Detecting Anomalies in Daily Activity Routines of Older Persons in Single Resident Smart Homes: Proof-of-Concept Study

BACKGROUND: One of the main challenges of health monitoring systems is the support of older persons in living independently in their homes and with relatives. Smart homes equipped with internet of things devices can allow older persons to live longer in their homes. Previous surveys used to identify sensor-based data sets in human activity recognition systems have been limited by the use of public data set characteristics, data collected in a controlled environment, and a limited number of older participants. OBJECTIVE: The objective of our study is to build a model that can learn the daily routines of older persons, detect deviations in daily living behavior, and notify these anomalies in near real-time to relatives. METHODS: We extracted features from large-scale sensor data by calculating the time duration and frequency of visits. Anomalies were detected using a parametric statistical approach, unusually short or long durations being detected by estimating the mean (μ) and standard deviation (σ) over hourly time windows (80 to 355 days) for different apartments. The confidence level is at least 75% of the tested values within two (σ) from the mean. An anomaly was triggered where the actual duration was outside the limits of 2 standard deviations (μ−2σ, μ+2σ), activity nonoccurrence, or absence of activity. RESULTS: The patterns detected from sensor data matched the routines self-reported by users. Our system observed approximately 1000 meals and bathroom activities and notifications sent to 9 apartments between July and August 2020. A service evaluation of received notifications showed a positive user experience, an average score of 4 being received on a 1 to 5 Likert-like scale. One was poor, two fair, three good, four very good, and five excellent. Our approach considered more than 75% of the observed meal activities were normal. This figure, in reality, was 93%, normal observed meal activities of all participants falling within 2 standard deviations of the mean. CONCLUSIONS: In this research, we developed, implemented, and evaluated a real-time monitoring system of older participants in an uncontrolled environment, with off-the-shelf sensors and internet of things devices being used in the homes of older persons. We also developed an SMS-based notification service and conducted user evaluations. This service acts as an extension of the health/social care services operated by the municipality of Skellefteå provided to older persons and relatives.