In this paper, we explore the seeming stability of aging. More precisely, we offer an empirical account of how aging – images of aging, embodiments of aging, feelings about aging – is enacted in company practice, both in place and across time. Drawing on ethnographic fieldwork conducted at SMCare, a small-to-medium sized company active in the care technology sector, we show how aging achieves its stability not through practices that are characterized by affection, or purposefully targeted at maintaining or caring for aging, but due to ongoing re-enactments in the shadows of other care practices. In so doing, we mobilize STS care literature that foregrounds the often-invisible relationships among objects that are otherwise neglected, marginalized and excluded. In particular, we interrogate the interlinkages between aging and caring practices as emerging in the shadows of care. In these blind spots, we find, certain unloved and disliked objects such as aging may aggregate and grow, becoming stable and durable as they are incidentally brought into existence, drawing energy from, and feeding off, other care practices.

Background: New social alarm solutions are viewed as a promising approach to alleviate the global challenge of an aging population and a shortage of care staff. However, the uptake of social alarm systems in nursing homes has proven both complex and difficult. Current studies have recognized the benefits of involving actors such as assistant nurses in advancing these implementations, but the dynamics by which implementations are created and shaped in their daily practices and relations have received less attention. Objective: Based on domestication theory, this paper aims to identify the differences in the perspectives of assistant nurses when integrating a social alarm system into daily practices. Methods: We interviewed assistant nurses (n=23) working in nursing homes to understand their perceptions and practices during the uptake of social alarm systems. Results: During the four domestication phases, assistant nurses were facing different challenges including (1) system conceptualization; (2) spatial employment of social alarm devices; (3) treatment of unexpected issues; and (4) evaluation of inconsistent competence in technology use. Our findings elaborate on how assistant nurses have distinct goals, focus on different facets, and developed diverse coping strategies to facilitate the system domestication in different phases. Conclusions: Our findings reveal a divide among assistant nurses in terms of domesticating social alarm systems and stress the potential of learning from each other to facilitate the whole process. Further studies could focus on the role of collective practices during different domestication phases to enhance the understanding of technology implementation in the contexts of complex interactions within a group.

IntroductionSocial robots are accompanied by high expectations of what they can bring to society and in the healthcare sector. So far, promising assumptions have been presented about how and where social robots are most relevant. We know that the industry has used robots for a long time, but what about social uptake outside industry, specifically, in the healthcare sector? This study discusses what trends are discernible, to better understand the gap between technology readiness and adoption of interactive robots in the welfare and health sectors in Europe. MethodsAn assessment of interactive robot applications at the upper levels of the Technology Readiness Level scale is combined with an assessment of adoption potential based on Rogers' theory of diffusion of innovation. Most robot solutions are dedicated to individual rehabilitation or frailty and stress. Fewer solutions are developed for managing welfare services or public healthcare. ResultsThe results show that while robots are ready from the technological point of view, most of the applications had a low score for demand according to the stakeholders. DiscussionTo enhance social uptake, a more initiated discussion, and more studies on the connections between technology readiness and adoption and use are suggested. Applications being available to users does not mean they have an advantage over previous solutions. Acceptance of robots is also heavily dependent on the impact of regulations as part of the welfare and healthcare sectors in Europe.

Background Home care is beset with work environment issues and high staff turnover, while research concerned with interventions to improve the work environment is sparse. Few of the existing interventions apply a participative approach, despite this being associated with more positive outcomes and sustainable change. This paper presents a framework, rooted in action research and action learning, for participatory work environment interventions in home care, and demonstrates how this framework has been implemented in four Swedish home care organizations. Methods The framework has three phases (pre-intervention, intervention planning and intervention implementation) and consists of cycles of action and reflection in three constellations: a group of researchers, a reference group with labour market organization representatives and home care managers, and intervention work groups in the home care organizations. The work was documented and analysed with focus on the realization of the framework and challenges that were met on the way. The interventions were evaluated using a pre-/post-test questionnaire design. Results Parts of the framework were successfully implemented. The pre-intervention phase and the intervention planning phase, with intervention work groups, worked well. All four groups identified one intervention relevant to their own context. However, only two of the proposed interventions were fully implemented and evaluated. The high staff and management turnover, and the high rate of organizational changes made it impossible to evaluate the interventions statistically. Yet, data from open-ended questions in the post questionnaire showed that the two implemented interventions were perceived as successful. Conclusions The participatory framework, presented in this paper, seems promising for work environment interventions in home care. The framework was designed to reduce the risk of known disturbances affecting the process in unstable organizations. Despite this, it proved challenging to execute the framework, and especially the interventions, due to changes happening at high speed. In the two cases where organizational changes were not dominating, the interventions were implemented successfully. While the prerequisites for participation and successful implementation could be improved somewhat, the main issue, the instability of the organizational context, is hard for researchers or the individual home care units to tackle alone.

This paper explores user involvement in company practice as a method that is both contingent and transformative. Drawing on ethnographic research in a small- to medium-sized care technology company, we trace how user involvement is enacted in diverse forms to resolve, deal with, and circumvent the frictions and tensions surrounding it. While encompassing similar types of configuration work, these varying enactments differ as they selectively enroll different actants, objectives, and procedures. We refer to these peculiar enactments as occurring in shifting interstices of coalescing tensions. In so doing, we are in conversation with literature in science and technology studies studying the socio-material constitution of users and the social role of methods. We build on and extend previous arguments revolving around the effects of methods and implicit ways of designers configuring users to draw attention to the situational character of doing user involvement. In particular, we argue that investigating shifting interstices offers novel ways of analyzing and thinking about the spatialities, temporalities, frictions, and objects involved in method practices, raising awareness of what it takes to momentarily “do” method this way, and not otherwise. We conclude by discussing conceptual and practical implications for understanding and remaking methods.

Background Technologies such as social alarm systems contain expectations about how they should be integrated and used in practice. These expectations, also called technology scripts, usually fail to consider all the complexity in care practice. Shifting the focus from technology scripts to care practice, this paper examines how a social alarm system is used in assistant nurses' care practices in nursing homes. Methods The paper draws on observations of assistant nurses' daily tasks (32 h) and semi-structured interviews with assistant nurses (n = 12) in two Swedish nursing homes. The observation data were used to understand the care contexts and assistant nurses' technology-mediated care practices, while interviews were used to deeply understand assistant nurses' perceptions of the system, their care practices, and which aspects they considered during the provision of care. Findings We show the complexities involved in integrating a social alarm system into care practices based on assistant nurses' situational and personal interpretations of both technology scripts and quality of care. The technology-mediated care practices consist of receiving alarms from residents, checking alarms via alarm phones, responding to alarms via alarm phones, checking specific residents' situations in person, documenting all finished alarms, and documenting some finished alarms. In these practices, the assistant nurses defined technology scripts according to their expected requirements and outcomes, and meanwhile considered the quality of care by evaluating the priority of practical, moral or relational care in the situations at hand. Through further negotiations with the defined scripts and the considered quality of care, the assistant nurses decided on the final way of following (or not following) specific scripts in practice. Conclusion Results from our study portray the complexity of technology in care practices. The findings contribute to increased understanding of technology-mediated care practices in nursing homes, and research on technology scripts in institutional settings.

Better home care and home care technologies are no longer requested solely by nonimmigrant older adults but also by members of the fast-growing older adult immigrant population. However, limited attention has been given to this issue, or to the use of technology in meeting the needs of aging populations. The objective of this review is to map existing knowledge of older adult immigrants' use of information and communication technologies for home care service published in scientific literature from 2014 to 2020. Twelve studies met the established eligibility criteria in a systematic literature search. The results showed older adult immigrants faced similar barriers, which were independent of their ethnic backgrounds but related to their backgrounds as immigrants including lower socioeconomic status, low language proficiency, and comparatively lower levels of social inclusion. Technology use could be facilitated if older adult immigrants received culturally-tailored products and support from family members and from society. The results imply that the included studies do not address or integrate cultural preferences in the development of information and communication technology for home care services. Caregivers might provide an opportunity to bridge gaps between older immigrants' cultural preferences and technology design. This specific research field would also benefit from greater interest in the development of novel methodologies.

Involving older people through co-design has become increasingly attractive as an approach to develop technologies for them. However, less attention has been paid to the internal dynamics and localized socio-material arrangements that enact this method in practice. In this paper, we show how the outcomes that can be achieved with user involvement often pertain to learning, but their content can differ significantly based on how the approach is implemented in practice. Combining explorative, qualitative findings from co-design conducted in four countries (Canada, the Netherlands, Spain, and Sweden), we illustrate how different types of learning occurred as design workshops engaged the experiences and skills of older people in different ways. Our findings make visible how learning can be a core outcome of co-design activities with older adults, while raising awareness of the role of the power relations and socio-material arrangements that structure these design practices in particular ways. To benefit from the full wealth of insights that can be learned by involving older people, deeper knowledge is needed of the implicit features of design, the materials, meanings, and power aspects involved.

This article critically interrogates how participation is practiced during the design process. We present the findings of three different configurations of participatory design workshops, each involving a different stakeholder group (age researchers, care experts and older adults). Building on insights from Science and Technology Studies (STS), we reveal how, in design practice, different configurations of participation enact and materialize multiple versions of ageing. To refer to this ontological layer of design processes, we introduce the concept "design multiple". Our study adds to current debates on the practices of participatory design and STS, as it shows how different configurations multiply enact objects into several material realities. We raise awareness on the practices of configuring participatory design, and their ontological consequences

The Corona pandemic has accelerated the digitalization of Swedish society showing that most new Internet users turn out to be 76 years and older. At the same time, digitalization of elderly care is progressing more slowly than expected. Why is this? In this paper, robots and personal emergency response systems are examples of digitalization of elderly care, discussed using result from Swedish and European research on social uptake of new technology and work conditions in the care sector. The result points out the contradiction between the high expectations and the large investments made in digital cutting-edge technology for the care sector and the fact that this issue is under-theorized. Also, what works is what is well organized and well integrated in the work and in daily habits and routines. Robots and PERS represent two opposites where the alarms are well integrated but robots based on expectations only.