Co-design with the care team: uncover the role of technology in dementia care

Photo by Alvaro Reyes on Unsplash

When we talk about smart healthcare, we talk about data collection, analysis and visualization; we imply we work with sensors, algorithms and digital products; we treat technology as an enabler, a facilitator, and a friend.

However, not all end-users would think in the same way. Without involving them in the design process early-on, the adoption of the final design could be scarce. For example, in 2009, despite the good intention of the smart meter initiative put forward by the Ministry of Economic Affairs in the Netherlands, without involving the citizens (who are the end-users of the smart meters) in the process, the privacy issue was overlooked, causing a delay in the roll-out of this technology.

This smart meter project in the Netherlands is a cautionary tale for me. I find integrating technology into the healthcare environment should be thought of as a sociotechnical intervention, in which social context, relationships, and power dynamics are central, not an afterthought.

My project involves exploring the value of Indoor Positioning System (IPS) in dementia care. The IPS is deployed to collect real-time location data of the caregivers and residents in a nursing home for people with dementia. The intention is to help the care team develop a better understanding of each resident based on data-enabled insights, which could lead to more personalized care. The care efficiency might be enhanced accordingly, and the wellbeing of both the care team and residents could be improved in the long-term.

However, in the short term, the workload of the care team becomes higher when using IPS. To illustrate, for the IPS to collect location data properly, the caregivers have to wear a physical tag during their shifts and help the residents to wear the tags as well. After their shifts and when the residents go to bed, they have to return the tags to the charging station in the office. After the data are visualized, the care team have to gather together to analyze the visualizations. Given these extra work, would the care team be willing to use this technology?

As a theoretical base, the current models for user acceptance of assistive technologies have identified the main determinants for user acceptance, which are ease-of-use and perceived usefulness.

With ease-of-use, there is a body of work in cognitive ergonomics about reducing the cognitive workload for the users. Besides the literature, I got a general understanding of the working routine of the care team from work shadowing and observation, and I involved them in the design process by arranging co-design sessions.

As for perceived usefulness, I organized a focus group to understand the motives and values of the care team regarding smart dementia care; and explored what kind of visualizations, facilitated by IPS, could align with their values and help them to achieve their motives. I adopted the mindset of Value Sensitive Design to shape a desirable final solution.

For more details about the co-design sessions and the focus group, I made a presentation as attached below. Please note that I altered the sound of the video slightly to reduce my accent for better understandability, so it doesn’t sound like me. You may also start watching from 18:37 onwards for the takeaways.

In the end, I would like to share the eight values that the care team holds for smart dementia care (mentioned in the video above) in a shortlist:

Informed consent: the system allows its users to voluntarily participate

Safety and health: the system does not harm people

Privacy: the system allows users to determine which information about themselves can be used and communicated

Efficiency: the system improves the efficiency of care

Correctness: the system processes the right information and performs the right actions

Universal usability: the system can be easily used by the users

Cooperation: the system collaborates with users instead of replacing them

Accountability: the system explains, justifies and takes responsibility for the visualizations and notifications it generates

This project is by no means the best way to co-design with the care team for smart dementia care; it is a learning process for me, which helped me to broaden my knowledge and refine my skills for future projects. Hopefully, this co-design approach and this value shortlist could inspire future researchers and designers in deploying technology in the healthcare context.

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PhD in Human Centred Design at TU Delft, global citizen.

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Gubing Wang

Gubing Wang

PhD in Human Centred Design at TU Delft, global citizen.

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