Vol. 5, No. 10, 2014 Proposal and Evaluation of Toilet ......suggestion to use the toilet when he...
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Proposal and Evaluation of Toilet Timing Suggestion Methods for the Elderly Airi Tsuji Graduate School of Engineering and Science, Kyoto Institute of Technology Matsugasaki, Sakyo-ku, Kyoto 606-8585, Japan Tomoko Yonezawa Kansai University 2-1-1 Ryozenji, Takatsuki Osaka 569-1095, Japan HirotakeYamazoe Osaka University 1-31 Machikaneyama, Toyonaka Osaka 567-0047, Japan Shinji Abe Hiroshima Institute of Technology 2-1-1 Miyake,Saeki-ku Hiroshima 731-5193 Japan Noriaki Kuwahara Graduate School of Engineering and Science, Kyoto Institute of Technology Matsugasaki, Sakyo-ku, Kyoto 606-8585, Japan Kazunari Morimoto Graduate School of Engineering and Science, Kyoto Institute of Technology Matsugasaki, Sakyo-ku, Kyoto 606-8585, Japan Abstract—Elderly people need to urinate frequently, and when they go on outings they often have a difficult time finding restrooms. Because of this, researching a body water management system is needed. Our proposed system calculates timing trips to the toilet in consideration with both their schedules and the amount of body water needing to be expelled, and recommends using the restroom with sufficient time before needing to urinate. In this paper, we describe the suggested methods of this system and show the experimental results for the toilet timing suggestion methods. Keywords—Elderly; Suggestion-method; I. I NTRODUCTION For healthy elderly people, leaving their homes is one of the most important activities in preserving their cognitive and physical abilities; this also provides good mental stimulation and pleasure in their daily lives [1]. Promoting barrier-free environments in Japanese public spaces encourages the elderly to leave their homes without assistance. However, going out is likely to become difficult for some elderly people as they age, especially when managing their body water balances. Because elderly people often have weak bladders, they are likely to experience the need for frequent urination and often encounter difficult situations when searching for restrooms while controlling their bladders. If a caregiver accompanies the elderly person, the caregiver can suggest going to the restroom in sufficient time before the elderly person needs to use one, or can look for the nearest restroom for their patient. However, the number of the elderly living alone is rapidly increasing in Japan, and they cannot receive such support. Consequently, they often tend not to drink enough water during their outings due to their anxiety about using restrooms. This is a likely cause of dehydration, especially in the summer [2]. In order to aim for elderly people’s comfortable and independent outing experiences, we have researched and developed toilet and drinking timing suggestion systems according to their outing schedules, their surrounding environments, and their activities like eating and drinking [3][4][5]. However, our calculation formulas regarding the amount of body water encountered some problems. Therefore, we have been trying to resolve these issues by researching notification methods. In order to improve our system, we have devised suggested methods of toilet timing for the elderly, trying to avoid interfering with their outing schedule while not ignoring trips to the restroom. In this paper we describe the experimental results when two toilet timing suggestion methods were evaluated. II. TOILET TIMING CALCULATION METHODS A. Estimating the amount of body water According to previous research on water balance in the human body, we formulated a simplistic physiological formula for non-invasive estimation of the amount of body water; based on those estimations, times to drink fluids and use the toilet are calculated. According to previous studies, the total amount of voided volume of a well-rounded healthy elderly person in a day is assumed to be about 1500 ml, and the amount of the urine in the bladder when they feel the need to void is assumed to be 150 ml [6][7]. We also assumed that the total amount of voided volume changes according to the increase of body surface area and body surface area correlates with body weight [8]. In a statistical survey of physical fitness and exercise abilities conducted by the Ministry of Education, Culture, Sports, Science and Technology, the average weight of Japanese adults was 65.15 kg for male and 53.04 kg for female [9]. Furthermore, we assume that that the total amount of voided volume changes according to the air temperature [10]; it increases or decreases by 0.6ml / 1oC from the baseline of 19.4oC. Consequently, we obtained the physiological formula www.ijacsa.thesai.org 140| Page (IJACSA) International Journal of Advanced Computer Science and Applications, Vol. 5, No. 10, 2014
Transcript of Vol. 5, No. 10, 2014 Proposal and Evaluation of Toilet ......suggestion to use the toilet when he...
ProposalandEvaluationof Toilet Timing SuggestionMethodsfor the Elderly
Airi TsujiGraduateSchool
of EngineeringandScience,Kyoto Instituteof TechnologyMatsugasaki,Sakyo-ku,Kyoto
606-8585,Japan
TomokoYonezawaKansaiUniversity
2-1-1 Ryozenji,TakatsukiOsaka569-1095,Japan
HirotakeYamazoeOsakaUniversity
1-31 Machikaneyama,ToyonakaOsaka567-0047,Japan
Shinji Abe HiroshimaInstituteof Technology2-1-1Miyake,Saeki-kuHiroshima
731-5193Japan
Noriaki KuwaharaGraduateSchool
of EngineeringandScience,Kyoto Instituteof Technology
Matsugasaki,Sakyo-ku,Kyoto 606-8585,Japan
KazunariMorimotoGraduateSchool
of EngineeringandScience,Kyoto Instituteof Technology
Matsugasaki,Sakyo-ku,Kyoto 606-8585,Japan
Abstract—Elderly peopleneedto urinate frequently, and whenthey go on outings they often have a difficult time findingrestrooms.Becauseof this, researchinga body water managementsystem is needed.Our proposed system calculates timing tripsto the toilet in consideration with both their schedulesand theamount of body water needing to be expelled,and recommendsusing the restroom with sufficient time before needingto urinate.In this paper, we describe the suggestedmethods of this systemand showthe experimental results for the toilet timing suggestionmethods.
Keywords—Elderly; Suggestion-method;
I. INTRODUCTION
For healthyelderly people,leaving their homesis one ofthe most importantactivities in preservingtheir cognitiveandphysicalabilities; this also providesgood mentalstimulationand pleasurein their daily lives [1]. Promoting barrier-freeenvironmentsin Japanesepublic spacesencouragestheelderlyto leave their homeswithout assistance.However,going outis likely to becomedifficult for someelderly peopleas theyage, especially when managingtheir body water balances.Becauseelderly people often have weak bladders,they arelikely to experiencethe needfor frequenturinationandoftenencounterdifficult situations when searchingfor restroomswhile controllingtheir bladders.If a caregiveraccompaniestheelderlyperson,thecaregivercansuggestgoingto therestroomin sufficienttime beforetheelderlypersonneedsto useone,orcan look for the nearestrestroomfor their patient.However,the numberof the elderly living alone is rapidly increasingin Japan,andthey cannotreceivesuchsupport.Consequently,they often tendnot to drink enoughwaterduring their outingsdue to their anxiety about using restrooms.This is a likelycauseof dehydration,especiallyin the summer[2]. In orderto aim for elderlypeople’scomfortableandindependentouting
experiences,we have researchedand developedtoilet anddrinking timing suggestionsystemsaccordingto their outingschedules,their surroundingenvironments,andtheir activitieslike eating and drinking [3][4][5]. However, our calculationformulas regarding the amount of body water encounteredsome problems.Therefore,we have been trying to resolvetheseissuesby researchingnotification methods.In order toimprove our system,we have devisedsuggestedmethodsoftoilet timing for the elderly, trying to avoid interfering withtheir outing schedulewhile not ignoring trips to the restroom.In this paperwe describethe experimentalresultswhen twotoilet timing suggestionmethodswereevaluated.
II. TOILET TIMING CALCULATION METHODS
A. Estimatingthe amountof bodywater
According to previous researchon water balancein thehumanbody,we formulateda simplisticphysiologicalformulafor non-invasiveestimationof theamountof bodywater;basedon thoseestimations,times to drink fluids and use the toiletarecalculated.Accordingto previousstudies,the total amountof voidedvolumeof a well-roundedhealthyelderly personina day is assumedto be about 1500 ml, and the amountofthe urine in the bladderwhen they feel the needto void isassumedto be 150 ml [6][7]. We also assumedthat the totalamountof voided volume changesaccordingto the increaseof body surfaceareaand body surfacearea correlateswithbody weight [8]. In a statistical survey of physical fitnessandexerciseabilities conductedby the Ministry of Education,Culture,Sports,ScienceandTechnology,theaverageweightofJapaneseadultswas65.15kg for maleand53.04kg for female[9]. Furthermore,we assumethat that the total amount ofvoidedvolumechangesaccordingto the air temperature[10];it increasesor decreasesby 0.6ml / 1oC from the baselineof19.4oC.Consequently,we obtainedthe physiologicalformula
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of Eq.1 andEq.2 for the non-invasiveestimateof the amountof body water.The total amountof voidedvolume is dividedby thelengthof hoursspentawake(about17 hours).Thetoilettiming is calculatedby Eq.3.
MaleU
= 1500 + (W − 65.15)× 1.0− (T − 19.4)× 0.6 (1)FemaleU
= 1500 + (W − 53.04)× 1.0− (T − 19.4)× 0.6 (2)ToiletInterval = 150/(U/17) (3)
U is the total amountof excretion in one day[ml], Intervalis the basic interval[hr], T is outside temperature[degreesCelsius],W is body weight[kg].
We set the prediction formula (Eq.4) to calculate theamount of sweat per day. The amount of sweat increasesor decreasesby 2.72 g / Body weight / 1 ℃ when theair temperatureis more than 16.5℃ [10].The amount ofexcretionperhour(Eq.5)considerstheamountof voidedurineand perspirationamounts(9.1ml). The appropriatedrinkingtimes (Eq.6) arederivedfrom the risks of dehydrationdue toinadequatedrink intake.
Sweat
= W × (S0 + (T − 19.4)× 2.72) (4)Drainage
= (U/17) + (Sweat/17) + (9.1×W/17) + (900/17) (5)DrinkInterval = (W × 0.02)/Drainage (6)
U is the total amountof excretionin oneday[ml], Intervalis the basic interval[hr], T is outside temperature[degreesCelsius],W is body weight[kg]. S0 the amountof sweatingper body weight[ml].
B. RearrangingToilet Timing
In order to maintain good health, adequatehydration isnecessary.For thispurpose,Japaneseelderlypeopleoftencarrywaterflaskswhenleavingtheirhomes;theyoftenhavelunchordinner with their friends or family during their outings.Suchactivities increasethe overall amountof body water. Excesswaterin thebodyis excretedby thekidneysandpassedinto thebladder.We assumethe amountof the water intake per mealis 200ml, and recalculatethe total amountof voided volumeat eachmeal (Eq.7). Toilet timing is rearranged(Eq.3), withU representingthe total amountof voidedvolume[ml].
DrinkU = U + 200 (7)
U is the total excretionof the day[ml].
C. ProblemsInherentin TheseFormulas
We discovered some formulaic problems in previousstudies[5]–forexample,malesubjectsproducedlargeramountsof urine than 150ml, and one male subjectdidn’t receivethesuggestionto usethetoilet whenhewanted.We areimproving
the formula. However,just improving the formula would notsolveall problems.To addresstheseproblems,we createdthefollowing suggestionmethods.
III. SUGGESTIONMETHODS
In order to avoid interfering with their outing scheduleand ignoring the suggestions,we devisedtwo toilet timingsuggestionmethods.
A. “Consideration” StrategySituations
Thesituationwheretheusercan’t go to therestroomeasilyoften occur during daily activities. In order to preventsuchsituations,thesystemconsiderstheuser’sscheduleandavoidsnotifying the userduring activities suchas shopping,havinglunch, or seeinga movie. Therefore,if the next toilet time isexpectedto be in the middle of an activity, the restroomtimeis adjustedto 5 minutesbefore the activity’s start time. Thesystemmakesadjustmentsto the time calculatedby Eq.1.
B. “Step-by-Step”SuggestionStrategy
Timing to usethe restroomis a sensitiveissuein general.If our proposedsystemunnecessarilyrecommendsgoing tothe restroomrepeatedly,the usermight feel that the systemisannoying.Also, thesuggestionmight beignoredwhentheuseris in the middle of their activities. Furthermore,the elderlyare likely to have hearing difficulties; the verbal toiletingsuggestionsmight sometimesgo unnoticed. Therefore, wecreatedwith the “step-by-step”suggestionof toilet timing.It consistsof three types of suggestionsdependingon theurgency;“Recommend”,“Notification”, and “Alert”. In orderto explain the details of the suggestionalgorithm as shownbelow we definetwo typesof intervals;current interval Ic iscalculatedfrom the recenttoilet timing usingEq.3,while theinterval for suggestionis Im. Also, Ti denotestheelapsedtimefrom the last restroomtiming.
RecommendWhen Im ¡ Ti ¡ Ic, becausethe situation is lessurgentthesystemonly recommendsthesubjecttousethe restroomby both voice andtext message.
NotificationWhen Ic = Ti, becausethe urgencyincreasestosomeextent,the systemnotifies the subjectoncemore to usethe restroomby both voice and textmessage.
AlertAfter eachsuggestionasshownabove,thesystemrequires the user to confirm whether the useractuallywent to the restroom.If the userignoredboth suggestionsand a certain period of timeelapses,dueto the increasein urgencythesystemalerts the subjectto use the restroomrepeatedlyby both voice andvibration.
IV. EXPERIMENTAL OVERVIEW
In order to evaluate the effectivenessof the proposedsuggestionmethodswe conductedthe following experiments.Gaugingthe taskachievementlevel andthe delaytime, tenta-tive shoppingtasksweresetasshownbelow.We measuredthe
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TABLE I: ExperimentalConditionsof SuggestionMethod
Experimentalconditions Considering Stepby stepNo strategy × ×“Consideration”strategy ○ דStep-by-step”strategy × ○Using both strategies ○ ○
delay from the suggestionto the action that the subjecttook,plus the task’s end result. The experimentswere conductedby comparingthe four conditionsasshownin TableII, incor-poratingthe “Consideration”and “Step-by-Step”approaches.In this experiment,“Consideration”meantthat the suggestionoccurredbefore or after each shopping task; the “Step-by-Step” intervalswere15 secondsand10 seconds.The subjectsperformed trials under all conditions in random order. Inorder to investigateimpressionsof all conditionsthe subjectsnot only answereda questionnaireafter each trial, but alsoanswereda questionnaireat the end of the experimentstoindicatewhich conditionsweremostpreferable.
A. Subjects
Thetargetusersof our proposedsystemareelderlypeople.Therefore,the subjectswererecruitedfrom the agegroupsasshownin Table II.
TABLE II: SubjectsOverview
Groupname Number(male,female) Age(ave)Subjects 26(13,13) 64-75(69.27)
B. ExperimentalSetup
The experimentalsetupis shown in Fig.1, and the setupsimulatingtoilet timing suggestionsduring shoppingis shownin Fig.2. Pushing the button while the subject sat on theavailablechair indicatedthat the subjectwent to the restroom.There were three places (A, B, and C) to pick up ballsthat simulatedshoppingitem displays; the room also had acheckoutcounter.Coloredconesandplastic tapeswereused,indicatingthewalking path.Balls coloredred,yellow andblueare shown in Fig.3; picking up the balls simulatedbuyinggoods.Thesubjectwasnotifiedof thetoilet timing suggestionsby an audiblecueemittedfrom a portabledevice.
C. ExperimentalScenario
Theexperiment’sscenariowasasfollows. Fig.1 showstheshoppingtask.The subjectwaitedon the chair for a directionfrom thehand-heldterminal.Whenthedirectionwassuggestedto the subjectasshownbelow, s/hefollowed the instructions.
Start Shopping TaskA voice announced,“Start shopping”and “Takea red ball.” In order to simulate shopping thesubjectcarriedthe basketto locationsA, B, andC, picking up colored balls in accordancewiththedirections.Thenthesubjecttook their coloredballs to the checkoutbasket.The subjectcontin-uedshoppinguntil the “End ShoppingTask” wasannounced.
Fig. 2: ExperimentalSetup– RoomView
Fig. 3: Balls UsedDuring the Experiment
End Shopping Task“Stop shoppingand return to the waiting chair”wasannounced.Thesubjectreturnedtheshoppingbasketto the start position and sat down on theavailablechair, waiting for the next suggestion.
Suggestionto Use the ToiletFirst, a voice messageannouncing“The time togo to the restroomis approaching”was heard.The subjectcould pushthe button nearthe chairto simulategoing to the restroomafter this sug-gestion. If the subject ignored the first sugges-tion, “The time to go to the restroom will beapproachingquickly” was announced5 secondsafterthefirst suggestion.Whenthesubjectpushedthe button by the chair, the subjectcannotbringthe shoppingbasket to the chair in accordancewith real shoppingsituations–shoppersare usu-ally prohibitedin bringing shoppingitems to therestroombeforecheckout.Therefore,the subjectmust return the shoppingbasketto the startposi-tion before returning to the chair. After pushingthe button, the subject could resumeshopping.However,thesubjectcouldalsoignorethesecondsuggestion.
Toilet Alert10 secondsafter the subject ignored the second
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Fig. 1: ExperimentalSetup
suggestion,a voice messageannouncing“Go tothe restroomnow” washeard,alongwith a beep-ing sound.The subjecthadto pushthe buttonbythe chair as soon as possible.When the subjectpushedthe button by the chair, they could notbring theshoppingbasketwith them;theshoppingbasketmust be returnedto the starting position.The subjectcould resumeshoppingafter the but-ton waspushed.
V. EXPERIMENTAL RESULTS
A. DelaysFrom Suggestionsto Actions
The delay from the suggestionto action was the timeelapsed from the first toileting suggestionto the subject
pushingthe button.Fig.4 showsthe resultsof elderly subjectgroup’s averagetimes under each condition. We performedtwo-factorANOVA with thesignificantlevel = 0.05to analyzeeachsuggestionmethod’sdelay time. The ANOVA indicatedtwo within-subject factors (“Consideration” and “Step-by-Step”); the results are shown in Tab.III. The results showthat our proposedsuggestionmethodscould shortenthe timesbetweensuggestionsand toileting.
TABLE III: ANOVA Analysisof Delay Result
Considering Step-by-step Two-factor interaction
F 795.322 352.371 11.473significant(5%) Significantly Significantly Significantly
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Fig. 4: ExperimentalDelay Results
B. ShoppingTaskAchievements
Fig.5 is the task achievementresult. We performedtwo-factor ANOVA with the significant level = 0.01 to analyzeeach suggestionmethod’s shopping task achievements;theresults are shown in Tab. IV. The results show that the“Consideration”strategycould improvetaskperformance.Onthe other hand, the “Step-by-Step”strategyhad an adverseeffect on the task performance.However, there were somereasons–onewas that the time from the first notice until theactual suggestionwas very short. The samevoice was usedfor both the first suggestionand the actual notice, causingmiscommunicationandpoor performance.
Fig. 5: ExperimentalTaskResults
TABLE IV: ANOVA Analysisof TaskResult
Considering Step-by-step Two-factor interaction
F 1.177 79.816 0.916significant(5%) No significantly significantly No significantly
VI. DISCUSSION
This experiment’stwo key points are listed below. Bothsuggestionmethodswere effective in reducing delays fromsuggestionsto actions.
• Both suggestionmethodswere effective in reducingdelaysfrom suggestionsto actions.
• The “Consideration”strategycould improvetaskper-formance.
These notifications seem to be enough to achieve oursystemaimswithout being ignoredand interferingwith othertasks.However, the numberof completedtasksdecreasedinthe experimentswhen the “Step-by-Step”notificationswereused;it is consideredthat the time from thefirst suggestiontotheactualnoticewasvery short;thesamevoicewasalsousedfor both, leadingto miscommunicationandpoorperformance.
VII. CONCLUSION
In this paper,we proposedtwo toilet timing suggestionmethodsfor the elderly in order to support their activitiesoutsidethe home.For this purpose,the “Consideration”and“Step-by-Step”strategieswere considered.Basedon the ex-perimentalresultsof the suggestionmethods,the delay timefrom respondingto the suggestionsto toileting improvedby using the proposedmethods.As for the two suggestionmethodsconsidered,task achievementimproved only underthe “Consideration”strategycondition.However,this it mighthavebeenpartly due to improperexperimentalsettings.
ACKNOWLEDGMENTS
This researchis supportedby the Ministry of InternalAffairs andCommunicationsof Japananda Grant-in-Aid forChallengingExploratoryResearchfrom JSPS.We would liketo thank Dr. Norihiro Hagita of ATR for the opportunity toconductthis research.This work waspartly supportedby JSPSKAKENHI GrantNumbers24300047.
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