How do we help family caregivers take care of our elders? Families are spreading out. Health care costs are high. Assisted living and rehab centers ("homes") are expensive and often undesireable. The silver tsunami - the boomers - means that there will be over 75 million caregivers by the year 2030 in our country alone.

Discovery

Caregivers are likely to be middle aged women who live close to elder parents. These “family caregivers” are in reality the backbone of the health system, yet they are often overburdened and stressed. We conducted standard and participatory interview techniques with caregivers to gain empathy and inspiration for design solutions. Participatory interviews incorporate stimulus and help individuals better express their emotions and ideas, particularly around an ideal future state.

A manifestation of Jennifer's ideal caregiving experience. Jennifer is a ~40 year old Austinite caring remotely for an elderly parent. She is a public health researcher and part-time real estate agent.

"At some point, you become a parent. they still care for you, emotionally. I'm helping them get dressed. I figure out bills and money. I feel like I am giving back to them. It's giving back, even when it's a little painful sometimes. We take care of our family, and that's our model."
Julie (far right) is a ~45 year old from Boston, full-time office manager, and lives with her parents at their home.

"I tried to do everything. It would have been better to share the load."
Betsy was a caregiver for 11 years, inviting first her parents (behind), and then her husband's parents, into their home. She is now a part-time caregiver. She is also a dancer and makes childrens toys.

Synthesis

We transcribed notes and identified patterns and insights from the data using a technique called affinity diagramming. Our most important insights from research were:

These in turn helped us develop our design pillars. Design pillars are the core of any designed solution - what the solution must do to be successful.


See our design pillars here.

Caregiving experiences evolve through 5 stages. This style of journey map was influenced by Instructor Chris Risdon. Click the journey map for a high resolution view.

Ideation

With our insights and design pillars in hand, we conducted a forced ideation session over multiple days. A forced ideation session is a brainstorm session where one literally matches insights and design trends (some relevant, some not) listed on sticky notes to come up with hundreds of ideas.

We brought each idea that we liked through a downselection process of feasibility and expected impact based on our design pillars. Another decision we needed to make was which stage of caregiving should we support first? We began to settle on a new task management concept that we initially called CareShare (now CareWell). The issue of asking for help seemed to be a root issue at all stages. It was, and is, our belief, that making it easier to balance and share tasks will create space for more delight, better communication, and better relationships through caregiving and beyond.

We developed a lot of concept diagrams in regards to how this service might work.

We envisioned that our service would buffer caregivers from the logistical back-and-forth required to get help.

This is a simple model I created to summarize how caregivers and their helpers would interact within CareWell - how the buffer would work.

We needed to flush out a more detailed version of our service, incorporating emotional support and realistic scenarios of care.

Envisioning

The primary interface for helpers is text messaging. The interface's main job for helpers is to evolve based on their commitment over time - first, for preference setting, and later to sign-up for open tasks. Caregivers need to be able to add tasks and check schedules.

We envisioned a responsive, mobile-first web interface. Caregivers and helpers, like everyone else, are often on the move. This offers flexibility in case a user wants to interact on a bigger screen without adding complexity.

I often would use the whiteboard to imagine possible flows through the software. This particular session helped me think through the "what if" scenarios off of the main setup flow.

We believe that quantification of activity can serve as an invitation to do more. Text messages should be cheery yet direct, because they can always be (unlike humans). A task dashboard should clearly show what's been accomplished and what's open/yet to be claimed.

Here is a scenario Chuck and I created to illustrate how CareWell might be used.

Prototyping

Throughout the creation of the wires process, we practiced a form of user testing known as think aloud with caregivers. This allowed us to see where there were disconnects between the design and a user's mental model. This helped us innovate quickly.

Alongside the interface think aloud tests, we ran a pilot to determine if the service offering (everything outside of the app, particularly the text reminders and follow ups) were delivered at an appropriate frequency and time. I developed a pilot protocol to ensure our service was as close to reality as possible.

I gained over 50 insights based on this testing alone. The results led me to create a software requirements document to help codify those learnings. In general, one family isn't enough; I am cognizant of some unique aspects of the family organization. However, I was very pleased with Denise's summation.

"You would have been a Godsend in 2009/2010 and I would have paid any amount of money for your service. In that situation, it truly would have been priceless."


See an example screen from a pilot designed for mobile here.

See the requirements document here.

Development

I spent a good part of the summer months learning the code required to build CareWell. I was not advancing at the pace I needed. I realized that I also love to learn in a more collaborative atmosphere; simply put, I wasn't having fun going it alone. I enrolled with MakerSquare in Austin, TX: a bootcamp to learn Rails, JS, front end frameworks, HTML, and CSS, among others.

For the month of January, I worked with Tom Hanlon and Brian Sisney as a lead developer on the project. I completed both front end styling as well as backend features, such as initial Twilio integration for text messaging, iCalendar integration, and AJAX/Rails features for improved interactivity.

In 2014, I set aside CareWell to pursue other projects and a full-time career in design, but the experience leading to the initial web based, interactive prototype was invaluable to my growth as a designer, and prepared me well to work with developers in the future given a deeper knowledge of front and back end code.


Check out the code here.

Check out the live app on heroku here.

The current CareWell homepage. I want you to know that this is not like other caregiving software. I am designing and building a welcoming experience.