Contemporary Themes in the Design of AT for the Ageing Population: Materiality, Co-design and Cultural Influences

  • Gabriella SpinelliEmail author
  • Massimo Micocci
  • Emmanuel Tsekleves
  • Yu-Han Wang
  • Wendy Martin
  • Yonghun Lim
  • Umber Shamim
Part of the Intelligent Systems Reference Library book series (ISRL, volume 167)


Products we purchase are much more than artefacts that fulfil functional needs in our life. We have grown to enact our consumer choices, even those regarding fast moving consumable goods, with careful considerations informed by numerous trials, recommendations and, growingly, environmental concerns in mind. Advanced manufacturing and progress in research and development are providing more choices for consumers even in quite specific and complex product markets. An exemption to this market trend is represented by assistive technologies (ATs). This is a relatively underdeveloped context despite the growing demands for assistive devices by those in later life who need either support in accomplishing everyday life to stay independent or have complex co-occurring conditions. In this chapter, we explore why ATs, especially for older adults, are underdeveloped by exploring issues related to design approaches and cultural and social perceptions that have contributed to making consumers more or less sensitive and demanding towards the role of ATs in their lives. The chapter will conclude with recommendations that may be able to shift the perception of assistive devices so as to facilitate the user’s emotional investment in the devices, attachment to them, which, in return, may lead to better adherence and faster adoption.


Assistive technology Adoption Identity Desire Lifestyle Older adults 


  1. 1.
    Escalas, J., White, K., Argo, J.J., Sengupta, J., Townsend, C., Sood, S., Van Boven, L.: Self-identity and consumer behavior. J. Consum. Res. 39(5), xv–xviii (2013)Google Scholar
  2. 2.
    Assistive Technology: Retrieved 17 Mar 2019 from (2018)
  3. 3.
    Consumer Focus: Equipment for Older and Disabled People: An Analysis of the Market. Consumer Focus, London (2010)Google Scholar
  4. 4.
    Newell, A.: Inclusive design or assistive technology. In: Inclusive Design, pp. 172–181. Springer, London (2003)Google Scholar
  5. 5.
    British Standards Institute: 7000-6: 2005 Design Management Systems—Managing Inclusive Design—Guide. Author, London (2005)Google Scholar
  6. 6.
    Dong, H.: Global perspectives and reflections. In: Trends in Universal Design, p. 38 (2013)Google Scholar
  7. 7.
    Clarkson, P.J., Coleman, R.: History of inclusive design in the UK. Appl. Ergon. 46, 235–247 (2015)CrossRefGoogle Scholar
  8. 8.
    Hocking, C.: Function or feelings: factors in abandonment of assistive devices. Technol. Disabil. 11(1, 2), 3–11 (1999)Google Scholar
  9. 9.
    Verganti, R.: Design Driven Innovation: Changing the Rules of Competition by Radically Innovating What Things Mean. Harvard Business Press (2009)Google Scholar
  10. 10.
    Giacomin, J.: What is human centred design? Des. J. 17(4), 606–623 (2014)MathSciNetGoogle Scholar
  11. 11.
    Brown, T., Katz, B.: Change by design. J. Prod. Innov. Manag. 28(3), 381–383 (2011)CrossRefGoogle Scholar
  12. 12.
    Hassenzahl, M., Diefenbach, S., Göritz, A.: Needs, affect, and interactive products—facets of user experience. Interact. Comput. 22(5), 353–362 (2010)CrossRefGoogle Scholar
  13. 13.
    Pullman, M.E., Gross, M.A.: Ability of experience design elements to elicit emotions and loyalty behaviors. Decis. Sci. 35(3), 551–578 (2004)CrossRefGoogle Scholar
  14. 14.
    Hekkert, P., Mostert, M., Stompff, G.: Dancing with a machine: a case of experience-driven design. In: Proceedings of the 2003 International Conference on Designing Pleasurable Products and Interfaces, pp. 114–119. ACM (2003)Google Scholar
  15. 15.
    Norman, D.A.: Emotional Design: Why We Love (or Hate) Everyday Things. Basic Civitas Books (2004)Google Scholar
  16. 16.
    Phillips, B., Zhao, H.: Predictors of assistive technology abandonment. Assist. Technol. 5(1), 36–45 (1993)CrossRefGoogle Scholar
  17. 17.
    Dawe, M.: Desperately seeking simplicity: how young adults with cognitive disabilities and their families adopt assistive technologies. In: Proceedings of the SIGCHI Conference on Human Factors in Computing Systems, pp. 1143–1152. ACM (2006)Google Scholar
  18. 18.
    Kintsch, A., DePaula, R.: A framework for the adoption of assistive technology. In: SWAAAC 2002: Supporting Learning Through Assistive Technology, pp. 1–10 (2002)Google Scholar
  19. 19.
    Lebbon, C., Boess, S.: Wellbathing-attitudes and well-being of older consumers in relation to bathing. In: 3rd International TIDE Conference Quality of Life for the European Citizen, Helsinki, Finland (1998)Google Scholar
  20. 20.
    Luborsky, M.R.: Sociocultural factors shaping technology usage: fulfilling the promise. Technol. Disabil. 2(1), 71 (1993)CrossRefGoogle Scholar
  21. 21.
    Polgar, J.M.: Using Technology to Enable Occupation. Retrieved 12 Mar 2003 (2002)Google Scholar
  22. 22.
    Parette, J.M., Scherer, M.: Assistive technology use and stigma. Educ. Train. Dev. Disabil. 39(3), 217–226 (2004)Google Scholar
  23. 23.
    Barnard, Y., Bradley, M.D., Hodgson, F., Lloyd, A.D.: Learning to use new technologies by older adults: perceived difficulties, experimentation behaviour and usability. Comput. Hum. Behav. 29(4), 1715–1724 (2013)CrossRefGoogle Scholar
  24. 24.
    Epstein, S.: Integration of the cognitive and the psychodynamic unconscious. Am. Psychol. 49(8), 709 (1994)CrossRefGoogle Scholar
  25. 25.
    Reyna, V.F.: How people make decisions that involve risk: a dual-processes approach. Curr. Dir. Psychol. Sci. 13(2), 60–66 (2004)CrossRefGoogle Scholar
  26. 26.
    Bright, A.K., Coventry, L.: Assistive technology for older adults: psychological and socio-emotional design requirements. In: Proceedings of the 6th International Conference on Pervasive Technologies Related to Assistive Environments, p. 9. ACM (2013)Google Scholar
  27. 27.
    Shinohara, K., Tenenberg, J.: A blind person’s interactions with technology. Commun. ACM 52(8), 58–66 (2009)CrossRefGoogle Scholar
  28. 28.
    Shinohara, K., Wobbrock, J.O.: In the shadow of misperception: assistive technology use and social interactions. In: Proceedings of the SIGCHI Conference on Human Factors in Computing Systems, pp. 705–714. ACM (2011)Google Scholar
  29. 29.
    Pape, T.L.B., Kim, J., Weiner, B.: The shaping of individual meanings assigned to assistive technology: a review of personal factors. Disabil. Rehabil. 24(1–3), 5–20 (2002)CrossRefGoogle Scholar
  30. 30.
    Elliott, G.C., Ziegler, H.L., Altman, B.M., Scott, D.R.: Understanding stigma: dimensions of deviance and coping. Deviant Behav. 3(3), 275–300 (1982)CrossRefGoogle Scholar
  31. 31.
    Kraskowsky, L.H., Finlayson, M.: Factors affecting older adults’ use of adaptive equipment: review of the literature. Am. J. Occup. Ther. 55(3), 303–310 (2001)CrossRefGoogle Scholar
  32. 32.
    Wessels, R., Dijcks, B., Soede, M., Gelderblom, G.J., De Witte, L.: Non-use of provided assistive technology devices, a literature overview. Technol. Disabil. 15(4), 231–238 (2003)CrossRefGoogle Scholar
  33. 33.
    Federici, S., Borsci, S.: Providing assistive technology in Italy: the perceived delivery process quality as affecting abandonment. Disabil. Rehabil. Assist. Technol. 11(1), 22–31 (2016)CrossRefGoogle Scholar
  34. 34.
    Spinelli, G., Massimo, M., Martin, W.: Objects of desire and of disgust: analysis and design of assistive technologies. In: Design4Health 2018, Sheffield, 4–6 Sept 2018Google Scholar
  35. 35.
    Department of Work and Pensions. Office for Disability Issues. Official Statistics: Disability Facts and Figures. (2014)
  36. 36.
    Metz, D.H.: Mobility of older people and their quality of life. Transp. Policy 7(2), 149–152 (2000)CrossRefGoogle Scholar
  37. 37.
    Cook, A.M., Hussey, S.: Assistive Technologies: Principles and Practice (2001)Google Scholar
  38. 38.
    Pullin, G.: Design Meets Disability. MIT press (2009)Google Scholar
  39. 39.
    Ravneberg, B.: Usability and abandonment of assistive technology. J. Assist. Technol. 6(4), 259–269 (2012)CrossRefGoogle Scholar
  40. 40.
    Herriott, R., Cook, S.: Inclusive design for assistive technology. In: Universal Design 2014: Three Days of Creativity and Diversity. Proceedings of the International Conference on Universal Design, UD 2014 Lund, Sweden, 16–18 June 2014, vol. 35, p. 175. IOS Press (2014)Google Scholar
  41. 41.
    Williamson, T., Kenney, L., Barker, A.T., Cooper, G., Good, T., Healey, J., Heller, B., Howard, D., Matthews, M., Prenton, S., Ryan, J., Smith, C.: Enhancing public involvement in assistive technology design research. Disabil. Rehabil. Assist. Technol. 10(3), 258–265 (2015)CrossRefGoogle Scholar
  42. 42.
    Blanco, T., Berbegal, A., Blasco, R., Casas, R.: Xassess: crossdisciplinary framework in user-centred design of assistive products. J. Eng. Des. 27(9), 636–664 (2016)CrossRefGoogle Scholar
  43. 43.
    Dickey, R., Shealey, S.H.: Using technology to control the environment. Am J Occup. Ther. 41(11), 717–721 (1987)CrossRefGoogle Scholar
  44. 44.
    Craig, A., Tran, Y., McIsaac, P., Boord, P.: The efficacy and benefits of environmental control systems for the severely disabled. Med. Sci. Monit. 11(1), RA32–RA39 (2005)Google Scholar
  45. 45.
    Noyes, J.M., Haigh, R., Starr, A.F.: Automatic speech recognition for disabled people. Appl. Ergon. 20(4), 293–298 (1989)CrossRefGoogle Scholar
  46. 46.
    Jiang, H., Han, Z., Scucces, P., Robidoux, S., Sun, Y.: Voice-activated environmental control system for persons with disabilities. In: Proceedings of the IEEE 26th Annual Northeast Bioengineering Conference (Cat. No. 00CH37114), pp. 167–168. IEEE (2000)Google Scholar
  47. 47.
    Aguilera, F., Ataeefar, A., Brothers, R., Castellano, M., Ginart, A., Grangeia, G., Noel, Y.: A personal computer based environmental control system for the disabled. In: 1992 14th Annual International Conference of the IEEE Engineering in Medicine and Biology Society, vol. 4, pp. 1533–1534. IEEE (1992)Google Scholar
  48. 48.
    Geggie, C.: Voice control of environmental control systems. ACNR 3(4) (2003)Google Scholar
  49. 49.
    Hawley, M.S.: Speech recognition as an input to electronic assistive technology. Br. J. Occup. Ther. 65(1), 15–20 (2002)CrossRefGoogle Scholar
  50. 50.
    Judge, S., Robertson, Z., Hawley, M., Enderby, P.: Speech-driven environmental control systems—a qualitative analysis of users’ perceptions. Disabil. Rehabil. Assist. Technol. 4(3), 151–157 (2009)CrossRefGoogle Scholar
  51. 51.
    Greenhalgh, T., Wherton, J., Sugarhood, P., Hinder, S., Procter, R., Stones, R.: What matters to older people with assisted living needs? A phenomenological analysis of the use and non-use of telehealth and telecare. Soc. Sci. Med. 93, 86–94 (2013)CrossRefGoogle Scholar
  52. 52.
    Polak, P.: Design for the other ninety percent. In: Kim, C.R. (ed.) Design for the Other Ninety Percent, pp. 19–25. Cooper-Hewitt, New York (2007)Google Scholar
  53. 53.
    Chamberlain, P., Wolstenholme, D., Dexter, M., Seals, E.: The State of the Art of Design in Health: An Expert-Led Review of the Extant of the Art of Design Theory and Practice in Health and Social Care. Sheffield Hallam University, Sheffield (2015)Google Scholar
  54. 54.
    Kouprie, M., Visser, F.S.: A framework for empathy in design: stepping into and out of the user’s life. J. Eng. Des. 20(5), 437–448 (2009)CrossRefGoogle Scholar
  55. 55.
    Van de Poel, I.: Can we design for well-being? In: Brey, P., Briggle, A., Spence, E. (eds.) The Good Life in a Technological Age, pp. 295–306. Routledge, New York (2012)Google Scholar
  56. 56.
    Spinelli, G., Micocci, M., Ajovalasit, M.: Behavioural strategies of older adults in the adoption of new technology-based products: the effects of ageing and the promising application of smart materials for the design of future products. In: Tsekleves, E., Cooper, R. (eds.) Design for Health. Design for Social Responsibility Series, pp. 358–374. Taylor & Francis (2017)Google Scholar
  57. 57.
    Sanders, E.B.N., Stappers, P.J.: Co-creation and the new landscapes of design. Co-design 4(1), 5–18 (2008)Google Scholar
  58. 58.
    Visser, F.S., Stappers, P.J., Van der Lugt, R., Sanders, E.B.: Contextmapping: experiences from practice. CoDesign 1(2), 119–149 (2005)CrossRefGoogle Scholar
  59. 59.
    White, S., Pettit, J.: Participatory approaches and the measurement of human well-being. Human Well-Being, pp. 240–267. Palgrave Macmillan, UK (2007)CrossRefGoogle Scholar
  60. 60.
    Buse, C., Martin, D., Nettleon, S.: Conceptualising ‘materialities of care: making visible mundane material culture in health and social care contexts’. Sociol. Health Illn. 40(2), 243–255 (2018)Google Scholar
  61. 61.
    Lindsay, S., Jackson, D., Schofield, G., Olivier, P.: Engaging older people using participatory design. In: Proceedings of the SIGCHI Conference on Human Factors in Computing Systems, pp. 1199–1208. ACM, New York (2012)Google Scholar
  62. 62.
    Xie, B., Druin, A., Fails, J., Massey, S., Golub, E., Franckel, S., Schneider, K.: Connecting generations: developing co-design methods for older adults and children. Behav. Inf. Technol. 31(4), 413–423 (2012)CrossRefGoogle Scholar
  63. 63.
    Davidson, J.L., Jensen, C.: Participatory design with older adults: an analysis of creativity in the design of mobile healthcare applications. In: Proceedings of the 9th ACM Conference on Creativity & Cognition, pp. 114–123. ACM (2013)Google Scholar
  64. 64.
    Mawson, S., Nasr, N., Parker, J., Davies, R., Mountain, G.: Developing a personalised self-management system for post stroke rehabilitation: utilising a user-centred design methodology. Disabil. Rehabil. Assist. Technol. 9(6), 521–528 (2013)CrossRefGoogle Scholar
  65. 65.
    Nasr, N., Leon, B., Mountain, G., Nijenhuis, S.M., Prange, G., Sale, P., Amirabdollahian, F.: The experience of living with stroke and using technology: opportunities to engage and co-design with end users. Disabil. Rehabil. Assist. Technol. 11(8), 653–660 (2016)Google Scholar
  66. 66.
    Craven, M.P., De Filippis, M.L., Dening, T.: Quality of life tools to inform co-design in the development of assistive technologies for people with dementia and their carers. In: International Workshop on Ambient Assisted Living, pp. 394–397. Springer (2014)Google Scholar
  67. 67.
    Hwang, A.S., Truong, K.N., Cameron, J.I., Lindqvist, E., Nygård, L., Mihailidis, A.: Co-designing ambient assisted living (AAL) environments: unravelling the situated context of informal dementia care. BioMed Res. Int. 2015(Article ID 720483), 12 (2015)Google Scholar
  68. 68.
    Craig, C., Gwilt, I., Langley, J., Partridge, R.: Thinking through design and rehabilitation. In: Encarnacao, P., et al. (eds.) AssistiveTechnology: From Research to Practice, pp. 798–803. IOS Press, Amsterdam (2013)Google Scholar
  69. 69.
    Reed, H., Langley, J., Stanton, A., Heron, N., Clarke, Z., Judge, S., Tindale, W.: Head-up; an interdisciplinary, participatory and co-design process informing the development of a novel head and neck support for people living with progressive neck muscle weakness. J. Med. Eng. Technol. 39(7), 404–410 (2015)CrossRefGoogle Scholar
  70. 70.
    Steen, M., Manschot, M., De Koning, N.: Benefits of co-design in service design projects. Int. J. Des. 5(2), 53–60 (2011)Google Scholar
  71. 71.
    Williams, R.: A Vocabulary of Culture and Society. Fontana, London (1988)Google Scholar
  72. 72.
    Botero, A., Hyysalo, S.: Ageing together: steps towards evolutionary co-design in everyday practices. CoDesign 9(1), 37–54 (2013)CrossRefGoogle Scholar
  73. 73.
    De Couvreur, L., Dejonghe, W., Detand, J., Goossens, R.: The role of subjective well-being in co-designing open-design assistive devices. Int. J. Des. 7(3), 57–70 (2013)Google Scholar
  74. 74.
    Leong, T.W., Johnston, B.: Co-design and robots: a case study of a robot dog for aging people. In: International Conference on Social Robotics, pp. 702–711. Springer, Cham (2016)Google Scholar
  75. 75.
    Szebeko, D., Tan, L.: Co-designing for society. Australas. Med. J. 3(9) (2010)Google Scholar
  76. 76.
    Borgerson, J.: Materiality, agency, and the constitution of consuming subjects: insights for consumer research. Adv. Consum. Res. 32, 439–443 (2005)Google Scholar
  77. 77.
    Hamlett, J., Hoskins, L.: Comfort in small things? Clothing, control and agency in county lunatic asylums in nineteenth- and early twentieth-century England. J. Victorian Cult. 18(1), 93–114 (2013)CrossRefGoogle Scholar
  78. 78.
    Latimer, J.: Afterword: materialities, care, ‘ordinary affects’, power and politics. In: Buse, C., Martin, D., Nettleton, S. (eds.) Materialities of Care. Encountering Health and Illness Through Artefacts and Architecture, pp. 136–147. Wiley Blackwell, Oxford (2018)Google Scholar
  79. 79.
    Miller, D. (ed.): Materiality. Duke University Press, Durham (2005)Google Scholar
  80. 80.
    Woodward, S.: Objects, interviews, material imaginings and ‘unsettling’ methods: interdisciplinary approaches to understanding materials and material culture. Qual. Res. 16(4), 359–374 (2015)CrossRefGoogle Scholar
  81. 81.
    Buse, C., Twigg, J.: Dressing disrupted: negotiating care through materiality of dress in the context of dementia. In: Buse, C., Martin, D., Nettleton, S. (eds.) Materialities of Care. Encountering Health and Illness Through Artefacts and Architecture, pp. 97–109. Wiley Blackwell, Oxford (2018)Google Scholar
  82. 82.
    Ahmed, S.: The Cultural Politics of Emotion, 2nd edn. Edinburgh University Press, Edinburgh (2014)Google Scholar
  83. 83.
    Spinelli, G., Micocci, M., Martin, W.: Objects of desire and of disgust: analysis and design of assistive technologies. In: Design4Health 2018, Sheffield, 4–6 Sept 2018Google Scholar
  84. 84.
    Spinelli, G., Micocci, M., Martin, W.: Objects of desire, objects of disgust. In: British Society of Gerontology 47th Annual Conference—Ageing in an Unequal World: Shaping Environments for the 21st Century, Manchester, UK, 4–6 July 2018Google Scholar
  85. 85.
    Puig de la Bellascasa, M.: Matters of care in technoscience: assembling neglected things. Soc. Stud. Sci. 41(1), 85–106 (2011)CrossRefGoogle Scholar
  86. 86.
    Mynatt, E., Melenhorst, A.-S., Fisk, A.D, Rogers, W.A.: Aware technologies for aging in place: understanding user needs and attitudes. Pervasive Comput. 3(2) (2004)Google Scholar
  87. 87.
    Throsby, D.: Economics and Culture. Cambridge University Press, Cambridge (2001)Google Scholar
  88. 88.
    Storey, J.: Cultural Theory and Popular Culture, 3rd edn. Pearson Education Limited, England (2001)Google Scholar
  89. 89.
    Eagleton, T.: The Idea of Culture. Blackwell, Oxford (2000)Google Scholar
  90. 90.
    Gay, P.D., Hall, S., Janes, L., Mackay, H., Negus, K.: Doing Cultural Studies: The Story of the Sony Walkman. Sage, London (1997)Google Scholar
  91. 91.
    Kroeber, A.L., Kluckhohn, C.: Culture: A Critical Review of Concepts and Definitions. Museum of Cambridge Massachusetts, USA (1952)Google Scholar
  92. 92.
    Statistics Canada: Conceptual Framework for Culture Statistics 2011. Statistics Canada. Retrieved from–542-x/87-542-x2011001-eng.pdf?st=10sbfza5 (2011)
  93. 93.
    Kasnitz, D., Shuttleworth, R.P.: Introduction: anthropology in disability studies. Disabil. Stud. 21(3), 2–17 (2001)Google Scholar
  94. 94.
    McElroy, A.; Townsend, P.K.: Medical Anthropology in Ecological Perspective, 5th edn. Westview Press (2009)Google Scholar
  95. 95.
    Kagawa-Singer, M., Dressler, W.M., George, S.M., Elwood, W.N.: The Cultural Framework for Health: An Integrative Approach for Research and Program Design and Evaluation. National Institutes of Health (2014)Google Scholar
  96. 96.
    Burke, N.J., Villero, O., Guerra, C.: Passing through meanings of survivorship and support among Filipinas with breast cancer. Qual. Health Res. 22(2), 189–198 (2012)CrossRefGoogle Scholar
  97. 97.
    Belk, R.W.: Possessions and the extended self. J. Consum. Res. 15(2), 139–168 (1988)CrossRefMathSciNetGoogle Scholar
  98. 98.
    Holt, D.B.: How Brands Become Icons: The Principles of Cultural Branding. Harvard Business School, Cambridge, MA (2004)Google Scholar
  99. 99.
    Krippendorff, K.: On the essential contexts of artifacts on the proposition that “design is making sense (of things)”. Des. Issues 5(2), 9–39 (1989)CrossRefGoogle Scholar
  100. 100.
    Dewey, J.: Art as Experience. Capricorn Books, New York (1934)Google Scholar
  101. 101.
    Wang, Y.: Chinese cultural features for new product design development. Ph.D. Thesis, Brunel University London. Retrieved from (2016)
  102. 102.
    Marcus, A., Aykin, N.M., Chavan, A.L., Prabhu, G.V., Kurosu, M.: SIG on one size fits all? Cultural diversity in user interface design. In: CHI Extended Abstracts, pp. 342 (1999)Google Scholar
  103. 103.
    Sparke, P.: An Introduction to Design and Culture: 1900 to the Present, 2nd edn. Routledge, Oxon (2004)Google Scholar
  104. 104.
    Appledaily: Sales of aging products increased by 1.5 times. AppleDaily News. Retrieved from (2017)
  105. 105.
    FIND team: A Report of Senior Citizens’ Shopping Behaviour in Taiwan. Institute for Information Industry. Available at (2017)
  106. 106.
    Lin, L.: A study on intention of adopting living aids for aged people. Master Dissertation. Available from National Digital Library of Theses and Dissertations in Taiwan (2017)Google Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Gabriella Spinelli
    • 1
    Email author
  • Massimo Micocci
    • 2
  • Emmanuel Tsekleves
    • 3
  • Yu-Han Wang
    • 4
  • Wendy Martin
    • 5
  • Yonghun Lim
    • 6
  • Umber Shamim
    • 1
  1. 1.Brunel University London, College of Engineering, Design and Physical ScienceLondon, UxbridgeUK
  2. 2.Department of Surgery and CancerImperial College London, NIHR London In Vitro Diagnostics Co-op.LondonUK
  3. 3.ImaginationLancaster, Lancaster UniversityBailrigg, LancasterUK
  4. 4.Department of Product Innovation and Entrepreneurship, College of Innovation ManagementNational Taipei University of BusinessPingzhen Dist., Taoyuan CityTaiwan (R.O.C.)
  5. 5.Brunel University London, College of Health and Life SciencesLondon, UxbridgeUK
  6. 6.Bournemouth UniversityPooleUK

Personalised recommendations