New & Emerging Technologies for Old & Ageing People

1. New & Emerging Technologiesfor Old & Ageing People Louis Neven - Avans University of Applied Science

2. Introduction • Dr. Louis Neven – Lector Active Ageing • innovations for active older people • U Twente, U Lancaster, U Utrecht -> Avans Hogeschool • STS/Innovation Studies: has a lot to do with sociology • Sociologists study the everyday lives of people and their functioning in their surroudings, social ties, families, laws, norms, values, role patterns, cultural connections etc. • I study how this relates to technology; i.e. the relation between people and technology • You could say I am a Sociologist of Technology • Would you rather be a sociologist of technology or an engineer? • You are both!

3. Because you make User Representations(Akrich 1995) Imaginations of the future user - Who is this person? - What do they do? - What do they look like? - What do their lives look like?- What do they think is cool?- What do they think is wrong? - What problems do they have? - What do they like? Etc. You form a mental image of who the future user of a technology will be. This is a user representation. And this matters. A lot.

4. User representations • User representations are important • They influence the design of technologies • Effect acceptability, appropriation and use of technology • May lead to forced use, stigmatization and other ethical problems if you get it wrong • If you get it right: Key success factor in design for end users • Particularly older people, which is the topic of today • Illustrate this with the case of robots for older people • break • 7 suggestions for the design of technologies for older people • But first a short introduction to ageing

5. Should you be interested in Ageing? • 1 in 9 persons worldwide is currently above 60 • In 2050 this will rise to 1 in 5 (UNFPA 2012) • In western societies currently 1 in 6 is above 65 • In 2060 this will be nearly 1 in 3 (EC 2012) • In the Netherlands currently 2.500.000 people are above 65 • and 800.000 are above 80 (CBS 2011) • Which is before the retirement of the vast majority of the baby-boom generation • EU: ageing is a “grand challenges” for Europe • Ambient Assisted Living: investment in assistive technology for older people (measured in billions) • In addition: older people are relatively affluent • And will increasingly provide for their own care (technology) • The “silver market” is going to be very big

6. One area of investment: Robots & Older people: aibo

7. Robots & older people (2): Paro

8. Robots & older people (3): Ifbot

9. Introduction • So the development of robotics – and for that matter other technologies as well – for older people is big business • How is the older user of a (health) robot represented in the development of such a robot. • Focus on a laboratory test with a human interaction robot (iRo)

10. iRo – a human interaction robot • IRo • Small and immobile, sits on table • Speak to iRo in plain Dutch, will reply likewise • Facial expression, emotional responses • Can be programmed to do various tasks • E.g. set alarm clock, remember people to measure blood pressure, provide companionship • In this case programmed as a game companion • Cognitively challenging games • Study of a test with iRo and older test participants • Analysed the way the older user was represented in these tests • Multi-method approach: interviews, observations, document analysis

11. Developing iRo & learning about (older) users • Dutch multi-national company • Technologies for health and well-being • Increasing focus on older users • iRo developed by research department • Research prototype to study human-robot interaction • With a view to further development into a product • Knowing the user • Literature review, workshop, consultation with experts • Learning about practices: testing

12. The tests • Two rounds of tests: • Laboratory test • Field test • Participants • 65 years and older, living in single person household, equal gender distribution, cognitively healthy • Goals: technical, easy to use, enjoyment, recruiting for field test • According to researchers tests went well • A few problems, participants enthusiastic about games, generally liked iRo

13. User Representation: Needing and wanting iRo • Ageing society • Number of older people is growing, cost of (health) care is increasing, shortage of qualified care workers • Older people want to live independently as long as possible • Quality of life may be reduced when they live alone • Older people worried about their mental health • Robots • Practical assistance, which allows people to stay at home • Intellectual and emotional companion older people can bond with • Older people seen as needing, but eventually also wanting robots • Clear-cut case for the development of robotics • Researchers not the only ones making user representations

14. Test users have a different image ‘I still lead too much of an active life; I’ve always been amongst people. I don’t need an iRo, not yet anyway.’ (Mrs. A) ‘I collect old army radios, you see. (…) I don’t need to be kept busy. But I think there are plenty of old people sitting behind their geraniums who need to be kept busy, for them it would be good.’ (Mr. B) ‘If you were, say, old and growing demented, then I could imagine this being a good thing, but for me? (…) You’d have to be a lonely old person, chained to your home with few contacts. I still go to my checkers club.’ (Mr. C) • 10 out of 12 participants gave this response

15. Test users images: how not to be old and lonely • For the participants, iRo was a signifier of old age, loneliness and needing care • Participants did not see themselves as such • Active dissociating from ‘old people’ • Presented themselves as (socially) active, independent, and physically and cognitively healthy • Researchers attributed reaction to the media

16. Being helpful and not old • Participating in the field test • Counterintuitive • Participating in tests to help other, older, people ‘I think it’s fun and interesting, not because I want one but to help somebody else. I like that (...) I think I am helping people with this.’ (Mrs. D) • Position themselves as active, healthy, altruistic, helpful older people, seemingly (still) untouched by the negative consequences of aging. • Further widening the gap with the perceived prospective user of iRo

17. Researchers’ responses • Taken into account in a very limited way • Downplaying of responses • Cause is media • Quick fix: early introduction of iRo • Keeping responses from skewing the results • Additional user representation: what older people are like as test users • Hard to recruit, not open, turn up early, take more time, an outing, limited attention span, quite easily overburdened, more explanation • older participants are thus positioned as different and difficult • Thus created a setting in which they could negate the participants ideas about the imagined user of iRo.

18. Conclusion • Representation of being old and frail could lead to resistance and non-use: problems of appropriation • Reflecting on representations into account could prevent ageist designs • More reflexive redesign of technologies, better adapted to the practices and identities of older users • A smart designer does not just know the technology, but knows his (older) users as well • That is not particularly easy, but it is very important, if you want to produce a successfull innovation • Questions about this case?

19. What are older people like? And how to design for them?

20. Seven Suggestions for Design (1) Reflect on cultural representations of older people • Cultural representations of ageing • Images of older people (e.g. in the media): all the same, frail, ill, grey, slow, lonely, cost a lot of money, don’t contribute, (cognitive) health problems, but deserve respect. • While older people are very diverse • Ageism: Most accepted – and understudied – form of discrimination • Internalisation by older people themselves • Particularly: The ageism of good intentions • Example: Belgian ING bank • Beware of normative elements in “innovating for older people”, they may lead to lack of reflexivity with regard to user representations of older people (and thus flawed technologies)

21. Seven Suggestions for Design (2) Reflect on the effects of the ageing-and-innovation discourse • Very dominant discourse in the context of technology & ageing • Crisis account: People are getting older, increased need and costs of (health) care, too few care workers to care for older people. • This can be solved with the introduction of new technologies • Triple win • Positions people as ill, frail and in need of help • Move beyond this reasoning, and provide better arguments • Beware of positioning people as old, lonely and frail • Also chances: Tap into third age repertoire of successful ageing • EVEN if people ARE a bit frail or need help with some things • an example

22. Examples 1: Nordic walking sticks (1)

23. Examples 1: Nordic walking sticks (2)

24. Example 1: Nordic Walking sticks (3)

25. Seven Suggestions for Design (3) Older people are not technologically illiterate • Older people have a different technological literacy • In a sense older people lead highly technological lives • More technologies and expertise (then you might think) • Potentially more dependent of technologies • More likely actual cyborgs (pace-makers & other implants) • More technologies during their lives (increased reflexivity) • Different technological generation (Docampo Rama 2001) • Software, electro-mechanical, mechanical generations • Although they may not be as apt in using current technologies, older people are far from technologically illiterate. • Tap into the literacy that they do have (the case of Cees)

26. The case of Cees €300,- Innovation?

27. Seven Suggestions for Design (4) Some older people can participate in design processes • Secondary representations • what older people are like as participants in design processes • ‘quickly overburdened’, ‘can’t think conceptually’, ‘please-me answers’, ‘don’t know what’s possible’, ‘discard options beforehand’ • These are often homogeneous images, but older people are divers • Some older people are very capable of participating in design • Morecambe, Preston • Find them, cherish them, pay them • Thus generating alternate views of older people (also pr) • Older people as experts • Where are the older designers? (mining engineer and army radio man)

28. Seven Suggestions for Design (5) Reflexive design • Risk of naturalisation/normalisation of bad design • Engraining exclusion, passivity, lack of options • Some use of technology is forced!! • Especially for older people • If stereotypical and ageist ideas about older people form the basis for the design of technologies for older people, these technologies may further reinforce and naturalise these stereotypical and ageist ideas • Thus reflexivity with regard to the way older users are represented in design processes and the way these images are built into technology is called for

29. Seven Suggestions for Design (6) Adaptability as an essential pre-requisite • recognise that singular images of older users are simplifications • even though older people are often seen as a homogeneous group • Older people and their practices are diverse • Practices, health conditions change • (other) new technologies are introduced → allow for adaptability by people with different technological literacies (as older people, care workers, informal carers may have) • Some older people may have more skills for adapting technology than you might think

30. Older people as lead-users (not laggards)(Vivette van Cooten, Louis Neven, Alexander Peine)

31. Seven Suggestions for Design (7) Resistance as input for design • Resistance may be the result of the (implied) user representation • Allow for resistance, non-use, selective use, “sabotage” etc. • Study forms of resistance as they are instances of reflexive learning on the part of the user about who she or he is, what she or he wants, needs, prefers, dislikes etc. • “Small” or “insignificant” issues can have big impacts on how a technology and the user is perceived • Consider resistance in the context of appropriation • Example: the problems of appropriating iRo

32. ‘But obviously not for me’ User representations can be designed into technologies Potentially ageist results They may then affect use practices And (older) people may reject a technology Failure is expensive understanding (older) people leads to more sophisticated user represen-tations A key to a successful design Suggestions for representing older people Reflect: cultural representations of ageing Ageism of good intentions Reflect on Ageing & Innovation discourse Third age views provides options Older people are not tech. illiterate Older people can participate in design Reflexive Design Adaptability as pre-requisite Resistance as input Wrapping up

33. Opdracht • Hoe kun je zien dat het een ontwerp voor ouderen is? • Wat veronderstelt dit over oud zijn? (user representations) • Stel je de vraag: hoe zou ik het vinden als iemand dit voor mij ontworpen had? • Zoek 5 technologieën voor ouderen (beeldmateriaal) • Als je zelf oud was, hoe zou je het ontwerp dan veranderen? • Voorbeelden technologieën • Doro telefoons, andere ouderen telefoons • Telecare systemen en andere monitoring apparatuur • Multifunctionele Beeldbelsystemen voor ouderen • Hulpmiddelen (ouderenwinkels, welzorg) • Etc.