“There are a lot of technology solutions that have the potential to help older adults, and people with dementia and their caregivers,” says Dr. Julie Robillard. “The problem is, most of them don’t get used. Technology that stays on the shelf doesn’t benefit anyone.”
A new analysis by Dr. Robillard, Assistant Professor of Neurology at the University of British Columbia and scientist at BC Children’s Hospital & BC Women’s Hospital & Health Centre, and Dr. Ian Cleland and Dr. Chris Nugent at Ulster University in Northern Ireland, along with Dr. Jesse Hoey at the University of Waterloo, found that despite the possible benefits to older adults, tech tools that range from smartphone apps to websites to intelligent assistive technology including robots are often designed without feedback from this important demographic, which ultimately means the intended user is not adopting the technology.
“Some of the technology solutions on the market can have a positive impact in the lives of people with dementia and their caregivers,” says Dr. Robillard, who conducted this work at the Djavad Mowafaghian Centre for Brain Health. “They can support autonomy, improve safety and decrease caregiver burden. But it’s critical that these technologies are designed to meet the needs of older adults, rather than solve problems that researchers and developers who do not have experience with aging or dementia perceive to be important.”
“To be effective,” says Dr. Robillard, “technology solutions need to be informed by research and by the priorities of older adults and their care partners, and need to align with them on an emotional level.”
“The one-size fits all approach doesn’t work well for an older adult population. If you are designing an assistive technology, such as a robot to help with cooking, for example , you can’t imagine that the same robot will work just as well for a retired chef as it would for a former engineer,” explains Dr. Robillard.
Varying levels of familiarity with computers, individual preferences, and changing moods all need to be factored in to how technology interacts with its end-users.
“We have new and exciting tools in our toolbox now: adoption modeling, machine learning, artificial intelligence – these tools, when applied using key ethical principles, can help us create technology solutions that will become readily adopted and will greatly benefit our older adult communities.”
With this in mind, Dr. Robillard and her collaborators have offered new guidelines for tech developers intent on building technology tools for older adults. Published today in Alzheimer’s & Dementia, the journal of the Alzheimer’s Association, Dr. Robillard and colleagues offer 18 practical guidelines for the development of tech initiatives to ensure that older adults and people with dementia and their caregivers find the tools useful and successfully incorporate them into their daily lives.
Dr. Robillard’s team identified five priorities to inform better design, and to provide a framework for developers to identify gaps in their own processes.
Priority areas for designing tech tools for older adults
Inclusive participatory design
Engaging users in the design process will enable the end product to more closely align with user needs.
- Does the tool solve a real problem?
- Does it consider the limitations of older adults, such as variability in comfort with and aptitude for using tech tools?
- Does it anticipate user challenges with visual cues or audio?
- Does it benefit both the user and their companion or caregiver?
Creators of tech tools must recognize that human emotion plays a significant role in how people make decisions.
- Are there stigmas associated with the tool that might be barriers to adoption?
- If there are prompts, what tone do the prompts use? For example, are the prompts neutral in language and tone, or are they associated with a particular mood? How will that mood align with the user as they experience the prompts?
- If the tool is intended for older adults or as an assistive tool for those experiencing cognitive impairment, has the user interface and workflow been tested on older adults or people with dementia and their caregivers?
A better understanding of user groups will allow developers to identify and avoid barriers to adoption of the end product.
- Who might use the tool, and who might not?
- What are the reasons someone might not use the tool, and how might the benefit if those reasons could be overcome?
- Do any barriers that exist seem more significant to a specific population, and how might those barriers be anticipated and avoided in order to convey the benefits to those groups?
Ethical standards assessment
For dementia in particular, technology must adhere to ethical guidelines to protect privacy, avoid conflicts of interest, promote informed use, and discourage over-reliance on the tool.
- Does the tool ask the user or their caregiver to provide informed consent before submitting sensitive or personal information?
- Is the consent mechanism clear and direct?
- Does the tool respect the user’s autonomy?
- Are the funders and conflicts of interest clearly stated, if appropriate?
- Are claims associated with the tool’s benefits stated without hyperbole? Are the limitations of the tool clear to the user?
Education and training
For technology to be useful to older users or those with dementia, the tool should be useful to its full potential with minimal training or familiarity with tech tools as a prerequisite.
- Will adopting the tech be easy, or will it frustrate users with less experience?
- How much learning is involved in adopting the tool?
- Does the experience of learning to use the tool take into consideration varying degrees of familiarity with modern technology?
- Is technical support available for users who are struggling?
The pace at which new products and applications are coming to market is accelerating, especially in the health sector. It will be increasingly important over the coming years to ensure that new technologies designed for older users take a user-led, participatory approach through the entire development process in order to ensure these tools are useful and engaging to their intended audience.
“Thankfully, we are not starting from zero,” says Dr. Robillard. “Many companies and researchers are doing great work, and involving end-users in the technology development process is increasingly the standard. We are hoping that our recommendations can serve as a checklist of best practices, bridging high-level thinking with the day-to-day realities of tech development. If we combine recent advances in what technology can achieve with mindful and ethical development practices, the future of health technology looks very promising.”