Ash at CIID

Ashwin Rajan's blog while at the Copenhagen Institute of Interaction Design.

User Research in Elderly Homes in Copenhagen

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Some weeks ago, CIID pilot year students conducted user research in five elderly homes in Copenhagen based on the following brief: ‘the study aims to create a deep understanding of user needs in different situations between residents and staff in old people’s homes, in order to design screen based technologies that can make life better for both groups.’

The three themes we focused on were:

  • What is important for the elderly and staff in terms of improving the SOCIAL LIFE of the elderly?
  • What is important for the elderly and staff in terms of improving PHYSICAL ACTIVITY of the elderly?
  • What is important for the elderly in terms and staff in terms of creating AUTONOMY for the elderly in their everyday life?

The team I was with visited two old people’s homes: Plejebo and Aftensol. The observations recorded from the homes differed considerably. But in compiling a list of final observations, we listed those that seemed to stand-out and proved most ‘interesting’ – both in terms of capturing critical or core needs of the residents, as well as in defining a full-bodied ‘opportunity space’ for design.

An informal chat with a elderly resident.

An informal chat with a elderly resident.

The following are only some of the exceptional learnings and observations from the two field trips (not in order of importance):

– The carer was continuing a conversation with one of us when one of the elderly was choking on food.
– A carer reported how sometimes the resident men try to get one of the resident women into their room (indicating a continuing desire for sexual contact even at average ages of seventy and above).
– The residents have ‘olympics’ competitions against peers from other old age home, and look forward to such social occasions with enthusiasm.
– There is an old gentleman who is an alcoholic, but gets taken out to a bar from time to time by one of the carers for a break.- These places are the very definition of ‘assisted living’.
– A lady could not read the activity board (which was supposedly an important social glue bringing together people for events), and as a result didn’t know anything about the various activities going on in the home.
– A aged resident lady, who was a ballet dancer, was put in the elderly home by her younger husband, who drives a taxi by night and cannot take care of her.
– The residents are depressed during the first weeks of arriving in the old age home, the period typically understood as the most difficult in adjusting to their new lives.
– Emmy was angry she could not play bingo when she wanted to.
– One of the residents wanted someone to read aloud to her.
– There was a strong need for simple devices, such as simple and intuitive communication devices.
– It was clear they were losing the ability to remember day-to-day things as well as motor skills.
– The resident’s rooms or apartment are usually full of photos.

In a resident's room.

In a resident's room.

Some of the important quotes that inspired us:

– “Today is a good day” – Resident, Female, 83 years old
– “I never use it” – Resident, referring to the emergency tug rope in her room which pages carers.
– “Would be good if Tilde got on it and just pressed start …” – Gym instructor, referring to lack of customization options on the gym equipment like the treadmill.
– “She wasn’t able to stand … she has grown younger now.” – Carer, referring to the particular extraordinary case of a resident who had purchased a motor scooter, acquired the proper license and went riding it outside the old age home on her own.
– “These are the only things that I have left” – Resident, referring to the meager belongings in her room.
– “I miss my home” – Resident
– “They live so far away” – Resident, referring to her immediate family
– “There is not always room for all of us” – Resident, referring to the weekend car trips around Copenhagen that are run by the home.
– “The food was horrible, but it was so much fun”  – Resident, referring to
– “I can’t find the radio channels I am looking for” – Resident, referring to her digital radio
– “When you turn chores into activities, it keeps them going” – Carer, on making chores fun for the elderly
– “Everybody needs to be close to someone and that’s easier if they smell nice” – Carer, on caring for the residents
– “We need to help them to remember their identity” – Carer
– “Its important to give them a future” – Carer
– “They need to be stimulated by peers” – Carer
– “I want to go to Sicily. I want to propose is to the trip council” – Resident, commenting on her choice of holiday
– “I got my ceramics exposed downstairs” – Resident, proud of her work which was displayed in the ground floor hall
– “Sure, I like to dance” – Resident
– “We call ourselves the elite group” – Resident, who was one the few ‘elite’ – those considered most participative and good at working out in the home gymnasium.
– “My grandson, he is a graphic designer” – Resident.

Initial observations and evidence support brainstorming for insights.

Initial observations and evidence support brainstorming for insights.

In an effort to better understand our observations, the team re-framed the needs of the elderly based on observations in the following ‘Help-me-to’ statements:

  • Help me to cope with my first fifteen days in the home.
  • Help me to watch my favourite TV shows without interruption or disturbance.
  • Help me to spend more time with young people.
  • Help me to have familiar people come back.
  • Help me to view the activity board, and know more about the activities in the home.
  • Help me to remember my day-to-day present better.
  • Help me to keep active and have more happening in my life.
  • Help me to have more of the life that I did not have before I was committed to this facility.

What did it all mean – insights?

Based on its observations, the research team arrived at the understanding that the following needs were shared by the elderly and the carers:

  • Dignity
  • Pride
  • Ownership
  • Identity
  • Autonomy
Rough first draft sketch of the framework.

Rough first draft sketch of the framework.

The team developed this set of core needs into a ‘framework of interdependence between residents and carers’, as shown in the image above. The framework reveals the critical feedback loop between the elderly and the support staff. Inputs from the carers include help with everyday chores, appearance and hygiene, tenderness in caring etc. If this effort on the part of the carers is successful, then it works to fulfill some of the needs of the elderly as outlined above – a sense of identity, dignity etc. In turn, the joy, trust, and autonomy experienced by the elderly provide positive feedback to the carers, who experience a sense of purpose and motivation in life and increased job satisfaction.

Further, the team learnt that each elderly person has his or own unique needs when it comes to achieving this joy and satisfaction, in other words an enhanced sense of ‘autonomy’, and termed that subtle enabling point their ‘autonomy sweet spot’.

Chief insights framework illustration.

Chief insights framework illustration.

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Written by Ashwin Rajan

December 16, 2008 at 12:03 am

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