What Help Do Older People Need? Constructing a Functional Design Space of Electronic Assistive Technology Applications
Dennis Maciuszek, Johan Aberg, Nahid Shahmehri · 2005 · Proceedings of the 7th International ACM SIGACCESS Conference on Computers and Accessibility (Assets '05) · doi:10.1145/1090785.1090790
Summary
This paper constructs a functional design space for electronic assistive technology (EAT) applications aimed at frail older people, providing both users and designers with a common framework for choosing and producing relevant EAT. The researchers conducted a multi-site field study across Sweden and Germany involving six informant groups: aging researchers (pilot study), caregivers at a German home care service, German caregivers from retirement homes and a nursing home, German elders at a retirement home and assisted living facility (mean age 85), Swedish elders and carers at a retirement home (ages 70-95), and a focus group of German caregivers. Methods included individual interviews (30-90 minutes), questionnaires, presentation of short film clips showing care scenarios, use-scenario design exercises, and participatory observation using "quick and dirty" ethnography. The design space has two dimensions: needs (what the older person requires help with) and patterns of assistive interaction (by what means an application assists). A specific EAT application is characterised as a pair of one need and one pattern, evaluated across four features: importance, correlation (how well the pattern fits the need), reusability (how many different needs a pattern supports), and interconnectivity (how well patterns work together).
Key findings
The study identified 20 categories of needs organized in a hierarchical taxonomy covering personal hygiene, toileting, mobility, kitchen work, using technology, shopping, laundry, housekeeping, medication handling, administrative tasks, health, safety, emotional concerns, social contact, recreation/education, physical difficulties, and cognitive difficulties. These mapped strongly to Maslow's hierarchy of needs, with deficit needs (physiological, safety) requiring fulfillment before being-needs (social contact, recreation, self-actualisation). Fifteen patterns of assistive interaction were identified: operator, mediator, supplier of activities, communicator, listener, monitor, reminder, guide, locator, informer, trainer, supplier of objects, recommender, reinforcer, and participator in activities. The eight most valid pattern-need pairings included operator (caregiver does difficult tasks), monitor (watches for unusual situations), reminder (prompts about upcoming tasks), and guide (explains how to do things). The operator pattern had the highest reusability (15 need categories) and was the dominant pattern in human care. For safety needs specifically, a majority preferred a high-automation operator over a low-automation guide. Several carers described a telecare model where users could contact a human assistant via video as a desirable alternative to fully automated systems.
Relevance
This work provides a practical planning tool for anyone designing or selecting assistive technology for older adults. The design space framework — mapping needs to interaction patterns with ratings for correlation, reusability, and interconnectivity — helps designers avoid the common trap of being technology-driven rather than need-driven. The finding that needs map to Maslow's hierarchy offers a principled way to prioritize: deficit needs (safety, medication, hygiene) must be met before addressing being-needs (social contact, recreation). For accessibility practitioners, the 15 interaction patterns provide a vocabulary for describing what assistive technology does functionally, independent of specific implementations. The pattern approach also enables a software architecture vision where patterns map to reusable multi-agent software components that can be composed into personalized applications. The study's observation that many carers and elders were skeptical of technology ("This is Utopia. Maybe in 50-100 years.") while simultaneously describing concrete needs that technology could address underscores the importance of involving end users in design and demonstrating tangible benefits rather than technological possibility.
Tags: aging · assistive technology · design space · ageing in place · activities of daily living · user-centered design · field study · design patterns · caregiving · smart home