Making videocalls work for the aged

Topic: 

While videoconferencing may not make sense for everyday use, I think it has special value for contact with distant relatives, particularly older ones who don't travel very much. They may not get to see the grandchildren, great-grandchildren or even children very often, and their lives are often marked by a particular loneliness, particular at senior homes.

But today's videoconferencing tools are getting quite good and will get even better. Skype now offers a 640x480 video call if you have enough bandwidth and CPU, which is not far off broadcast quality if not for the mpeg artifacts they have trying to save bandwidth. It's also pretty easy, as is Google's GMail video chat and several other tools. We're just a couple of years from HDTV level consumer video calling.

Many seniors, however are unfamiliar with or even afraid of many new technologies, and often in places where it's hard to get them. And this in turn means they can't readily set up computers, cameras or software. There is also still not internet access in many of the locations you might want ot reach, such as hospital deathbeds and senior homes. (Had they had the access in my stepfather's hospital room, I could have had a video conversation at the end; he died as I was heading to the plane.)

Video calls also offer extra human bandwidth, which is a big plus with people who are getting infirm, less strong of mind and hard of hearing. Reading lips can help improve how well you are understood, and physical cues can mean a lot.

And so I think it's crazy that senior homes, hospitals and hospices don't come standard with a video call station. This is not anything fancy. It's a computer, a webcam, and a megabit of internet. Ideally wireless to move into rooms for the truly infirm. Yet when I have asked for this I have found myself to be the first person to ask, or found that there are policies against internet use by any but the staff.

I'm going to describe two paths to getting this. The first uses off-the-shelf hardware and freeware, but does require that the staff of these facilities learn how to use the system and be able to set their residents up in front of it when it is time for a call. This is not particularly difficult, and no different then the staff being trained in any of the other things they do for residents and patients. Then I will discuss how you would design a product aimed for the sector, which could be used without staff help.

Basic setup

A senior home will contain both fully able-minded residents and some who are slower. It will have technophobes. While there are several video call tools, and in a perfect system you would be able to talk to whatever the grandkids use, supporting this is probably too complex. If you settle on one system -- I would recommend Skype at this time -- you can get the more tech-aware parties at the other end to use it. It is available for Windows, Mac and Linux, which is a big plus.

Unfortunately, Skype and most of the other systems are geared mostly to a single user. You can log out and log back in to change users, but technophobe seniors will not be up to doing this, or even remembering userids and passwords. One account, always logged on, is much easier to get going, though it means that this account will have a huge buddy list of all the contacts of each senior. Skype has contact groups which can help here, but it's not going to be perfect. If Skype, or some other tool, put together a much simpler multi-user interface, like I will describe in the latter section, it would help a lot. A plugin for the Skype API could also help do this. In this case, we're mostly giving up security -- any senior, or anybody else, could log in as anybody, but the risks to that are low.

Hardware

The full quality video calls require a fairly modern CPU to send the good video, unfortunately. A dual core processor is needed. These are now starting to get cheap, even in used laptops. For mobility, I think a laptop is the best device to use. It's not hard to find a cheap, 1-2 year old laptop with dual core and an integrated camera. Due to the fading vision of many seniors, a large screen laptop is useful, or even an external monitor when the laptop is not being used in mobile mode.

However, it may be argued that the video grandma sends doesn't have to be the full HQ level stuff, it's more important that the view of the grandchildren be sharp. That requires them to have a newer computer (which is far more likely) and good upstream bandwidth. The senior home computer can be an older generation, single-core, 2-3ghz model. Such systems can be had for a song in the used market, and almost certainly could be had from a donation by a relative of a resident.

It is best not to stint on the camera, but good quality cameras can be had for $50-$60. Skype pretends that it insists on Logitech's latest cameras which cost $70-$100, but in fact it can be told to do HQ video from almost any recent camera.

Because many seniors will be more comfortable with old style telephone, I recommend the addition of a USB phone handset. A wide variety of these are sold for use with Skype and other programs. (I don't think any have a "Start Video" button, it would be nice if they did.) If the handset has a number pad, it could also be used by almost all seniors to start a call by picking it up and dialing their relatives with Skype-Out. They would not need to know they are using Skype-Out. The relative would get the call, and then go to their computer and log into Skype. They would then hang up the PSTN call and place the video call, knowing grandma is at the video console. This would require a quite small Skype-Out budget for the station, which should be easily afforded by any institution, as long as it's not abused. (A version of Skype that could only skype-out to a limited set of numbers for calls of just a few minutes could solve such an issue.)

The USB handset must feature a high-volume feature for the hard of hearing. In addition, there should also be a set of headphones. These are better than a handset, but just not as familiar. They can offer better audio, less echo, higher volume and a different balance for those with different hearing in their two ears. While computer control of balance is possible, there is not a good UI for it, so headphones with a balance dial would be better, though such a feature is not easy to find.

Of course, Skype also does speakerphone quite well, though it's always better if both ends don't do speakerphone. Since calls to families may have several people on the other end, it makes sense to avoid speakerphone at the senior station.

Using it

The computer would be kept on, with Skype running. Calls would probably be set up using the PSTN, though more aware seniors could go to the system, log in to their own account if they know how, and see if their relatives and friends are online to talk to them.
The computer might also live at the nursing station, where families could call in (over Skype even) to ask that the computer be taken to their relative, or that he/she come to the station.

Start with phone call

An interesting interface, that would be quite handy in regular video call software like Skype would be a "start with phone call" interface.

In this interface, the user would dial a phone number on a keypad, ideally on a USB phone handset. The system would look up the number and see what computer user that is. If the computer user is online, it would connect over the internet to that user. If the user is not online, it would place a PSTN call to the phone number. For example, in Skype, using Skype-Out.

When the other party answers and is told it's a video call, they would go to their computer. Once they logged into the video call software, they could place an internet call to the person who called them on the phone. When the client that made the PSTN call receives this 2nd call, it would seamlessly hang up the PSTN and switch to to internet call, adding video. The senior who dialed the phone would have no idea this took place, they would just see audio quality improve and video start up.

Even better, the target's client, once it logs in, could be made aware of the PSTN dialog and make it all automatic on their end too, so all they have to do is log in, and immediately voice and video start.

Since the PSTN portion of these calls would be short, the cost would be minimal and could be done on a monthly fee.

This approach requires no buddy lists or identification or security at the senior home end.

Dedicated Senior Video Call Terminal

Things would be better with a bit of custom software. This would start with a PC/Laptop mostly dedicated to this function. The UI must be extremely simple, perhaps even automatic. Note that I recommend the use of a standard PC rather than trying to make a dedicated device, because standard PCs are very cheap and the software available for them is much better. It matters more that the system be compatible with what the families have, and that means the PC based systems -- and the ability to change to another system if trends change.

For example, in an ideal system, the senior would come and sit before the screen. The camera, using face recognition, would identify which senior it is -- this is not too hard to do when dealing with only a small set of people, and can be done with face geometry. If, for some reason, it can't distinguish between two people, it could then display their two names and faces on the screen, and let the senior select who they are, perhaps with a touch screen, or by saying their name.

If face recognition seems too hard, speech recognition is certainly good enough off-the-shelf to let the senior say their name to be identified. Or if that's still too much, they could pick from a list of names on a touch screen. I think a touch-screen is a must if there has to be pointing -- many seniors are not familiar with a mouse, or may have disabilities that prohibit the use of a mouse. Another alternative is a keypad on the phone handset that should come with this. As noted, seniors will all be highly comfortable with the phone, and pressing a number on a phone can work as a means of input. Indeed, a simpler to build UI would just have the names of all seniors on the screen with numbers, and the senior picks up the phone and dials their number (or says their name) to start using the system.

(Note that while these systems might provide some security against impersonation, home staff/nurses will need to be able to get into any account to help set up buddies or any special config for them.)

Once the senior is recognized, the screen would show their buddy-list, primarily the family members who are online and ready. Again, each name should have a number after it (which never changes, no matter who is online) and the senior should be able to call one of them by pressing their number on the handset or keyboard. Sure, mouse and arrow keys should work as well, for those able to handle that.

For many seniors there may be just one person they talk to. In that situation, it should take nothing more than identifying to the computer, and confirming by voice or keypad press that you want to call. If the other person is already ready, they can initiate the call.

Since this is a video call terminal, it should send and receive video automatically, unless told not to, at least in calls to the recognized buddies. If there are concerns about the security of this, it could require that there be somebody present at the computer for this to happen, and this person would be able to cancel the video. For example, if there is nobody present, video start would be manual. If somebody is present, the terminal would display "video starting in N seconds, say 'no' to cancel" and then automatically start.

(Underneath, the system could be working with multiple video and buddy systems, so that grandchildren can be found on Skype, GMail, MSN, AOL, iChat or what have you. The Senior should not be particularly aware of that. It should be up to the family member to set this up, perhaps working with a nurse or assistant.)

There's a lot to be said for keeping the interface just like a phone call, with the video added. It may make sense that the seniors can just go to the handset and dial the real world 7 or 10 digit number of their relative and have this number be recognized so that it all works. Indeed, even though the face-recognition system might provide a simple, no-touch interface, some seniors might adapt better to the familiarity of the phone style interface.

If headphones are to be made available, the system should remember what volume level and left-right balance the senior uses, and set this. Initial setup of this can be done with a simple UI, or the assistance of a helper the first time. The system should be able to automatically detect if the user is using the headphones, a handset or the speakerphone with no UI required to switch. It can tell just by what volumes it gets from the microphones, off-hook signals from the handset and echos of signals it sends out the various speakers. This does require that all the audio devices be independent, which is becoming much more common in modern computers and is easy to do with USB audio devices.

Note that this computer could also be a full-function computer for use by the seniors who know how to use it, and do E-mail and web browsing. However, these would be things such users would have to click to get with the mouse, rather than the typical default of a computer that is in full-power mode and lets you run a program to do video calls.

Intermediate steps

We could get closer to this ideal system with a few tweaks from the video call developers, or perhaps plugins that go on top:

  • The tools could all support a shared computer better, with easier identification of who the user is and switching, without requiring them to use the mouse or do login procedures.
  • Tools could support an easy, but reasonably secure, semi-automatic start of video, or accept a keypress from the handset for start-video. In general a mouseless interface should be considered.
  • In general, a much cleaner UI skin with just a few features presented unless asked for would allow better adoption by the aged.
  • Good support for multiple audio devices. Figure out if the user is using the handset, headphones or speaker without them having to specify. Do this by listening to all microphones and the echo coming through them.

Funding

The hardware for this is cheap or getting cheaper. I would not at all be surprised that if the software were available, the relatives of seniors would donate older computers, or possibly even newer computers. In addition, if the facility doesn't have internet, donations could easily be arranged. The system could even be built to require that the families who use it contribute to its cost, if the money can't be raised any other way.

Further, the system could send calling family members to a URL for donations not just for the video system, but to the senior home itself, making this a money-raiser, rather than a cost.

In a senior's home

Of course, there is a desire to get a video call facility into private homes of seniors who are not yet in group homes. Usually this is up to the family, though software to make it easier and more phone-like would be a plus. However, many seniors do not have internet access. This can often be solved by connecting to a neighbour's wireless internet. In most of the world's cities, there are tons of local wireless nets visible in just about any home, especially if an antenna is put by the window. With a very light usage pattern predicted, what neighbour would not allow access to a dedicated system that lets the old lady see her grandchildren once a month?

Of course, some ISPs forbid any sharing of connections over wireless networks. They should be shamed out of this, at least in the case of a video terminal for seniors. These are people who would not buy a full connection and who put little strain on the system. If any of them tried to block such a usage, I am sure enough negative press could be generated to get them to reverse such a decision.

Comments

Brad, I'm delighted and encouraged by your post above. My names is James Corbett and I received a level 1 award from Social Entrepreneurs Ireland in June to pilot a project bringing video-calling to seniors, the disabled, carers and other socially isolated or marginalized groups.

But our pilot project is focused on the ederly and while ultimately we want to get to lonely individuals in their own dwellings we are starting with retirement/senior homes, nursing homes and respite centers. There we're using a mix of devices running Skype.

I recently acquired the first Skype Videophone - the Asus AiGuru SV1 - and in my testing have determined that it will be a very good option. It's a dedicated Skype device which boots straight into an optimized and more user-friendly UI than on the PC. Navigation is via an equally user-friendly D-pad with only a few other buttons required. I believe the elderly will have little problem in learning to use this device un-aided.

However the device we're really looking forward to is the brand new Asus Eee Top - the first truly affordable touchscreen PC which, I agree with you, will make all the difference to usability. We will also be customizing the Skype interface and configuring it for automatic call pick-up, video-on, etc.

I'm looking forward to reading your further thoughts on this subject.

Yes, I read about your project and was going to point you to the blog post (your bots must have found it.)

My own experience shows seniors so averse to new tech as to resist even being wheeled in front of a video call somebody else set up, which is what is driving me to the handset approach, which should work with anybody able to make regular phone calls. Reviews I have rad of the Asus suggests poor video quality, and a small screen, which may not be suitable for the impaired vision of seniors. Can it connect to an external monitor for such folks? I presume it's not up to the level of skype HQ video with its 640x480 and 30fps? I find that makes a big difference, and is worth the money for the hardware.

I'm also starting to wonder if the "dial a 10 digit number" isn't a better interface for the seniors than a login and buddy-list. As noted, a buddy list shared among all the seniors at a senior home is a bad idea, as is having them have to login to use it. If they dial the number of one of their relatives, the system can immediately know who they are and who they want to talk to, without touching the screen.

Perhaps the interface should be as simple as that. They pick it up, call the number, and if the person is not online with skype, it calls that number via skype-out. When the relative answers, the relative could go to their computer, and log-in to skype, where they could place a call back to the senior home. As soon as the box gets this call back, it would switch, as seamlessly as possible from the PSTN/skype-out call to the live call. The senior would not even be aware of this.

Skype could make it even better, if the client on the relative's PC is told about the attempted call that went to PSTN, so that the moment they log in, it takes over the PSTN call. This "Start as PSTN" would be a useful feature for all Skype users.

One other resistance I have to the dedicated phone is that it never has the chance to do anything else (ie. talk to ichat or google video or msn etc.) nor, I suspect, to improve as better cameras and software come out. I expect a lot of improvement, and in fact a move to HD. I was shocked when I plugged into the secret ethernet in my grandmother-out-law's nursing home to find they had 20 megabits down, 4 megabits up, which is enough for HD already.

Thus the dedicated computer hiding as a video terminal makes more sense. Plus, for seniors who know how to use it, they can call up the full OS, E-mail clients etc. making it easier to justify the cost. The EEE Top sounds good but does a single core Atom have enough power to do the Skype HQ video? As I have noted, good video can really help seniors who are starting to lose hearing or other faculties as you get the lips and higher quality audio together, at a higher volume in their ear. (And the option to also let them read text if their hearing is getting really poor.) But that needs high frame rate and video quality, which is something that really hasn't been here at the consumer level prior to Skype HQ. The Atom should be able to receive the HQ video but may not be able to send it -- this may suffice, but is not as good for the relatives.

(The one curse of Skype HQ right now is that it requires the Logitech cameras. The cameras are nice, but their driver package is a 30 megabyte behemoth that is confusing and slow to install, and has, last time I tried, problems on Vista. That driver does too much for the more basic user, so Logitech should release a very simple plug and play driver if they can, and let people upgrade to the fancy one.)

I am interested in any research you do on what seniors will embrace. How many will use a mouse and keyboard? How many a touch screen or a handset keypad? How many will take a simple speech interface? How many would fear a video call that works just like an audio call to start, just because it's all newfangled?

"My own experience shows seniors so averse to new tech as to resist even being wheeled in front of a video call somebody else set up"

I always cite the example of my father when people express doubt about the ability of seniors to grasp new technology. He was 76 when he passed away a few years ago and lived his life as a small farmer in rural Ireland. As such his exposure to technology and electronics was minimal throughout his life. He was if fact what some might call a technophobe. For instance he refused to learn how to use the microwave oven, or to record a TV programme. BUT.... one thing he didn't shy away from was learning how to use the Telext system once he realized that he could access the sports results ANY time he wanted to. That was almost miraculous to him, and significant enough that he was MOTIVATED to learn how to use the remote control buttons. When Dad could do it, I've no doubt anyone can - it's all about motivation, encouragement and a little hand-holding.

"Asus suggests poor video quality, and a small screen"

I guess it's subjective. We've fond the video quality plenty good. Yes, the screen is small but my short-sighted 72 year old mother had no problems with it. We've also set her up with a 9" netbook (Dell Mini) for Skype Video calls to my sister in another part of the country and again, she finds it very enjoyable, regardless of the non-HQ qualiy on an Atom CPU. The advantage with the AiGuru SV1 is the ease of use - booting directly into Skype, customized/optimized icons and menu system, D-pad and dedicated buttons, etc.

I think it's a mistake to see HQ as a necessity. One of the inspirations for our project was a chat with the team behind 3Gdoctor.com, who are also based in rural Ireland and facilitate video-calls with their patients over the mobile network on SMALL cell/mobile phones. In our discussion I was intrigued to learn that many of their elderly patients are in the habit of phoning back regularly, even when there is nothing wrong with them. 3Gdoctor eventually realized that those people simply appreciated having full eye contact, regardless of the size of the image. 'ATTENTION' was the word they repeated - elderly patients love knowing that they're getting full attention during the conversation, unlike they often get when on the POTS (when their relatives are often not paying attention at all, with one eye on the TV or magazine).

"As noted, a buddy list shared among all the seniors at a senior home is a bad idea, as is having them have to login to use it."

We use Contact Groups to get around this. Each user has a contact group labelled with their own name. Granted, the interface isn't optimal but with the Eee Top touchscreen we think it'll be fine. So we currently use a single Skype username for each Retirement Home and obviously the relatives know who's calling, there's no need for multiple logins. This means we can launch Skypbe on bootup, open in full-screen mode and auto-login.

"The EEE Top sounds good but does a single core Atom have enough power to do the Skype HQ video?"

No, HQ requires Dual Core but we're not too worried about the quality the relatives receive as long as it's 'good enough'. Which it is with 1.3mp webcams on Atom CPUs. We've decided that netbooks with that spec meet our base entry requirements.

"The one curse of Skype HQ right now is that it requires the Logitech cameras"

I've read in the support forums that configs for other webcams can be hacked to make them work but I haven't tried it myself. Of course we're looking forward to moving to HQ on all our devices within a year or so but for the moment it's not a priority.

"How many will use a mouse and keyboard?"

That's an issue we plan to get around with (1) D-pads (as on the AiGuru), (2) Touchscreens (Eee Top) or (3) nurses/attendants placing the call on their behalf, or (4) Just auto-reciving the call made by a relative on a pre-determined schedule.

Yes, most of the seniors are capable of using the technology and learning it. However, quite frequently I encounter fully capable seniors who reject the new for no rational reason. They have just become set in their ways. After a while it becomes clear that you might be able to get them to use it by pushing them, but you don't want to push them. If your project can find ways to motivate them to embrace the new technology, and document those techniques, that will be a big plus. But just giving them the tech is not enough for many.

Actually, the Atom should allow receiving HQ video (though I have not tested it) but presumably not sending. Eventually we'll start to see webcams that generate mp4 inside which would allow any processor to make it work. When it comes to Skype HQ (which is only 640x480 but someday will probably graduate to 1280x720) the webcams are already up to it -- it's the sending processors that are not.

As far as login/contact groups, I think that once we find a good interface, the next step is to start pushing Skype and other vendors to implement it. The PR and social good aspects of this may well help push that. The "start with POTS" plan I detail above also makes sense for all users.

I look forward to hearing more formal study of what happens when you put the AiGuru in front of lots of seniors.

Brad and James, I'm so excited to read this exchange between you because it's focused on the tools and technology. I'm focused on the social and communication issues people must address to make effective use of these tools. And there are lots of them.

In an earlier incarnation, I was VP of communication for the Texas Association of Homes for the Aging and learned a ton of interesting stuff about the culture of nursing facilities and other long-term care environments (including continuous care communities). I'm living in an area now where there are lots of retirees and a major chunk of the local economy is focused on caring for people between retirement and death.

Moving here, I've shifted the focus of my business to helping independent business people make more effective use of virtual meeting tools (especially the free ones). I'm also starting into conversations with long term care providers about how to better support non-F2F communication between their clients, the clients' families and their health care providers.

I'd love to bring all three of us together for a virtual conversation about how our passions overlap. My hunch is there plenty of people who would like to listen in. Interested?

Just wanted to share my delight to read through this discussion. I spent the last 2 month looking for a decent solution for connecting elderly people to the outside world.

I am a media sociologist by education but I have worked most of my time in the online and digital media industry in Europe and Japan in the last 10 years.

I played around with a WiFi enabled pictureframe supporting RSS to push pictures. (I set up such a device at my grandparents place). This opened my mind for new ways of helping seniors who face a either an aversion or an inability to use devices such as PCs. Technology should be an enabler and not a threat to those people.

What I am looking for is a simple, touch based device with a very simple interface that serves as a digital pictureframe (updated remotely), a video conferencing system and also a video and picture library. I was also thinking of the new EEE Touch given there would be a very simplistic, easy to comprehend interface. I do not want for example my grandparents to get lost in Skype with its many options. Everything should be nicely embedded into a simple interface very much like a walled garden. And I (or the operator) should be able to install/modify the device and the applications through a simple remote web interface and upload picture & videos via a mobile phone.

I have seen some solutions but most of them were half-hearted, not built with an elderly persons usage patterns in mind.

What I found a good "entry point" to get seniors interested is to pitch such a device as a "digital picture frame". They can see the benefit and in the best case there is nothing they have to do. Just enjoy pictures of their family and friends which get updates frequently over the net. The latest wifi frames even have a setting for turning them off and on automatically. As a next step a little interaction can happen (touch interaction preferred) and after that learning curve is taken, things could become a bit more advanced in terms of functions. (Video calls, medication reminders, watching videos of the grandkids, maybe sending a very simple message, etc)

So I would be happy if you could keep me in the loop about your further discussions,

Best,

Marco

Yes, I have also blogged about those. With those, you do need auto update. Problem of course is there is rarely internet in a tech-averse senior's room or house, but it often comes wirelessly from neighbours.

One of the earliest digital picture frames plugged into the phone line and downloaded new photos. They charged a monthly fee, though, which turned people off.

I do agree that if the terminal is to be for a single household, making it also be the picture frame is a good plan. For that we also like high resolution, it amazes me how sucky the resolution of most picture frames is.

I commented on Burningbird some time ago that some things were a social issue not a technical issue, and noticed that got a lot of traction for a while. Maybe it's just me but, I think, a lot of the comment about old people, children, and the poor can be a bit arrogant and insensitive. My first thought about the OLPC project was it was agenda driven procrastination. It's primary focus has pretty much failed but it has raised questions about quality, accessibility, and cost. I hate paying through the nose for crap. Perhaps, we need a less consumption and scarcity based economy and a focus on better quality and redistribution. Nobody likes junk and working God knows how many hours in some soulless job, so why do we do it? WHY? George Monbiot wrote in The Guardian that we need to shift from a growth based economy to a development based economy. I think, he has a strong case.

Hmmm. I was dumping a bit, there. Sorry.

I think, it's important to realise that some people don't want these goodies and, often, for very good reasons. Also, those who want them may be just as capable of using them if they had the opportunity. Folks often have impressions about people that are out of their personal loop, and jump to all manner of conclusions that usually turn out to be wrong. I've done it, myself, often enough so try to keep that in check before I get too carried away. It's why I view opportunity, liquidity, and self-development as key values. Mostly, we're our own worst enemies and the problem isn't achieving things or other people but how we deal with things. But, I'm a Buddhist and would say that. As populations age and new markets emerge, I'm sure, folks will grasp that and adapt. So, things aren't so bad even with these recessionary forces swirling around.

You are correct in saying that sometimes people just don't want the new technology. They didn't grow up with it, it's not part of their way of life, and they don't see the reason for the excitement.

Nonetheless, the younger generation sees the value it would get from having a video conversation with the elders, and wants to find a way to make the elders try it. Often conversations between descendants and seniors are awkward (for both parties I am sure) and this gets worse as the seniors lose more faculties, and gain the additional stubborn streak that age adds to most of us. I don't think it's wrong for the younger generation to "push" a little to improve the channel.

To do this, it makes sense to try to adapt the video channel to be as palatable to the seniors. In the end, if they still hate it, I agree it is wrong to force it, though in many cases they will do it because it's what the grandkids want, and they do want more contact with their children and grandchildren. What parent doesn't lament about how little the kids call? They used to lament about how little they visited, but now the audio phone call is fully integrated into everybody's whole life.

You make some good points, Brad. I don't disagree with them but think it's important that people have a rounded view. The alternative to better communication is, well, folks getting together in the real world. People can jump on cars, phones, and work as reasons to shrink the amount of time they spend with each other but that's something that can need challenging. Like politics, it's easy to get into some winner takes all ding-dong but that's not what I'm shooting for. As I said, sometimes, we have to take these things steady whichever direction we go in.

Can't remember what it's called but the French had a system before the internet which was text based. If you had a phone they supplied you with a terminal and you could do a whole bunch of stuff like use government services over it. Britian had Prestel, which used spare capacity in TV channels to push out stuff like news and travel. They're clanky as both were implemented before the GUI and internet but they were useful, low maintenance, and cheap. As I've grown through the change in tech stuff seems to get more complicated and expensive for, sometimes, little gain. More simplicity and accessibility would certainly help things become more universal.

As a bit of mind toy, coincidently, I was wondering what a wall sized 3D screen would be like for meeting up with family in another country. If it was big enough, had a high enough resolution, and had depth of field the experience would be like sitting in the same room. With a bit of faking it could be fudged enough to join two seperate rooms together with, say, a table that cut through both locations. Cutting edge conference systems are heading in this direction but they're hideously expensive. Perhaps, something like better e-paper and ubiquity in places like shopping centres would help introduce other folks to stuff like this and it will get cheaper and more invisible.

Alan Watts commented on these issues years ago. I'm in the middle of something so can't check it but there's a vid up on youtube where he comments about 3 fantasies ( http://uk.youtube.com/watch?v=dinwZswOjuE ). One of them is the holodeck which we saw given flesh on fictional bones in Star Trek: TNG and The Matrix. It's an interesting and slightly whimsical journey from initial conception to the final product and a sobering, yet, humorous sting in the tail.

Is not an option for family living thousands of miles away, as happens a lot these days, or if somebody is literally on their deathbed.

What I was getting at is that distance compressing things, like cars and the internet, can cause problems as much as solve them. Getting to perfection is like trying to hit lightspeed - effectively impossible. There's always going to be a problem for someone whatever is done. The danger for technologists, as much as old people or the poor, is that people have their view and try to shape the whole world to fit. But, that's just another spin of the wheel and leads to other issues down the line. So, I'm not agreeing or disagreeing, just looking at the bigger picture.

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