Aging in Place Better

Uncovering opportunities for improving quality of life for older adults at home

To comply with confidentiality agreements, this case is a reinterpretation of the original. All team members and research participants are anonymized.

In 2014, it was clear that the needs older adults were facing were much greater than the available tools. Panasonic, with its brand promise of creating a comfortable home life and its developing Internet-of-Things technologies, established a Health and Wellness innovation team to address this trend. This is the story of how I helped the team understand and stay aligned with the unique needs of these potential customers while designing new products and concepts.

 

My Role

I directed user insights and experience design for the core internal team. Leading external and internal design consultants, and also working individually, I researched insights into older adults and their adult children caregivers, created personas, insight frameworks, and design principles for short-, mid-, and long-term products. I collaborated with design, product development, engineering, and executives to integrate user understanding into every step of the process.

Project Characteristics

Contextual inquiry, problem (re)framing, personas, opportunity framing, behavioral displacements, design imperatives

Industries

Consumer electronics, healthcare

Goals: A New Process and New Products

Our team of five had three main objectives:

  • Develop a user-centered and lean process for product/solution development and innovation in North America
  • Promote better quality of life for older adults in the USA
  • Generate a new pipeline of products/services, the first launched in 18 months

This was a personal challenge for me, as my first time directing research for a full product roadmap. I was the only long-term Panasonic employee on the team, and I quickly became the interpreter of company culture and internal connector for other members.

Design research flow

Overview of process map that I mapped out and followed for the program and individual projects.

Approach: A River of Content with Product Tributaries

We needed to launch our first product in 18 months, so I dug in with planning. I wanted to have ongoing fundamental design research as inspiration for new product ideas and as continual grounding for any products we began prototyping and developing.

Demo room for home health monitoring

We created a prototyping and demo room, starting by prototyping a home health monitoring system using off-the-shelf bluetooth devices. In addition to presenting major usability challenges for people with dexterity, balance, and sight challenges, we found the emotional effect of being monitored felt invasive and shaming.

Building Understanding in the Team

My team members had deep engineering and tech business experience but were mostly new to the design thinking and lean processes. I wanted to give them ongoing contact with real people they were designing for. It was vital for my efforts as a design researcher to inform and inspire all the product design stakeholders, not just for me to understand the users.

Team member adjusting watch

Team member setting a talking watch for a participant. The watch was designed for the blind, and the participant was unable to set it because of near blindness and arthritic hands.

A common mistake is to ask participants direct questions about solution concepts. You almost never get the information you’re looking for with these questions formulated from the design team’s point of view. To help my team members understand this, I included them in interviews as often as I could. I’ll never forget the disgusted look one of our participants gave a team member when he asked her, right after a deeply personal revelation, “Wouldn’t you like a scheduling app to manage all of your appointments and medications?” She had terminal cancer, and what she wanted most was to be able to walk in the woods outside her home every day for as long as she could. The team member learned to ask questions such as, “Could you show me how you manage your medications?” or “You mentioned that you have to drive two hours to your specialist. How does that feel? Can you tell me more about how that works?”

Studying People with Chronic Disease and Continual Care Needs

We started with the idea of “caregiver and care recipient,” which was the parlance used in much of the market research.

On the surface, the greatest need seemed to be physical care and safety.

Adult children, the “sandwich generation,” were often juggling this parent care with care for their own children, so caregiving management concepts bubbled up.

Two initial ethnographic studies looked at

  • care recipients with different chronic conditions, such as diabetes, macular degeneration, or cognitive challenges
  • different caregiver relationships, including adult child, adult grandchild, friend, or spouse.
Whiteboard mind mapping

Mind mapping with one of the design teams after early interviews.

To understand the ecosystem, we also interviewed professional caregivers, retirement community and assisted living staff and administrators, and other stakeholders in the constellation of care, as we were beginning to call it. We analyzed the data using clustering, 2×2’s, an era analysis, zooming in and out, and other methods.

Caregiver relationship two-by-two

We plotted different attributes to understand the ideal caregiver relationship—for instance, as shown here, we explored how to be close enough to be caring without being blinded by denial and guilt, as can happen with adult children.

Insights

Pivoting to Reciprocity and Staying in the Game

We soon saw that while caregivers were exhausted, they felt a sense of satisfaction from the care they gave. Care recipients, however, often resented this care, feeling a loss of control and shame at being dependent. Looking at successful care relationships through this lens, we noticed that care recipients who also gave back, either to the caregiver or someone else, were much more willing to accept caregiving with dignity.

Our initial understanding was skewed. We now knew that any product we designed needed to incorporate reciprocity, connectedness, and purpose to make users feel included rather than marginalized.

The Mental Model for Technology is Fundamentally Different Across Generations

To understand our participants’ relationship to both digital and analog technology, we studied their use of devices and appliances through in-context demonstrations and emotional collage maps. We learned that most participants have a confident sense of mastery with home appliances, even when they struggle with vision and dexterity, but that they feel insecure and often lost with digital technology, unless they have a clear set of instructions for specific use cases.

An era analysis can uncover cultural shifts and the events that triggered them, helping teams better understand the context their users live in. This is how we synthesized our understanding of the three generations’ relationship to technology, which correlated with the way they had initially learned it. It’s a gross over-generalization to assume that all people necessarily approach technology with the mental models fixed in their youth, or that all people in our target market had or have access to the most current technology. However, we felt it worthwhile to explore earlier, more analog relationships with technology as an inclusive, accessible model for design of digital products for all generations.

U.S. personal technology era analysis

We used this era analysis to understand mental models for technology interaction developed during youth and early adulthood.

We then asked, if older adults are “digital foreigners,” what cross-cultural communication could we embed in our designs? How might we bridge this wide gap between the 1:1 generation and the all:all generation? We hypothesized that designing digital products for the 1:1 analog-like experience could potentially improve experiences for the other two customer groups.

Personas for this Group Are About Relationship Models

In this market, we felt the critical design persona should be archetypes of pair relationships, based on actual people we worked with. We created four relationship personas based on whether pairs had healthy or unhealthy information diets and whether care and decisions were driven by the caregiver or the care recipient.

Ada and Justin relationship persona: "We owe it to each other."

In this relationship persona, there was deep love and an incalculable sense of duty, but exhaustion and discouragement had set in, and both sides were losing a feeling of control.

To help all the team members understand, I organized workshops, made posters of the personas, and tied product decisions back to them. We needed to focus on personas that could be helped by the types of solutions we could create. At one end, pairs who had gone beyond us and needed crisis intervention. At the other end, pairs were humming along successfully and probably wouldn’t avail themselves of our solutions. We focused on the other two—improving communication in one case and improving a sense of control in the other.

The American Ideal Is “Life is Good to the End”

Finally, we synthesized our research into an overarching framework. While the ideal expressed by participants was staying completely independent and then suddenly dying, the reality was a series of downward steps in independence, each representing a new normal achieved after a health event. Without advanced preparation and understanding, this could create incredible frustration. In addition, heavy-handed focus on safety made people feel out of control and depressed. And depression, we knew, was the greatest predictor of morbidity in this population. We wondered how we might help people create a softer landing while still maintaining dignity and joy?

Aging framework, with independence and emotional growth mapped against time

The American ideal of aging, overlaid with two possible realities, along with the possible arc of emotional growth.

The Meaning Journey Drives Health More Than Physical Needs

The Wonder of Aging, by Michael Gurian

The Experience Economy, by Joseph Pine II and James Gilmore

At about this time, I read Michael Gurian’s The Wonder of Aging, which maps out three stages of emotional growth in life after 50: transformation, distinction, and completion.  I felt this framework created the best opportunity for Panasonic to develop not only products, services, or even experiences, but “transformations,” as  defined by B. Joseph Pine II and James Gilmore in The Experience Economy. The team agreed, and we developed a set of design imperatives and opportunity buckets for digital and physical products.

We knew that products needed to provide purpose, connectedness, and reciprocity. More specifically, they needed, to name a few of the design imperatives,

  • 1:1 interaction
  • Digitally enabled analog experiences
  • An appropriate learning model, such as a daisy, always looping back to a “home base,” or a skeleton, mastering the core tasks before the more complicated tasks are even visible
  • Physical + cognitive + emotional fit to gain acceptance
  • Increased “fabricky” communication in families, meaning everyday communication conveying emotional and personal connection, as opposed to logistical or scheduling communication.

 Results

Picture of 911 cell phone, "Walter" in background with crossed arms

Walter’s daughter and caregiver gave him this “cell phone for seniors” with a 911 button on the back. He has never tried it, and isn’t clear he can use it.

I learned through this two-year program the complexity of designing for a constellation of stakeholders and how to keep a razor sharp focus on the people who will ultimately use the product. Too many products in this space, most notably PERS devices and in-home monitoring systems, have been designed for the purchaser (the caregiver) and have resulted in the loss of dignity and joy that they are intended to relieve.

The research also also brought home to me how digital technology has made so many wise and smart people feel stupid.

“I should be able to navigate the world like an old sea captain, but I feel like the kid left behind in a department store,” said one of our participants. 

What’s interesting is that the disorientation older adults experience with sophisticated digital designs is actually true for younger generations, too, simply disguised by familiarity. If we design for older adults as extreme users, we will create better experiences for everyone.

The program had many challenges, but one of the most difficult for me was keeping so many design and product teams aligned around united insights. We had strong “star” personalities on our core internal team, several external design and development teams whose research I needed to integrate, and remote internal executive and marketing teams whom we struggled to convince about the value of our process and decisions. This required continual communication, and I focused again on real stories of real people who would be using these products and a vision for improving lives. I also listened to each group’s needs and tried to integrate them as best I could into the work, without compromising my critical focus on the end user.

In 18 months, we ended with

  • one functioning prototype of a smart home for health monitoring,
  • one fully launched tablet app and service for shared book reading and game playing between distant grandparents and grandchildren,
  • one mobile wearable device and service,
  • a prototype for a multi-sensory exercise bike-controlled experience for older adults in assisted living facilities, and
  • a longer-term bucket of ideas for products and services focused on de-medicalizing the home and exploring themes of dignity, joy, legacy, and reciprocity.
Bicycle-controlled screen experience prototype

Aura soothing outdoor experience for people who are unable to go outdoors, designed in collaborative project with Stanford mechanical engineering students.

This team of tech- and business-focused stars had previously produced products that were engineered with great expertise yet had failed to emotionally connect with users. I was excited that my work enabled them to see more clearly the real stories and insights of potential users, and to bring products to life that touched people’s lives in positive emotional ways. Working with them through this transformation was one of the most gratifying parts about this program.

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s