How’s Mom Doing? An App That Helps You Stay in Touch With Elderly Relatives

Kenny Ma, Claire Nikong, Aydan Bailey, Jiamae Wang

PROBLEM AND SOLUTION OVERVIEW

These days, seniors vastly prefer aging-in-place over staying in assisted-living facilities. If you have an elderly relative who stays at home and needs any kind of care, then you know that at times, providing care can be stressful and taxing. As students taking the Human Computer Interaction (HCI) course at the University of Washington, our group explored how we might help adults in America (our target user group) provide care for their elderly relatives.

In our research, we found that many of our user’s common problems trace back to the communication and relationship issues between the caregiver and their elderly relative. While technology may not be able to fix these fundamentally human problems, our solution attempts to alleviate these difficulties by encouraging, in various ways, more frequent communication between relatives.

Our design is an application that connects to the user’s mobile app and the elderly relative’s senior-friendly tablet device. This design helps users support their elderly relatives by having users receive daily journal entries and allowing them to help manage their relatives’ tasks. Two-way interaction and support is then facilitated by encouraging users to reply to journal entries to let their relatives know what they have going on. This strengthens the relationship between the caregiver and relative, even while geographically separated.

DESIGN RESEARCH GOALS, STAKEHOLDERS, AND PARTICIPANTS:

We conducted the majority of our research using two research methods: surveys, which allowed us to identify general patterns within our user group, and interviews, which granted deeper insights into users’ specific situations.

For surveys, we created an online form that asked about users’ habits when caring for elderly relatives. Questions focused on quantifiable information (e.g. “How often do you call your relatives?”) with options to explain in further detail. A few qualitative questions like “What do you wish you could change?” were also included. Working within tight course time constraints, we did our best to mitigate bias due to convenience sampling by distributing our survey as widely as possible via various public platforms, including requesting distribution on the Seattle AARP mailing list, as well as posting on EdStem (our course discussion board), Discord servers, and Reddit. In the end, we only received results from the last two — around 8 of 11 survey responses came from the subreddit “r/SampleSize.” Ideally, we’d collect more research from broader, public platforms to be more representative of our target population.

Our three interviews were semi-structured: they began with a set of pre-written questions to scaffold the interview, but intentionally branched off into particularly interesting topics or stories. For our interviewees, we attempted to maximize degrees of separation from team members, but this was particularly difficult due to time constraints and the sensitive nature of our research topic. We ended up speaking with one of our family members, the parent of a friend, and a classmate, receiving unique accounts from all three.

DESIGN RESEARCH RESULTS AND THEMES:
There were several themes that emerged from our research and design process:

• Pushback from the elderly relative — elderly relatives sometimes resisted care due to embarrassment and/or a desire to retain autonomy. For example, one interviewee’s grandma once had a bad fall. Tensions arose between the grandma’s desire for autonomy and her family’s concern that she remained supervised whenever leaving the house.
• Uncertainty about how to provide care — many caregivers are not entirely sure how they should be providing help. For example, one interviewee’s mother was living with MS and Parkinson’s. The interviewee had difficulty figuring out how to help, especially when her mother wasn’t forthcoming about her own needs and desires. This resulted in a lot of guesswork and friction.
• Distance — our findings indicate that providing good long-distance care is next to impossible. Even with effective long-distance monitoring, there isn’t really a way to actually respond to emergencies.
• Range of tasks — caregivers have to accomplish a myriad of tasks. The range of tasks — from booking appointments, to visiting specialists, to buying them a shower chair because they might slip, to cleaning hard to reach places in the house — was wider than we expected.

“Communication” also kept coming up in our results — survey respondents rated “Communication” as the most important issue among “Monitoring relative’s health”, “Long-term care”, and “The burden on you”. Many respondents explicitly reported a desire for more open communication with their relatives about their relatives’ needs. After analyzing themes, we believe communication is actually the foundation of all of the above. For pushback and uncertainty, simply increasing the frequency of communication can build a stronger sense of understanding and expectations between family members, and create the space for difficult but necessary conversations about care. This can also eliminate much of the guesswork and overstepping of boundaries, which are the typical causes of friction. Communication can also, not solve, but mitigate the issue of distance by substituting physical separation with emotional closeness. For accomplishing a wide range of tasks, a strong line of communication is critical not just for ensuring that the relative’s needs are ultimately met, but that those needs can be identified in the first place.

PROPOSED DESIGN:

Our findings imply that communication between caregivers and their elderly relatives needs facilitation, and when either party is busy, asynchronous conversations are the most effective and convenient. To facilitate this kind of communication, we propose the following solution: an application connected to a senior-friendly tablet (cheap, lightweight, portable, large-font, etc.) that allows the elderly relative to write daily journal entries and send them to the user’s phone. The user can then read these journal entries, keep track of their relative’s care-related tasks, and send replies to share how they’re doing themselves.

Journal entries

For the journal entries, the elderly relative writes whatever they’d like — health concerns, thoughts, day-to-day activities, or life updates — and clicks the send button, delivering these entries to the user. Entries can be written using a stylus, keyboard, or by importing a handwritten document, and even include uploaded photos. The user can install an application on their existing mobile device to receive these entries and connect with their family member.

An example of this interaction is illustrated in the storyboard below (Figure a), where a user is wondering how their mom is doing. The user checks on the most recently uploaded journal entry and sees that their mom was feeding birds and felt some knee pain. Knowing this, the user decides to call their mom to catch up a little and make sure things are okay.

Figure a: Storyboard of Possible Journal Use Case

To ensure that both parties feel like they’re providing and receiving communication and support, there will also be a reply function for the user to post whatever they’d like, and a record/feed of posts where the elderly relative can see what their loved ones are up to. Since the user may be quite busy, this feature provides a convenient way for them to reciprocate (as opposed to sending a full journal entry back). Additionally, if users haven’t replied to their relatives in a while, the app can try to reignite communication, e.g. by displaying response prompts like “Draw the best part of your day today” or “What were the highlights and lowlights of this week?” — we’re still thinking of ways to scaffold the habit of constant communication.

Task Management

The device will also track tasks that the older relative needs to complete each day, ordered by priority to ensure that nothing is missed. Tasks — such as taking pills, or arranging transportation to an appointment — can be created by the elderly relative on their tablet. The caregiver can also create tasks on their mobile app and send them to their relatives for approval, before being added to the task list. This design intentionally emphasizes relatives retaining control and autonomy. On the same note, it’s important to implement a reliable method for users to gently remind their relatives of outstanding to-dos. This provides the user some peace of mind without making them seem overbearing. The storyboard below (Figure b), shows how this might work: first, our user checks up on what tasks Grandma is up to. After realizing that she hasn’t taken her pills yet, the user clicks the “remind” button which notifies Grandma. In most cases, this is sufficient. Otherwise, the user is given full view of the task list, so they can reach out more directly as needed.

Figure b: Storyboard of Possible Tasks Use Case

Ultimately, our design seeks to improve communication and nurture relationships between older and younger family members, no matter the distance between them. This includes facilitating difficult conversations about care, as well as helping both parties stay involved in each other’s lives through small, low-investment, but regular interactions. Ultimately, we hope that encouraging this kind of communication/interaction will make providing care easier by removing some of the guesswork and reframing care as a goal that both parties work towards together.