Dementia patients may benefit from new technology – or will they?

By qwerty at 12:48 pm on March 6, 2009Comments Off on Dementia patients may benefit from new technology – or will they?

New technology arising from the UK is focusing on helping the elderly through technology.  In particular, they are creating devices which can help dementia patients be able to live on their own for longer.  Typically, when people start suffering from dementia, or experiencing memory loss, it is vital that someone be appointed to watch over them to be sure they don’t unknowingly do something harmful or forget to do something vital.  This could involve a family member living with them and watching after them 24/7, or moving to an inpatient center or nursing home, under the supervision of a nurse.  Engineers at Bath University beleive that computers can solve this problem, and help the family member or nurse, allowing the individual to stay at home longer.

The new technology involves a system integrated into the user’s home which has functions such as monitoring actions, speaking to you, turning off appliances, contacting help when needed, and even emailing a status to family members or caretakers.  The system can remind you to turn off appilances or shut off the water if you forgot to, and can even turn them off itself if the user fails to comply.  If the user unexpectedly gets up in the middle of the night, the system will turn the light on for you, and, if you are gone for long enough, will start talking to you and letting you know that “it seems a little late – don’t you think you should be getting back to bed?”

I think that a message like this coming from the walls at 2:00 AM could be quite startling, and especially confusing for individuals with dementia.  In light of this, the creators suggest that family members record their voice for these type of messages, creating a familiar voice the user can identify clearly.  This could still be quite startling to begin with.

So, to take a look at this new technology in light of security, I think there a a few flags to be thrown when designing an in-house computer system…

First, lets look at the optimal design for this type of system:

  • A system like this one should not provide any ambiguity to the user.  Since these users are already in a state of diagnosed disorientation, we want to be sure that no more disorientation is created, and that the user will be able to understand the system and be able to interact with it willingly.
  • Talking to the user is one of the hardest things to get right.  The system shouldn’t be too demanding or annoying when talking to the user.  We don’t want to aggravate the user and run their life either.

Now, what kinds of security risks does a system like this present?  We do not know exactly how the system is implemented, but as with any home security system, once an adversary has access to the passcode, it has access to your home, you, and all your things.  Assuming that the system has a passcode for changing administrative things, I’m sure that it would not be any more difficult to crack than a home security system (having worked for a home security company in the past – but that is a whole other security review).  An adversary could be someone who is out to get the homeowner, to steal their belongings, to force them into doing something for them, or even someone who is personally against having old people with dementia in this world… who knows.

Just by reading the article about this new technology, I can come up with a few weaknesses in the sytem – from a usability perspective.  With a system like this – and a patient like this – it is expected that you will want to convince the user that it should obey the system, and that everything that it tells you to do should be taken as beneficial to their saftey and well-being.  Given this – once the user has gained trust in the system, an adversary could easily compromise the system, change the voice recordings to something they wish the user to do, and let the system “tell them” to do it.  For example, in the case of when the user leaves the gas stove on, the adversary could change this voice recording to say something like “have you had your cigarrette today?”, or just confusing them more than they already are.

As with the computer system HAL shown in the 1968 movie “2001: A Space Odyssey”, the system could also be modified to do things against the users needs/desires.  If the system is able to turn off stoves and faucets, this means it is probably pretty easy to make the system turn them on when an adversary choses.

Some mechanisms could be placed to try and protect against these type of threats to the user, and some of them may already be in place.  The article already states that the system is designed to support the heath care providers – not replacing them.  Therefore, the care takers will be kept in the loop and be sent status updates on at least a daily basis.  This way, if the system or the patient starts doing unexpected things, it will be called to the attention of the health care providers and they can take the appropriate actions.

This doesn’t mean that a user can’t change these notifying mechanisms.  Just as in the movies, sometimes you will see the attacker switch the security cameras to be operating on a loop rather than showing live data.  The people viewing the security cameras trust that the data is live, but nothing guarantees it.  So the health care providers should not trust that the data is valid.

Due to this fact, I think it is very important that the security of the administrative interface of the system not be overlooked.  In order to change the settings, at least a secure password should be required.

With a system that helps you live, you want to make sure that it is helping you live a better life and not a worse one.  With dementia patients, they may not be able to tell the difference between the two.  This means that care must be taken when using the system, and the system should be thouroughly tested before being sold to the public.

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