CTF blogg: Digital assistive technology in health and elderly care – much more than devices and efficiency

We often think and visualize life as a cycle, beginning with birth and ending with death; where each phase is characterized by specific events, such as the discovery and development of childhood, the identity seeking of adolescence, and towards the end of a long life – the wear of aging. Childhood and aging can sometimes be considered to be each other’s opposites but are also perhaps a reason why we think of life as a cycle. What we learn and develop during childhood is lost, and or, weakened during old age. For example mobility and strength, which ultimately leads us to lose the independence and autonomy we strive for throughout life. Independence and autonomy are in many ways the structural keys for quality of life, and something we have been afforded gradually throughout life. Think how restrictions of independence and autonomy by incarceration is the ultimate punishment for criminal acts in most countries. Thus, restrictions in independence and autonomy is a terrible loss for anyone.

One way to help elderly persons, as well as persons with functional impairments, keep or regain their independence and autonomy is by means of digital assistive technology (DAT), that is, digitalized tools to help with everyday tasks. DAT is thought to be the answer to the declining resources due to population aging, not only will the monetary cost increase, but there is also a diminishing workforce to pay for this increased cost. In other words, the needs exceed the resources and DAT is considered one solution. However, so far, we know very little about if and how DAT can help solve the elderly’s problem of restricted independence and autonomy, or how this will affect the care situation for both the elderly and the care personnel. Thus, it is imperative that we study the effects of different DAT on both the elderly and the care personnel.

In 2017, CTF was presented with the opportunity to study the user-experiences of elderly and care personnel at an assisted living facility here in Karlstad, that was about to test an automatic shower solution designed and developed by Robotics Care. The shower solution was designed to allow the elderly to become more independent in the shower situation.
The study showed that even the smallest changes could transform the user-experience of the care situation. For example, whilst the personnel did not experience the new shower situation with the automatic shower solution as very different from the previous shower situation, it had great consequences for the elderly. The care personnel described a work situation that mainly remained the same, it did have some perks, for example not having to dry off the floors after the shower or not having to wear the protective clothes in the shower, but the personnel still experienced that the elderly needed their help. Thus, remained dependent. The elderly, on the other hand, felt empowered and enjoyed the new shower situation, they recognized that they still need help, but did not consider this to be dependence. It was mere assistance. This implies that the experience of the care situation was transformed for the elderly despite very small changes in the care situation.

Consider again the life cycle were we as children learn new skills and discover new abilities, where we develop self-efficacy and perseverance. We learn that by trying over and over again we can succeed. As we grow old and our abilities decline, such as balance, this loss tends to spread like a disease to other, unrelated, abilities. This is referred to as learned helplessness, and refers to our sense of losing the power to control what happens to us. The automatic shower solution helped the elderly in this study to regain that sense of power, and thus counteracted learned helplessness. We know from research, and our contacts at the Karlstad municipality and the assisted living facility, that other DAT have showed similar patterns, that is, empowerment in one area spreads to other areas and therefore helps elderly remain independent and autonomous.

The shower is still in use. Mainly by people who live at home, who on a weekly basis travel to the assisted living facility to use the shower solution instead of being showered by care personnel in the privacy of their own homes; they go by electric wheelchairs or by transportation service. Although no one can dispute the weight of cost effectiveness, this study shows the significance for independence and autonomy, and the importance of studying the users’ experiences to fully understand how the introduction of DAT can transform a care situation.

Charlotte Bäccman
PhD in Psychology

Linda Bergkvist
PhD Information systems

For further reading:
Bäccman, C., Bergkvist, L., & Kristensson, P. (2020), Elderly and care personnel’s user experiences of a robotic shower, Journal of Enabling Technologies, 14(1), pp. 1-13. https://doi.org/10.1108/JET-07-2019-0033.

Bäccman, C., & Bergkvist, L. (2019). Welfare technology and user experience: a study of seniors’ expectations on and first impressions of a robotic shower. Presented at Hawaii Conference on System Sciences (HICSS-52), Maui, Hawaii, January 8-11, 2019. https://scholarspace.manoa.hawaii.edu/handle/10125/59867.