The Heart of the Matter: Aging-Related Conversations

If you’ve been following our project on the AC4D blog, you know that our group (Maryanne Lee, Laura Galos) is working on a design project to help facilitate the difficult conversations seniors and their families have around the major changes that come with aging. We are just past the midpoint of our ideation and development phase, and we felt it would be worth going back to the research to recap our findings and how we got to our current iterations.

Last quarter, we spent eight weeks conducting qualitative research with a range of individuals in their 30’s to their 80’s. We started with a focus on how people are planning for and financing their post-work years in the context of increasing longevity.

After some preliminary synthesis, in which we took our collected data and began to identify patterns, we saw that our research participants had a idealized view of retirement—filled with vacations, travel, and freedom from stress—that was misaligned with many of the realities of retirement, especially later retirement. One participant, despite suffering from health issues, summed it up with, “I think [retirement] is when your problems should just go away…I can’t think of anything really hard about being retired.”

Sickness, decrease in mobility, the potential difficulty of finding purpose, when and if to move to a retirement home—all of these contributed to a picture of “retirement” that was not nearly as rosy as the word normally conjured up. And this led us to our first insight. Our insights, while they stem from our research, are also the product of our interpretations. As a result, they are provocative. We used strong wording intentionally, as this would help us in creating design ideas around them. Our first insight was:

The idea of retirement is an overpromised fantasy, difficult to achieve and disrupted by the eventualities of sickness and deterioration.

In response to our initial findings, we began to shift our line of questioning. We also wanted to know, how do the elderly and their families manage major age-associated life changes? Going into a retirement home, limiting driving, and experiencing health issues—these major events are the cause of many difficult conversations between the elderly and their families. Or not. For some families, broaching these hard subjects is too difficult to bring up until forced by external events. Some of our insights around age-associated changes include:

Elderly individuals fear asking for help because taking others’ time and resources will result in being robbed of their own independence.

Elderly individuals’ attempts to avoid becoming burdensome to family lead them to hide their immediate needs. These needs eventually turn into crises, at greater cost to the family.

We shared our findings at the Q2 presentation. Next, our team came up with over 300 design ideas around retirement, saving for retirement, hobbies, finding purpose, and communication amongst family members, to name a few.

Through a process of downselection, we focused on a theme in our research that surfaced repeatedly. This theme was the difficulty family members had in broaching and conducting conversations with elderly seniors about difficult aging-associated changes. A particularly charged instance of this was conversations about limitations in driving. In each case, it seemed that because of the topic’s sensitivity, families deferred having these conversations for as long as possible. And for seniors, the abrupt changes–often with a high cost in terms of their freedom and independence–was too unpalatable to proactively discuss.

Our team has been considering some design solutions to address this issue. In particular, we have been thinking about the need for a gentler “ramp-down” for seniors, rather than the abrupt changes that happen as a result of small problems growing into large ones. On the other hand, we clearly see a need to give the elderly as much control as possible in making choices about their lives.

To this end, we are creating a communication tool to help seniors and their families talk about these major changes. After mapping how an ideal conversation between family members and the elderly would feel, we began to bring the communication tool to life.

Our team began by exploring different game and communication mechanics as a way of easing family members and the elderly into those tough conversations. These are the four avenues we explored:

  • Balloon Bounce: A game of keeping conversations “afloat” by using a digital interface that prompts questions.
  • Best Bets:  A game in which players win real-world prizes by finding common ground with family members.
  • Conversation Cards: A game in which players win points by answering questions about the other players.
  • Meaningful Mail: A service that allows families– from the web–to introduce difficult aging-related conversations by sending physical letters to seniors.

The intent behind our initial designs was to test how tough topics could be more approachable for everyone involved.

User Testing through Scenario Validation

To test our ideas, we conducted a scenario validation. Scenario validation is an approach that presents participants with scenarios and storyboards to illustrate proposed solutions so designers can gather feedback and reactions. We tested each of these four ideas with this method.

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The top three things that we discovered from our user testing include:

Have open-ended discussion prompts: The solutions that used open-ended discussion prompts were preferred over game mechanics that forced particular outcomes

One participant said, “I thought [Conversation Cards] were more of a conversation, something I would do day-to-day with my dad. My dad would think it’s fun finding out about each other or the solutions to problems.”

Enable ongoing conversation: Game mechanics that had potential for follow-up did much better than games that only took up one moment in time

Another participant shared, “My dad, once he got [Meaningful Mail], it would probably prompt him to call me and talk about other memories as well.”

Minimize or eliminate technology for seniors – Anything that was physical and simple with minimal technology was perceived as a useful for seniors. Technology was well-received when used by family members to simplify their communication.

One participant said, “I spent half an hour on the phone with my dad last night because he accidentally deleted an app. What information are they gaining from this [Best Bets]? Even if it was useful, it wouldn’t be worth downloading an app. I’d end up on a call trying to fix it.”

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The Next Step:

After completing scenario validation testing, we decided to move forward with Meaningful Mail (working title). Meaningful Mail will be a web-based service that helps family members bring up difficult aging-related conversations with seniors. From the web, family members will be able to send seniors physical letters about the subjects they most need to discuss. This week will be spent on creating wireframes for main flows and testing with both seniors and involved family members.

Below is a storyboard that illustrates our initial thoughts about how Meaningful Mail will work.

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EPSON MFP imageEPSON MFP imageLindsay Josal was also on our research team. See where she’s taking her design idea here.