Can technology bring a difference to the lives of the non-technology savvy elderly?

Executive summary

According to U.S. Census Bureau, by year 2040, elderly are going to constitute around 1/5th of the total U.S. population. Despite these numbers, very few technology solutions are built specifically for them. My team and I wondered if we could do something for them.

To understand their needs, my team spoke with the elderly residents and and management team of Campbell Stone Assisted Living Community in Atlanta. We realised that some of their primary needs are enjoying post-retirement life and staying safe and healthy. They not too tech-savvy and they felt exercises were boring. Hence, we thought of combining exercise with games. We created a prototype of an indoor gesture controlled kayaking game which also serves as an exercise for the upper arms.

Usability tests revealed that the elderly were delighted by the game and in particular loved collecting the gold coins, pleasant sounds of the river, and simple interactions. On the other hand, we didn’t find them to be even slightly tired; which was a concern because we were building an exercise game after all.

Kinect Kayaking Prototype

Acknowledgements

Campbell Stone Assisted Living for letting us interact with their residents.

Professor Dr. Bruce Walker, Georgia Tech for guidance

My superb team, Liza George, Lisa Li and John Thompson

Key details

Team Liza George, Lisa Li, John Thompson, Varsha Jagdale
Duration 4 months
Role Shared responsibility of user research, prototyping and concept testing
Research Methods Observation, Interview, Wizard of Oz testing
Field Studies Campbell Stone Assisted Living Community, Atlanta

Process

  1. Choice of the problem space
  2. User Research (Interview and Observation at an assisted living centre)
  3. Narrowing the problem space
  4. Identifying the design constraints
  5. Brainstorming solutions
  6. Choosing a solution
  7. Prototyping (using Unity)
  8. Concept testing (Wizard of Oz testing)
  9. Reflection

1. Choice of the problem space

According to the U.S. Census Bureau 2012, the elderly (people above 65 years) are going to constitute around 22 % of the total U.S. population. Despite these numbers, very few technology innovations are built specifically for them. They have distinct needs due to the differences in the cognitive and physical abilities. This made the problem space important and interesting.


2. User Research

Research goal

To understand the needs, attitudes and behaviours of the elderly. We decided to work with an assisted living community to get direct access to the participants.

Campbell Stone Assisted Living Community

Research questions and choice of method

RQ1 How is it to live in an assisted living community?

RQ2 How do the residents spend their day?

RQ3 What activities to they participate in?

RQ4 What kind of interactions do they have?

RQ5 What type of technology exists in the community?

As these questions are behavorial, we decided to conduct passive observations on different days, time and by different researchers. It also helped formulated some more questions.

RQ6 What does the management think about their resident’s needs?

RQ7 Why are exercise activities less popular?

RQ8 What are some major concerns and wants of the elderly?

RQ9 What kind of experience do they elderly have with technology?

As the questions were more attitudinal, we decided to conducted semi-structured interviews with elderly and the assisted living community team.

Challenges

Initially we were turned down by a few assisted living communities because they were unsure of our intentions. In later attempts, I think stressing on our affiliation with a research institute and being guided by a professor helped us show trustworthiness.

Conversations with elderly went off the tangent and we later started factoring in extra time for that.

Because it was my first time in the United States and working with a community far different from me, there was a cultural gap. It was personally difficult for me to think of relevant ice-breakers. I started observing how my American teammates were handling these conversations and learning from them.

Event Schedule and Bingo Board with numbers in large font

Insights

1 User profile 65+ in age, retired, limited mobility (use of wheelchairs or walkers), very limited knowledge / use of technology, limited retention

2Needs staying physically and mentally fit, staying safe, enjoying post-retirement life, motivation to exercise and socialise

“I don’t like going for outdoor walks. It is just not safe. I might fall.” — an elderly woman resident

3 Context facility is equipped with computers, LCD displays, and Kinect, elderly use basic phones.

LCD Display in an activity room at Campbell Stone

3. Narrowing the problem space

Elderly residents and the management team considered physically and mental to be the top most priority. Exercise activities were not popular because elderly found them to be boring and / or unsafe.

We wondered how we could motivating the elderly residents of Campbell Stone to exercise in order to stay fit

4. Identifying the design constraints

Our research also helped us understand our design constraints

Enjoyable enough to create motivation
Safety
Easy learning curve


5. Brainstorming solutions

We brainstormed multiple ideas, evaluated them based on our design constraints and the time we had to develop a prototype. Additionally, we decided to focus on physical fitness because our team didn’t have the required medical knowledge to handle mental fitness issues.

Concept 1 — Digital bingo with exercises instead of numbers

Concept 2 — Gestured controlled video game (e.g. kayaking, walking)

Concept 3 — A pedometer that uses emoticons for displaying status

Special acknowledgement: Lisa Li for wonderful illustrations


6. Choosing solution

We explained our design concepts to the elderly. However, we couldn’t get much constructive feedback because of the low fidelity of our prototypes.

Because we were also pressed for time, we decided to go ahead with gestured controlled video game (e.g. kayaking, walking) as it satisfied our design criteria the best.

Enjoyable enough to create motivation — Collecting coins, reaching the finish line
Safety — Played indoors
Easy learning curve — Simple and easy to remember interaction

Bonus Constraints
Could be played by people using wheelchairs or walkers
Use of existing technology, Kinect and LCD display


7. Prototype

Just sketches weren’t useful for getting feedback and building an actual game that interfaced with Kinect was time consuming. We decided to go ahead with a mid-fi prototype (realistic 3D imagery but controlled via keyboard)

Low-fi to Hi-fi prototype
Mid-fi prototype

Interaction design details

Motivation — Introducing a story of kayaking on a magical river where gold coins are just scattered everywhere and they can be collected by kayaking below it. Also, reaching the finish line faster gives more coins. 
Easy learning curve — Interactions based on natural movements required for kayaking left, right and straight.
Feedback — Avatar which mimicked the user action, visuals and audio after collecting a coin and reaching finish line.

Different stages in the game

8. Concept Testing

Setting measurable success metric is very important. We later realised that we couldn’t test the impact of our game on user’s motivation to exercise in just one test session.

It would ideally require a longitudinal study. We redirected our focus to evaluate the exercise game concept and usability.

Research Questions

Concept
How do the elderly feel about mixing exercises with game?
What aspects of the game interest them and what don’t?How to make it more engaging?
How long the game should be for it to be an effective form of exercise?

Usability
Do they face any difficulties while performing the kayaking gesture?
Are they able to understand the interface?

Research Method

Because we weren’t able to create a fully functional prototype, we used Wizard of Oz evaluation method wherein a “wizard/moderator” would observe the participant’s actions and control the game accordingly using keyboard.

For a realistic setting, we conducted the sessions in the activity room of Campbell Stone. The participants were given instructions on how to kayak towards the finish line and collect coins. Considering the nature of our research questions, we collected both behavioral data (facial expressions, speech, movements) and attitudinal data (post evaluation questionnaire).

As we had a good rapport with the elderly residents, we were afraid that they won’t give honest feedback verbally. We administered a paper based questionnaire to get more candid responses.

Participant Recruitment

The community manager helped advertise the study through community noticeboards. Despite this effort, very few residents initially showed up. More people started to trickle in later; only after listening to the experience of their co-residents. We observed a snowball sampling.

Concept testing timeline
Activity room with the test environment setup

Insights

We had a total of 11 participants (8f, 3m) with an average age of 76.5. We received tactical as well as strategic feedback from them.

On a strategic front, the concept of exercise game was well received (all but one liked it) and was easy to understand (4.18 on 5; with 5 being easy to understand). They had varied reasons for liking the concept — fun, real life activity instead of sterile exercise routine, pleasant imagery and challenge of collecting gold coins.

On the downside, we didn’t find the participants to be tired; which was a concern because we were building an exercise game after all. Despite being just 4 minutes, few participants complained that the game was long.

This feedback made us think how we could build and test an exercise game which can keep the user engaged for a longer amount of time and is physically challenging.

Tactical insights were to add a route map to indicate progress and to add an applause after collecting a coin.

What participants did was different from what we observed.

They rated the kayaking action as easy. (4 on 5; 5 being most easy). But we observed that halfway through the game majority participants weren’t performing the exact kayaking action. My team mate later offered the participants an oar prop (stick) to help with the kayaking action. Maybe this could be a permanent prop for our game.

9. Reflection

This project is very close to my heart because it is my first human centred design project and as with any first it involved a lot of failures and learning. The most important learning was that there people unlike you with different needs and how to build a connection to understand them better.

Also, as with any other school project, we didn’t iterate on this project later. Retrospecting, there are multiple areas which we could have later worked on — how to evaluate the impact on motivation to exercise, determining the effective duration of the exercise game, understanding which games resonated with users. But most importantly deploying the solution in the Campbell Stone assisted living community so that the elderly could have some more fun; we were doing this for them after all!

One clap, two clap, three clap, forty?

By clapping more or less, you can signal to us which stories really stand out.