Digital technology has great potential to support human health, including the complex needs of older adults in aged care services and treatments. This scoping review aims to explore the current state and roles of digital technology in supporting aged care following the PRISMA-ScR guidelines. We included 47 studies from the last 10 years covering five databases discussing the development, implementation, evaluation, or review of digital technology in aged care services and the broader clinical system. Seven key roles of digital technology were identified, including health monitoring and assessment, remote healthcare services, assistive technology to support treatment, self-care management, social technology to facilitate interaction, clinical decision support, and aged care quality measurement carried out by twelve technology types. Our findings show the potential of digital technology in enhancing the capability and efficiency of aged care services for developing or improving socio-technical aged care systems. We conclude with six recommendations for future research.

We present a qualitative study that examines how aged and community care professionals conceptualise generative AI applications, with particular attention to issues of agency, ethics, and emergent practices and behaviours. There is a growing body of research describing individual AI applications, their effectiveness and ethical implications. However, multiple applications of AI could more radically distort service boundaries and change provider practices for collaborative human-AI teams. Little is known about practitioners’ desired future roles and values for human-AI implementations and possible service innovations. Changes driven by care providers, AI service providers and government policies will have significant implications for complex settings such as aged care and community care. Through seven focus groups employing multiple qualitative methods, we identify coherence and gaps between theoretical and practitioner perspectives on the uses and implications of generative AI. Our findings suggest an urgent need for education and research to bridge theory and practical understanding of generative AI in aged and community care settings and policies to ensure marginalised groups are not locked out of future care services and models.

Generative AI is rapidly evolving with high expectations about its potential use and benefits; however, the health and aged care sectors balance risks with gaining value from its implementation and adoption. It is also challenging for policy makers to ensure public safety without constraining innovation. In this exploratory study, we interview seven experts from Australia and internationally with a range of expertise across the Health Care ecosystem with an interest in Generative AI. We aligned our enquiry to policy, organizational, practitioner and patient views and levels of abstraction to understand the enablers and barriers to AI implementation and adoption. We found that many of the factors we identified were consistent with prior research. We understood some factors in more detail in the Australian context and further emphasized the importance of cultural perspectives, participatory design and a gap between the international policy setting and practice considerations. Based on our findings we suggest the need for co-design integration across different levels of the health and aged care innovation ecosystem within aspects of the Generative AI ‘design, develop, and deploy’ lifecycle.

Technologies can support the well-being of people living with dementia in residential care by fostering meaningful interactions through multimodal and playful features. This article presents the evaluation of A Better Visit, an app that aims at engaging residents and visitors in shared activities. We define engagement in terms of dyadic interactions with the interface of the device, and interactions within the social context of the care home. We generated two Motivational Models that describe different perspectives of how people engaged with the system: the first was built with the design team, and the second was built using the first Motivational Model as a sensitising concept for the analysis of data from four care homes that used the app for periods of three months. Our findings show that the facilitation of activities plays a relevant role for engaging in social interaction. We discuss how technologies can contribute to engaging people living with dementia in social interaction: firstly, facilitation can be understood as a concept that is supported by people and technology. Secondly, we discuss the influence of the social context of the setting and the understandings of the individual in how people assess the engagement of the residents in social interaction.

This project aims to foster shared positive experiences between people living with moderate to advanced dementia and their visitors as they may struggle to find topics to talk about and engaging things to do together. To promote a better visit, we trialed a previously developed app that includes eight games with twenty-one residents and their partners or carers across four care centers for three months each. Through interviews and data logging, we found that residents preferred games that were closer to their interests and skills, and that gameplay and cooperation fostered meaningful and shared interactions between residents and their visitors. The contribution of this work is twofold: (1) insights and opportunities into dyadic interactions when using an app and into promoting positive social experiences through technology design, and (2) reflections on the challenges of evaluating the benefits of technology for people living with dementia.

Requirements engineering involves the elicitation, representation and communication of diverse stakeholder needs. However, this can be particularly challenging when developing technology embedded within complex social systems. So-called socially-oriented requirements can be abstract, ambiguous and driven by the organisational, cultural and political contexts of the stakeholders involved. Motivational models are one solution which supports project-wide understanding of the key goals of stakeholders. Yet, there is still a lack of understanding about the role they can play in larger industrial projects. We present our use of motivational modelling in an Australia-wide project that develops new technology to assist people who are homeless in accessing service providers. We interviewed 100 stakeholders and utilised motivational models to advocate for the needs of key stakeholder groups. We discuss the benefits, challenges and lessons learned.

This paper considers what we can learn from the experiences of people who choose not to participate in technology-based social interventions. We conducted ethnographically-informed field studies with socially isolated older adults, who used and evaluated a new iPad application designed to help build new social connections. In this paper we reflect on how the values and assumptions guiding the technological intervention were not always shared by those participating in the evaluation. Drawing on our field notes and interviews with the older adults who chose to discontinue participation, we use personas to illustrate the complexities and tensions involved in individual decisions to not participate. This analysis contributes to HCI research calling for a more critical perspective on technological interventions. We provide detailed examples highlighting the complex circumstances of our non-participants' lives, present a framework that outlines the socio-technical context of non-participation, and use our findings to promote reflective practice in HCI research that aims to address complex social issues.

Older adults are normally characterized as consumers, rather than producers, of digital content. Current research concerning the design of technologies for older adults typically focuses on providing access to digital resources. Access is important, but is often insufficient, especially when establishing new social relationships. This paper investigates the nature and role of digital content that has been created by older adults, for the purpose of forging new relationships. We present a unique field study in which seven older adults (aged 71-92 years), who did not know each other, used a prototype iPad application (Enmesh) to create and share photographs and messages. The findings demonstrate that older adults, even those in the \'1c"oldest old\'1d" age group, embraced opportunities to express themselves creatively through digital content production. We show that self-expression and social engagement with peers can be realized when socio-technical systems are suitably designed to allow older adults to create and share their own digital content.

Intimacy is a crucial element of domestic life, and many interactive technologies designed for other purposes have been appropriated for use within intimate relationships. However, there is a deficit in current understandings of how technologies are used within intimate relationships, and how to design technologies to support intimate acts. In this paper we report on work that has addressed these deficits. We used cultural probes and contextual interviews and other ethnographically informed techniques to investigate how interactive technologies are used within intimate relationships. From this empirical work we generated a thematic understanding of intimacy and the use of interactional technologies to support intimate acts. We used this understanding to inform the design of intimate technologies. A selection of our design concepts is also presented.

The context in which a device is used has a major impact on mobile device design. Despite this, there are few system design methods that assist user interface designers to represent use context in a useful and systematic manner throughout the whole design process. Current scenario-based design approaches are able to represent context, but still present a challenge to support a shared understanding of the rich context in which activities take place and in encoding dynamic use context due to time issues such as sequential and parallel actions. This paper reports on a method called Picture Scenarios. The method was used by four design teams whilst designing mobile information devices for use in a public square. Results show that picture scenarios provide an effective way of communicating and debating use context with design partners. The suggested format of the picture scenarios facilitates to represent use context during design activities in a systematic way. These scenarios are easy to create, easy to use, and capture important contextual details about activity that is difficult to represent otherwise.

When designing a usability evaluation, choices must be made regarding methods and techniques for data collection and analysis. Mobile guides raise new concerns and challenges to established usability evaluation approaches. Not only are they typically closely related to objects and activities in the user's immediate surroundings, they are often used while the user is ambulating. This paper presents results from an extensive, multi-method evaluation of a mobile guide designed to support the use of public transport in Melbourne, Australia. In evaluating the guide, we applied four different techniques; field-evaluation, laboratory evaluation, heuristic walkthrough and rapid reflection. This paper describes these four approaches and their respective outcomes, and discusses their relative strengths and weaknesses for evaluating the usability of mobile guides.