This is a proposal to create an "Assistance Phone", a mobile device that is simpler to use than the simplest commercial mobile phone, yet technologically far more capable, designed specifically for remote assistance services for America's 38 million older adults aged 65 and over. The Assistance Phone will enable older users to obtain help from special operators to assist with those instrumental activities of daily living (IADLs) that lend themselves to remote assistance;for example, taking medication, shopping, controlling home thermostats or dishwashers, and planning a walking route that avoids the risk of falling. The Assistance Phone enables a new kind of care service that will support and improve quality of life, well-being, and the ability of older adults to live independently and safely at home. The current alternative, in-home care, is expensive and burdensome. The Assistance Phone will enable care both in the home and on the go for $30 to $100 per month, using remotely-located, trained operators via an architecture similar to that currently under development by Blindsight for its "Sight on Call" service. The Assistance Phone's form and user experience must accommodate the mix of deficits that increase in normal aging, while its technologies must support effective remote assistance. This combination is not available today: simple phones lack the necessary technologies, while powerful smart-phones have intricate controls, and even those lack key technologies needed for remote assistance. Hence, our Phase I project aims are (1) to create and test a novel design for the form factor and user experience, with the aid of a panel of experts, a focus group of end-users, and a world-class design firm;and (2) to select and prove certain technology modules such as inertial navigation, not available in today's mobile phones, but necessary to enable remote operators to help older users to complete IADLs. In Phase II, pre-production prototypes will be constructed and field-tested with a large, representative sample of elders on a wide range of IADLs connecting to Blindsight's remote services architecture. Blindsight will roll out the device and service to older adults in Phase III, beginning with pilots sponsored by government agencies and/or health organizations such as Kaiser. PUBLIC HEALTH RELEVANCE: The proposed Remote Assistance Phone service falls squarely in the NIA mission to further the development of practical applications using innovative technologies to support and improve quality of life, well-being, and the ability of older adults to live independently and safely at home. About one eighth of the US population (38 million people) were aged 65 and older in 2008 (the last year for which data is currently available). This number is expected to almost double, to 72 million, by the year 2030. In 2005, about 37% of those over 65 reported a severe disability of one type or another, and 16% reported needing some type of assistance as a result. In the over-80 age group, these figures rose to 56% and 29% respectively. The Assistance Phone will enable elderly users to obtain help from special operators to assist with those instrumental activities of daily living (IADLs) that lend themselves to remote assistance;for example, taking medication, shopping, controlling home thermostats or dishwashers, and planning a walking route that avoids the risk of falling. The service will provide an affordable and user-friendly aid that compensates for the normal deficits that occur with aging, lessening the need for in-home assistance from caregivers and family members, and supporting independent living and the conduct of everyday tasks at home.