Moving Toward the Promise of Participatory Engagement of Older Adults in Gerotechnology

Abstract

Limited uptake and use of developed technologies by older adults have prompted interest in participatory design and related approaches in the gerotechnology field. Despite this, recent systematic reviews suggest that researchers continue to passively engage older adults in research projects, often only in providing advice or feedback in the early or later phases of research. A key barrier to more meaningful and active engagement of older adults is a lack of understanding as to how participatory design differs from other participatory approaches, and in particular participatory action research. We address this gap in understanding by exploring the theoretical similarities and differences of participatory design and participatory action research, including their scope, goals, and the nature of the involvement of older adults in each. We conclude with key barriers that are critical to address in order to achieve greater involvement of older adults in gerotechnology, and to broaden and enrich the goals of this field.

Supporting Healthy Aging through the Scale-Up, Spread, and Sustainability of Assistive Technology Implementation: A Rapid Realist Review of Participatory Co-Design for Assistive Technology with Older Adults

“…While this may be seen as itself a limitation (a bending of the rules of inclusion), we feel that it significantly enhanced our final product. Another limitation of our study, and consistent with other recent reviews (Fischer et al, 2020;Grigorovich et al, 2021;Merkel & Kucharsky, 2019), is that we still have a paucity of concrete descriptions from PCD study reports about the details of their engagement processes, including barriers and challenges faced. One significant issue is that while we know that older adults constitute a very diverse group, marked by multiple and intersecting identities, very little information is available about how these different sub-populations of older adults engage or do not engage with PCD processes.…”

“…Participatory co-design of technology supporting older adults aging in place requires ongoing evaluation with the involvement of older adults (Sumner et al, 2020). Furthermore, collaborative knowledge production or production of scientific knowledge can also be part of the successful co-design experience (Grigorovich et al, 2021). Exactly what mix of stakeholders (in addition to older adults themselves) should be involved is dependent on the specific context or setting of the AT implementation, that is, home, residential care or long-term care, but clearly informal care and support (e.g., family, friends, and neighbors) constitutes one common group.…”

“…This lack of a concrete democratization component in many studies is in itself an interesting finding, as there seems to be a drift away from the more explicit politics of participatory research and participatory design (Bygholm & Kanstrup, 2017), with more emphasis on the epistemological focus of action research. Grigorovich et al (2021) point out that this contrast can be seen between approaches that take a participatory action research approach, as opposed to a “co-design” or “participatory design” approach. Some authors argue that, if we avoid stereotypes, while emphasizing empowerment and democratization, through mechanisms of learning, adjusted design, and the improvement of the sense of participation, these can lead to successful PCD experiences (Fischer et al, 2020).…”

“…First, there is something about the “early and often” nature of concerted and well-planned iterative cycles of AT development that, in itself, leads to more successful engagement through a mechanism of trust building , that reinforces the message to older adult/informal carer stakeholders that their input is valued and is not merely a token gesture. It is clear that while the ideal of the iterative participatory process is to have stakeholders engaged at all stages of the process, exactly who is engaged, when they are engaged, and how they are engaged, varies widely, and is not often clearly stated in terms of the precise plan for implementing a consistent process of stakeholder engagement (Fischer et al, 2020; Grigorovich et al, 2021). Thus we have: C-M-O-C “If consistent, repeated strategies of engagement are instituted in all stages of the development process (C), then the mechanism of trust building (M), can lead to active and effective participation of older adults in the co-design process (O)”…”

“…A context with robust ethical governance, and deep commitment to participatory principles, is essential to ensure effective knowledge integration. (Grigorovich et al, 2021; Martin et al, 2013). Fourth, the systems that form the overall context within which AT implementation processes must be initiated, are complex, multi-level adaptive systems, that have recursive feedback and causal loops.…”