Co-Designing Ambient Assisted Living (AAL) Environments: Unravelling the Situated Context of Informal Dementia Care

Abstract

Ambient assisted living (AAL) aims to help older persons “age-in-place” and manage everyday activities using intelligent and pervasive computing technology. AAL research, however, has yet to explore how AAL might support or collaborate with informal care partners (ICPs), such as relatives and friends, who play important roles in the lives and care of persons with dementia (PwDs). In a multiphase codesign process with six (6) ICPs, we envisioned how AAL could be situated to complement their care. We used our codesigned “caregiver interface” artefacts as triggers to facilitate envisioning of AAL support and unpack the situated, idiosyncratic context within which AAL aims to assist. Our findings suggest that AAL should be designed to support ICPs in fashioning “do-it-yourself” solutions that complement tacitly improvised care strategies and enable them to try, observe, and adapt to solutions over time. In this way, an ICP could decide which activities to entrust to AAL support, when (i.e., scheduled or spontaneous) and how a system should provide support (i.e., using personalized prompts based on care experience), and when adaptations to system support are needed (i.e., based alerting patterns and queried reports). Future longitudinal work employing participatory, design-oriented methods with care dyads is encouraged.

UnderstAID, an ICT Platform to Help Informal Caregivers of People with Dementia: A Pilot Randomized Controlled Study

“…Anyhow, expressing this desire is only a declaration of intentions that many times cannot be executed due to the economic crisis that affects worldwide, hence the need of creating new tools to ease the duties of these caregivers in a cost-effective way and consequently improving their quality of life. Information and communications technology (ICT) in the frame of AAL interventions is a promising treatment not only for people suffering from cognitive decline, thus slowing the evolution to dementia [37], but also for patients with dementia and their informal caregivers [19]. According to a recent review of the emerging role of smart technologies in dementia care, patients can benefit by maintaining their cognitive skills and social interaction while the informal caregivers are the vast majority target group for telemedicine [38] as it happens with the understAID application whose main target group are the informal caregivers of people with dementia.…”

“…ICT can support ambient assisted living (AAL) interventions to enable older adults to age at their own home and their communities. In fact it has been already suggested that AAL interventions not only could assist the informal caregivers and their relatives with dementia, but also can alleviate their transition to a situation of greater dependency while the disease evolves [19]. …”

“…These kinds of interventions can assist informal caregivers by offering them relevant education, support, and training at home with a relative low cost and with the possibility of customizing the activities and contents they wish to consult or even when they would like to obtain this support according to their availability, preferences, priorities, or emotional state [19]. …”

“…Based on the review of McKechnie et al [24], we hypothesized that the use of this application would reduce the depressive symptomatology and improve the wellbeing and coping skills of the relatives and according to previous research [19] it would have a positive impact on their competence and confidence as caregivers by complementing the care provided by them. This study had different aims: (a) to test the technical and pedagogical specifications of understAID, (b) to assess the satisfaction of the caregivers with the application, and (c) finally to evaluate the impact on the psychological status of the participants.…”

Assistive Technologies to Address Capabilities of People with Dementia: From Research to Practice

“…A positive impact is the increased caregivers awareness of their remaining abilities and reducing the potential of a person to be seen as a victim (Jury, 2016;Swaffer, 2014). AAL environments can be designed to support informal caregivers in fashioning "do-it-yourself" solutions that complement tacitly improvised care strategies and enable them to try, observe, and adapt to solutions over time, decide which activities to entrust to technology support, how a system should provide support and when adaptations are needed (Hwang, Truong, Cameron, Lindqvist, Nygård and Mihailidis, 2015). 4.5 Usages and appropriation of technologies by people with dementia Within the biopsychosocial model of disability, technology can be viewed as an enabling tool to promote autonomy and citizenship of a person with dementia throughout daily life activities.…”