An Iterative Participatory Design Approach to Develop Collaborative Augmented Reality Activities for Older Adults in Long-Term Care Facilities

Title of the Paper

An Iterative Participatory Design Approach to Develop Collaborative Augmented Reality Activities for Older Adults in Long-Term Care Facilities

Paper Information

• Subject Area: Design and application of augmented reality (AR) technology, with a particular focus on collaborative AR interaction activities in elderly care settings
• Keywords: Collaborative augmented reality, long-term care, older adults, accessibility, iterative participatory design, human-computer interaction, social isolation

Research Background and Issues

• Existing Problems and Challenges:

  • Over 4 million older adults reside in long-term care (LTC) facilities, facing severe loneliness. Social isolation further leads to issues such as mental health deterioration, cardiovascular diseases, and cognitive decline.
  • Existing interactive communication technologies (e.g., internet platforms and 2D audio-video applications) fail to effectively enhance social presence and are unable to meet the interaction needs of older adults with their relatives.
  • Augmented reality (AR), as an emerging technology, offers high immersion and realistic social presence. However, its feasibility and user experience among older adults, particularly those with cognitive and physical limitations, remain underexplored.

• Importance and Motivation:

  • Loneliness poses a serious threat to the long-term health of older adults and is an urgent public health issue.
  • Using AR technology tailored to the needs of older adults has the potential to strengthen their social connections with family members and improve their quality of life in LTC environments.

• Related Work:

  • Existing research primarily focuses on using AR to promote social interaction among different populations, with limited studies specifically addressing the design of collaborative AR activities for older adults with cognitive and physical limitations.
  • Most AR designs lack deep involvement from older users during development, resulting in low applicability and acceptance.

Proposed Solution

• Methodology:

  • This study employs an "Iterative Participatory Design (IPD)" approach to design two collaborative AR activities for older adults in LTC settings to interact with their family members ("Board Game" and "Decorating the Fireplace").

• Innovations:

  • Involving older adults, family members, and LTC staff in the design process to ensure their needs are fully addressed.
  • Developing and implementing AR interaction modes adapted to the cognitive and physical abilities of older adults, including a combination of voice commands and gesture interactions.

• Implementation Steps:

  • Preparation Phase: Selection of AR hardware and initial functionality development.
    • Microsoft HoloLens 2 head-mounted display (HMD) was used, combined with 3D scanning tools to generate realistic personalized virtual avatars (user portraits).
    • A hardware system was created to capture facial expressions and body gestures, and a shared virtual space was developed for remote synchronization.
  • Iterative Design:
    • Each participant tested the AR system during activities and provided immediate feedback.
    • Based on feedback, interface layout, interaction modes, and design details were gradually adjusted.
  • Final Optimization and Validation:
    • Optimized voice commands, intuitive user menus, and interaction feedback mechanisms were tested to better accommodate users with cognitive and physical limitations.

Research Outcomes

• Specific Results:

  1. Activity Preferences:
     • Older adults preferred simple, engaging, and relatable activities (e.g., board games, fireplace decoration, social chatting).
  2. Interaction Design Optimization:
     • Voice command assistance was added for users with difficulty using gestures.
     • Menu and object placement hierarchy were simplified.
  3. UI Design Improvements:
     • Highlighting mechanisms helped users with visual impairments or reduced reasoning abilities to distinguish options.
     • Customizable text size and voice guidance enhanced usability.
  4. Avatar Optimization:
     • The Metahuman platform was used to generate virtual avatars, making them more realistic and naturally animated.
  5. Hardware Adaptability Validation:
     • Continuous use of the HMD for 30 minutes did not result in dizziness or other negative physiological effects.

• Comparison with Existing Solutions and Advantages:

  • Compared to traditional audio-video platforms, collaborative AR significantly enhanced social presence and simulated realistic interactions.
  • Created better adaptability and usability for users with cognitive and physical limitations compared to traditional AR experiences.

• Experimental Results:

  • The study found that most older adults and family members held positive attitudes toward AR technology and exhibited psychological changes such as increased confidence.
  • Older participants gradually mastered and remembered operations, requiring only minimal prompts to enhance independence.
  • The combination of voice commands and gestures proved effective for accommodating varying degrees of cognitive and physical impairments.

• Limitations and Future Directions:

  • Limitations:
    • Small sample size (8 older adults, 5 caregivers, 2 family members), requiring validation in larger populations.
    • The study was limited to a single LTC facility, making it difficult to generalize across different cultural, linguistic, or environmental contexts.
  • Future Work:
    • Expand sample size and diversity, including cases from different countries, languages, and cultural backgrounds.
    • Conduct longitudinal randomized controlled trials to scientifically assess the long-term impact of collaborative AR on loneliness and well-being among older adults.
    • Explore privacy protection and data-sharing mechanisms based on ethical considerations.

Through this study, the authors successfully developed adaptive and user-friendly collaborative AR activities for older adults in LTC settings and validated the effectiveness of the IPD approach in technology solution development. This work lays a significant foundation for further expanding the application of AR technology in elderly care.