Matching values to technology: a value sensitive design approach to identify values and use cases of an assistive system for people with dementia in institutional care

Abstract

The number of people with dementia is increasing worldwide. At the same time, family and professional caregivers’ resources are limited. A promising approach to relieve these carers’ burden and assist people with dementia is assistive technology. In order to be useful and accepted, such technologies need to respect the values and needs of their intended users. We applied the value sensitive design approach to identify values and needs of patients with dementia and family and professional caregivers in respect to assistive technologies to assist people with dementia in institutionalized care. Based on semi-structured interviews of residents/patients with cognitive impairment, relatives, and healthcare professionals (10 each), we identified 44 values summarized by 18 core values. From these values, we created a values’ network to demonstrate the interplay between the values. The core of this network was caring and empathy as most strongly interacting value. Furthermore, we found 36 needs for assistance belonging to the four action fields of activity, care, management/administration, and nursing. Based on these values and needs for assistance, we created possible use cases for assistive technologies in each of the identified four action fields. All these use cases already are technologically feasible today but are not currently being used in healthcare facilities. This underlines the need for development of value-based technologies to ensure not only technological feasibility but also acceptance and implementation of assistive technologies. Our results help balance conflicting values and provide concrete suggestions for how engineers and designers can incorporate values into assistive technologies.

Smartwatch-Based Interventions for People With Dementia: User-Centered Design Approach

“…There can be conflicting needs both interindividually and intraindividually. This inconsistency in the statements is not due to cognitive deficits but reflects ambivalent attitudes that exist in all people to a greater or lesser extent [ 29 ]. We emphasize that unreliability in certain individual cases should not be a reason to prevent the whole group of patients with dementia from participating via self-reports [ 51 ].…”

“…We also addressed the issue of technical assistance, design ideas, and circumstances that promote or hinder the acceptance and adoption of existing and potential future technologies. We applied qualitative content analysis according to Mayring [ 28 ] to analyze the material (refer to the study by Köhler et al [ 29 ]).…”

“…On the basis of the analysis of needs (step 1 in Figure 1 ), we conducted an intervention study that aimed to increase certain daily activities by prompting the participants. We have published the results of the interviews elsewhere [ 29 ]. The core element of this paper is the results of the intervention study, which represents the final part of the SAMi study.…”

“…We decided to prompt participants to engage in 1 task each from the “activity” and “nursing” fields [ 29 ]. We implemented short instructions that completely appeared on the smartwatch’s screen.…”

AI-assisted ethics? considerations of AI simulation for the ethical assessment and design of assistive technologies

“…Patients and professionals might differ regarding the criteria of acceptance of such technological guidance ( Buhr and Schweda, in prep . ; Köhler et al, 2022 ). Values such as autonomy (of the person with dementia), privacy (of the user but also of other residents), safety, wellbeing, and costs (e.g., professional time) are balanced or prioritized differently across different stakeholders, as an empirical ethics study revealed ( Buhr et al, under review ; Welsch and Schicktanz, 2022 ).…”