Nursing Home of the Future Lab Preps for Move into Active Experimentation
As BIF heads into 2009, work continues full steam in the Nursing Home of the Future (NHoF) laboratory. Leveraging the work of Phase I and the relationships BIF has created with Tockwotton Home, NHoF project advisors, BIF partners from the private sector, and elder care experts from across the country, the NHoF team is now set to begin active experimentation in areas most deeply in need of new solutions. At the heart of this next phase of work is a strategy that engages elders directly in the development of protocols that govern NHoF lab methodology.
Elder Engagement Design Workshops
Members of the NHoF lab are currently working to refine and test the protocol set that governs NHoF lab methodology. NHoF lab personnel are designing protocols using a unique process that engages elders directly in the methodology development process. As with all lab activities, this approach has offered the team an unprecedented opportunity to understand the elder experience in an intensely intimate way from the inside in.
Through a series of design workshops with elders, the NHoF team has solicited feedback on draft protocols for conducting experiential research, data capture techniques, use of physical and virtual lab environments, and approaches for sustained elder engagement in all lab activities.
This activity has enabled NHoF lab personnel to construct methodologies that directly reflect the needs, unique competencies and expectations of elders engaged in lab activity. This approach, which will be mirrored in the NHoF lab’s expansion into non-institutional and virtual environments in 2009, is one of several features that differentiate the NHoF laboratory from traditional product development services.
The lab also is busy preparing for activities that will expand our experimental capacity to include individuals living in non-institutional environments (such as in the home) and baby boomers who live independently but are preparing for life changes associated with aging.
Field Notes from the NHoF’s Elder Engagement Design Workshops
On January 6, the NHoF design team ran the second of a series of participatory design workshops with the Assisted Living residents at Tockwotton Home, focusing on bathrooms and personal care routines. The euphemistically named "personal care" encompasses all sorts of private activities, from brushing teeth and putting on makeup, to using the toilet and taking a shower or bath.
In Phase I, our design observations uncovered that personal care routines were a high impact area for re-thinking the elder experience and that the small space in which they take place, the bathroom, was ripe for redesign to better meet the elders needs, wants, and capabilities.
So what better way to re-think the bathroom than with the elders who use it daily? The team set up in Tockwotton's solarium, a pleasant room with plenty of chairs and tables and provided a surface for post-its and quick sketches. Nine assisted living residents walked and wheeled in, curious about what was about to occur. One woman was accompanied by her daughter.
Lead designers Michael Lye and Julianne Gauron gave a brief introduction explaining the process; the elders were free to act like design students, with no wrong questions and no bad ideas. It was up to the team to facilitate, to write and sketch, to give examples and to make sense of the residents' input. With that they split into small groups, each with a design facilitator, to walk through and describe bathroom routines, uncover major problems and challenges where the bathroom didn't match needs, and to think about what better solutions would accomplish.
In these smaller groups, the elders were inspired to think about their bathroom experience. As the groups began to discuss the specific problems they had in the bathroom environment, conversations about challenges and opportunities began to flow freely...so freely that the facilitators had trouble keeping up with all the ideas and issues being raised!
Needing assistance with showering was a topic that generated many comments. Though the residents felt that the aides did a great job helping, the mechanics of having one person in the shower while trying to keep the other from getting drenched was very difficult. Other problems that were noted included the lack of holders to place soap, shampoos, or other products in the showers and sinks - something commonplace in many bathrooms but a particularly acute problem in small bathrooms that many elders have and sometimes need to share. The residents also spoke of the difficulties of showering while sitting down, especially when using a hand-held shower. It's hard enough hanging on to a wet, slippery hand shower while wrestling with the hose. Imagine having to hold it in one hand while holding onto a grab bar in the other in order to maintain balance. Certainly makes it pretty difficult to take a relaxing shower. Even just maneuvering in the bathroom when needing to use a walker or a wheelchair pointed out the fact that many bathrooms were really not designed with the needs of this specific population in mind.
Similar to so many of the conversations elders have in the NHoF lab, discussions about solutions all focused around a common aim, independence. Some simple solutions involved redistributing bathroom storage spaces. More sophisticated technology-based concepts included motion sensors for lighting, bathroom-specific environment controls, and warmed and more slip-resistant floors.
The space itself was re-envisioned, prompting questions like “if we are meant to shower sitting down, why do we still have shower stalls which suggest upright use?” The shower structure should be completely redesigned for a seated user and the independent shower head should accommodate weakened grips of users. The space around the sink also needs radical rethinking, as became evident when almost every participant admitted that they abandoned their wheelchair or walker to clamber around the bathroom on their own. This creates enormous risk of falling but comes out of the unmanageability of a movement aid in the space, as evidenced by the fact that a walker or wheelchair cannot fit under the sink and must be awkwardly put aside. What if the sink allowed walkers under it and was organically reshaped to avoid reaching on the users part? These and many more concepts were discussed. It was clear that once the residents were given examples and comfort around design solutions, the floodgates opened and ideas came rushing in.
By the end of the session, the residents were so energized and full of new solutions and we brought the workshop to a close for dinner. From these many ideas, the design team will produce sketches that will be posted around Tockwotton for the residents to see how their inputs can be turned into possible solutions and how tangible and enlightening the results of their efforts can be.
The purpose of these sessions goes beyond generating seemingly random ideas. As the lab begins more focused and active experimentation, lab personnel require a protocol for elder engagement that ensures designers can accurately capture an experience and solicit elder feedback on new solutions. This activity is an essential compliment to other data capture techniques (such as video and photographic capture).
Over the next few weeks, lab personnel will continue to refine these techniques and enter into a series of experiential beta experiments to put principles developed through the design workshops into active use.