This article looks at some of the issues associated with the Ageing Society and discusses the merits of some of the projects which use Serious Games, Gamification, Enabling and Assistive technologies to support independence and improve the lives and wellbeing of older people. I conclude that Independent Living and addressing the challenge of the Ageing Society can be a very difficult and emotive subject, especially where the care of the elderly is concerned. The strains on the care sector, the well-publicised abuse cases, and the transfer of responsibility for care from the public to the private and community sectors are all symptoms that the status quo expectations around care are unsustainable. Ultimately, as with various other lifestyle related medical conditions such as diabetes and obesity, the answer will have to come from individuals empowered to accept more responsibility for health and well-being management. This will require not only the use of enabling technologies such as the internet of things, cloud computing, artificial intelligence and broadband to improve access to services and service providers but also, through Gamification and Serious Games to challenge, motivate and continuously develop older people in ways that help them to live better for longer by contributing to society rather than being dependent on society.

1. Tackling the Ageing Society
The Role of Enabling and Assistive Technologies
This article looks at some of the issues associated with the Ageing Society and discusses the
merits of some of the projects which use Serious Games, Gamification, Enabling and Assistive
technologies to support independence and improve the lives and wellbeing of older people.
Introduction
It is now over two years since my mother passed away in a Leicestershire Care Home. She died in her
sleep whilst I was on board a plane bound for an international conference in Thailand. I believe she
had chosen to let her life slip away because she did not wish to be a burden on anyone and her
dementia made the quality of life unbearable for her. I was fortunate enough to know that she had
been well cared for throughout her slow decline into infirmity but since her death, I have often
reflected on what the future holds for the ageing society and how we can best apply a combination
of technology and strategy to tackle the issues we face as a society and as individuals living in a
world with a growing proportion of older people.
In many ways, my mother was very fortunate to have been born in the 1920s for although she lived
through the hardships of World War 2, the growing prosperity and quality of life from the 1960s
onwards meant that she had a level of support for her ageing that had not been available to
previous generations and, in my opinion, is unlikely to be available to future generations without
radical interventions in the way we view ageing. For my mother, and still for many people,
retirement in your sixties was viewed as a golden age when you could reap the rewards of your
working life and enjoy increased leisure time with the secure knowledge that society would look
after you when you needed help.
My mother left her terraced house in 2005 and was provided with a small flat in a council run
sheltered accommodation. She received excellent support from social services and had a very
pleasant lifestyle in which almost everything was done for her. As the only son, this was very
reassuring and took a large potential burden away from me but in hindsight I have the question
whether this was the best environment for her because, without the challenges of doing daily tasks
for herself, she became increasingly dependent on others. It is arguable that her care was too good
in the sense that it contributed to her physical and mental decline which led in the end to her being
transferred to a care home with just a single room and 24x7 specialist staffing to provide even more
support, leading to even more dependence.

2. Betty Wortley at Lenthall House in 2011
Eventually my mother became very dehydrated, went into hospital, almost died, went through a
process to rehabilitate her before finishing up in a different care home where she died a couple of
months later.
The Role of Technology in Care for the Elderly
The Past
It seems to me that our historic perspective on the use of technology to care for the elderly and
disabled has been based on empowerment and productivity. We use technology to enable us to
extend our physical and mental capabilities and allow us to manage our daily lives more
independently with less reliance on other human beings. This strategy has positively transformed
the lives of disabled people and also increased the productivity of those working in the care sector.
In my mother’s case, her flat in the sheltered accommodation had been fitted with sensors in each
room that allowed myself and authorised care workers to check her movements around the flat and
provide her with a panic button to alert people in the event of a fall or illness.
The paradoxical effect of our quest for more powerful and intelligent enabling technologies seems to
be that for many of us, probably the majority, the greater the level of independence these
technologies bring, the more dependent we become, not only on the technology, but also on other
human beings. The net effect of this is that improvements in longevity, quality of life and
empowering technologies removes a lot of the challenges we need as human beings to continuously
grow and develop. Without these challenges, our capacity for self-motivation and continuous
physical and mental development can be reduced causing, in the long term, a potential crisis in the
provision of resources to support the ageing population.

3. The Present and Future
I do not believe that it is any coincidence that there is a growing interest in and demand for Games
and Gamification. Games are well established as arguably the best outlets for personal physical and
mental development because their mechanisms provide the challenges and motivations that are an
essential part of our raison d’etre. The paradox of all this is that complete mastery of any activity is
actually detrimental to the human spirit. This is why the best games can never be completely
mastered and will continue to provide enduring and fresh challenges and outcomes that constantly
engage and motivate us.
The time is right now both from a technological and societal perspective to shape the use of
enabling, assistive and empowering technologies around human psychology and motivation for the
benefit of both individuals and society as a whole. This means developing strategies for the use of
technology to continuously engage, challenge and develop us throughout our whole lifetime so that
our capacity as human beings for self-motivation and management grows for the whole of our life.
There are some examples of existing projects that indicate this shift in strategy away from all-
embracing total care towards the equivalent of “tough love”.
The EU MIRROR Project
This is a European project designed to explore the potential of technology for reflective learning,
especially in a care home setting. Partners across Europe include City University in London.
Intelligent Sharing of Knowledge in Care settings
The key thing about the MIRROR project is that it focuses on personalisation and collaboration in
ways which embed some of the Gamification elements that both enable and also challenge our
human capabilities. The screenshots above show how City University have been working on mobile
interfaces that encourage sharing of experiences whilst acting as a catalyst for creative thinking

4. around problem resolution. This is especially important for dealing with difficult or challenging
behaviour in care home settings.
Whilst the MIRROR project now drawing to a close focused on care home staff, DOREMI focuses on
the use of serious games and enabling technologies for elderly wellbeing. As I mentioned in my
opening remarks, the care given to my mother, whilst very much appreciated and dedicated, was in
some senses counter-productive because it completely removed common daily challenges from my
mother’s life and although she had the option to join many social activities at her sheltered housing
accommodation, because everything she needed was done for her, she settled into a totally
sedentary and unchallenged lifestyle in which nothing was expected or required of her.
I was involved in a small way during my time at De Montfort University in writing part of the DOREMI
project bid and recruiting the UK care home partners. DOREMI has just started and involved
technology and serious games pilots in a number of care homes designed to support independent
living by continuously development of the physical and cognitive skills of groups of residents.
Mini Games for Assessment, Learning and Development by Imaginary
Milan-based serious games developers Imaginary created some simulations and games that
followed the same philosophy by creating 3D virtual care home environments and simulating
challenging situations. These applications could be used in many different contexts in the care
sector as a way of not only continuously developing skills to deal with difficult situations but also as
an assessment tool to provide on demand pre-employment testing and orientation for potential
recruits. With the very high staff turnovers and well-documented patient abuse cases, this use of
technology will become increasingly important.
This approach is a form of Gamification which focuses on human psychology and motivation to help
to shape future strategies for empowering elderly people and addressing Ageing Society challenges.
A series of mini-games will be developed within Doremi by Imaginary to support physical and
cognitive development of the elderly residents.
The EU DOREMI Project (http://www.doremi-fp7.eu/)

5. Conclusions
Independent Living and addressing the challenge of the Ageing Society can be a very difficult and
emotive subject, especially where the care of the elderly is concerned. The strains on the care
sector, the well-publicised abuse cases, and the transfer of responsibility for care from the public to
the private and community sectors are all symptoms that the status quo expectations around care
are unsustainable.
Ultimately, as with various other lifestyle related medical conditions such as diabetes and obesity,
the answer will have to come from individuals empowered to accept more responsibility for health
and well-being management. This will require not only the use of enabling technologies such as the
internet of things, cloud computing, artificial intelligence and broadband to improve access to
services and service providers but also, through Gamification and Serious Games to challenge,
motivate and continuously develop older people in ways that help them to live better for longer by
contributing to society rather than being dependent on society.