ABSTRACT
Technological advances are currently being directed to assist the elder population. These products, which can be charted in the assistive robotics literature, emphasize the independence of the elderly as a primary goal. They provide support for a range of basic activities, including eating, bathing, dressing, and toileting (MOVAID, 2002; RAID Workstation, 2002; RAIL, 2002). They support mobility in the form of ambulation assistance and rehabilitation (GuideCane, 2002; Haptica, 2002; Morris et al., 2002; NavChair, 2002; Wheelesley, 2002). They provide household maintenance in the form of monitoring and maintaining safety in particular environments (Mynatt, Essa, & Rogers, 2000). However, many of these products have been designed with little consideration of the social, aesthetic, and emotional relations that elders will form with the product. Future assistive robotic products will need to move beyond task-based interactions and be attractive, affordable, and nonstigmatizing. Accessibility, ease of use, and reliability will also be particularly important for aging users.An example of how people’s values can affect their usage of an assistive product may be seen in the case of current mobility aids. Walkers, rollators, and canes assist in mobility for all who use them. For the elder population specifically, these products mediate the activities of daily living, provide opportunities for partaking in social activities, and reduce the risk of falls. Studies of elders have shown that nearly one third of these devices are abandoned within the first 3 months (Guralnik et al., 1993); the disuse rate is as high as 54% (Scherer & Galvin, 1994). These products’ appearance inhibits many from using them in normal social situations (Hirsch et al., 2000). Elders who do use walkers are inspired by the autonomy they afford; for these people, aesthetic considerations are secondary (Mann, Hurren, Tomita, & Charvat, 1995).Roboticists have developed a number of mobility enhancing assistive technologies. Most of these share control over motion with the user, undertaking path navigation and obstacle avoidance (Lankenau & Rofer, 2001; Mazo, 2001; Prassler, Scholz, & Fiorini, 2001). The GUIDO (2002) walker provides power-assisted wall or corridor following. The PAMM (Dubowsky et al., 2000) project focuses on navigation for residents in an eldercare facility, adopting a customized holonomic walker frame as its physical form. Although these examples are inspirational, we need to better understand the context that these products will be used in.Our examination of the emerging field of rehabilitative robotics revealed several opportunities for design research. The home is a growing area of need. Many debilitating accidents happen to the elderly and infirm while unattended at home (Living at Home, 2002). As robotic products emerge to ad
dress these safety problems, design research can support their broader usefulness and desirability to elders in their own environments. 1.2. Ethnographic Studies of Aging
The social sciences have a rich body of literature on aging and the elderly, much of it having implications for product design. Within sociology and anthropology, substantial ethnographies have examined the individual’s experience of aging and interpreted that experience within social, cultural, and even economic frameworks (Bailey, 1986; Golant, 1984; Hazan, 1994; Silverman, 1987; Ward, La Gory, & Sherman, 1988). These works provide valuable insight into understanding the role of objects, environments, and activities within the lives of elders and caregivers; they give designers clues for future product designs.We found two of these studies to be of particular interest. The “Casser Mai-son” Ritual (Marcoux, 2001) provides a material culture perspective on aging. The author followed an elder who downsized her home and redistributed her possessions to others in preparation for moving to a care facility. In this situation, the elder retained products whose functions served her particular impairments as well as those that signified her former lifestyle. Dorfman (1994) described an “ideal” aging experience in an extensive ethnography of elders in a Quaker community. The context for the study, an upscale residential retirement facility, offered an environment Dorfman felt was void of many of the stresses common to elders. The values of remaining autonomous, sustaining personal growth, helping others, maintaining social ties, and experiencing pleasures were identified as important for this age group (Dorfman, 1994).Our investigations identified a clear need for design research focused on how robotic products might support or hinder the values identified in this previous research; for example, keeping possessions that link one to the significant past. We focused our research on elders’ relations with products they currently own. In an earlier study, we found that assistive products can feel threatening as well as helpful to people. One woman refused to install bathroom grab bars although her husband had fallen several times in the bathroom; the bars would have ruined the decor of the house (Hirsch et al., 2000). In a related study for a Pittsburgh company developing a wearable monitoring product to improve health and fitness practices, we asked men and women, ages 30 to 55, to describe their reactions to a sleek, stylish, arm-worn medical monitoring device (McCormack & Forlizzi, 2000). Despite the fashionable product form, over one half of the participants said they would not feel comfortable wearing it, particularly at work and in other public places. One third of the participants described the product as reminding them of a lie detector or a blood sugar monitor, despite the high design of the product form. These pre
liminary studies suggested that we need a better understanding of how assistive products will be perceived and used. 1.3. Ecology of Aging
Our literature review and our previous research led to the development of a theoretical framework to guide our ethnographic research. An ecology is a set of interdependent parts that have particular relations within a system. Whether one is studying migration patterns in Liberia or the use of cleaning products in California homes, an ecological framework can be useful to examine relations among components of people’s experience. In anthropology, cultural ecology is the study of the symbiotic relation between people and their social environment (Netting, 1986). Researchers using a cultural ecology approach collect detailed descriptions of people’s behavior in their daily environments (Harris, 1979).More recently, Nardi and O ’Day (1999) used the term information ecology to describe an interrelated system of people, practices, values, and technologies within a local environment. An information ecology is used to situate new technologies ethically and responsibly, and to understand technology as a catalyst for change. Bell (2002) used the term ecology even more broadly, to include all the aspects of a specific experience in context. According to Bell (2001), cultural ecologies and the ethnographic research behind them help to convey an experience, a sense, a glimpse, or a window into another world ... a way of talking about deep cultural patterns that implicate everything we do. Knowing these stories, interests, and patterns makes it possible to design and develop products and services that fit (intuitively) into people’s lives, (p. 2)
Bell’s (2001) approach seems most relevant for new product design because it offers a mechanism for examining multifaceted aspects of products.We offer our ecological framework as a way to make sense of the experience of aging. It helps us to sift through the complex interactions between people, products, and activities, and the experiences that result. These interactions take place in a local environment bounded roughly by the home and the elder community. We have found it useful to consider these interconnected components of experience as an ecology of aging.The components of the ecology of aging include people, products, the built environment, and the community. The components themselves can be systems or networks. For example, the elder’s community is also a social network. Components may or may not reflect the roles and functionality they have in the rest of the society. The nurse’s approach to providing care is drastically dif
ferent from that of the superintendent in an apartment building, but both may be called on to assist with a caregiving task.The components of the ecology of aging are part of a system and are interconnected in the following ways: First, they are adaptive. If one part of the elder’s life breaks down (e.g., an elder is no longer able to drive safely), another part must change (the elder will rely on family and make less frequent trips, or hire a community taxi service created specially for seniors). Second, the flow of information among components can be complex and can have unexpected consequences. An elder may rely on his or her primary care physician for information ranging from blood pressure to how to deal with depression. The physician, in turn, may rely on the elder’s family for reports on the elder’s general physical and mental well-being. The elder, in turn, may feel the family is interfering, and tell the family less. Third, the components are dynamic and evolving. An elder who has broken a hip will have a myriad of opportunities for assistance in the first few critical weeks, including family, institutional care, home health care, and private and government services. Choosing any one of these can cause the particular experience of an independent elder to change greatly. Finally, the ecology has the potential to break down. Continuing with the aforementioned example, if an elder’s family imposes a move to a care institution, the outcome may be more detrimental than beneficial to the elder, resulting in reduced quality of life and well-being.Our focus in this study was specifically on the role of products within the ecology of aging. Products play a role in a balanced ecology. They help well elders in a variety of activities and experiences, and support independence and well-being. For example, Mrs. G. disseminated information about social events at her community center, and made sure newcomers felt welcome by telling jokes and giving small gifts. Mrs. C. befriended her cleaning lady, preparing a home-cooked meal to share on housecleaning days. Figure la depicts an elder within a healthy ecology of family and social connections interacting with products and undertaking activities, connected and vital within a local environment.The ecology of an elder experiencing decline can be described as one of imbalance. Changes in physical and cognitive abilities contribute to fundamental changes in product interactions. In turn, the elder is less able to undertake activities, and may relinquish independence and rely on assistance. For example, Mrs. R. was clearly struggling to manage her household, and was hurt and upset that her son had begun to “help” by removing items such as her prized Victorola. Mrs. L. relied on a local meal delivery service, but did not like the way the food was prepared and had begun to lose substantial weight.Figure lb depicts the ecology of a declining elder who can no longer use all the products she formerly relied on. As a result, a gap is created between the elder and her environment, and a contraction of physical and social lifespace occurs.
