AHFE Open AccessHuman Factors in Aging and Special Needs
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Understanding Constraints on Family Caregivers’ Coping with Psychological Burden: A Qualitative Study Toward Support System Design
Family caregivers experience substantial psychological burden in daily caregiving, yet it remains unclear how they cope with this burden in everyday life and what constraints shape the effectiveness of their efforts. This exploratory qualitative study aimed to classify daily coping strategies, identify factors distinguishing successful and unsuccessful experiences, and derive implications for support system design. We conducted in-depth semi-structured interviews with five family caregivers as a contextual informant, and analyzed the data using a bottom-up coding approach.The analysis identified four categories of coping strategies: behavioral and environmental adjustments, collaborative support with family members and professionals, emotional regulation, and cognitive reappraisal. Behavioral adjustments were sometimes effective but could paradoxically increase caregiver burden. Collaborative support was often constrained by care recipients’ resistance, leading to psychological isolation. Emotional regulation was selectively practiced within relationships where empathy was anticipated. Although record-keeping supported cognitive reappraisal, it offered limited immediate emotional relief and was difficult to sustain. Overall, the findings suggest that caregivers’ coping efforts are shaped by contextual and relational constraints, resulting in reliance on internal adjustments. Future support systems should complement these internal coping processes by facilitating emotional processing and reducing the psychological costs of reflection and sharing.
Ziqiong Zhang, Momoko Nakatani, Yuki Taoka, Naoki Mukawa
Open Access
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Conference Proceedings
Evaluation of a Model of Relational Expectation Misalignments in Care: Case study of a public nursing home in Japan
Solving caregiving issues requires a perspective that captures the interaction between caregivers and care recipients, rather than focusing on a single individual. We previously developed a model to systematically analyze the "expectation misalignments" between two parties. This study verified the applicability of this model using video observations and reflection workshops at a nursing home. We analyzed two contrasting cases. In the case of Resident B (dementia with high physical ability), the model successfully visualized a "behavioral conflict" caused by a lack of prediction, highlighting the need for environmental design. Conversely, in the case of Resident A (high cognitive ability), while behavioral expectations appeared aligned, the workshop revealed a "latent discrepancy" caused by the resident's "over-adaptation" to the caregivers' busyness. The results suggest that while the model is effective for structuring observable interactions, it requires extension to represent "hidden expectations" and "personal backgrounds" that are not expressed in action. Future work will aim to implement this model as a practical reflection tool for caregivers to design appropriate conflict resolution strategies.
Hiroto Miyatake, Yuki Taoka, Emi Fuse, Naoki Mukawa, Momoko Nakatani, Shigeki Saito
Open Access
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Conference Proceedings
Designing a Social Exergame for Community-Dwelling Older Adults: The Impact of Collaboration Conditions on Psychological Needs and Gaming Well-being
Against the backdrop of the "active aging" concept driving innovation in community-based elderly care services, enhancing the quality of social participation among older adults through technological means has become a critical research focus. Employing a design thinking framework, this study developed a prototype for a two-player gesture-based exergame through five stages: empathy, definition, ideation, prototyping, and testing. A within-subjects controlled experiment was conducted to compare the effects of symmetric and asymmetric collaboration conditions on the basic psychological needs and gaming well-being of 22 community-dwelling older adults. Findings indicate that the asymmetric condition fostered greater mutual attention and positive communication, thereby strengthening the sense of relatedness. In contrast, the symmetric condition provided a psychologically safer environment that facilitated recognition of individual contributions, leading to a stronger sense of competence. Both conditions yielded similar levels of autonomy and gaming well-being. Future designs of social games for older adults should explore more diverse and flexible collaborative forms and cultivate a shared culture conducive to exploration and growth. This study offers practical implications and insights for designing social exergames for older adults in community-based active aging initiatives.
Youle Liu, Zhuang Mou, Hanling Zhang
Open Access
Article
Conference Proceedings
Age-Friendly Design of In-Vehicle AR-HUD Interface Based on the KANO-AHP-QFD Integrated Model
Addressing the issues of low acceptance and high cognitive load associated with in-vehicle Augmented Reality Head-Up Displays (AR-HUD) among the elderly driving population, this study aims to investigate the critical requirements and design strategies for age-friendly AR-HUD interface design. Based on the integrated KANO-AHP-QFD model, this paper identifies the needs of elderly users regarding vehicle AR-HUD interfaces. Firstly, the KANO model is employed to classify the attributes of elderly user requirements. Secondly, the Analytic Hierarchy Process (AHP) is applied to calculate and rank the weights of these requirements, thereby identifying twelve core design elements for AR-HUDs. Finally, Quality Function Deployment (QFD) theory is utilized to construct a House of Quality (HoQ) for age-friendly AR-HUD interface design, transforming vague user needs into quantifiable design parameters. Through weight calculation and prioritization, this approach provides design strategies and practical guidance for the development of age-friendly vehicle AR-HUD interfaces. Subsequently, a design scheme for a vehicle AR-HUD interface that satisfies the needs of the elderly is derived based on these identified design elements. By employing the KANO-AHP-QFD model, accurate elderly user requirements can be obtained and translated into specific design elements with a clear order of importance, thereby guiding age-friendly AR-HUD design. This research offers a viable pathway to reduce the cognitive burden on elderly drivers and enhance driving safety and interactive experience.
Mingxuan Ding, Yu Wang, Yanhua Xu, Jiejun Dai
Open Access
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Conference Proceedings
Factors associated with the objective outcomes of Electric Pallet Truck Interventions for Aging Workers
Electric pallet trucks (EPTs) are commonly subsidized as job accommodation measures to reduce physical workload associated with material-handling tasks among aging workers. This retrospective study examined perceived post-intervention outcomes among 91 workers aged 45 years and older who received EPT subsidies through a government-funded job accommodation program in Taiwan. Perceived outcomes were assessed three months after implementation using a six-item self-reported scale capturing problem-solving effectiveness, productivity, work autonomy, work quality, comfort/safety, and ease of use.Fixed-effects regression analyses revealed item-specific associations between worker characteristics and perceived outcomes. Increasing age was negatively associated with perceived improvement in problem-solving effectiveness. Educational level showed differentiated associations across outcome domains, with lower educational attainment associated with greater perceived improvement in problem-solving effectiveness but lower perceived gains in productivity and work quality, while higher educational attainment was positively associated with perceived improvement in work autonomy. Manufacturing industrial workers reported significantly greater perceived improvements in productivity and work quality than workers in other job categories.Partial least squares structural equation modeling further demonstrated that perceived intervention effectiveness played a central role in linking EPT-based job accommodation to perceived improvements in work performance, whereas perceived usability did not show a significant direct association with intervention effectiveness. Overall, these findings indicate that the perceived benefits of EPT interventions are item-specific and strongly shaped by worker characteristics, job roles, and task contexts, underscoring the importance of aligning assistive-device provision with essential job demands rather than adopting uniform job accommodation approaches for aging workers.
Yi-Ying Lin, Jen-Suh Chern, Wanyin chen
Open Access
Article
Conference Proceedings
Living with Time: Designing Olfactory Rhythms and Adaptive Homemaking in Dementia Care
Changes in the perception and experience of time are widely observed among people living with dementia. Rather than being perceived as a linear sequence, time may be experienced as fragmented sensory moments shaped by bodily states, routines, and environmental cues. Phenomena such as increased disorientation during late-afternoon transitions—commonly described as sundowning—illustrate how temporal orientation is closely intertwined with sensory and contextual conditions. Consequently, environmental adaptation in dementia care must be understood not only in spatial terms, but as a multisensory and relational process that mediates memory, activity, and perception in everyday life. While design research has explored supportive domestic environments through concepts such as safe space, small world, and connection within the broader framework of the sense of home, limited attention has been paid to how temporal rhythms themselves can be intentionally designed. This study addresses this gap by investigating how temporal, spatial, and sensory dimensions of home can be co-designed with people living with dementia through olfactory and multisensory rhythm interventions. The research began with a literature-informed primary mapping of olfactory interventions in dementia care, focusing on reported effects, temporal patterns of use, and everyday sensory practices. Insights from this mapping informed the development of the Chrono-Olfactory Home Map, a participatory design tool that supports the articulation of daily rhythms by mapping activities, perceived energy, and sensory cues across time. Workshops were conducted with five residents with mild to moderate dementia and care staff in a dementia care setting in Milan, combining sensory elicitation, narrative interviews, and collaborative mapping. Findings indicate that scent-based micro-interventions, when embedded within everyday homemaking practices rather than delivered as isolated therapies, can support temporal orientation, emotional regulation, and a sustained sense of home. The study highlights temporal–sensory design as a critical yet underexplored dimension within human factors approaches to dementia care.
Natsumi Wada, Silvia Maria Gramegna
Open Access
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Conference Proceedings
Reframing Life Experiences: Emotional Reappraisal Through AI-Generated Memory Videos for Older Adults
Reframing negative past experiences is crucial for the psychological well-being of older adults. While Generative AI has shown potential in automating reminiscence material creation, existing systems often overlook the delicate process of handling negative emotions. This study proposes a novel photo-based reminiscence system designed to support "emotional reappraisal" by creating psychological distance. Using Generative AI, the system transforms personal dialogues into "memory videos" featuring third-person narratives and cinematic effects. We conducted an exploratory pilot study with four older adults to compare the emotional impact of these AI-generated videos against a static photo viewing condition. Preliminary results indicated that while static photos tended to sustain high-intensity negative emotions (e.g., anger, sadness), the AI-generated videos significantly reduced negative affect. Notably, three out of four participants reframed their primary emotion from negative states to "Joy" after viewing the video. These findings suggest that the objective narrative structure and visual presentation provided by the system can facilitate emotional reframing, helping older adults integrate painful experiences into a positive life story. This research highlights the potential of Generative AI in fostering ego integrity and resilience in the aging population.
Kakeru Takahashi, Noriaki Kuwahara
Open Access
Article
Conference Proceedings
AI-driven art therapy: A domestic interactive platform for children with high-functioning autism
Art therapy is widely applied in interventions for children with autism to promote emotional regulation and communication, yet it remains challenging to implement within daily home environments. Parent-Child Interactive Therapy (PCIT) and generative artificial intelligence (AI) technology offer new pathways for delivering art-based healing within family settings. This study aims to develop a home-based interactive platform integrating art therapy, PCIT, and generative AI technology for children with high-functioning autism (HFA).This study employs Design Science Research. First, semi-structured interviews with parents and experts of HFA children were conducted to analyze their interaction patterns and identify pain points. Design strategies were then formulated based on PCIT's core principles, leading to the development of a product prototype and initial testing. Iterative refinements based on feedback resulted in the final product, which underwent evaluation.The design features an integrated interactive platform that combines art creation, AI story generation, and parent-child interaction prompts, comprising a drawing tablet and app. Children create artwork on the tablet surface, which AI analyzes to generate corresponding stories presented to users. During this interaction, the product guides parents via prompts displayed on their app, encouraging them to respond to and guide their child's creations. This extends human-machine interaction into high-quality parent-child engagement.The study confirmed the feasibility of integrating PCIT, AI technology, and art therapy within home settings. Preliminary evidence indicates this prototype reduces parental guidance pressure while effectively enhancing parent-child interaction quality. It offers innovative insights for traditional art therapy and provides a viable model for AI technology to strengthen human emotional connections.
Chenhui Yang, Yanli Huang
Open Access
Article
Conference Proceedings
A Plug-and-Play Desktop System for Remote Care of Older Adults with Alzheimer's Disease
Family members of individuals with Alzheimer’s disease and related dementias (ADRD) frequently provide care from a distance to support their loved one’s desire to age-in-place. To meet the needs of remote care dyads, we previously developed a multifunction daily management web application for collaborative use by care receivers and caregivers. However, even thoughtfully designed applications offer limited benefit when obscured behind forgotten passwords, complex navigation, and unreliable hardware. Moreover, scalable remote care requires streamlined setup, automated recovery, and remote monitoring capabilities. To address these challenges, we developed a plug-and-play system designed for seamless, persistent access. This solution involved two key steps: (1) selecting user-friendly hardware and (2) optimizing the operating system (OS), firmware, and web browser. Hardware selection was informed by usability testing with older adults with cognitive impairment. System optimization was achieved through a series of automated PowerShell scripts. We field-tested the system in four homes over four weeks. Participants reported high satisfaction with the system’s appearance and automatic login functionality, emphasizing relief at not needing to remember credentials or navigate to the application. Concerns about continuous power usage emerged and will inform future refinements. This pilot demonstrates the feasibility, acceptability, and technical viability of a self-maintaining, plug-and-play desktop infrastructure to support remote caregiving for individuals with ADRD aging in place.
Shreyas Aswar, Andrew Weakley, Priyanka Koppolu, Sarah Tomaszewski Farias, Alyssa Weakley
Open Access
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Conference Proceedings
Designing for Reminiscence in Digital Photo Systems for Older Adults: A Scoping Review
Photographs have long been regarded as important cues for autobiographical reminiscence and as conversational anchors that facilitate social interaction among older adults. However, as recording practices shift from physical artifacts to large-scale fragmented digital assets, older users increasingly encounter cognitive load and interaction barriers during browsing, organizing, and sharing. Consequently, traditional album models centered on storage and retrieval are becoming insufficient, and digital photo systems are evolving from simple content repositories into interactional media that support cognitive assistance and social engagement. Although various photo-support systems for older adults have been proposed, existing research predominantly focuses on individual prototypes or short-term experimental contexts, lacking a comprehensive synthesis of technological pathways and underlying design logic. To address this gap, this study adopts a scoping review methodology following the PRISMA-ScR reporting guideline, systematically examining literature across human–computer interaction, gerontology, cognitive psychology, and design research. The review addresses two research questions: (Q1) What technological pathways can be identified in photo-support systems for older adults? (Q2) What core functional dimensions should digital photo systems embody to support older users? The findings identify three primary technological pathways: conversational AI systems that transform photos into interactive cues for reminiscence, embodied interface systems characterized by tangible and touch-based interactions, and immersive narrative systems enabled by AR/XR technologies. In addition, the review synthesizes three core functional dimensions that contribute to older adults’ well-being: memory support, emotional support, and social connection. Based on these findings, the study proposes three design implications: reframing systems from “photo searching” toward “storytelling,” preserving user agency beyond automated organization, and transforming one-way sharing into a “family co-creation” model to foster sustained intergenerational communication and collaborative narration.
Yiting Shen
Open Access
Article
Conference Proceedings
A Multi-level Elderly Care System: Exploring Spatial Planning and Digital Integration in China’s Cities
While the design of elderly care architecture and campuses is burgeoning in China, comprehensive research on a unified planning layout spanning from urban master planning to interior design is rarely encountered. This study begins by analyzing spatial usage and medical support levels within China’s diverse elderly care models, highlighting their current limitations. Against the backdrop of emerging technology, it contrasts digital elderly care paradigms with traditional ones. Combining the authors’ practical experience as architects in the design of three ‘Taikang Community’ campus projects, the study proposes a novel, digitally-enabled elderly care system. The system interconnects four spatial and social layers: Home life, Neighborhood Circle, Intermediate Circle, and Urban Circle. The spatial configurations and operational dynamics within this multi-level system are articulated and analyzed. The findings aim to provide a foundation for the architectural planning and interior design of elderly care environments and offer insights for structuring related internet-based service systems.
Zongyang Cui, Ying Nie, Xiaoqi Wang
Open Access
Article
Conference Proceedings
Memory Path: An Inclusive Multimodal Interaction System Design for Home-Based Alzheimer's Care
Alzheimer's disease is a progressive cognitive disorder characterized by memory decline, spatial disorientation, impaired executive function, and emotional-behavioral changes. Its caregiving challenges manifest continuously within the domestic living environment. In China, where home-based care remains the predominant model for elder support, patients frequently experience task forgetting, spatial disorientation, difficulty locating objects, operational errors, and emotional distress within familiar surroundings due to the hidden nature of early symptoms, insufficient daily support, and the limited professional competence of family caregivers. Caregivers, in turn, must sustain long-term responsibilities including reminding, companionship, monitoring, emergency response, and emotional regulation, facing considerable coordination burden. Existing digital health products predominantly focus on singular functions such as medication reminders, health record management, or remote monitoring. Conventional mobile applications continue to rely on text-based reading, hierarchical menus, and active user input, while traditional reminder tools fail to integrate with real domestic spaces and specific task contexts. These limitations make it difficult to simultaneously address the compound needs of low cognitive load for patients, remote coordination for caregivers, and continuous spatial support within the home environment.In response to these challenges, this paper proposes the Memory Path multimodal home support system, taking the triadic interaction relationship among patient, caregiver, and domestic space as its design entry point. The system is grounded in inclusive design theory, operationalizing the principles of recognizing exclusion, designing for one and extending to many, and treating diversity as a resource into concrete design methods. By identifying exclusion contexts in patients' task comprehension, spatial navigation, interface operation, and emotional stability, the system develops low-load interaction strategies. With Alzheimer's patients as the primary user group, simplified interfaces, voice prompts, spatial guidance, and remote collaboration mechanisms are extended to individuals with mild cognitive impairment, elderly users, and diverse family caregiving scenarios. Patient ability differences, caregiver experience variations, and home spatial configurations are simultaneously reframed as configurable resources. The design responds to diverse ability levels and environments through information hierarchy simplification, enhanced multi-channel perception, reduced operational steps, fault-tolerant feedback, and configurable spatial anchors.In terms of system architecture, Memory Path is not a single application but an integrated system comprising a minimalist patient-side application, a caregiver monitoring dashboard, AR spatial anchor navigation, smart bone-conduction earphones, and home environment optimization components. Caregivers can configure daily tasks, edit spatial anchors within the home, and upload family messages, photographs, and familiar music. Patients receive synchronized visual, auditory, and spatial cues through task cards, AR guidance paths, object highlighting, and bone-conduction voice prompts, triggered by specific times, locations, or task states. The system thereby establishes a closed-loop mechanism of configure, trigger, recognize, guide, feedback, and accompany, transforming medication reminders, indoor wayfinding, remote assistance, status feedback, emotional support, and memory prompts into visualizable, audible, and configurable multimodal interaction processes.For subsequent prototype evaluation, the study plans to invite early-stage Alzheimer's patients, family caregivers, and interaction design experts to participate in scenario-based usability testing, System Usability Scale (SUS) assessment, and semi-structured interviews, subject to ethical approval and informed consent. Core interaction flows including medication reminders, AR-based indoor navigation, remote caregiver assistance, and emotional content triggering will be validated. The evaluation will focus on task comprehension difficulty, operational burden, spatial guidance clarity, caregiving coordination experience, and emotional support effectiveness, providing evidence for iterative refinement of interface hierarchy, anchor configuration, and multimodal prompt strategies. This study provides a low-burden, coordinated support pathway for home-based Alzheimer's care contexts and offers practical references for the application of inclusive design principles in cognitive assistance systems.
Pengcheng Guo, Meichen Lin, Peiyuan Du
Open Access
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Conference Proceedings