Hello Caregiver is a digital conversation tool that informs, supports, and prepares unpaid caregivers of older adults with dementia or cognitive impairment. As it learns more about the caregiver and care-recipient, it initiates automated conversations that provide guidance around caregiving & self-care. These conversations explore caregiving techniques, topics, and terminology (e.g. “power of attorney”, “activities of daily living”, “redirection”). They also connect the caregiver with relevant, local services (e.g. adult day care centers). By empowering caregivers with knowledge and support systems, Hello Caregiver hopes to fight caregiver burnout and isolation — and to promote well-being for both caregivers and care-recipients.
To maximize our reach and allow for fast product iterations, our prototype exists as a web-app that’s usable by anyone with access to the web on their phone. Hello Caregiver is a resource that caregivers can access at any time, but what sets it apart is how it reaches out to the caregiver with brief, simple, practical advice. That way, caregivers can cover the broad swath of information in a way that is easily digestible and comes to them.
Currently, the prototype reaches out to caregivers by texting them, but we envision this happening across any platform the caregiver already uses (e.g. email, Facebook Messenger); imagine a caregiver receiving a Facebook notification about a new conversation from Hello Caregiver. And because the main web-app experience is simply a conversation, these same conversations can take be recycled for a variety of platforms (e.g. email, texting, Alexa, etc). Our goal is to maximize accessibility, and our conversational approach allows for distribution across a range of communication channels — meeting caregivers on the platforms they have access to and are most comfortable with.
Hello Caregiver grew out of the 2017 Fellowship of Blue Ridge Labs — the tech incubator arm of Robin Hood, New York City’s largest poverty-fighting organization. The Fellowship recruits mid-career product, engineering, design & subject matter experts to research and develop technical tools for communities often overlooked by technology.
The 2017 Fellowship was centered around building tools for low-income older adults and their caregivers. Starting with an intensive 8-week Research Phase, participants conducted desk research and in-person interviews with members of the community in hopes of generating ideas for technological interventions. This was followed by an 80-day Build Sprint, where various product ideas were tested, validated, and built as prototypes.
During the Fellowship, the Hello Caregiver team focused on the unique challenges faced by unpaid, low-income caregivers of individuals with dementia or other cognitive impairments. While all forms of caregiving have psychological and physical demands, the challenges faced by a caregiver of someone with cognitive impairment are distinct. Aside from the logistical challenges particular to dementia caregiving, this population often experiences the emotional challenges of overwhelm, social stigma, and isolation. Such difficulties only multiply among low-income demographics, where constraints on bandwidth and resources already contribute to overwhelming circumstances.
Although our initial iterations were focused on serving this particular demographic, we’ve arrived at an approach that can serve the entire caregiving community while still remaining considerate of the needs and sensitives of those with constrained resources. As explained above, the goal of our approach is to maximize accessibility. As such, a vital facet of our process is to continuously focus on how our product can reach those who are hardest reach, to serve those who are hardest to serve.
Based on the OpenIDEO Challenge Personas we developed User Journeys to explore how Derrick (Persona #1) and Helen (Persona #5) would be introduced to and engage with Hello Caregiver. These provide an opportunity to explore how caregivers of someone recently diagnosed and someone much further along in progression of dementia would be introduced to and engage with Hello Caregiver.
PROTOTYPES & USER FEEDBACK
In a short time, we have already come a long way in the evolution of Hello Caregiver. The earliest iterations where paper prototypes with mock-ups of potential conversations. In late summer, our team had several rounds of interviews with community members, caregivers and potential caregivers at Queensbridge Housing's Jacob Riis Senior Center in NYC. Interviews walked users through the types of interactions we envisioned they might have with our tool, tested their response to content, and included follow-up surveys to better understand the information that would be most useful.
As we continued development of the Hello Caregiver concept during the early fall, we consulted directly with caregivers and established advisory relationships with clinical and social services partner organizations. Through product-testing and interviews, each stakeholder group provided invaluable guidance on developing relevant and approachable content, optimal ways to guide users to complementary existing services, and how to prioritize the list of desired features.
We received invaluable feedback on the tone, content and features that were of the most value to our user population. Users didn't want the tool to be too playful, but they appreciated a more friendly and casual conversation. We had concerns about over-stuffing too much educational information into the conversations but were pleasantly surprised at how positively users responded to the content. There was a hunger for more information about potential causes of challenging behavior, activities to entertain and engage care recipients, resources on services for caregivers, and guidance on how to approach daunting administrative tasks (e.g. figuring out how the care recipient might qualify for Medicaid or estate planning).
By November, we had five extended conversation topics available on Facebook Messenger (available Hello Caregiver V1 Facebook Messenger) for independent user testing by our partners and their caregiver clients. This testing allowed us to observe users interaction with Hello Caregiver without someone sitting with them while they navigated the product. We received highly valuable feedback, a better understanding of the content users gravitated to, and additional eyes for discovering and troubleshooting issues with the content and flow.
Caregivers want their questions answered, not to be asked questions. - Stephanie, Supervisor of CaringKind's 24-7 hotline
Upon being accepted into OpenIDEO's Refinement phase, the NYC OpenIDEO Chapter graciously offered to host a Pop-Up Refinement Workshop. The prospect was exciting and the timing was perfect, as the Hello Caregiver team had started designing significant revisions based on the Facebook Messenger tests.
These updates pivoted the extended conversations to more "bite-sized" conversations that focused more on providing quick, practical information and links to resources. These include resources such as videos, articles, and local organizations that can offer support relevant to the topics raised in the Hello Caregiver conversation. The updates also altered the main way users interact Hello Caregiver: rather than having to remember to visit the service, the service texts you and links back to Hello Caregiver's web app. This allowed us to offer more robust and intuitive user navigation, the ability to navigate between topics instead of trying to fit in all into one ongoing chat, and to provide additional features going forward, such as profiles, an event calendar, a library of resources suggested, and in-context links to define medical and caregiver vocabulary.
On December 12th, 2017, a version of Hello Caregiver redesign pivot was shared at the NYC OpenIDEO Pop-Up Refinement Workshop. We were fortunate to have a diverse participant audience that included product and UX designers, medical professionals, and caregivers of different age groups.
“Technology is sometimes thought of as distancing people but what this does beautifully is refer people to in-person resources.” - Lola, Former caregiver for her Father
After presenting an overview of Hello Caregiver including a demo (with an opportunity for participants to text into to receive messages on their own phones), the workshop participants rotated through 3 stations to dive into specific areas where our team was seeking user feedback and guidance. These stations included User Journey & User Adoption, Navigation & "Other" Functionality, and Conversations & Topic Areas. Below is description of each station & highlights of the feedback gathered and user suggestions for additional functionality.
User Journey & Users Adoption
Goal: to learn about the context around the tool, such as how people learn about and sign up for Hello Caregiver, when and where Hello Caregiver reaches out to you, and who the key players that need to know about the product.
- Consider wider range of medical professionals that caregivers might interact with - pediatricians, gynecologists, etc.
- Explore a wide range of ways caregivers could discovery Hello Caregiver. Where are they stressed, what are products we could cross promote with, 1st-responders should know about the tool & have cards to share.
- Don't be afraid of levity and humor to establish a personal connection.
- Add a User Journey for a long distance caregiver. How would they engage with Hello Caregiver.
- Craft the user-tool interaction using practices from the "Anticipatory Guidance" approach used in medical care.
See all the notes from this station here.
Navigation & "Other" Functionality
Goal: to get feedback on the navigation style and functionality, and to gather thoughts on our list of “other” functions and feature wishlist.
- Needs a warmer welcome. More introduction on how to use it.
- We need to engender trust – why should the user trust Hello Caregiver? What gives us authority?
- Some found topic navigation overwhelming. Others liked being able to select topics they were interested in.
- People loved the idea being able to search and create caregiver & care recipient profiles. Also imaging how the "Other" - calendar or resource features could be used.
- Ability to re-visit previous chats and having a collection of save resources was popular.
- Allow users to dip into different topics, at different depths. Support non-linear exploration.
See all the notes from this station here.
Conversations & Topic Areas
Goal: to hone in on particular conversations and to refine how we might organize our topic area navigation.
- Users wanted to be able to search topics based on key-words. They also identified they wouldn't necessarily know the topics to search. Balance between suggesting & search response needed.
- Desire for more navigation within chats - to get definitions for vocabulary, re-routing to other, related topics.
- Caution around personalization/referring to the care-recipient by name. Don't use their name when describing common symptoms, but OK when presenting more open-ended questions about their behavior.
- While trying to address common challenges balance that will communicating how every case is different.
- Be a bridge to community. Make the human element of interactions a priority. Highlight benefits & opportunities to engage with real-world community - churches, meals on wheels, the VA, etc. (Also tap into these networks as we're working to get the app into users hands).
See all the notes from this station here.
Additional User Suggestions
- A "Call Me" options that triggers a call to a caregiver by service agency or support service.
- Have the ability to "Like" particular topics that will generate more such content for the user.
- Provide audio version option.
- Include the ability to send resources to their reading app or e-reader.
- Questions in a quiz format could be engaging and provide more back & forth in the chat.
To see our current prototype in action, text "Hello" to +1 (724) 749-5982!
Following on Hello Caregivers rapid early development, over the next 6 months we target to roll out various pilots with our clinical and social agency partners. During these we will gain invaluable user insight to continue expanding the application content and features.
Based on our learnings from these pilots, Hello Caregiver will leverage its functional core with localized resources suggestions to be available in areas beyond our initial pilot areas in NYC. We are also especially eager to work with our partners to culturally and linguistically translate Hello Caregivers content.