How can we increase sociability amongst elderly through Interaction design?

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How can we increase sociability

amongst elderly through

Interaction design?

Felix Lindén

Interaktionsdesign Bachelor 22.5HP Spring/2019

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Abstract

This project explores social isolation and loneliness among elders. The goal of the project is to increase sociability among elders. The methods are based on a user-centered approach and with qualitative research and quantitative data generated. As part of an interaction design study. Theories about what has been done in the field are presented and related work to get an understanding of the field. The insights gained from the empirical study define problems in the design process, from the interviews and survey. In the design process methods that are used to create ideas are presented as well as the result. The design process presents nine concepts as a solution to the research question. The conclusion and discussion present new ideas and thoughts on how the project might have been taken in a different design approach and exploration.

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Acknowledgment

I would like to thank all of those who have participated in my workshop and those who also participated in my interviews and survey.

Thanks to my supervisor Jens Pedersen who guided me through the entire project.

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Table of content

1. Introduction……….…….………7

1.1. Background……….……….7

1.2. Purpose……….……….7

1.3. Delimitations……….……….7

1.4. Intended target group………8

1.5. Research question………8

2. Methods……….8

2.1. Literature reviews………8

2.2. User-centric design (double diamond) ………8-9

2.3. Qualitative research……….………9

2.4. Surveys……….…………...10

2.5. Brainstorming………..………10

2.6. How might we………..………10

2.7. Ethics……….…………10-11

3. Theory……….….……….11

3.1. Assistive technologies………11-12

3.2. Social isolation and physical health………..12

3.3. Designing for elderly………..…………13-14

3.4. Related work………..…14-15

4. Empirical data and analysis……….……….15

4.1. Insights ……….…16-22

5. Design phase……….………….23

5.1. Outcome of research……….…………23

5.2. Design opportunities……….………..23

5.3. Workshop brainstorm………..…………24-25

5.4. Scenarios……….………..….26-34

5.5. Sketching ………..……….….………..35-38

5.6. Concept ……….…….……39-40

6. Discussion and conclusion………40

6.1. Discussion……….………40

6.2. Conclusion……….………40-41

7. References………..42-43

8. Appendix………..……..44-45

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Figure list

2-1 Double Diamond………9

3-1 InTouch prototype………..15

5-1 Scenario 1……….27

5-2 Scenario 2………...28

5-3 Scenario 3………...28

5-4 Scenario 4...29

5-5 Scenario 5...30

5-6 Scenario 6...31

5-7 Scenario 7………..32

5-8 Scenario 8……….33

5-9 Scenario 9……….34

5-10 Concept 1...35

5-11 Concept 2……….36

5-12 Concept 3………36

5-13 Concept 4……….37

5-14 Snapshot from workshop……….………....38

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Introduction

This thesis project is about social isolation among the elderly in a rapidly advancing world of technology. To explore design opportunities with the help of the field of interaction design by using interaction design. Elders become isolated through many reasons and can become lonely. With the help of research and design methods that are user-centric this project intends to produce possible design solutions. The purpose of the study is to increase sociability among the elders and so they are not digitally excluded in society.

1.1 Background

Social isolation and loneliness have many factors that are related. Studies have shown that both men and women are affected by this when they outlive, their partners and living alone (Wenger, Davies, Shahtahmasebi & Scott 1996). Loneliness associated with widowhood is reported in many studies and are the most intense when the person has recently lost their partner. Visits from one’s children can lighten the feeling of loneliness amongst those who are widowed. Seeing one’s children is linked with both loneliness and social isolation and sometimes they are unlikely to turn to their children when at times they feel lonely (Wenger et al., 1996). Studies show that loneliness does not only mitigate when you see your children but also that friend plays an important role to ease the feeling of loneliness. The lack of any frequency of any relationship affects the persons feeling of loneliness. Retirement is also linked with social isolation and loneliness since when one retires you loose part of your social connection related to that (Wenger et al., 1996).

As physical health and the impairment of mobility can get worse with age it is also associated with loneliness. Social isolation is linked with increased mortality due to that isolation is linked with depression and negatives health effects (Beaccker, Sellen, Crosskey, Boscart & Neves, 2014). People who become depressed and are lonely is connected to mental illness. Isolation can lead to mental health problems (Wenger et al., 1996).

1.2 Purpose

The purpose of this study is to research what challenges elders face when living socially isolated and to increase sociability among them. How it affects them and to try and find design opportunities in the field of interaction design to help to reduce the feeling of loneliness. Using methods to find design opportunities with the help of research. It will share insights on how to design for elders and working towards a more socially included society for elders that are socially isolated.

1.3 Delimitations

The research is limited to those who live socially isolated in Sweden. Although not all that live isolated are lonely the purpose is to find those who are. Interviewing elders at their home in the city of Malmö that are the age of 65 and older. The study is limited to the time period of the project. Almost all who is socially isolated lives alone but living alone doesn’t mean you feel lonely. They can have rich socially active lives

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1.4 Intended target group

The intended target group is those who live socially isolated in the age 65 and older, both men and women.

1.5 Research question

How can we increase sociability amongst elderly through interaction design?

Methods

2.1 Literature reviews

To create an understanding of the research topic one must review the literature and the previous knowledge surrounding it (Paré & kitsiou, 2017). Ones the research question has been formulated then there has to be made a decision if there is a need for a review. Ones the material has been gathered it has to relevant to the topic. Then one must extract the data that is relevant and from that, the data will then be analyzed and what has been learned from the data collected to move on what to investigate more in.

As aforementioned, the literature review was picked to get an understanding of the topic chosen. Since no prior knowledge was known about the topic. This would be a good starting point for the project. The data from the literature review is then to be analyzed and reviewed to then further investigate with the interviews. With the knowledge gained from the data then being able to formulate the questions to the elders.

2.2 User-centric design (Double diamond)

User-centric design is where the user shapes how the design takes shape in the design process. With the help of different methods. The goal is to make the design so that the user requires as little effort as possible to accomplish their intended task. The design does not only take into account the user who uses the artifact that is intended but also those who sometimes use the artifact as well. A wide range of stakeholders must take into account the design of the artifact. To establish the need for the user of the artifact interviews and surveys are to be made, collecting data for evaluation of the design (Abras, Maloney-Krichmar & Preece, 2004)

One method to use in user-centric design is the double diamond. The double diamond is divided into four phases, Discover, define, develop and deliver. Instead of only converging once the method does these two times instead to ensure that the design gets tested and fined tuned multiple times before proposing a solution.

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“Discover – The first quarter of the Double Diamond model covers the start of the project. Designers try to look at the world in a fresh way, notice new

things and gather insights.

Define – The second quarter represents the definition stage, in which designers try to make sense of all the possibilities identified in the Discover phase. Which matters most? Which should we act on first? What is feasible?

The goal here is to develop a clear creative brief that frames the fundamental design challenge.

Develop – The third quarter marks a period of development where solutions or concepts are created, prototyped, tested and iterated. This process of trial

and error helps designers to improve and refine their ideas. Delivery – The final quarter of the double diamond model is the delivery stage, where the resulting project (a product, service or environment, for example) is finalized, produced and launched.” (Designcouncilorguk, 2015) These four stages show how the process of using the double diamond works in a creative process.

Figure 2-1: Double diamond.

2.3 Qualitiative interviews

According to DiCiccio-Bloom & Crabtree (2006), interviews are done to get to know the person being interviewed better. To explore the meaning and knowledge to gain a better understanding. All interviews are made to get to know the person that is interviewed better. Semi-structured interviews are done often after there has been researching about the subject to form the questions that need furthers investigation (Wilson, 2013). As Wilson (2013) mentions, semi-structured interviews are questions that are defined in advance with open-ended questions to allow for further exploration.

“The goal of the semi-structured interview is to gather systematic information about a set of central topics, while also allowing some exploration when new issues or topic emerge.” (Wilson, 2013, p.24). Interviews that are done in the interviewees home tells a story about their culture and the environment that they live in that help you understand the user more (Wilson, 2013).

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2.4 Surveys

The method survey is most used to get quantitative research data and to get people’s opinions on a topic (Muratovski, 2016). But surveys are not only for quantitative data they can also contain qualitative questions with open-ended questions that will gain some additional understanding. Though people’s opinions are to be collected they might not give enough time of thought to the questions at hand they have been asked. As Muratosvski (2016) mentions when asking a question that are sensitive, they should not be asked at the beginning of the survey but instead later in the survey when they have become more familiar with the topic of the survey. The survey should be as short as possible to not feel that people who are asked taking part in it will waste their time. It should have a clear focus on a specific topic. Questions should not be leading to a specific answer (Muratovski, 2016).

2.5 Brainstorming

“The objective of brainstorming, for example, is to develop as many ideas as possible.” (Elspeth, 2000, p.63)

The more ideas that are brought out there is a bigger chance that the participants in the brainstorming session will come up with not just the quantity of ideas but also generate some original and quality ideas. The important thing when brainstorming in a group is that no ideas are bad and having a judgement free environment where no judgment of another one’s ideas is allowed to create a relaxed atmosphere (Elspeth, 2000). The ideas are to be written down on post-it notes.

2.6 How might we

To start a brainstorming session using how might we questions is a great way. The idea is to solve the design challenges and turn those into design opportunities. Insights that are gathered from research. To use the “how might we” method you start with the problem. Then you try to rephrase the problem using how might we at the beginning of the sentence and write them down on a post-it notes. The goal is not to have too broad or to narrow questions, just enough narrow and broad to explore new ideas. (Interaction-designorg, 2019).

2.7 Wireframes

A wireframe is a low/high fidelity visual design layout that shows the structure and behavior or the system. They show the interface and visual design. Wireframes can be hand-drawn or made from softwares. Wireframes are a simple way to prototype when you want to show different layouts and navigation options of the product (everyinteraction. 2019).

2.8 Ethics

The ethics will ensure the quality and integrity of the research. Honest data report, methods, and procedures. With no intent to fabricate or falsify data.

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Carefully and critically examine the work of others. For each interview, they will be handed a consent form. Where the participant’s information will be handled by confidentially and anonymously in the research. All of the recordings is kept private and only used to present data in the research that is relevant to the project. All of those who has participated in the research have done so voluntarily. The research presented is independent and impartial.

Theory

Different theories

In this chapter, I will present relevant work and theory surrounding the elderly. The theory is based around designing for the elderly to get an understanding of what challenges there is. Other kinds of assistive technologies to get insight into what has been done. The elderly’s health which is the reason this project started to learn how serious social isolation can be and affect one's health.

3.1 Assistive technologies

Assistive technology is made to make everyday life safer and better for the elderly while trying to maintain independence. With monitors and sensors that can track and monitor your wellbeing (Frank, 2001).

Community alarms

According to Frank (2001), alarm systems originally designed for the elderly and those with the lower-income who has limited access to telephones. The community alarm began its use 20 years later. They were used in sheltered housing where older people with disabilities or other vulnerable people lives to work as an emergency line to the warden when they are off-site. Later the development has led to wearable alarm units which we can see today. When pressing a button on the wearable it sends out a signal to community alarm center which can respond accordingly. The service is very effective when living in isolation and can relieve anxiety and increase the confidence of elderly living alone.

Video-monitoring

Video monitoring which was originally designed for surveillance security has been adopted to domestic video and audio communication (Frank, 2001).

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Video monitoring allows for someone who is off-site to look at the patient and determine if the patient is in need of aid for example if they have fallen and can't get up. Video monitoring is also good for linking it with other alarms for extra security and efficiency.

Health monitors

The health monitor is a device worn on your wrist and is the same size as a wristwatch. It monitors vital sign continuously and the movement of the one wearing it. During the first days, it is to the wearer and develops a pattern so in case of a deviation from the norm it can alarm the community alarm center (Frank, 2001).

Fall detectors

The fall detector is also another safety device that can determine if the wearer has fallen and is in need of aid. They are worn around the chest or around the waist of the patient. According to Frank (2001), they use an accelerometer and a tilt meter to determine if the wearer has fallen or not and is in need of aid or not.

3.2 Social isolation and physical health

According to Linda (2009), elderly living in social isolation is related to substandard health when living alone. Living alone and having a small social network also affects health and lower lack of support from others increases the sense of feeling lonely. Participation from social activities also increases the effects of loneliness.

Physical health connected to social isolation is linked to a higher rate of morbidity. The dangers of social isolation are equivalent to those who are smoking and people who are overweight (Linda, 2009). Social isolation is also linked to numerous other health-related problems such as increased infections, depression and cognitive decline.

The decline in physical health is not just affected by the elders but of all ages but has the most effect of elderly people living alone.

Social isolation can be categorized into two categories, social disconnectedness and perceived isolation (Linda, 2009).

Social disconnectedness means that having an absence of contact with

other people and a small social network. Social disconnectedness is also having a meager social interaction with others and having a lower level of participation in social activities.

Perceived isolation is how you feel your connection is to other people, the

feeling of support from other people. The feeling of loneliness and the support from others perceived as low. Intimacy from others is also felt as lacking from one's social connection than one would like to have.

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3.3 Designing for elderly

As one grows older there is a big possibility that the senses will decline in some way. Challenges like impaired vision and impaired fine motor skills, dexterity, decreased hearing and cognitive abilities (Claudia & Jones, 2013). This also affects the emotional declines when one's abilities decline as you age and needs to be taken into consideration.

The accelerated advancement of today society with new ways of social interactions and cultural changes makes it hard for older adults to stay connected with friends and family that want to be connected with them. As Claudia & Jones (2013) mentions there are many upcoming technologies for elderly to aid them with their lives but for them, it may be more challenging. They have a positive mind towards new technologies and want to engage themselves with it, but interfaces can be challenging and complex. Screen-based technologies with complicated hardware and software are an ineffective use for technology if you want to encourage them to use it.

For older adults there they must also find them useful and relevant to use. The willingness to adopt something new to learn and accept it (Helene, Tobie, & Judy, 2010). The decision of adopting is made if they find the technology useful for them and then there is acceptance phase if they approve the usefulness of the technology.

Sympathetic design is the field for designing for the elderly generation (Claudia & Jones, 2013). It is a field that is growing and has created an increased interest in other fields such as designers, computer scientists, and psychologists. The sympathetic design uses a framework that has been developed in projects related to projects when designing for the elderly.

The framework is meant to aid when designing for the elderly and what to take in consideration. When designing a product, it should be simple to use while focusing on the basics and the needs of the elderly (Claudia & James, 2013). The interface should be tangible and use physical interactions instead of touch screens. This makes it more accessible. Participatory also known as co-design should be used in the design process. In Co-design the user becomes the expert, in this case, the elderly become the expert of their own field.

To address a wide range of older adults’ abilities one must use universal design principles. These seven are fundamental for designing for accessibility in products and environment for all people.

Equitable use Flexibility in use

Simple and intuitive use Perceptible information Tolerance for error Low physical effort

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Emphasis on the enjoyment when the design on a product is being done should also be taken into consideration. Finally, as mentioned previously all of the products should develop with technologies that have become traditional to ensure that they do not go out of age too quickly (Claudia & Jones, 2013).

3.4 Related work

3.4.1 Tangible user interface and technology acceptance

Wolfgang (2011), explores the potential of using a tangible user interface instead of the standard way of using a graphical user interface.

The standard way of designing the interface of a PC has been almost the same since the 1970s by using the WIMP GUI( Graphical user interface based on windows icons, menus, and pointing device) setup. Challenges that the elderly faces due to age-related problems are physical and cognitive impairment when using the standard interface. Fine motor skill impairment can cause problems when operating the mouse to navigate and clicking on icons.

Wolfgang (2011) proposes to use a tangible user interface instead of the traditional aforementioned way. Instead of using a mouse as an input TUI uses physical objects to interact and manipulate the digital output.

TanCu

A prototype was made to explore the use of TUI when designing a communication system (Wolfgang, 2011). It was made from wood and has two cubes; one has pictures or symbols of a recipient. The second cube has different ways of communication. Cubes were chosen because it is a familiar item from childhood when playing with building blocks. The output of the device consists of three OLED which indicates what action has been taken.

The two examples show that tangible user interface makes it more accessible for elders to use. Ease of use of a product makes elders more acceptance and makes it easier for them to adopt. Even elders with no prior computer knowledge make it easier to interact with a device using TUI instead of the standard WIMP GUI (Wolfgang, 2011).

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3.4.2 Technology to reduce loneliness

Relevant to this paper is the work of Baecker, Sellen, Crosskey, Boscart, & Neves (2014). They talk about the importance of integrating media between intergenerational people and the importance of not feeling left out. The importance of introducing them to use technology for those who are not comfortable to use it and giving them other options for the same technology. There need to be design guidelines that are clear and simple with little to no room for error to happen.

In their study, they implement their prototype InTouch which is used by the elders allowing them to communicate through it with Email, images, voice recordings and pre-set messages that they can receive and send. The participants in the study felt that they were no longer left out and could keep up with what their families were doing (Baecker et al., 2014).

Figure 3-1: InTouch prototype.

Empirical data and analysis

This episode is about the insights gained from the empirical studies done in the field. From the interviews and surveys that people have been a part of. They will work as a guideline for the design process.

Documentation

The main focus has been elderlies that are pensioners and are the age of 65 and above. In total there have been 5 persons taken part in the interviews that have been made. All of the elders that have taken part in the studies are women for no particular reason. All of them are living alone in different circumstances. Ranging from the nursing home to their own houses. The physical health of all the participants is different with each one facing their own challenges in their everyday life. From the interviews, there were also made a survey where younger participants are grandkids to elderly relatives. There are three target

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groups, elders with kids, elders without kids and grandkids. All with unique insights that support the field.

Participants

Anna

Anna 70 years old lives alone in her apartment in central Malmö. She has had a former marriage but is now separated since a few years back without any kids from her marriage. She retired five years ago from a sales company. Her family lives in another country so she speaks with them on a weekly basis. She is an active, healthy person and enjoys her walks outside.

Gunn

Gunn is 79 years old and is living in a three-room apartment in the city of Malmö. She has been living alone ever since her husband passed away 15 years ago due to illness. She has kids and grandkids that also lives in Malmö. Recent years she has been renting out one of her spare rooms to younger girls. Right now, she lives with a 22 year old who is an athlete traveling a lot and is not home a lot compared to her former tenants that usually are students. Gunn is healthy for her age both mentally and physically.

Siv

Siv age 84, lives in a nursery home with their own apartment and other elderly people that can’t take full care of their own. There is staff around the clock. Siv has had polio since a young age which has left her with multiple handicaps. Now she sits in a wheelchair. Ever since her husband passed away 30 years ago, she has been living alone. She has kids and grandkids.

Inger

Inger also 79 years old and livers in her own small house by herself at Sibbarp, Malmö. She recently lost her husband 3 years ago and has lived alone ever since. She can take of herself, but a bad hip has made her get a stroller to be able to walk around and has left her unable to use her car. She has no kids or grandkids. But she has some relatives close by and some further up in the northern part of Sweden.

Britt

Britt is 75 years old and lives close to Möllevångstorget in Malmö by herself. Her husband passed away 2 years ago. From her marriage, she has kids and grandkids as well that also live in the city of Malmö. She is healthy both mentally and physically and enjoys being outside.

Survey

The survey was conducted to reach out to the younger generation with a focus on people that has elderly grandparents to see how their relationship is toward

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them. The survey was made to find answers about how frequent they were in contact with their elders if at all.

4.1 Insights

From the insight we state problems. These problems are challenges that we then can extract design opportunities from that will later help in the design phase.

Challenges facing the elders when using technology

During the interview with Gunn, she talked about how technology came in late in her life and that she has been starting to use it more and more, but I come with challenges for her due to her age.

“Technology came in late in my life” (Gunn, personal communication, March 28, 2019)

She has taken classes to learn how to use a smartphone which she now uses every day. She likes that she can stay connected with all her friends through it, but she is having not ever been a very technical person.

“I have never been a technical person”. (Gunn, personal communication, March 28, 2019)

Even though technology and social media have made you stay connected with more people than ever before there is something that has made less satisfying than before and something that is missing. The participants talk about how it was better before when you met people and socialized with them on a daily basis instead of sending them messages over social media.

“it was better before.” (Gunn, personal communication, March 28, 2019) They see themselves having this problem since they also use social media themselves and feel that they also get caught up in it.

“I'm not a fan of it. I don't like it; people don't socialize anymore, and they keep watching their phones.” (Anna, personal communication, March 28,

2019)

Problem: Smartphones are hard and complicated to use.

Design opportunity: The design should solve

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They worry about their grandkids not realizing the value of actually socializing with each other than being on their phones all the time.

There are associations that host events for elders to try and help them get out of social isolation and meet other elders and people. The challenges when creating events is to make it appealing to all elders. Since age affects everyone differently and some are more mentally and physically healthier than others.

“I and my friend went to an event to try it out, but it was nothing for us.” (Gunn, personal communication, March 28, 2019)

The problem was that it was to mix, and it was not easy to communicate with everyone. Gunn and her friend want to meet others like them, that are healthy. Even if they are old, they don’t want to feel old and want to be able to find others like themselves that they can socialize and connect with.

The problem that many faces when getting older is that their sight deteriorates by some degree, some more than others. For them, this creates problems when using devices that are made for the general public. It is easy to be left out and since we are so used to using our phones every day and socialize through them. “My sight is bad, and I can´t read the small text like there is on screens and

small devices” (Siv, personal communication, March 4, 2019)

To be able to do things she enjoys she has been given aid devices, for example, an enlargement glass that enables her to solve her crosswords she does every day.

“I read crosswords with the help of an enlargement glass that I can see on a screen” (Siv, personal communication, March 4, 2019)

Problem: Social media makes you meet people

less physically.

Design opportunity: The design should make

them value physical meetings.

Problem: Events for elders to socialize are not

appealing to everyone.

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Solving problems that make you enjoy the thing that you couldn’t have done without technology bring joy back into people lives and you may likely feel less hindered by a disability.

“I have bad hearing and I have to use hearing aid” (Siv, personal communication, March 4, 2019)

Hearing bad creates many difficulties socially and non-socially. Watching your favorite TV show or just trying to listen to what other people is saying becomes frustrating. During the interview questions had to be repeated since she didn’t hear it all. She explains that during family meetings she often feels left out since she can’t always hear what the others are saying to each other. Asking all the time what someone is talking about interrupts the others conversation and she can sometimes feel like she becomes a burden and then resigns to be quiet.

“It is not easy to be a part of conversations when there is more than one talking,” (Siv, personal communication, March 4, 2019)

Though she is a very talkative person she rather sits quietly. The hearing aid helps but she still has had problems hearing everything. Finding something that works for both parts to make a conversation more enjoyable again.

Siv who has received the virus polio before there was a vaccine for it. This left her paralyzed in her legs and she has had crutches all her life until ten years ago she hasn’t been able to support herself by her arms and she has been left in a wheelchair.

“Polio from a young age has given me limited movement in my legs so I am dependent on my wheelchair,” (Siv, personal communication, March 4,

2019)

Problem: Vision impairment makes everyday

life harder.

the problems engaging with devices that are screen based.

Problem: The loss of hearing makes it hard to

participate in conversations.

the problems when interacting with others in a group.

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Due to this, she is not able to move around by herself and when she wants to visit her family, she needs transport by car to get to them. Gunn on the other hand who is healthy in both her legs can still walk and bicycles around to get to places. The challenges Siv faces is that she is very dependent on others to take her to places and others do not always have time to come and visit her when she feels lonely.

“Very is for me to break my loneliness since my kids and grandkids live very close to me.” (Gunn, personal communication, March 28, 2019) “Freedom for me is being able to walk in the forest” Inger, personal

communication, April 26, 2019)

Something that Inger has done all her life but is unable to do anymore is to go out in the woods and pick mushrooms. This is something she misses a lot to do and she has had many good memories through her years doing this.

“I have a car, but I can’t drive it anymore because of my bad legs” Inger, personal communication, April 26, 2019.

Being able to move around freely whenever you want is something most of us have been able to do all of our lives. But disabilities that come with age hinder you from this and this is something that comes with a challenge for many how to face this. This seems to affect the persons that can’t do it.

“Freedom is important to have when older I think.” (Gunn, personal communication, March 28, 2019)

Since Siv is not able to fully take care of herself she lives in an assisted living with others that are not able to the same. There is staff that helps her every day and the others around the clock. The others that live there are all different and many are not mentally well and can’t communicate as well as Siv so there isn’t always someone to talk to.

“Even though I live with others here, I can talk with only a few of them since the others are not as healthy mentally” Siv, personal communication, March

4, 2019)

When she feels lonely, she often turns to the staff, but they don’t always have time to just talk and are busy taking care of the others that live there. Her

Problem: Disability of movement limits the

freedom of moving around by yourself.

Problem: Can´t break isolation when you want. Problem: Unable to drive her car.

Design opportunity: Give them the feeling

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daughters also work full time, so they are not available at all time often only during the evenings.

“The staff that works here doesn’t always have time to just talk with me” Siv, personal communication, March 4, 2019)

During the interviews, almost everyone had moments when they feel lonely for some as aforementioned it is easy to break it but for the others, they often turn to their TV when feeling lonely. For Anna and Inger, they feel loneliest in the evening.

“The evenings are the hardest.” (Anna, personal communication, March 28, 2019)

“Feels the loneliest in the evenings.” (Inger, personal communication, April 26, 2019)

Having something or someone to turn to when feeling lonely when you live alone is important. Since they don’t have a partner or someone, they live with the companion becomes the TV.

“I watch it quite a lot, the TV becomes like a companion for me.” (Inger, personal communication, April 26, 2019)

When you feel lonely you are alone with your thoughts and having someone to talk to would be very helpful for them.

Problem: Moments when they feel lonely. Design opportunity: The design should solve

the issue when living alone to have someone to talk to.

Problem: The staff has limited time for

conversation.

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Survey

Through the survey, they were asked how frequently they interact with their elders’ whether they contacted them over the phone or met them physically. Almost none of the participants in the survey contacted them more than once per month even less. For the elders, the family means a lot and is the ones they met the most since other relationships that they had before has passed or lost their connections with.

“Kids and grandkids are the most important for me.” (Gunn, personal communication, March 28, 2019)

The participants in the survey felt like they didn’t contact their elders as much as they would have liked. For Siv, she feels like she doesn’t get to see her grandkids as much as she would have liked before. When she could take care of herself and had a car, she could make the decision herself if she wanted to go and meet her grandkids and kids whenever she wanted. But now she is unable to do any of it and relies more on that people visit her.

“I wish I could see my grandkids more than I do now” Siv, personal communication, March 4, 2019)

In the survey, they were asked: “what can you do to increase your contact?” (Appendix Ι). The most common answer was to call them more often and that it was up to themselves to actively make that choice.

Problem: Contacts them only a few times per

month.

Problem: 90% wish that they contacted their

elders more often.

Problem: Doesn’t see her kids or grandkids

often as they would like.

Problem: Think it’s up to them to make an

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Design phase

This part is about the design phase which is the second phase of the design process. Based on the finding from the research phase that was gathered through the interviews and the survey the challenges the elders face when being socially isolated was highlighted. The problems that have been defined will generate new design opportunities to hopefully help when being socially isolated. By using methods such as workshops, brainstorming and creating scenarios. Many ideas have been generated and iterated.

5.1 Outcome of the research

The research phase gave a good understanding of the stakeholders and the challenges they face. Through the data generated 13 problems have been defined that the elders feel when they are socially isolated and lonely. These problems will serve as a guideline for the design phase as listed.

Problem: Smartphones are hard and complicated to use. Problem: Social media makes you meet people less physically.

Problem: Events for elders to socialize are not appealing to everyone. Problem: Vision impairment makes everyday life harder.

Problem: The loss of hearing makes it hard to participate in conversations. Problem: Disability of movement limits the freedom of moving around by

yourself.

Problem: Can´t break isolation when you want. Problem: Unable to drive her car.

Problem: The staff has limited time for conversation. Problem: Moments when they feel lonely.

Problem: Contacts them only a few times per month.

Problem: 90% wish that they contacted their elders more often. Problem: Doesn’t see her kids or grandkids often as they would like.

5.2 The design opportunities

The design challenges are meant to influence the iterations in the design process to solve the needs of social isolation and loneliness among the elders.

Design opportunity: The design should solve the problem that makes

phones hard to use.

Design opportunity: The design should make them value physical meetings. Design opportunity: The design should solve why they don’t find it

appealing.

Design opportunity: The design should solve the problems engaging with

devices that are screen based.

Design opportunity: The design should solve the problems when interacting

with others in a group.

Design opportunity: Give them the feeling back of being free.

Design opportunity: The design should solve how they manage time. Design opportunity: The design should solve the issue when living alone to

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5.3 Workshop brainstorm- how we can implement

the ideas to IDX

With the data gathered from the interview and the survey and the problems defined as aforementioned to move on with the design process, a workshop was held. The workshop was held to try and generate as many ideas as possible. To do this the method brainstorming was used where each of the participants was supposed to create different “how might we” statement on each of the defined problems. As the goal of brainstorming is to evolve as many ideas as possible in a quantity that will hopefully create some quality ideas as well (Elspeth, 2000). Each problem was shown a few minutes and all of the participants down “how might we” solutions on post-its.

5.3.1 Outcome of the workshop

The outcome of the workshop generated many “how might we” statements that created new design opportunities. To move forward with the design process the questions that are broad enough and not to narrow were picked that are useful to the topic, as listed below. The next step is to brainstorm about what possible design solutions that can be designed. Some statements were too ordinary and weren’t developed further.

How might we solutions

Design opportunity: How might we create a community for the elders to create their own events?

Design opportunity: How might we visualize a conversation?

Design idea: Hearing aid with voice to text.

Design opportunity: How might we make smartphones more tangible? Design opportunity: How might we use less social media and encourage physical interaction?

Design idea: To be able to talk on social media you must earn points

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Design opportunity: How might we create a sense of being somewhere else?

Design idea: User VR to simulate the sense of being in the forest. Design idea: Use smell to imitate the forest.

Design idea: See-through a camera worn by others.

Design opportunity: How might we make relatives feel empathy?

Design idea: An app that can send out what you feel

Design idea: An avatar that gets depressed the less you interact with

your elders.

Design opportunity: How might we visually show the staff when they feel lonely?

Design idea: Smartwatch so that they can send out their emotions to the

staff.

Design opportunity: How might we send out the feeling of loneliness?

Design idea: Logging how much time they spend with each person.

Design opportunity: How might we punish them if they don’t contact their elders?

Design idea: Interacting with a TUI that sends out feeling to others

Design opportunity: How might we reward them to contact their elders?

Design idea: The monthly allowance is based on how much you contact

your elders.

Design opportunity: How might we create the feeling of longing be felt by their kids and grandkids?

Design idea: An app that can send what you feel.

Design idea: An avatar that gets depressed the less you interact with

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5.4 Scenarios

The next step in the process was to create scenarios. Scenarios are stories of people in a setting somewhere. Where they have a goal or an objective to make (Carroll, 2000).

“Scenarios can provide a framework for a design based science of human computer interaction. By making use the object of design, scenarios be tools

to address fundamental issues about the design.” (Carroll, 2000, p.48). For each scenario, a persona was created that was taken through a series of steps to solve a problem with the intended design. Working with each of the “how might we questions” another nine concepts was created.

Concept 1

The problem many elders faces when getting older is that they lose their mobility and can’t walk around or take themselves to places they want. The idea of this concept is to use VR and smell vision to create the feeling of being somewhere else. Those who are unable to walk without aid should not be hindered by their handicap. By combining VR and smell vision you become immersed in the virtual world. The person can sit comfortably in their own home when wearing the device and be able to “walk” around by themselves in a virtual world.

Figure 5-1: Scenario 1

The solution that is trying to be solved:

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Concept 2

The challenge many elders face is that they can´t interact with small screen-based devices such as mobiles phones which is the standard communication device. As Claudia & James (2013) mentions, the interface should be tangible instead of screen based when designing for elders. For someone that socially isolated it´s not easy to reach out to someone, they might not have the courage to bother their elders by picking up the phone. The idea is a tangible interface that the person can interact with. With a simple push, the person should be able to send out that they feel lonely. The recipients that are connected to the device e.g. Kids and grandkids will receive this as a message on their phones and can respond back by calling or texting the person.

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Concept 3

Today most elders that live in nursing homes wear wristbands with alarms they can use in emergencies, but they are only used in that case. Taking advantage of already traditional technology as one of the fundamental for designing for accessibility (Claudia & James, 2013). This traditional technology is the smartwatch. By using interactions with your fingers and assigning a function to each finger this opens up a lot of design opportunities (Park & Lee, 2019) which makes it easier for and elderly to interact with and more tangible. With this, the elders can communicate with the staff what they want and how they feel. Each finger can assign a certain emotion for them to communicate.

Design opportunity: How might we visually show the staff they are lonely? Concept 4

The problem with social media is that people spend more time interacting with the virtual world than what we do with the physical meeting. For the elders that participated in the study, they value the physical interaction more and is something they always have done before the social media came into the world. By limiting how much you can use your phone based on how much you spend time with people physically. To be able to use social media you must earn points. These points you earn by interacting with people in real life. This is to encourage people to use less social media and value meeting and spending time with people than spending time in the virtual world.

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Design opportunity: How might we make people use less social media and encourage physical interaction?

Concept 5

For Siv who doesn’t feel like she sees her grandkids as much as she wants and is unable to go and visit them. The idea is to create a system that rewards the grandkids with for example giving them a part of their allowance each time they interact with their grandparents. If they don’t do it, they won’t get the allowance each month. This will benefit both parts and hopefully, create a better connection between the two parts.

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Design opportunity: How might we punish/ reward if they don’t contact their elders?

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Concept 6

Many people live with a busy schedule and feel that they don’t have time to speak or visit their elders. Sometimes you also forget those you haven’t interacted with in a while. The idea is to create an app for those who wish to track those they haven’t spoken to in a while. It will visually show those you have frequent contact with and those you do not have spoken to in a long time. You should be able to prioritize those you feel you want to increase interacting with, so you get reminders when you do not have spoken to them. This will hopefully spark the interaction with the person you have set to prioritize e.g. your grandma that you keep forgetting to speak with.

Design opportunity: How might we visually show those you haven’t contacted in a long time?

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Concept 7

With age comes deterioration of your senses one common is the loss of hearing. While hearing aid helps some, for some others the hearing has gotten to bad so that hearing aid won’t always help when trying to listen to a conversation. The idea is to make the speech visual with the help of text to speech. The hearing aid is to be fitted with a microphone that picks up others speech. The speech is then translated into text that is shown on a display by the user. The user then can read what the person has said and can then reply accordingly.

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Concept 8

When not seeing a person in person you can’t tell how they feel. It is easy to go unnoticed of that when you haven’t seen a person or talked to that person in a while. The idea of the solution is to create a virtual avatar that symbolizes a person you know. The avatar emotion changes when you don’t have been in contact with the person it symbolizes. The goal is to keep it happy and thus the person the avatar symbolizes will get frequently more interacted with. If the person sees the avatar, they will feel empathy and contact that person.

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Concept 9

When not being able to move around freely as before you forced to stay in your home. There you often spend a lot of time watching TV during the days and it becomes your companion. The idea of the solution is to follow along someone’s “adventure”. As Inger used to love doing outside was to go on a walk in the forest and pick mushrooms which she is no longer available. But by using a wireless camera attached to another person e.g. her relative that is planning to go out into the forest with her own kids she can follow along with them. The smart TV has an app as in the form of webcasting that she can connect to the camera of the wearer that is going to the forest. Now she can sit at home and listen and watch as they walk around in the forest.

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5.5 Sketching

After the scenarios were made, they were analyzed and then the ones that seemed the most feasible were selected to be presented to the stakeholders for feedback and to have a workshop with them. The concepts that were selected are concept 1,2,6 and 9. Each of the concepts is sketched out for the workshop.

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Figure 5-11: Concept 2

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Figure 5-13: Concept 9

5.5.1 Feedback and workshop

Two workshops were held with former participants of the study. One was with the elderly and the other one with grandkids. Each of the chosen concepts was presented at a time. They were all each given printed pictures of the sketches to use for the workshop.

First, they discussed the concepts, giving feedback on which they like the most and after that, they brainstormed with each concept trying to come up with ideas together. The idea of the workshop was to sketch around the sketches that they were presented with and adding on themselves with ideas and thoughts using post-its. Each concept got 10-15 min of time for sketches. After that, they discussed again which one, they liked the most and could see being more worked on.

5.5.2 Outcome of the workshop

In the discussion, both groups preferred concept two and six of the presented ones. The elders weren’t familiar with VR so for them it seemed to be complicated and the camera doesn’t let them meet people only follow along and they can’t really interact with them. For the grandkids, they didn’t think VR was something for the elders especially when they have trouble seeing. Concept two seemed simple for them to use with only a button to push and concept six was mostly for themselves to get better at remembering to interact with their elders. The focus then surrounded concept two and six.

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Figure 5-14: snapshot from workshop

Concept 2 & 6

From the ideas that were generated for each concept, the best ones were chosen by the group. These ideas were then discussed, and the group gave feedback on the one they liked the most and which one the project should explore more with.

Concept two had the most ideas but also seemed the be the most technically challenging for the project to be made. Thereby the group chose concept six because it´s an app that can much easier be deployed and prototyped.

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5.6 Concept

5.6.1 The concept “Remember”

The concept Remember is an app that lets you make reminders of people you want to interact with more that you feel you want to increase your relationship with as well. Its tracks all social media apps, phone calls, text and GPS location if you have been near the. It shows those who you have the most frequent interaction with and those you have chosen that you want to increase contact with.

With this concept, you get a visual representation of your interaction with people.

Figure 5-15: “Remember” Wireframe.

As shown (Figure 5-15) you start by choosing the person that you want to be notified about interacting with. It lets you choose the level of how much you will get notifications about. While viewing you can see trends and when you have last interacted with them at what date.

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Testing wireframes

Wireframes is a cheap way of prototyping. Weather they are hand drawn or made on a computer they can be quickly made. Then they can be tested by the users for user testing for further feedback. With wireframes they can test the experience of the concept, testing navigation and function. This would be the next step of the process.

Discussion and conclusion

6.1 Discussion

The intended target group was the most challenging in this project and finding people that would participate in the study that also fits the intended target group was a challenge. Since the scope of the participants was narrow as well. Conducting semi-structured interviews was also something new and getting people to share private and personal was challenging. Getting good at interviews takes a long time and with this project and it limited time it was hard to develop those skills to get the most out an interview but overall most of them were a success and helped the design process.

Would the outcome of the design process have been different if Co-design would have been used?

The methods that were presented and used where all user-centric methods. In the field of sympathetic design, one of the frameworks when designing for elders that should be used is Co-design in a workshop. This is a participatory approach and is a collective creativity of collaborating designers (Sanders & Stappers, 2008). Also, to include the stakeholder in the entire design process. Even though the target group was hard to work with this would have been an interesting approach to the project.

How would a Hi-fi prototyped of the concept have been received and what would the stakeholder think of “Remember”?

6.2 Conclusion

This project explored the challenges that elders face when they are socially isolated. It is a big subject and can be hard to grasp the importance of not feeling lonely when you get older. Social isolation can have huge implications on one’s health and should not be taken lightly by the public.

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How can we increase sociability amongst elderly through interaction design? The project started with gathering knowledge about the stakeholder and what implications they might get from being socially isolated. This showed that it is a worldwide problem and not only geographically pinpointed to Sweden where the research was done. It also stated that social isolation is something almost everyone experiences. The feeling of loneliness can have great implication on mental health. With this stated exploration of related work was done to explore what others have done in the field of social interaction and designing for elders. This research showed that it is a relatively new field called sympathetic design and new ways of designing in the field of social isolation among elders are something we all can benefit to explore. Also, tools such as a framework to help designers design when design for elders to increase accessibility in products. Since this is a project in interaction design methods in the field was used with a user-centered design approach. The research that was conducted helped the design process to develop design opportunities.

The empirical studies from those who live in social isolation that participated in the interviews explored what it means to live in social isolation and what causes the feeling of loneliness. Where the interviewees expressed themselves in the semi-structured interviews and shared their challenges and what their need is. For some, the feeling of loneliness was harder than the others and this was through their own personal struggles. The survey gave an understanding of how the grandkids interact with their elders and what level of communication they had with them. Analyzing both the survey and the interviews gave insights that then could be made into problems that got defined. These defined problems allowed the design process to move forward into the next process for design.

With problems defined and opportunities to help and influence the iterations in the design process to solve the needs of social isolation and loneliness. With the help of workshops and brainstorming with how might we statement many ideas were generated. Then they were iterated again were they were brainstormed again to create design ideas for possible design concepts. The design concepts were then implemented by using scenarios were tested in a fictional setting. Nine scenarios were presented as possible design solutions. They were then iterated again and was reduced to four concepts. These were then presented to the stakeholders and a new workshop was held. Finally, a prototype was made as to the final outcome. The concepts are meant for others to jump on and explore further.

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Appendix

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