An ethic-of-empowerment: e-health and healthy ageing

Anita Melander Wikman, PhD, Ass.professor Luleå University of Technology

What methodolgy can be used to create an-ethic-of-empowerment?

Research questions for an ethic-of-empowerment

What methodology can be used to develop products and services which:

help facilitate a more active role in health care and rehabilitation

sustain autonomous living enable older people to become fully active

participants in healthcare and rehabilitation programs

All in cooperation with relevant organisations.

Research contextEIC- E-health and Innovation Centre, LTU

• Development and research for Innovative Systems and Services that enable people to remain at home longer while ensuring a high quality of life.

MyHealth@Age (2008-2010) Project

1.Partners

2. Research persons

3. Findings

4. Research design and methodology

Research - Healthcare & welfare, ICT and Market• Luleå University of Technology• Norwegian Centre of Telemedicine• University of Ulster, Northern

Ireland

Fieldtrial• Pensioners organizations• Municipality of Boden and Luleå• County Council of Norrbotten• Municipality of Tromsö• Southern Health & Care Trust,

Ulster

• Blue Tree Services• McElwaine SMART Technologies• Swarm teams• Tieto• Arctic Group• IntelliWork• Nelilab

Market

End-UserNeed Technology

Participatory and Appreciative Action and Reflection Research (PAAR)

FormITLiving Lab

Older persons and Health and

Welfare staff

Research persons in the Swedish part of MH@A

3 older persons with experience of e-health projects

3 older persons from pensioners org.

7 older persons with functional limitations from e.g. stroke, heart disease, Parkinson.

Anita Melander Wikman; Alec 2012

The MyHealth@Age services

A mobile phone with three functionalities;

1. Safety alarm with locator and fall sensor

2. Prescribed care functionality

3. A functionality to stimulate social interaction and social networking

START

START

START

LARM

STÄNG

STATUS

Findings from the old persons’ perspective

• Safety and freedom of mobility was the most important need.

• They learned more about their own health• The system was motivational in being

active• The communication and interaction with

PT and GP was more easy

The design process was collaborative with space, voice and participation

Motivational factors:

• The older persons had an interest to better understand the technologies of today and tomorrow

• They wanted to contribute as best they could for the god of older people in general.

Methodology

A Model for Reflective Participatory Design (RPD)• Participatory and Appreciative Action Research

(PAAR)• FormIT

Forthcoming publication:Bergvall-Kåreborn, B., Melander Wikman, A. & Ghaye, G. (2012) The importance of space, participation and voice when designing systems with users. Health Informatics Journal

Participatory and Appreciative Reflection and Action

Understand• …..the best of what is

Imagine•…..what can be

Create• …what will be

PAAR's- 3 goals

FormIT - Three design cycles

• Exploring needs and identifying dreams and visions together with older persons

• Concept and prototype design• Assessment of the system in use and

evaluation of the whole process

Anita Melander Wikman; Alec 2012

A model for reflective participatory design (the RPD model) Bergvall Kåreborn, Melander Wikman & Ghaye

Anita Melander Wikman; Alec 2012

Reflective Participatory Design (RPD)

• The older participants were real participants in almost all work-packages (not management)

• Participants in application writing• Access to information via e-mail• Needfinding – conceptbuilding – system

requirements - prototyp testing

Conclusion

• ‘Opening up’, ‘widening’, or ‘broadening’ opportunities for elderly people to authentically engage in decisions about their health and care.

• Sometimes space for manoeuvre are limited by project deadlines and budgetary controls.

• An image of people coming together, to discuss, plan, question, reflect and make decisions is important

Participation

• The intention is to go beyond the practice of consultation

• Participation is to be more than the taking up of invitations to ‘be involved’

• Participation has to be learned, especially when (or if) those involved are used to being excluded.

CREATING ETHICAL SPACES FOR OLDER PEOPLE

• Explaining the ‘rules of the game’• Positioning older people in project design

forums • Agreeing relationships and responsibilities• Physical space – where to meet• The power of the words we use