Co-design priorities and components of AAL technologies with formal caregivers to support dementia care in Taiwan.

Purpose Dementia has become one of the most important and challenging areas in health care (Gauthier et al., 2021). Improving quality of life for people with dementia (PwD) relies heavily on optimal care quality and efficiency, which however, is difficult to be achieved as most health institutions are understaffed. Ambient Assisted Living (AAL) technologies provides an alternative approach of increasing the health outcomes of PwD as well as reducing the care burden for caregivers. As part of the European Union 'Active and Assisted Living Programme' project "HAAL: HeAlthy Ageing eco-system for peopLe with dementia", this study aimed to investigate the perspectives of formal caregivers working with PwD to establish priorities and components of designing a HAAL platform which combined different AAL technologies. Method There were nine major technologies combined in the HAAL platform to assist and/or improve the care quality for PwD including a senior tablet, indoor sensors, a smart mattress, a GPS tracker, a medicine dispenser, a care robot, cognitive and physical game, rehabilitation game, and a fall detection sensor. MoSCoW analysis (Kuhn, 2009) and Meaningful Try-out cards (Cornelissen & Suijkerbuijk, 2022) were mainly used as the co-design methods. We recruited 24 participants between Dec 2021 and Feb 2022. At the beginning of the session, all products were introduced to them, and then they were asked to rate individual products or combinations of the technological products as whether they thought a certain technology or combination as a 'must have', 'should have', 'could have' or a 'would (nice to) have'? To evaluate the requirement levels of different technologies, weighted average was applied by taking into account the varying degrees of the number of participants who chose different levels. We labelled the level 'must have' as 4 and 'would (nice to) have' as 1, with higher scores indicating higher requirement level. In addition to the requirement level, we also asked participants the reasons why they gave that rate for a certain product or combination. The Meaningful Try-out cards contains seven themes as functionality, usability, stakeholders, communication, organization, environment, and suppliers. We recruited 20 formal caregivers in Feb 2022 and interviewed them for their perceptions of the HAAL platform regarding different Meaningful Try-out themes. Twenty participants were asked to choose two themes out of seven and gave their opinions for each product. We received 39 replies for functionality, 79 replies for usability, 3 replies for stakeholders, 52 replies for communication, 2 replies for organization, 40 replies for environment, and 10 replies for suppliers. Results and Discussion Twenty-four formal caregivers attended the MoSCoW analysis session, and rated the requirement levels for all nine products and twenty combinations of different products based on their functions. Of all the nine products, the weighted requirement level was ranged from 2.0 to 3.6. The first three high rated technologies were fall detection sensor, smart mattress, and GPS tracker. The primary reasons of such rating were the wellbeing of PwD, psychological relief, and workload reduction. The top rated combinations of different technologies were (1) indoor sensors + smart mattress; (2) indoor sensors+ GPS tracker + fall detection sensor; (3) indoor sensors+ smart mattress + fall detection sensor. Despite of the high requirement level for these technologies, formal caregivers proposed valuable concerns and suggestions for the design of more feasible features or concise interfaces to solve the dementia care problems or fit the care process. For the Meaningful Try-out session, design components for each product were collected for further development. Take usability as example, we asked the learning time to start using each product, and the results were less than 0.5 hour (39%), 0.5-1 hour (46%), 1-2 hours (11%), and more than 2 hours (4%), we further asked them if this was acceptable and if not, what possible suggestions they would like to propose. The co-design process provided both quantitative and qualitative data on both priorities and components of the HAAL platform to help achieve a more adaptive user centered technological design for dementia care. [ABSTRACT FROM AUTHOR]