Include 2011 : The role of inclusive design in making social innovation happen.

Include is the biennial conference held at the RCA and hosted by the Helen Hamlyn Centre for Design. The event is directed by Jo-Anne Bichard and attracts an international delegation

Future bathroom: A study of user-centred design principles affecting usability, safety and satisfaction in bathrooms for people living with disabilities

Research and development work relating to assistive technology 2010-11 (Department of Health) Presented to Parliament pursuant to Section 22 of the Chronically Sick and Disabled Persons Act 197

The Challenge of Coming to Terms with the Use of a New Digital Assistive Device: A Case Study of Two Persons with Mild Dementia

There is an increased interest in supporting persons with dementia with technical services in daily life. The aim of this case study was to explore the complex issues involved in the process from a user driven development to the acceptance and usage of a new digital assistive device for persons with mild dementia. Even though it was developed in a user driven process and personalized to meet their individual needs they rarely used it. To deepening the understanding of this disparity between actual usage and perceived usefulness, the participants were studied whilst performing daily life activities through participant observations and interviews. Their partners were interviewed two years after the first observations to clarify the change in needs over time. The results show that the participant needs encompassed occupation, safety, social interaction, and memory support together with the receipt of general support. The overriding requirement for both participants was a need to maintain their self-image. When the digital assistive device did not correspond with the participants’ expectations or view of themselves, their interest in using it faded, since the digital assistive device failed to support their self-image. The acceptance of a digital assistive device by a person with dementia is a process that begins with identifying and personalizing the functions of the device according to individual needs, and then supporting the usage and the gradual integration of the device into daily life. During this process, the person’s self-image must be taken into consideration and supported

Digital support for self-management and meaningful activities of people with mild dementia:Development, implementation and feasibility of a person-centred touch-screen intervention

This thesis reports on the research that was conducted to develop and pilot test a person-centred touchscreen-based program (FindMyApps intervention) that supports people with mild dementia and their informal carers in how to use a tablet and apps for self-management and meaningful activities. The program consists of the FindMyApps training for informal carers in supporting people with mild dementia in using a tablet and the FindMyApps selection tool designed to help people with mild dementia find apps for self-management and meaningful activities that fit their needs, wishes and abilities. The program was developed following the Medical Research Council (MRC) Framework for the design and evaluation of complex interventions and in co-creation with end users. The chapters of this thesis describe the first three phases of this framework i.e.: the preclinical or theoretical phase (0); the modelling phase (I) and the exploratory trial (II). The execution of an RCT (III), and further implementation (IV) in case the intervention proves effective, are beyond the scope of this thesis. In the first phase user needs studies were performed to identify user requirements for desired self-management and meaningful activities and to identify user-requirements related to the use of apps. Eight focus groups were performed in which people with mild cognitive impairment (MCI) or mild dementia (n=13) and informal carers (n=15) participated. We also conducted a literature review to explore which training interventions are most effective for people with mild dementia in (re)learning how to use technologies, including handheld touchscreen devices. An electronic search was conducted in the following databases: PubMed, APA PsycInfo (EBSCO) and CINAHL (EBSCO). In total 16 studies met the inclusion criteria. Our review contributed to the growing amount of promising evidence on the potential impact of Errorless learning training interventions for people with mild to moderate dementia in (re)learning how to use technology. Based on these results we developed the FindMyApps training. In the second phase of the framework we developed a first concept of the FindMyApps selection tool based on identified user requirements. To ensure its usability, the web-based tool was developed using a ‘user-participatory design’ involving the close collaboration of potential users, a development team (researchers, developers and designers) and an expert team (experts in person-centred dementia care and ICT). In three short iterative rounds – so called ‘sprints’ – the users (people with dementia (n=8) and (in)formal carers (n=10)) were invited to test whether the prototypes were in line with their needs, wishes and abilities. This generated important insights into user-interface aspects relating to (i) useful content and (ii) a user-friendly tool design. In the third phase we pilot tested the FindMyApps intervention by means of individual semi-structured interviews and a pilot randomized controlled exploratory trial. Twenty people with mild dementia and informal carer dyads were randomly assigned to the FindMyApps group (n=10), receiving either the FindMyApps training and selection tool, or a control condition (n=10), receiving only a short tablet training. Pre- and post-test measurements at a three month follow-up, consisted of questionnaires and post-test semi-structured interviews. Based on the qualitative results and the effect sizes on the outcomes measured in this study, we consider that the FindMyApps intervention has the potential to positively influence the self-management and engagement in meaningful activities in people with dementia. Future studies with a larger sample should better indicate whether this expectation can be confirmed. The intervention will be further improved and tested in a larger pilot-RCT study and its effectiveness subsequently evaluated in a definite RCT

Outcomes for Older Telecare Recipients: The Importance of Assessments

The article explores both telecare in relation to its composition of assistive technologies, including sensors; and associated services that use such technologies as a means by which, often vulnerable, people can obtain help through their activation - with signals being routed to monitoring centres. The context is one where there are changes to such technologies and ongoing growth in the use of telecare services - despite there being no indicated benefits from a major study (the Whole System Demonstrators). The 'curious' investment in such technologies and services by Adult Social Care Departments in England is investigated through an interview survey that elicited over 100 valid responses. Iy gave particular attention to the assessment process by which effective targeting (to those who would be most likely to benefit) would, it had been assumed, have taken place. Key outcomes point to needed improvements to social care practice - including the need to balance a narrow focus on risk (determined in a largely top-down way) with other telecare offerings that could more proactively address (e.g. loneliness) and involve the user more proactively in relation to technology and service options. The file attached to this record is the author's final peer reviewed version. The Publisher's final version can be found by following the DOI link.Summary This article explores the role of telecare assessment, review and staff training in meeting the needs of older people living at home. Using original empirical data obtained from an online survey of English local authorities it reveals considerable variation in assessment and review practice and in training given to social work and other staff who assess and review, which may impact on outcomes for telecare users. The study findings are situated within an English policy context and earlier findings from a large, government funded randomised controlled trial. This trial concluded that telecare did not lead to better outcomes for users. Findings Our survey findings suggest that it may be the way in which telecare is used, rather than telecare itself that shapes outcomes for people who use it, and that ‘sub-optimal’ outcomes from telecare may be linked to how telecare is adopted, adapted and used; and that this is influenced by staff training, telecare availability and a failure to regard telecare as a complex intervention. Application The findings may help to reconcile evidence which suggests that telecare does not deliver better outcomes and local authority responses to this which either discount or contest its value. The article suggests that to use telecare to achieve optimal outcomes for older people, social workers, care managers and other professionals involved in assessing for telecare will need to be given enhanced training opportunities, and their employers will need to perceive telecare as a complex intervention rather than simply a ‘plug and play’ solution

Technology and dementia: the future is now

Background: Technology has multiple potential applications to dementia from diagnosis and assessment to care delivery and supporting ageing in place. Objectives: To summarise key areas of technology development in dementia and identify future directions and implications. Method: Members of the US Alzheimer’s Association Technology Professional Interest Area involved in delivering the annual pre-conference summarised existing knowledge on current and future technology developments in dementia. Results: The main domains of technology development are as follows: (i) diagnosis, assessment and monitoring, (ii) maintenance of functioning, (iii) leisure and activity, (iv) caregiving and management. Conclusions: The pace of technology development requires urgent policy, funding and practice change, away from a narrow medical approach, to a holistic model that facilitates future risk reduction and pre- vention strategies, enables earlier detection and supports implementation at scale for a meaningful and fulfilling life with dementia

Engaging older adults and people with dementia in the design of digital technologies

PhD ThesisImprovements in healthcare and nutrition have led to increased life expectancies for people around the world, and a growing need to support the larger numbers of older people living with chronic and age-related health conditions. Although the use of digital technologies is increasingly proposed for health and social care solutions, in practice the designers of these technologies are ill equipped to actively engage older people and in particular people with syndromes such as dementia. An examination of previous work on design for older people, and people with dementia, suggests that poor design arises from a gulf in knowledge and experience between the designers and their subjects. To address this divide the KITE participatory design method for engaging people with dementia in design is proposed. KITE facilitates engagement by structuring and scaffolding an empathic relationship between designers and their participants. The approach is elaborated and evaluated through an exercise to design a digital technology to help people with dementia have safe walking experiences. The analysis of this process leads to the formulation of the OASIS design method which is intended to apply to older people more generally. OASIS is evaluated and refined through a number of design studies for technologies to support healthy eating, day-to-day travelling needs and living safely within the community. Reflection on the application of the OASIS method highlights a number of key strategies that can be used to establish and maintain respectful, empathic, and productive participatory design relationships with older adults and people with dementia

Acceptance of ambient assisted living (AAL) technologies among older Australians : a review of barriers in user experience

One of the great challenges facing Australian society is that of an ageing population. Amongst the issues involved in this drastic demographic change, the most significant aspect is the demand for older Australians to live independently at home. The development of Ambient Assisted Living (AAL) technologies aims to address this issue. The advancement of AAL applications have been done to support the users with their daily-life activities and health concerns by providing increased mobility, security, safety in emergencies, health-monitoring, improved lifestyle, and fall-detection through the use of sensors. However, the optimum uptake of these technologies among the end-users (the elderly Australians) still remains a big concern. Thus, there is an elevated need to understand the needs and preferences of the seniors in order to improve the acceptance of AAL applications. The aim of this study is to investigate the barriers and perceptions in the use of AAL applications amongst older Australians. Focus groups and quantitative surveys have been conducted to provide a detailed analysis of these impediments. The results show that there are different factors that restrict the use of these technologies along with the fact that elderly people have certain preferences when using them. An understanding of these factors has been gained and suggestions have been made to increase the acceptance of AAL devices. This work gives useful insights towards the design of AAL solutions according to user needs