1. Faculty of Arts and Social Sciences (department Philosophy) 1 Social dimensions Ike Kamphof Technologically mediated care © Arjan Born

2. Faculty of Arts and Social Sciences (department Philosophy) 2 Research project On Identity of People with Dementia Case study: Activity Monitoring Technology for vulnerable elderly people living alone Methodology: (Post)phenomenological analysis of how technology mediates care Ethnographic observation of technology as used in homecare (NL) and in development (B)

3. Faculty of Arts and Social Sciences (department Philosophy) 3 What is activity monitoring?

4. Faculty of Arts and Social Sciences (department Philosophy) 4 QuietCare

5. Faculty of Arts and Social Sciences (department Philosophy) 5

6. 6 Social dimensions of activity monitoring Compounds of human and non-human, –technologies extend human bodies –technologies and human beings co-constitute each other –but the actors also differ… Concerns and experiences of various groups of users: developers, (care-management), formal and informal caregivers, clients

7. Faculty of Arts and Social Sciences (department Philosophy) 7 1 st story: Concerns of developers - How to organize care for frail elderly people in an ageing and more individualised society? - “secure appropriate care intervention, at appropriate time by appropriate person…” –support independence –enhance quality of life –keep care manageable

8. Faculty of Arts and Social Sciences (department Philosophy) 8 How? Need to know! about frail person’s selfcare  Technology! But: Easy to use Person should not feel threatened  unobtrusive design What can and what do we want to make?

9. Faculty of Arts and Social Sciences (department Philosophy) 9 Some observations What is independence? –Living at home –ADL, IADL + technological-practical possibilities –Active support? Quality of interdependencies! Quality of life is narrowly defined Threat of technology driven projects For whom is unobtrusive design?

10. Faculty of Arts and Social Sciences (department Philosophy) 10 2 nd story: Caregiver’s concerns Need to know? Caregivers worry Technology offered as a solution: Will technology replace human care? How difficult, time consuming is the use? Is this intruding too much into my client’s space?

11. Faculty of Arts and Social Sciences (department Philosophy) 11 How? Caregivers receive “extra eyes” and alerts that set limits to worry and categories that shape concerns they receive data in graphs and tables

12. Faculty of Arts and Social Sciences (department Philosophy) 12 Some observations Is it knowledge they receive? –Need for interpretation and familiarity –Shared decision and negotiation No replacement for human care Some worry is relieved, and new dilemma’s are introduced: need to know or ought to know?

13. Faculty of Arts and Social Sciences (department Philosophy) 13 3 rd story: client’s concerns Is there a need to be known? Desire to stay at home Fear of having an accident unnoticed Fear of being a burden Need for support and fear of interference Concern for stigma

14. Faculty of Arts and Social Sciences (department Philosophy) 14 How? Technology extends the body of frail person, and speaks –for person when incapable of speaking –in place of person The information is registered and sent out of the house to be interpreted, and read elsewhere

15. Faculty of Arts and Social Sciences (department Philosophy) 15 Some observations Is this technology for me? Limited support for independence/ quality of life Built in inequality  Caregivers need to secure privacy, good sensing, trust

16. Faculty of Arts and Social Sciences (department Philosophy) 16 Concluding remarks Social dimensions display tensions Design matters! The context set by healthcare politics and management needs to support trust, sensitive reading and careful response

17. Faculty of Arts and Social Sciences (department Philosophy) 17 Needed is a rich ethics that deals with - the quality of relationships - how to secure composite care acts and values. © Arjan Born

18. Faculty of Arts and Social Sciences (department Philosophy) 18 Thank you! i.kamphof@maastrichtuniversity.nl © Arjan Born