As people age, sleep often becomes lighter, more fragmented, and a source of increasing concern. Smart rings, like Oura, offer a discreet and comfortable means of supporting sleep tracking, yet it remains unclear how older adults engage with the sleep-related insights they provide. Our research investigates how older adults engage with wearable-derived physiological and behavioural sleep data, the barriers they encounter in understanding health metrics, and the ways these technologies influence self-perception and wellbeing practices. We report findings from a one-month diary study (n=20) and follow-up interviews (n=10) after around four months of ring use. Participants reflected on the meanings they attributed to app-based metrics, and whether such feedback felt useful, confusing, or intrusive, revealing misalignments with youthful defaults that negatively impacted engagement. We explore this in terms of "age friction" and discuss opportunities for more age-inclusive wearable technologies that promote meaningful engagement with personal health and wellbeing data.

Abstract The focus on managing problems that can arise for older adults has meant that extant HCI and Ageing research has not given the concepts of “age”’ and “ageing” the explicit theoretical attention they deserve. Attending to this gap, we critically examine a ten-year corpus of CHI publications through the lens of an existing typology that we have further developed to analyse how age is understood, interpreted, and constructed in the field of HCI. Our resulting multidimensional typology of age in HCI elucidates the distinctive characteristics of older adults considered when designing with and for this user group, but also highlights the need for a more critical, reflexive, social constructivist approach to age in HCI. Applying this approach, we explore age as a multidimensional system of stratification to better understand the phenomenon of the age-based digital divide.

In the context of extensive bank branch closures, and a rapidly ageing population, older adults’ (OAs’) reluctance to adopt digital banking platforms by themselves is concerning. However, many OAs rely on the support of close others (COs) to complete banking activities with them. This support is mostly provided through “unofficial” mechanisms such as sharing online banking credentials, which risk an OA's privacy and security. This paper replicates a Canadian study with OAs in a UK context and extends it with co-design workshops focused on novel banking solutions for OAs and COs, helping to formalise the role of unofficial proxies within online platforms. Results show that unofficial proxy banking also occurs with COs in a UK context and co-design reveals barriers to OAs’ use of banking technology independently. We discuss recommendations for flexible, easily authenticated and easy to learn digital banking solutions for OAs in the future.

Positionality is a concept that acknowledges subjectivities, values and experiences of researchers as influencing approaches to and outcomes and implications of research; it underlines the importance of reflexivity and self-awareness. To understand how positionality is used in HCI, we conducted two studies: (i) a scoping review of positionality and reflexivity statements in the CHI papers in the last 11 years and (ii) a survey of HCI researchers (n=75). Our findings show that positionality statements are often a box-ticking exercise and their influence on the research is rarely discussed. While positionality statements are often used and requested in papers, they are often restricted to more sensitive areas of research and impact marginalised identities. We argue that positionality statements can be valuable but not as markers of methodological rigour. Our contributions include a current snapshot of positionality in HCI and reflections on the role of positionality statements in HCI.

The uptake of digital technology by older adults and service-providers has been partly driven by the pandemic but more recently by the erosion of in-person services because of increasing austerity and a harsher global economic climate. Against the backdrop of the UK’s cost of living crisis, we examine technology used frequently within five older adults’ households. Through two rounds of interviews and participant diaries, we show benefits and struggles of participants’ costly technology use, reflecting on what ‘cost of living’ means when technology designed to simplify older peoples lives, encounters problems. For HCI practitioners, we provide evidence of how personal smart devices can be better tailored to help older adults support themselves both economically and practically, during the cost of living crisis. We propose avenues for future research and design that better support indirect costs and reflect on how personal devices can be made self-sustaining, integrated and repairable.

Social isolation is a common experience for LGBT+ older adults (OAs) that is often compounded by prejudices of age, sexuality, or gender identity. Little research has explored the specific social needs and barriers that LGBT+ OAs face, particularly in online spaces. To address this gap, we conducted interviews with 10 LGBT+ OAs and an inclusive housing service provider. Our research highlights the importance of LGBT+ community engagement and digitally-supported social networks’ role for LGBT+ OAs. We identify challenges such as managing online identity, navigating LGBT+ social media apps and websites, as well as digital disconnectedness challenges among those with lower digital literacy. Recommendations include improving social platforms allowing LGBT+ OAs to manage selective identity characteristics, promoting genuineness and trust in LGBT+ platforms by employing tiered blocking and interest-driven connections, and non-digital outreach strategies for collaborations between LGBT+ organizations and senior centers to engage hidden and isolated LGBT+ OAs.

Mental health issues affect approximately 13% of people aged 10-24 years old worldwide. In Western countries (e.g. USA, UK, Australia), mental health issues are particularly prominent in Culturally and Linguistically Diverse (CALD) individuals, yet they are disproportionately affected in relation to service provision. Despite demand, there is a significant lack of literature explicitly exploring the design of digital mental health tools for CALD populations. Our study engaged five professionals working in CALD mental health, to gain insights into challenges for service access and provision, and then engaged 41 CALD young people to explore their experiences. We contribute a set of unique insights into the barriers that CALD young people face when seeking help, and their needs for future digital mental health tools. We also provide design recommendations for future researchers on how they might better support the inclusion of CALD communities in the design of digital health tools.

There are growing efforts to reduce the harmful effects of deceptive patterns pervasively employed on e-commerce websites. However, efforts to produce new guidelines and introduce ethical design standards geared towards older adults have been limited. We investigate the potential of a serious game in fostering older adults' resilience against manipulative designs in e-commerce through two studies. First, a survey with older adults (N = 61), explored their attitudes towards deceptive patterns and identified characteristics influencing them. We then created a serious game, 'Shopopolis', to bolster older adults' resistance to manipulative designs online and evaluated its efficacy with older adults (N = 65). Our findings show that Shopopolis is a valuable tool for enhancing awareness, concern, and recognition skills related to e-commerce deceptive patterns. We discuss older adults' unique perspectives on deceptive patterns and consider how insights can shape the design of targeted protective measures like Shopopolis for older adults in e-commerce contexts.

Home health monitoring systems (HHMS) are presented as a cost-effective solution that will assist with collaborative care of older adults. However, instead of care recipients feeling like collaborators, such systems often disempower them. In this paper, we examine the dissemination, onboarding, and initial use of an HHMS to see how the discourse used by developers and participants affects users’ collaborative care efforts. We found that the textual information provided often contrasted with how our participants managed their care. Instead of providing participants with ‘independence,’ ‘safety,’ and ‘peace of mind,’ care recipients were placed in a more dependent, less proactive role, and care providers were pressured to take on more responsibilities. We position HHMS, as they are currently marketed and onboarded, as normalizing pseudo-institutionalization. As an alternative we advocate that the discourse and design of such systems should reflect and re-enforce the varied roles care recipients take in managing their care.

Whilst the use of smart home systems has shown promise in recent years supporting older people's activities at home, there is more evidence needed to understand how these systems impact the type and the amount of shared care in the home. It is important to understand care recipients and caregivers' labour is changed with the introduction of a smart home system to efficiently and effectively support an increasingly aging population with technology. Five older households (8 participants) were interviewed before, immediately after and three months after receiving a Smart Home Health System (SHHS). We provide an identification and documentation of critical incidents and barriers that increased inter-household care work and prevented the SHHS from being successfully accepted within homes. Findings are framed within the growing body of work on smart homes for health and care, and we provide implications for designing future systems for shared home care needs.

Explaining health technology platforms to non-technical members of the public is an important part of the process of informed consent. Complex technology platforms that deal with safety-critical areas are particularly challenging, often operating within private domains (e.g. health services within the home) and used by individuals with various understandings of hardware, software, and algorithmic design. Through two studies, the first an interview and the second an observational study, we questioned how experts (e.g. those who designed, built, and installed a technology platform) supported provision of informed consent by participants. We identify a wide range of tools, techniques, and adaptations used by experts to explain the complex SPHERE sensor-based home health platform, provide implications for the design of tools to aid explanations, suggest opportunities for interactive explanations, present the range of information needed, and indicate future research possibilities in communicating technology platforms.

A detailed understanding of the mental health needs of people from refugee backgrounds is crucial for the design of inclusive mental health technologies. We present a qualitative account of the digital mental health experiences of women from refugee backgrounds. Working with community members and community workers of a charitable organisation for refugee women in the UK, we identify social and structural challenges, including loneliness and access to mental health technologies. Participants' accounts document their collective agency in addressing these challenges and supporting social connectedness and personal wellbeing in daily life: participants reported taking part in community activities as volunteers, sharing technological expertise, and using a wide range of non-mental health-focused technologies to support their mental health, from playing games to supporting religious practices. Our findings suggest that, rather than focusing only on individual self-care, research also needs to leverage community-driven approaches to foster social mental health experiences, from altruism to connectedness and belonging.

Although the use of voice assistants to support older adults at home shows promise, little is known about how the next generation of these devices, which also include displays, can support health and care needs. This question has become more important during COVID-19, when issues of social isolation for older adults have been exacerbated. During social distancing measures in the UK, eleven older adult households (16 participants) were interviewed before receiving an Amazon Echo Show, shortly after receiving it, and after three months of use. We identify ways in which this multi-modal device is used by people in social isolation to support social, care, and information needs in the home. We frame these findings within the growing research area of smart homes for health and care, and provide implications for the adoption, use and acceptance of these devices to support aging in place together.

Gaining an understanding of people's diverse mental health needs is essential for informing the design of inclusive mental health technologies. However, conversations about mental health experiences can be challenging for both researchers and participants. We present the design of visual cards that illustrate an inclusive mental health concept to support researchers and participants in understanding and sharing mental health experiences. We illustrate the iterative design of the visual cards with our reflections and feedback from ethnically diverse participants. We found that designing the visual cards fostered insightful reflections within the design team regarding the roles of identity, gender, and ethnicity in designing culturally sensitive content and research. Participants from minority ethnic backgrounds valued the illustrative elements of the visual cards and highlighted the importance of supporting different languages and visual cultures. We discuss use cases for the visual cards and implications for designing culturally sensitive mental health technologies.

Stairlifts are a widely-used technology in the home that help people with mobility issues to go up and down stairs. However, it is unclear how stairlifts are experienced by all household members and what this understanding implies for home healthcare technologies. We investigated the impact of stairlift installations on older adults' households in the UK through a qualitative study investigating the lived experience of the adoption and acceptance of this technology. Interviews and focus groups with primary users, household residents and service providers showed how the wider household identify misalignments between simplified stairlift installation models from service providers and describe a more complex, nuanced emotional journey which involves decision making, conflict and trauma and catharsis and independence. Findings provide transferrable outcomes for the smart home domain by highlighting the multi-resident home, the emotional intrusiveness of home healthcare technologies and the diversity that comes with providing care, unique to every household.