Problem Statement

The group of people we are investigating is the elderly population and the lack of accessibility with “good” caretakers, especially in the Asian-American community. ​

A prominent problem in the elderly community is that it is hard to find a “good” caretaker. The elderly population tends to be more susceptible to neglect and abuse from their children. As a real-life example, one of our group member's loved ones is 85 years old and has gone through four caretakers for the past three years. Her aunt mentioned that hiring caretakers are done “under the table” through word of mouth. ​

Our motivation is that we want the elderly community to be safe and happy. Therefore elders must have a community of people beside them. We want to connect caretakers with the elderly via an honest platform to have increased access to care. Additionally, we can help the elderly build their social network and get them more involved in their community by giving them additional tools.

Background Research

During one of our group members' time studying abroad in India for 3-weeks, she visited a non-profit organization called “HelpAge India,” which focused on elders' concerns. In the visit, it is mentioned that by 2026 India’s elderly population will reach 173 million (Changing Cultural Ethos & Impact of Technology, 2018). In Indian society, around 60% of Elders confirmed that Elder abuse is prevalent (Changing Cultural Ethos & Impact of Technology, 2018). ​

In contrast to the United States, the aging of the baby boom generation could boost up to a 50% increase in the number of Americans aged 65 and older requiring nursing home care, from 1.2 million in 2017 to 1.9 million in 2030 (Elder Abuse Statistics & Facts | Elder Justice | NCOA, 2020). Also, 26% of women ages 65 to 74 lived alone in 2018, increased to 39% age 75 to 84, and 55% among women aged 85 and older (Elder Abuse Statistics & Facts | Elder Justice | NCOA, 2020). ​

The U.S. is facing an extraordinary demographic shift; with the population of older adults will nearly double, our older family members' care and support are at stake. Home-care agencies report that staff recruitment is their number one challenge since their public funds haven’t increased in three years (Sturgeon, 2017). Additionally, the work is irregular, and it isn't easy to find a new case that fits the aide’s schedule (Sturgeon, 2017). A new employment model for paid caregivers is vital for our community's health (Sturgeon, 2017). ​
Elder abuse is also a problem in the United States. Approximately 1 in every 10 Americans aged 60 and over have experienced some form of elderly abuse, some sources estimating up to 5 million per year (Elder Abuse Statistics & Facts | Elder Justice | NCOA, 2020). And unfortunately, only 1 in 14 cases of abuse are reported to authorities (Elder Abuse Statistics & Facts | Elder Justice | NCOA, 2020). ​

According to the National Association of Chronic Disease Directors, for elderly people aging 55-year-old or older, about 20% of them suffer from mental health problems, including depression, anxiety, cognitive impairment, and more (The State of Mental Health and Aging in America Issue Brief 1: What Do the Data Tell Us?, 2008). Elder people aged 65 or above have a higher rate of dissatisfaction in the amount of social and emotional support provided. One associated result is the high suicide rate for 85-year-old or older men (The State of Mental Health and Aging in America Issue Brief 1: What Do the Data Tell Us?, 2008). ​

Governments are beginning to pay more attention to informal carers than professional standard caretakers since they are difficult to find if there are financial restrictions. Due to the rise in popularity of informal carers, more research is being conducted (Loneliness in older people, n.d.). The research has shown that informal carers show increased symptoms of psychological stress, anxiety, and depression. A contributing factor to this is that intensive caretaking can result in social isolation for the carer (Loneliness in older people, n.d.).

Target Population

1. Elders (65+ years old)
2. Caretakers
3. Adults (Elders' children)

Existing Solutions

Existing Solution 1: Eldercare Location
- Eldercare Locator is a public service of the US Administration on aging. This website is designed to connect caretaker services to older adults and their families. It also provides services such as home care, caregivers, transportation, meals, etc., by linking those who need assistance with local agencies, community-based organizations.

- Pros:
1. This website does a great job by providing free, unbiased sources of information to older adults.

2. It is run by the government, which makes it trustworthy and secure. One interesting feature of this site is its effective search filters.
    -> The user can type in city/state and then get detailed information about various services provided in that region and offer online chat services.

- Cons:
1. Text-heavy: Not user-friendly to older adults.
    -> Once the user navigates off, they are left to fight for their own on a completely new website. ​

2. This also does not contain any individual caretakers’ information ​
    -> It connects the user with different agencies, while it could be tedious to go through this procedure.

3. It can only be used regionally and does not function globally, which could be a problem for older adults who want to travel.

Existing Solution 3: CareZone
- CareZone is an application for managing health information. It helps caregivers keep track of medical information by organizing medicines, allergies, IDs, etc. in one place.

- Pros:
1. It has many exciting features such as a journal for physician notes, a calendar, and to-do lists that make very nice tools to help the caretaker organize information about the older adult.

- Cons:
1. Lacks a few features: One feature they lack is an emergency call feature.

2. User reviews suggest that there have been a lot of issues with the sound of the alarms, nagging, etc. ​

3. Being text-heavy does not facilitate users with minimum education.

4. This application does not provide any share options which makes it difficult for the users to convey their medical information to their caretakers.

Stakeholder Groups

Direct Stakeholder - Elders
The needs of the elders include having appropriate social activities and relationships, maintaining the well-being of psychological health, and having assistance activities related to mobility, self-care, and domestic life (Abdi et al., 2019). Humans need social interaction no matter what age we are, it is written in our genes. For elders, they all have unique social needs according to reasons like life experiences and cultural differences. They also have a need for proximity, meaning having a support network created by people with whom they are very close. They also need meaningful relationships that will provide them with a sense of respect and purpose. The need to feel a sense of reciprocity from their social relationship which means a sense of being needed and helpful to others (University, 2018).

Direct Stakeholder - Caregivers
​​While caregiving is projected to be the largest occupation in 2020, the labor of caregivers has shown to be unattractive to many (Slaughter, 2016). The issues of employing caregivers stem from time conflict and financial strains (Slaughter, 2016). Agencies might not be able to provide caregivers with flexible work hours that match their schedules (Slaughter, 2016). Furthermore, those who work in the caregiving industry usually trade off long term security for short term financial gains (The Challenges Facing a Family Caregiver, 2015). A survey from the National Domestic Workers Alliance found that 65% of caregiving workers don’t have insurance, and the average hourly rate is only $9 (compared to a golf caddy at $17 and a Whole Foods bag handler at $19) (The Challenges Facing a Family Caregiver, 2015). In conclusion, caregivers are no longer willing to work for low salaries with inflexible hours. ​

Indirect Stakeholder - Hospitals
In the United States, elders make up 13% of the nationwide population, but elders represent nearly 40% of hospitalized adults (Mattison, 2019). Since hospitals are a high-risk location for elders with weaker bodies, numerous elderly patients worsen physically and mentally in the hospital, reflecting badly not only on healthcare professionals but also on the community (Covinsky, 2011). As a result, many elders are unfit to care for themselves after being released from the hospital (Gorman, 2016). Hospitals are considered indirect stakeholders because, even though hospitals are the one that cares for elders if they are sick, hospitals would not get affected if there was a system for elders to hire caretakers from other places.

Interviews

Stakeholder Interview
Katherine interviewed an indirect stakeholder is the current high school senior, Kiara T., who lives with her grandmother (Appendix A). As Kiara is leaving to attend the University of Michigan soon, she will not be directly impacted whether her grandmother at home will be taken care of at her house in Jakarta, at a separate house/apartment, or retirement home. An over-the-phone interview is appropriate because the interviewee and interviewer are relaxed and take their time to ask and answer questions.

Key questions Katherine asked Kiara were, how good is your grandma’s mobility? How often do you see your friends? Does she already have a caretaker? These questions were asked to get a better sense of Kiara’s grandmother’s mobility, how much assistance she requires, and what her social life is like.

Key learnings that were uncovered are that elders' characteristic is that they might be stubborn and too afraid to ask for help. Kiara’s grandma lives in her house, where both Kiara’s mom and dad work full-time jobs. Kiara’s grandma already feels like such a burden that she’s staying with her daughter and son-in-law. The last thing she wants is to ask for help. Also, it took an accident to occur for Kiara’s mom to prepare a helper to assist the grandma: It took Kiara’s grandma to fall, bruise, and get hospitalized until Kiara’s mom forced a helper to guide Kiara’s grandma around. Either it’s self-pride or stubbornness, but it seems like elders don't want to ask for help and believe they can go about their lives similar to their young days.

User Interview 1
Hoang interviewed his mother since she is currently taking care of his grandmother (Appendix B). The purpose of the interview was to learn more about her experience taking care of his grandmother. This research method was appropriate because interviews' one-on-one nature allowed him to go into vivid details.

Key questions were asked regarding the hours that she cares for my grandmother, the usual tasks, frustrations, and feelings. These questions were asked to compare Hoang’s mom’s experience to a caretaker while performing the same tasks.

After interviewing his mom, Hoang had a better understanding that taking care of her grandmother is her responsibility as a daughter-in-law. His mother is currently stressed out because she has taken time out of work to take care of Hoang’s grandmother. However, from his family’s previous experiences with hiring caretakers “under the table,” Hoang’s mother does not feel safe leaving her mother-in-law alone at home with them. Hoang’s mother expressed the need to find a caretaker from a reliable source.

User Interview 2
Xiao Xiao interviewed my grandmother, Shumin (79 years young), a potential user of the solution we are designing (Appendix C). The purpose of the interview is to find out her needs and main values. Important qualities of the caretaker if getting a caretaker, is also asked. Interviewing is the appropriate method since it can provide a lot of personal details about the interviewee. It is most related to their real-life experience.

Key questions were asked regarding how often her grandma socializes with friends and what her grandma considers important caretakers' important characteristics.

We found out that besides the need for medical and daily life work assistance, she also needs companionship. She mentioned feeling lonely after her husband passed away. It was hard for her to go through the transition of this loss. She needed more support, both mentally and physically. She mentioned her loneliness staying in the empty house by herself. She wanted to maintain socialization, but due to the old fashioned type of social method, she needs to be more interactive with them to keep in contact. Her decreasing mobility is limiting her from interacting with her friends. She meets with her friends a few times a month, which seems to be a frequency below her need. She mentioned her desire for someone to help her walk around and also for someone who can talk and accompany her.