Interaction around throwbacks creates happiness
Problem
As the number of elderly is growing, so grows the number of people suffering from memory diseases. Providing individual high-quality care for all is a challenge widely recognized. Especially fulfillment of mental needs of the elderly and their psychological well-being has been a subject of lively debate in public over the last few years.
In University of Tampere's & Futurice's, Let’s Re-Design Health Services -course, the client company Espericare ltd, specialized on care and housing services, gave the course attendees task of creating some kind of entertainment service for stimulus purposes for their residents who have different severe conditions of memory deceases. The workshop course organized students into randomized teams that would design service concepts to present at the end of the course.
Elderly adults suffering memory diseases require brain-activating stimulus and most important of all suitable entertainment. Especially in the case of Alzheimer patients, difficulties in creating a connection and a lack of motivation towards activities make this a particularly difficult task.
Solution
Facilitating connection between people with memory disorder and caregivers was in the core of Aikakone (Time Machine). As a web-service, Aikakone can be used anywhere, with bed-tied patients or with a group of people by a TV set, anytime, in short periods of time, and with anyone, with healthy senior citizen as well as a strongly cognitive impaired people, as a method of meaningful connection by building a bridge between generations.
Taking elderly person back to the old times by combining pictures, sounds and texts all telling the same tale, which provides multisensory stimuli that retrieve memories. This kind of conversation inspired by old photos, sounds and music, is called reminiscence therapy, a method with scientifical merit of decreasing depression in older adults. It improves self-esteem, as the persons can act as an expert on their own life instead of being mere objects of care.
Process
In Service Creation we followed Futurice Ltd’s Open Source Lean Service Creation canvases on organized sessions, this process was supported with expeditions to client company Espericare Ltd premises and meetings on our own, here’s roughly how it went:
- Including but not limited to:
- Business approach
- Existing Solutions
- Academic studys
- Contextual inquiry
- User Research
- Semi-structured Interviews
- Use Cases
- Paper mockups
- Service blueprint
- Minimum lovable product
- Digital mockup
Logistics
My Role
- Service Design
- UX Research
- Interaction Design
- User Testing
Research
After the first session of team forming and canvas work. We visited a facility of the client company Espericare for a contextual inquiry acompanied by Futurice employee. We got impressions of the facilities, took pictures, drew a floor plan of the area users inhabit and asked questions from the staff and residents. We would return later to do more structured interviews and perform a test with paper prototypes.
Meanwhile on our own we looked at existing market solutions, concepts of entertainment and ways to spend time with cognitive impaired people. Interesting idea we came across reminiscence therapy. Form of therapy that has been shown to improve the attitude of caregivers towards their patients. This is assumed to be due to caregivers’ increased knowledge of their patients’ backgrounds and personalities. Often in care homes, the turnover of personnel is quite high, which raises the need of a tool for such familiarization even more pressing.
Key takeaways from research, location visits, interviews and user needs:- Dementia/Alzheimer diseases increasing and growing concern about quality of health care systems.
- Nurses don’t have sufficient time to engage individually and it’s difficult to get patients excited in common activities.
- Residents are not able to tell about themselves so nurses have a hard time to get to know them and their history.
- Introduction to new nurses about the resident’s preferences is relies almost completely on coffeetabletalk.
- Family and friends of the residents want to do something for the resident’s benefit.
- It was hard for the nurses to get the residents excited about existing entertainment and stimuli options.
- Stimuli session should be something that is quickly started, because time to perform stimulus is scattered in to small time windows during shifts.
- Some of the residents were in poor health and spend most of their time in their own rooms.
Design
In our vision, as a result of well-performed care, the elderly are surrounded by people who know them by their individual qualities, not just by their diagnoses. Every day brings the elderly meaningful interaction and positive moments that include a caring human contact.
We introduced Aikakone (Timemachine) a tool for reminiscence therapy and entertainment with features of shared history (Aikakone), personal history (Elämänkaari), profile of and elderly person (Profiili), pictures of aikakone in categories (Kuvat), musicplayed with old enjoyable tunes (Musiikki), animal, baby and other videos in Videot.
Instead of old people using the service alone by themselves, a facilitator uses it with them. This person can be a nurse, a relative, a friend or a voluntary worker. By encouraging the involvement of these people, the service may even multiply the quality time spent with the elderly.
User Interface
As the course was service design focused, creating an MVP design was critical for the course presentation. Here the first ever digital draft of the concept, done in Microsoft PowerPoint of all the possible design tools available. 😎
Main focus of Aikakone was to present common memories that would resonate with elderly persons with memory disabilities and spark a conversation with a nurse, family member or a volunteer. With multimodal output of a visual and related auditive que for the elderly. The text is mostly for the companion to provide context and words to encourage conversation about the subject as nurses are often fairly young and unfamiliar with such topics.
Profile offers care givers a glimpse to character of the person they interact with. Filled in by family members and added to by nurses. Profile expedites the process of real caring and connecting between new staff members and residents.
Prototype
In the spirit of lean, I suggested to the team while we were still doing research that we try reminiscence idea. I performed this by printing out images from different decades from the web and engaged the elderly in talks after they had a moment to themselves to take the image in. I sat close next to them on a bed to be on the same side and in ease. The talks went fine, I had a decent success of guiding their attention to the image and got a reminiscence response from them and shared a few laughs.
Close to the end of the course we visited Villa Niemi to perform prototyping of our PowerPoint made MVP. We let the nurses get a feel to the concept by making the PowerPoint presentation to work like an app, they would get to “test” Aikakone in a guided session.
Then interviewed them about feasibility. How would they use this kind of application? What would be most important? How well would it suite for stimulation purposes? We also asked them to reflect on when and for how long would they see themselves using the application with an elderly person.
Conclusion
In nursing homes, time is often scattered in small fragments. Our service can be used efficiently also in short times like 20 minutes, which enables nurses to provide patients with more stimuli with the same amount of resources as before.
We were remarked as the second best concept in the course on the presentation day, based on vote by judges from Espericare, University of Tampere and Futurice.
Lean Service Creation taught me to think about creating services from outside-in perspective. It was my first glimpse into business goals and limitations, segmentation to concept and value proposition and even thinking about customer engagement. It inspired me to study 25 credits worth of customer centric marketing.
More of the story
After positive feedback from Futurice, course mates and most importantly usability tests, we stuck together and started developing the concept into a working software. We entered into an incubator program and with encouraging, but cautious feedback from mentors we were on track for forming a company. This is more or less where our courage gave out and our execution was inadequate. In hindsight our mental state approached the project more from a hobby project perspective. The fact that teams were randomized in the course factored into our team chemistry and sparks flew every once in a while. Everybody believed in the product, but the team was off and push to market ultimately failed, so we decided to go our separate ways after 8 months of development and user testing.
Next Project
Kiva Kaupunki
From thoughts to action...
