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Designing new technology for older people requires the ability to translate specific requirements from a heterogeneous group of people into a suitable application framework. As the proportion of older people continues to increase worldwide, the authors faced with a number of challenges to enable older people to remain at home and still have a quality of life. Many older people are technophobic, unfamiliar with modern computers or somewhat reticent about learning to use them, so ergonomic design is essential to ensure usability. The dependability model for assistive technology systems developed by Dewsbury et al has been developed as a basis for discussing and analysing home technology systems such as the Tablet software. By considering the needs of participants and directly reflecting them in the design process has led to a more efficient design which is clearly useable by the participants.

Technology provides nurses with a new set of tools to enable and improve the nurse–patient relationship. Although not all information and communication technology is 100% accurate, it still provides the ability for readings which can be used to support the management of long-term conditions in the community. Additionally, technology can empower the patient, enabling them to take control over their condition and enable the nurses who support them. It can break down barriers, such as language and distance. However, it is not without its drawbacks. This paper considers the advantages and disadvantages of community nurses using technology.

When it comes to updating records and other administrative tasks, pencils and paper are rapidly being replaced by smartphones and tablets. But in order to get the most out of new technologies you need to choose the right software

A good knowledge of the latest technology in software can offer a range of options that might enable better quality of care. Guy Dewsbury and Debbie Ballard provide an overview of the benefits of understanding technological advancements

Modern technology has always played a hand in shaping the way we live, work and care for those around us. In this article, Guy and Debbie Dewsbury take a look at the innovations in this area, and how they can help those working and living in care

Software supports the day-to-day management of care homes, which are increasingly becoming modernised and now can support web-based systems. There do not appear to be many providers of web-based software, but this form of system is likely to proliferate in the future, as it is easy and convenient

Whether you need a new nurse call system or an upgrade, the keys to a successful transition are careful planning and training. Get these right, say Guy Dewsbury and Debbie Ballard, and everyone will benefit

Nurse call systems can benefit staff in a variety of ways, be it through improved patient care, improved communication or nurse efficiency. Guy Drewsbury and Debbie Ballard give an overview of this essential service

Nurse call systems have a wide range of performance, functions and prices. A good system could be invaluable to your care home. A bad one, or the wrong one, could simply add to staff workload. The key, say Guy Dewsbury and Debbie Ballard, is to do your research

In today's economic climate, organisations, such as the NHS, are trying to make savings wherever possible. Embracing new technology is increasingly a cost-effective way to make care more efficient and personalised, with a number of products to investigate

Most telecare devices, if used appropriately, have the potential to benefit a person. However, as Guy Dewsbury and Debbie Ballard explain, the ethical dimension of any telecare device in relation to what the person expects from its use should be considered

Healthcare assistants (HCAs) and assistant practitioners (APs) can be using technology for much of the time during their working day, without really thinking about the technology itself. This article looks at some of the ways in which technologies will be part of the new care provision as well as technologies that can be used to assist caring for someone.

This paper traces the development of information and communication (ICT) within health care and the emergence of telehealth as a key component of modern health care delivery as health care moves from the 'face to face age' to the 'information age'. The paper examines the interface of ICT and nursing practice and highlights the limited evidence relating to the nursing contribution within telehealth particularly beyond data input and output analysis for other health care personnel. Additionally, the absence of research relating to the impact of ICT upon nurses and their working lives is identified. The paper concludes that nurses need to engage more fully with ICT so that they contribute to shaping the care system and emerge as leaders of the new care systems delivering future clinical activity.

Guy Dewsbury and Debbie Ballard talk us through the evolution of the nurse call system and suggest ways in which care and residential homes can use telecare to ensure residents are safe and that providers adhere to appropriate legislation

With proposals for a paperless NHS, care homes need to consider how they will adapt to an electronic health-care system. Guy Dewsbury and Debbie Ballard discuss how technology can support nurses and care assistants as well as residents

Designing applications to support older people in their own homes is increasing in popularity and necessity. The increase in supporting older people in the community means that cash-strapped resources are required to be utilised in the most effective manner, which often lends itself to technology deployment, rather than human deployment as the former is perceived as more cost effective. Therefore, the concern arises as to how technology can be designed inclusively and acceptably to the people who are to receive it. This paper discusses the issue of design, and how these concerns have been addressed in a series of projects targeted towards directly supporting people in the community.

Evidence from a variety of sources indicates that there is a correlation between environment, support structures and behavioural response for people with complex needs which affects the quality of life in living environments. As part of the shift from institutional living to community‐based options, an inclusive approach, working on a theoretical and practice‐based response, was established. The aim of the project was to achieve an inclusive package of support while encouraging development of individual skills of daily living, in a flexible and interactive environment. During the course of the project, 39 purpose‐built housing units were established using the approach described, and they are currently the subject of evaluation.

This paper describes a model that defines the attributes of domestic systems that lead to system dependability and a user-oriented specification method for support systems based on this model. We start by discussing technical dependability models and discuss how these have to be extended for use in a domestic context. We present an extended dependability model based on a socio-technical perspective. This extends the technical notion of dependability to take into account fitness for purpose, acceptability and adaptability. We then go on to discuss MDDS - a questionnaire-based method that reflects the socio-technical dependability model. It is intended for use by social care professionals who are specifying and designing support systems for older or disabled people. MDDS provides a basis for examining a design from a dependability perspective. We illustrate the use of the method and conclude with a discussion of its qualitative evaluation.

This paper documents work from the EPSRC ‘EQUATOR’ and Dependability Interdisciplinary Research Collaboration on Computer Based Systems (DIRC) concerned with the appropriate design of dependable assistive technology to enable older and disabled people to maintain a quality of life within their own homes. Technology, especially so‐called ‘smart home’ technology, can only be used to assist people if it is effectively designed. Designers are therefore required to consider certain key questions such as what situation they are designing for, what solutions should do, and who should use them. The focus in this paper is on understanding and identifying user needs and system requirements for dependability in the complex challenge of inclusive design. The feature of inclusive design addressed here is the new emphasis on the user, a living, breathing person situated in real world settings along with others, rather than some designer's abstraction. The acceptance or rejection of assistive technology relies on the users' perceptions of the designed technology as well as the appropriateness of the technology designed. Consequently, this paper suggests that despite highly imaginative views of future technologies, getting such dreams to work generally means they must, at some point, meet the real world and engage with the needs of users if they are to be sufficiently grounded. Given this emphasis on users, the highly personal character of domestic settings presents conventional research techniques with obdurate problems that can make research practically and ethically difficult. Researching domestic spaces and domestic values requires different methods to understand the unique needs and experiences of residents. Accordingly, the authors report on their experiences of using observational studies and adapting ‘cultural probes’ to foster an ongoing dialogue with the members of their user groups, to gain insights into their needs and generate design relevant information and inspiration. The paper discusses how such information might feed into dependable design through consideration of a model of dependability.

Social theories are usually developed to enable a clearer understanding of a situation or problem. The 'Social Model' in various forms is currently the dominant model for researching disability, addressing disability from within a socio-political framework that draws substantially on a 'social constructionist' perspective. This article critiques some of the core sociological assumptions of the Social Model, questioning what 'work' this kind of theory does in informing a set of practical concerns around the design of assistive technologies, suggesting an alternative framework of analysis, supported by extensive ethnomethodologically informed ethnographic research

This paper presents some early design work of the Care in the Digital Community research project begun under the EPSRC IRC Network project Equator. Gaining a comprehensive understanding of user requirements in care settings poses interesting methodological challenges. This paper details some methodological options for working in the domestic domain and documents the translation of research into design recommendations. We report on the importance of medication issues in a hostel for former psychiatric patients and present an early prototype of a medication manager designed to be sensitive to the particular requirements of the setting.

This article introduces the notion of telecare technology and its use within the community to enable older people to live independently. It identifies the essential things that healthcare assistants (HCAs) should be aware of when working with telecare.

This paper considers the design of technology in domestic, or home, settings. The systems themselves have become increasingly complex and the need for dependable systems correspondingly important. The design problem is concerned less with the creation of new technical artefacts than with their effective configuration and integration. Inadequate understanding of the lived reality of use and user needs is often responsible for lack of dependability. The paper illuminates and highlights some fields for future investigation.

Designing assistive technological solutions for disabled and older people is fraught with problems because of the number of agencies involved. These problems are compounded by the lack of under-standing that can exist between the engineers and the health staff. This lack of understanding can develop into extreme delays in installing the technology, while the needs of the person with disabilities are subsumed in preference to ease of design and installation. Clearly, these potential misunderstandings could be ameliorated by improved communication between the widely different disciplines each with their own culture, ethos, knowledge and jargon. The CUSTODIAN Smart-House simulation software provides a focus for discussion on CUSTODIAN's development in relation to reliability and safety of systems design.

The role of community nursing services is changing and the ability to adapt to the new roles and challenges using technology is becoming increasingly important. This article considers the positive role that using patient management systems and care registers can play in improving and developing new work patterns through the use of online, shared working practices.

Whilst the ubicomp community has successfully embraced a number of societal challenges for human benefit, including healthcare and sustainability, the well-being of other animals is hitherto underrepresented. We argue that ubicomp technologies, including sensing and monitoring devices as well as tangible and embodied interfaces, could make a valuable contribution to animal welfare. This paper particularly focuses on dogs in kenneled accommodation, as we investigate the opportunities and challenges for a smart kennel aiming to foster canine welfare. We conducted an in-depth ethnographic study of a dog rehoming center over four months; based on our findings, we propose a welfare centered framework for designing smart environments, integrating monitoring and interaction with information management. We discuss the methodological issues we encountered during the research and propose a smart ethnographic approach for similar projects.

Background There is growing interest in assisted living technologies to support independence at home. Such technologies should ideally be designed ‘in the wild’ i.e. taking account of how real people live in real homes and communities. The ATHENE (Assistive Technologies for Healthy Living in Elders: Needs Assessment by Ethnography) project seeks to illuminate the living needs of older people and facilitate the co-production with older people of technologies and services. This paper describes the development of a cultural probe tool produced as part of the ATHENE project and how it was used to support home visit interviews with elders with a range of ethnic and social backgrounds, family circumstances, health conditions and assisted living needs. Method Thirty one people aged 60 to 98 were visited in their homes on three occasions. Following an initial interview, participants were given a set of cultural probe materials, including a digital camera and the ‘Home and Life Scrapbook’ to complete in their own time for one week. Activities within the Home and Life Scrapbook included maps (indicating their relationships to people, places and objects), lists (e.g. likes, dislikes, things they were concerned about, things they were comfortable with), wishes (things they wanted to change or improve), body outline (indicating symptoms or impairments), home plan (room layouts of their homes to indicate spaces and objects used) and a diary. After one week, the researcher and participant reviewed any digital photos taken and the content of the Home and Life Scrapbook as part of the home visit interview. Findings The cultural probe facilitated collection of visual, narrative and material data by older people, and appeared to generate high levels of engagement from some participants. However, others used the probe minimally or not at all for various reasons including limited literacy, physical problems (e.g. holding a pen), lack of time or energy, limited emotional or psychological resources, life events, and acute illness. Discussions between researchers and participants about the materials collected (and sometimes about what had prevented them completing the tasks) helped elicit further information relevant to assisted living technology design. The probe materials were particularly helpful when having conversations with non-English speaking participants through an interpreter. Conclusions Cultural probe methods can help build a rich picture of the lives and experiences of older people to facilitate the co-production of assisted living technologies. But their application may be constrained by the participant’s physical, mental and emotional capacity. They are most effective when used as a tool to facilitate communication and development of a deeper understanding of older people’s needs.

This paper proposes that people with neurological conditions can be successfully supported by smart homes only when their needs and aspirations of the technological interventions are fully understood and integrated in the design. A neurological condition can and does provide a clue to the finished technological design but this alone fails to personalise the system and stands to be rejected by the person who requires the technology. This paper explores the underlying issues of the complexity of this design process when designing for people with neurological conditions, and advances a matrix to facilitate the assessment process to maintain a person-centred design of any system.

This book looks at socio-technical systems, that is systems which consist of a group of people working with some complex technology in order to achieve some common purpose. We shall be dealing in the main with the case of the technology being a computer system, though the ideas we shall present are applicable to other forms of technology, and we shall also discuss them in the context of a railway system. The main reason for looking at socio-technical systems is to explore the extent to which ideas of dependability, which have been developed for technical systems for some decades now, can be applied to socio-technical systems. It is no longer good enough simply to say that a failure was due to a computer error; in most cases there was a human error along the line too. We shall be looking at what sorts of thing can be said about error that applies to both computer error and human error. These ideas are not so much concerned with what causes errors, but how errors can be prevented or recovered from. It is this focus on prevention and recovery that led us to understand that there are indeed some concepts and structures that are common to the ways that errors are managed in both technical and human systems, though the actual causes may well be of very different kinds. We now introduce two major concepts that this book is about: dependability and responsibility. Dependability is a term that has been used by computer engineers for three decades or more to mean that the computer system can be trusted to do what it is supposed to do, and our discussion of dependability in this introduction will closely follow the standard texts. However, as we will see, some of the thinking has to be revised somewhat if it is to be applied to the kind of socio-technical systems that are the subject of this book. We shall show that these revisions bring in human concepts of responsibility –roughly, that doing what you’re supposed to do means discharging the responsibilities that you have been given or have assumed– and that this reinterpretation leads to ways of thinking about the relationship between people and computers in carrying out some socio-technical task to be performed by people and computers working together. We shall then introduce the idea of modelling responsibilities, saying something about what we mean by a ‘model’. We shall explain that making a model of responsibilities is a way of building a bridge between the social discourse of responsibilities for tasks and states of affairs in the world, and the architectural or engineering discourse of making an artifact that assists a person in performing those tasks or bringing about (or maintaining or preventing) those states of affairs. Since this book is about the social aspects of a socio-technical system as well as the technical ones, it will discuss the use of ethnographic methods to discover how responsibilities actually lie in an organisation. This chapter therefore also contains a brief introduction to the use of ethnographic studies in understanding responsibilities. These basic ideas –dependability, responsibility, modelling and ethnography– and the relationships between them are expanded later in the book, so although the reader may well be justified in thinking that this introduction raises questions that it does not answer and that there is more to be said, we hope the remainder of the book will go some way to saying more and answering at least some of these questions.

Introduction: Dependability and Responsibility in Context.- Introduction: Dependability and Responsibility in Context.- Philosophical and Social Aspects.- Responsibility: A Philosophical Perspective.- Responsibility in Practice.- Complex Organisational Responsibilities: The Ladbroke Grove Rail Inquiry.- Modelling.- Responsibility Modelling: Basic Concepts.- Models for Understanding Responsibilities.- Understanding Failure: The London Ambulance Service Disaster.- New Methods.- Models for Responsibility Assignment.- Causal Responsibility Models.- Modelling in Practice.

The development of the tablet platform and applications continues, the tablets successfully transmit the writing from one to another in real time and the chat and games applications have been developed to a beta stage. They are currently being tested with participants in their own homes. The technology developed is a direct result of the co-working relationship that the team have built up with the participants. Without them there would be no design, and without them there would be no improvements. Throughout the course of this research we have attempted to work with the participants as equals in the project and reflect their wishes in the final designs. It has been a learning experience for all members of the team. We also see that although the applications have been developed on tablets for tablet PCs there is no reason why we cannot use them on standard computers. Similarly, although the applications were developed for older people by older people, there is no reason why they cannot have as much worth with other people in the wider world.

It is now widely realised that the home is likely to prove an important site for new information technologies (Venkatesh 1985; 1995; Crabtree et al 2001). This book documents the extent to which the convergence of a number of technologies that link computers with various communication and entertainment technologies, have created new possibilities, of home shopping, video on demand, home banking, and so on. At the same time other reports such as the EU Report on the Electronic Home (Moran, 1993) have identified a number of social trends near zero population growth, the rise of the proportion of the elderly, the decline of multigenerational households, the increased number of 'non-traditional' homes, new forms of work, increasing leisure time, etc that may prove fundamental in shaping ideas about the development of the electronic home. Until comparatively recently, however, little attempt has been made to systematically study home life, as the EC (Moran, 1993) commented

Ian Sommerville, Guy Dewsbury, Karen Clarke, Mark Rouncefield Computing Department, Lancaster University. Our economy and national infrastructures are dependent on a range of socio-technical systems and, by and large, these systems can be trusted to provide a dependable service. For example, electricity and telecommunication systems are generally reliable, the bank ATM network can usually deliver cash to authorised customers and automated stock control systems have meant that large stores and supermarkets rarely run out of specific products. In essence, at least in Western societies, the vast majority of people trust the services that are provided through the physical and economic infrastructure. This trust is engendered because, these services almost always meet the expectations of their external users. In order to meet these expectations, complex socio-technical systems have to be put in place by the service providers and these now, universally, rely on computer-based information systems. These information systems are essential elements of the socio-technical systems so both the organisations running these systems and the system users depend on them. The information systems that support the socio-technical systems that run the national and business infrastructure have two important characteristics: 1. They are situated in organisations (banks, telephone companies, electricity generators) that have a history of service provision and that have well-established processes for managing the delivery of these services. External users of organisational systems trust these organisations to use their best endeavours to ensure that their computer systems deliver correct information. Furthermore, it can be assumed that the people in these organisations follow the defined operational processes when it is appropriate to do so and react in a contingent way when they are faced with exceptional situations not covered by these processes. 2. They are essential for the effective provision of organisational services and the people within the organisation who are involved in the process do not have the authority to decide whether or not the automated systems should be used. It can be assumed that the operators have received some training in the use of the software and also that, whatever

There is a growing recognition that gerontechnology must be about more than usability and technical reliability, it is also about addressing and fulfilling wishes and desires; fitting in to people’s lives and according, as far as possible, to their expectations. To create appropriate technologies that will be acceptable and appropriate demands a shift of emphasis from the technology to the people, from analyses of functional decline to more holistic views of ageing as personal and life experience. Most importantly, it demands innovative approaches to gerontechnology: a person-centred approach in which researchers form partnerships with older adults.