secure and flexible access right delegation in IoT-enabled assistive technology systems. We illustrate the process of transferring access right information and explore the importance of a secure and flexible delegation within these systems.

• We provide a list of unique challenges and enumerate some distinctive requirements for IoT-enabled assistive technologies.

The rest of the chapter is organized as follows. In Section 1.2, we discuss the background of our research. This section consists of five major parts. We detail the definition of assistive technology (Section 1.2.1), the emergence of IoT, including its basic architecture and functionality (Section 1.2.2), the importance of IoT-enabled assistive technology (Section 1.2.3), major requirements for IoT-enabled assistive technology (Section 1.2.4), and example use cases (Section 1.2.5). In Section 1.3, we discuss our proposed access control approach in detail. At the beginning, we discuss the importance of IoT access control (Section 1.3.1) and the state-of-the art mechanisms (Section 1.3.2). Next we discuss the access control architectural in detail (Section 1.3.3). We provide a discussion for access right delegation for such IoT-enabled assistive systems in Section 1.3.4. In Section 1.4, we list a set of challenges that need to be addressed to provide a safe, secure, and flexible access control for the IoT-enabled assistive technologies. Finally, we conclude the chapter in Section 1.5 and discuss future works.

1.2 Background

The goal of this section is fivefold. First, we provide a basic introduction to assistive technology. Second, we provide some a primary description of the IoT. Third, we discuss the emergence of IoT-enabled assistive technology. Fourth, we outline major requirements for IoT-enabled assistive technology. Finally, we illustrate some example use cases.

1.2.1 Assistive technology

According to the WHO, assistive technologies and devices can be defined as follows [15]: assistive devices and technologies are those whose primary purpose is to maintain or improve an individual’s functioning and independence to facilitate participation and to enhance overall well-being. They can also help prevent impairments and secondary health conditions. According to Ref. [16], assistive technology can be defined as follows: assistive technology is any item, piece of equipment, software program, or product system that is used to increase, maintain, or improve the functional capabilities of persons with disabilities. In Ref. [17], the authors define assistive technology as any product which has the primary purpose to maintain or improve an individual’s functioning and independence, and thereby promote their well-being. The authors of Ref. [18] refer to assistive technology as any item, piece of equipment, or product system, whether acquired commercially off the shelf, modified, or customized, that is used to increase, maintain, or improve functional capabilities of individuals with disabilities.

An assistive technology can be seen to be any device or technology that can provide better functionality to the overall activities of a user and assist in their well-being. These devices and technologies help and assist with communication, learning, mobility, social interaction and to achieve improved quality of life. Assistive technologies have several benefits apart from the usefulness to their direct users, as they may also support family members, caregivers, teachers, and other members of the community.

There are several types of assistive technologies that can be used based on the user’s need and the limitations that they can address, for instance, devices for augmented communication (for speech and hearing disabilities), computer access aids (e.g., light pointers and specialized keyboard), mobility aids (e.g., wheelchairs, scooters, and walkers), sensory aids for vision- and hearing-impaired people, computer software and hardware (e.g., voice recognition programs and screen readers), just to mention a few possibilities [19,20]. At present, there are a wide range of assistive technology applications available in the market. These applications can be for indoor or outdoor assistance. A detailed discussion of smart devices to assist independent living related to assistive technologies can be found in Refs. [21,22].

1.2.2 The Internet of Things

Before addressing the integration of the IoT with assistive technologies, in this section, we present a basic overview of an IoT system. We include a sample IoT architecture within which any assistive system can perform. The context

It is predicted that there will be 50 billion connected devices by the year 2020 [23]. These will form the fabric of the IoT. Various definitions for the IoT have been proposed. For instance, according to the Information Society and Media Directorate-General of the European Commission (DG INFSO) and the European Technology Platform on Smart Systems Integration, the IoT is defined as [24] things having identities and virtual personalities operating in smart spaces using intelligent interfaces to connect and communicate within social, environmental, and user contexts. This is a widely used IoT definition that follows a things-oriented architecture. Further, Atzori et al. [1] define things from three perspectives, for example, middleware service (MS), sensors, and information.

Buyya et al. [25] present a user-oriented definition of the IoT, independent of standard communication protocols, as follows:

interconnection of sensing and actuating devices providing the ability to share information across platforms through a unified framework, developing a common operating picture for enabling innovative applications. This is achieved by seamless ubiquitous sensing, data analytics and information representation with cloud computing as the unifying framework.

Tan and Wang [26] define the IoT from the viewpoint of communication, social, environment, and user contexts, as follows: things have identities and virtual personalities operating in smart spaces using intelligent interfaces to connect and communicate within social, environment, and user contexts.

Haller et al. [27] provide a definition of the IoT-independent particular technology and platforms. This definition is derived from a mobility and service integration perspective, as follows:

a world where physical objects are seamlessly integrated into the information network, and where the physical objects can become active participants in business processes. Services are available to interact with these ‘smart objects’ over the Internet, query their state and any information associated with them, taking into account security and privacy issues.

Broadly there is no single, widely accepted, definition for the IoT. There is an acceptance that the IoT is, in part, formed from the communication of myriad physical devices. Beyond that the definition depends upon the specific need for the system and the designer’s choice. Note, the IoT is not just a cyber-physical system that is limited to collecting, processing, and measuring state information and performing computation. It is more a networking infrastructure that combines the digital and physical worlds together for providing a better Quality of Service to both applications and services. Therefore it is essential that when we address the needs of an IoT-enabled system, we need to consider a wide range of issues combining architectures, users, communications, technologies, and applications. A basic Internet of Things architecture

In this section, we discuss a basic IoT architecture to show how an IoT system works. There are several proposals that have investigated and outlined different architectures for the IoT [28–33]. Most of the conventional architectures present an IoT architecture based on distinct layers. For example, a basic three layer architecture is discussed in Ref. [34], which consists of perception layer, network layer, and application layer. A more detailed layered architecture may consist of five layers [1], object layer, object abstraction layer, service management layer, service composition layer, and on top of them the application layer. We observe that an IoT architecture contains at least three distinct layers previously discussed (i.e., perception layer, network layer, and application layer) to deliver a seamless service to the end users. The major operations of these layers are collecting data, networking data, and managing data. In Fig. 1.1, we illustrate a basic three layer architecture. A brief description for each of them is as follows:

• Perception layer: The aim of this layer is to perceive physical properties of objects that surround us. The perception layer is able to collect data from the environment (e.g., temperature, humidity, and air pressure) and pass the collected data to the next layer of the architecture. The perception layer typically consists of computing nodes, for example, smart sensors, actuator, RFID (radio-frequency Identification) tags and various interconnected heterogeneous devices and smart objects. Many emerging and sensing technologies are being adopted to facilitate communication between the objects in this layer [35]. For instance, some sensing technologies in this layer are WiFi, ZigBee, and other technologies that suited to short-range communication, for example, NFC (near-field communication) and Bluetooth Low Energy (BLE). A more recent advancement, low-power wide area network (LPWAN) is a promising category of technology that is intended for low-power and long-range wireless communication. Some examples of LPWAN include long-range physical layer protocol and narrow-band IoT [36].

• Network layer: The network layer is the major communication layer in an IoT architecture. The aim of this layer is to collect data and then transfer it to the application layer. It facilitates secure data communication to various applications and servers [37]. A large number of heterogeneous networking technologies (both wired and wireless) are involved in this layer. Different networking technologies enable the network layer to communicate to applications and services that are running in the cloud [38]. Commonly used technologies in this layer include IPv6, 6LoWPAN (IPv6 over Low-Power Wireless Personal Area Networks) and RPL (IPv6 Routing Protocol for Low-Power and Lossy Networks). 6LoWPAN is a dedicated communication protocol that can fit well with the resource-constrained IoT devices. 6LowPAN is designed for IPv6 over IEEE 802.15.4. Similar to 6LoWPAN, RPL also facilitates communication in resource contained environments, for example, the IoT [39].

• Application layer: The application layer handles communication between the end users and various applications (e.g., smart home, smart transportation and logistics, and smart heath). The interaction between the applications and users are typically done via application programming interfaces (APIs) or using standard Web interfaces. The commonly used interfaces using HTTP and HTTPS are widely deployed in IoT. However, more dedicated resource-constrained application level protocols, for example, CoAP (Constrained Application Protocol) are available for use in this layer. Other messaging protocols, for example, Message Queue Telemetry Transport (MQTT), Advanced Message Queuing Protocol, and The Extensible Messaging and Presence Protocol is also commonly used within IoT applications [34,40].

Figure 1.1 An overview of a three-layer IoT architecture. IoT, Internet of Things.

Al-Fuqaha et al. [41] provide a detailed survey of various layered architecture for an IoT system. They argue that the scale of an IoT system must support a flexible layered architecture that is able to manage billions (and possibly trillions) of heterogeneous objects through the Internet. Some researchers have proposed a five-layered architecture for the IoT, for example Refs. [1,28,38,42,43], and readers are referred to those references for further information.

1.2.3 Towards Internet of Things–enabled assistive technology

The vision of IoT is to build a smart environment with the interconnected elements providing an autonomous service to the users [44–46]. In other words, the IoT is valuable for providing smart environments with the distinct power of ambient intelligence and pervasive communication (this can also be referred as pervasiveness of ubiquitous computing). When it comes to IoT-enabled assistive systems, there are several aspects that are significant. For instance, making an environment that is aware of its own state, providing intelligent services based on learning and reasoning and efficiently managing the connected and integrated environment.

The IoT can provide for integration of various sensors, both wearable and in close proximity to the user, allowing sensing and adaptation to the user’s needs [21]. The IoT, and particularly wearable devices (both portable and mobile), has significant potential in delivering assistive services for people with disabilities. By utilizing connected devices, sensors, actuator, especially within the user’s home, users with disability can better navigate daily life [47–52]. In Ref. [17] the authors argue that there are two pressing issues when it comes to assistive technologies and the user’s involvement within it, they are (1) people do not have access to the technology they need and (2) the technologies are frequently abandoned. Further, Ref. [21] adds to this by pointing out that the design and delivery of assistive technology needs to pay due regard to the human and social dimensions as well as the technical aspects. To address these issues, in this section, we first examine the state-of-the-art integration of IoT with the assistive technologies. However, this must consider the users of the technology as well as the design process for those systems.

There have been several contributions that discuss the emergence of IoT for assistive technologies [8,53,54]. For instance, Lopes et al. [55] discuss an IoT architecture for use with disabled people that combines IoT with assistive technology. In this approach the various layers of an IoT architecture are considered in delivering the specific needs of the intended users of the system. It considers a four-layered IoT architecture that consists of device later, network layer, service layer, and the application layer. This can be used, for example, in the development of a navigation system to help blind people to move in indoor spaces and unknown areas, using body sensors and RFID tags and readers. This can be extended using the global positioning system to provide more advanced monitoring in outdoor navigation.

Mulfari et al. [56] discuss an approach that supports IoT-enabled computing devices for people with disabilities. This helps a disabled person use their personalized assistive technology device for interacting with other computer-based devices. The user’s assistive technology device can enable access to computers and ICT systems without those systems having preconfigured for users of assistive technology.

Porambage et al. [57] discuss the critical requirements of end-to-end communication for constrained devices in IoT-enabled assisted living systems. In particular, applications and services integrate various technologies and devices to enable continuous monitoring of the health of elderly people. The authors argue that due to the resource-constrained nature of IoT devices (e.g., low battery power, processing capability or limited memory), it is challenging to employ resource-expensive cryptographic operations governed by the conventional security protocols. Their proposal suggests the use of lightweight protocols for the safeguarding of data generated by the IoT devices.

To provide more granular and fine-grained services for patients serviced by remote care, Verma and Sood [58] present a fog-assisted IoT-enabled patient health monitoring system for smart homes. In this approach, various assistive technologies and devices (e.g., smart tags and smart health-care devices) are employed.

Yelamarthi and Laubhan [59] present the design of a portable electronic travel aid for blind people. In this, they use ultrasonic rangefinders (mounted on the belt) and the assistive device is able to find obstacles in front of the user. Based on the information provided, appropriate navigation directions are suggested through a Bluetooth headphone. With a similar approach to Ref. [59], Laubhan et al. [60] discuss a depth sensor–based navigation system that is able to detect obstacles in front of the user for use by vision-impaired people. Once the system detects the obstacle, it informs the user through vibro-tactile feedback in the hand gloves.

Vasanth et al. [54] discuss the design of a speech conversion device for hearing impaired people. The authors use the Google speech API (that converts an audio to text). First, the speech is received via a microphone that isolates the required frequency signal and then sends it to the corresponding speech recognizer. The speech is encoded into an MP3 format. This is then sent to the Google API service for evaluation of audio content, which then further convents it to a text stream. Finally, the text stream is displayed on a LCD screen.

Mulfari et al. [61] discuss the use of wearable devices that can be used by disabled people for smart access to computers. This is achieved by using commodity smart watches and the development of a custom application. The smart watch acts as a sensor and data from it, particularly the built-in accelerometer, is sent to a Linux single-board computer. The system emulates a mouse. In the example given in the paper, the watch is affixed to the user’s head and enables mouse control by quadriplegic users. The device could, however, be attached at other positions on the body.

Gill et al. [52] discuss the design of a multisensor IoT-enabled assistive device for disabled people using gait monitoring. The device includes sensors to measure mobility and stability information, which can then be transmitted for analysis. This can improves the timeliness of interventions and allow users to maintain their autonomy while mitigating the risk of falls.

Abdelgawad et al. [62] discuss an IoT-enabled health monitoring system for active and assisted living. The authors present an IoT architecture customized for smart health-care applications. This includes the benefit of cloud computing technology where the processing of data is carried out. This reduces the computational complexity of processing collected data by the resource-constrained IoT devices and reduces power consumption.

Valera et al. [63] discuss an IoT-based architecture for supporting mobility and security in medical environments. The main goal of this approach is to develop and define an IoT-based architecture that is able to offer ambient assisted living services for elderly people in medical environments. In their approach the technology uses 6LoWPAN for communication between IoT devices and for passive communications RFID and NFC are used.

1.2.4 Requirements for Internet of Things–enabled assistive technology

The abovementioned summary demonstrates the tremendous potential for integrating IoT with assistive technology. It also demonstrates an emphasis on the direct technical aspects of solutions while placing less emphasis on usability or security aspects. The nature and quantity of sensitive information that may be involved in IoT-enabled assistive technologies is evident from the proposals discussed. This can range from long-term medical conditions to immediate location and physical data. There is then the question of who should be able to access such data and the sensors providing it. The abovementioned summary also demonstrates the frequency with assistive devices may be used (e.g., those supporting mobility and communication). Users will be more comfortable with such devices if they integrate easily with the user’s current environment. A good example of this is the cane described by Gill et al. [52]. It is unreasonable to expect users of assistive devices to be intimately familiar with technology or have the ability to understand and recall extensive technical details. Assistive technologies and devices can deal with extremely sensitive user data, including those around medical conditions. Security therefore becomes a priority and must, at the least meet basic requirements of integrity, confidentiality, authentication, authorization, privacy, and trust.

Next, we briefly outline some of the requirements that must be taken into consideration in developing a smart IoT-enabled assistive system.

• Minimal human memory dependency: People suffering from a disability and employing assistive technologies are likely to wish to employ such technologies with as little difficulty as possible. One aspect of this is requiring the users to remember as little possible information. In other words, in an assistive system, it is impractical to assume that the users (i.e., human users) are capable of storing their personal information efficiently and therefore be able to conduct the desire operations by their own. We argue that the involvement of such human memory should be avoided as much as possible in order to enhance the system’s

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