Meaningful Engagement, Ethical Care, and Design Opportunities: An Ethnographic Study on Social Activities in Long-term Care

Research Background and Issues

• Identified Problems or Challenges:
  Social activities organized in long-term care facilities can promote residents' mental health, but the effectiveness of these activities depends on whether residents can participate meaningfully. However, due to physical and cognitive decline, many residents may be unable to engage in these social activities. Additionally, caregivers face challenges such as heavy workloads, lack of support, and new staff being unfamiliar with residents, making it difficult to provide adequate assistance.

• Significance:
  Residents' inability to participate in social activities can lead to loneliness and social isolation, negatively impacting their quality of life. Addressing this issue not only improves residents' mental health but also optimizes the operation of long-term care facilities.

• Research Motivation and Related Work:
  Existing HCI research has developed numerous technological supports, such as virtual reality (VR), augmented reality (AR), and social robots, to enhance residents' experiences and social interactions. However, many studies overlook the complex realities of long-term care, such as how caregivers facilitate residents' participation in social activities in daily practice. Therefore, it is necessary to gain a deeper understanding of current caregiving practices in social activities to provide new directions for future technology design.

Proposed Solution

• Proposed Solution:
  Through a six-month ethnographic study, the authors analyzed social activities in an Australian long-term care facility from the perspective of care ethics, identifying design opportunities to facilitate residents' meaningful participation in social activities.

• Innovative Contributions:
  The study adopts care ethics as a theoretical framework, emphasizing relational, situational, and empathetic care, thereby expanding existing research. It not only focuses on social interactions between residents and caregivers but also identifies key areas where technology can intervene to alleviate barriers preventing caregivers from providing ethical care.

• Implementation Steps and Key Techniques:

  1. Ethnographic Study: The first author volunteered to observe how caregivers facilitate residents' participation in activities, meticulously recording observational data and informal interview content.
  2. Analytical Framework: The analysis was conducted through the lens of relational, situational, and empathetic care in care ethics.
  3. Technology Design Opportunities: The study identified the following design directions:
     • Create a detailed database of residents' interests and backgrounds.
     • Provide interactive prompts related to activities (e.g., using AI tools to generate conversation topics based on residents' interests).
     • Enhance the inclusivity of social activities, such as enabling participation for residents with visual impairments or those confined to bed.
     • Reduce language and cultural barriers by designing real-time translation tools for residents from diverse cultural backgrounds.

Research Findings

• Specific Findings:

  • Caregivers facilitate residents' participation through communication, integrating residents' backgrounds, and adjusting activities.
  • Instances of residents being excluded were revealed, including issues caused by vision loss, bed confinement, cultural, and language barriers.
  • Proposed technological design opportunities, such as creating resident databases and generating interactive prompts, can help reduce caregivers' workload.

• Advantages Compared to Existing Solutions:
  Unlike existing technology-based solutions for social activities, this study focuses more on how technology can be embedded within the complex caregiving context to assist caregivers in providing more ethical care, rather than merely designing single-function technological tools for residents.

• Experimental or Evaluation Results:
  Through ethnographic observation and thematic analysis, the study demonstrated the complexity of caregiver-resident interactions and the ethical care required. This process highlighted caregivers' work challenges and the potential for designing technological support.

• Limitations and Future Directions:

  • The study did not cover all excluded resident groups, such as those with advanced cognitive impairments.
  • The findings may not be applicable to all care facility contexts, such as monocultural or culturally specific care facilities.
  • Future research should focus more on how technology can improve caregivers' workflows and how to design more targeted technological solutions for residents from diverse cultural backgrounds.

Through in-depth ethnographic observation and analysis using the care ethics framework, this study provides new insights into the application of technology in long-term care facilities, emphasizing that technology should support caregivers in providing deeper ethical care and promoting broader resident participation in social activities.