WEBVTT

1
00:00:00.001 --> 00:00:14.619
Okay. So then I would suggest that we start on time to have enough time for all the presenters, and hopefully for a nice discussion afterwards as well. So I have the pleasure to welcome you all to today's session called Aging camp Technologies.

2
00:00:14.630 --> 00:00:42.379
We have 5 super interesting presentations, and they are all here on site, which is also super nice. So we will not waste time with zoom and technical issues hopefully. And the way the session will be organized is as following. I would just read out loud the acknowledgment of country, and then we will have the 5 presentations. And I ask you to spare your questions, to write them down, to have them in mind.

3
00:00:42.380 --> 00:01:01.800
and then we will have a bigger discussion hopefully at the end of the session. so please make sure to all present us that you have 15 min each, and I will just announce when there are 2 min left so that you can come to an end. So that we have yeah, some time afterwards for questions and answers and discussion.

4
00:01:02.070 --> 00:01:20.130
and so on behalf of everyone gathered. I pay respect to the spirit of country. Vietnam, where we are meeting. I acknowledged the past and present Colon nation veranderi voirang, as the sovereign people. Here the cultured knowledge holders who maintain and promote the norm aboriginal law, customs and custodianship responsibilities

5
00:01:20.140 --> 00:01:32.319
country and for people the country continues to sustain generation after generation into the future. For all of us. We acknowledge their threats, their sovereignty, and pay our respects to the elders and ancestors.

6
00:01:32.650 --> 00:01:48.039
And I now ask Jenny Whitecott, and who will present for her colleagues the presentation on technology for personal life, enrichments and aged care, a care ethics perspective. A very well welcome to you.

7
00:01:59.490 --> 00:02:07.420
All right. Thank you very much for the for the welcome and for including this talk in today's session.

8
00:02:07.440 --> 00:02:17.080
So I just want to explain a little bit where the perspective that I come from you can see up there. I'm from the school of computing and information systems at the University of Melbourne.

9
00:02:17.210 --> 00:02:33.720
And I'm a human computer interaction researcher. So I'm not a sociologist. But I do work in in an interdisciplinary, interdisciplinary area. And I focus very much on the human side of that relationship. So looking very, very much at people and how they use technology.

10
00:02:33.860 --> 00:02:48.970
 and before I begin I also want to add my acknowledgment. I acknowledge that I'm presenting from the lands of the laundry and woo-wong people of the colon nation, and I acknowledge and pay my respects to their elders, past and present.

11
00:02:50.280 --> 00:03:07.980
So the work I'm presenting today comes from this project which has been going on for 4 plus years. I sort of it. It hasn't quite, you know. It officially has ended, but not really It's seeding a lot of other work as well. So this project is called Emerging technologies for enrichment in later life.

12
00:03:08.050 --> 00:03:28.079
and I've got a little asterisk there next to later life, because I want to emphasize that I'm focusing in particular on institutional or residential care settings or long-term care what we call in Australia, residential, aged care facilities, but what people call elsewhere elder care, nursing homes, and so on.

13
00:03:29.030 --> 00:03:44.630
and emerging technology. So you can see from the images here that they might include robots and immersive virtual reality. So I've got a little video there showing what that looks like, you know, somebody wearing a headset and immersed in a virtual environment.

14
00:03:44.720 --> 00:03:56.859
But I'm also interested in other technologies as well, such as video calls, and so on. Any technologies that are being used as part of the social and activities program in residential care settings.

15
00:03:58.400 --> 00:04:21.580
So this is a quick overview of some of the research that has been done as part of this work. So I call this a program of research rather than a single project. It sort of encompasses a number of different studies, some led by my Ph. D. Students, or will research staff and some that I've been more actively involved in in doing the data collection for. So today, I'm going to be talking sort of

16
00:04:21.960 --> 00:04:26.689
bringing out some lessons from from this body of work, but particularly from the

17
00:04:26.730 --> 00:04:34.689
The interviews that we did with Staff, looking at how they were using technologies broadly for enrichment in aged care.

18
00:04:34.990 --> 00:04:47.800
and also interviews that focused on lifestyle staff, facilitating immersive VR experiences and drawing on that care ethics perspective to understand their role.

19
00:04:48.480 --> 00:04:56.220
And I'm not going to go into detail about the methods. But I'll just summarize and say that we are doing qualitative research. We use qualitative methods

20
00:04:56.240 --> 00:05:12.050
predominantly interviewing. And because of the timing of this research, most of those interviews have been with staff members. It has been difficult for us to go into aged care homes, although we are starting to do some some work in aged care homes now.

21
00:05:13.440 --> 00:05:33.719
So what do we mean by enrichment in aged care. I already mentioned, this is part of the social and activities programs. It's really about ensuring. People have social and emotional well-being while living in these residential care or institutional care environments. These environments, we know, can be quite lonely places to live.

22
00:05:33.790 --> 00:05:38.870
and Barbara has done a lot of work on on the loneliness that people experience in aged care homes.

23
00:05:39.010 --> 00:05:52.279
and they can also be environments in which people don't have opportunities to engage in meaningful activities. And I thought. The best way to really illustrate what we mean by enrichment in age care is to present some examples from my research.

24
00:05:52.680 --> 00:06:02.870
and the first example I have comes from the interview study we did with with staff working in aged care about the broad range of technologies they were using.

25
00:06:03.050 --> 00:06:05.330
and this this particular

26
00:06:05.480 --> 00:06:09.740
person we spoke to. He was a volunteer, and he was going into aged care homes.

27
00:06:09.820 --> 00:06:31.039
talking to residents, meeting with individual residents and then using VR experiences to to to help them connect with their past experiences and interests. And I really love this example. He he talked about going into a care home and working with a guy who was turning 100.

28
00:06:31.710 --> 00:06:34.680
So he knew this particular resident was a car fanatic.

29
00:06:35.000 --> 00:06:44.570
and when he asked about the Resident's dream what he wanted to do, what he'd always wished he'd been able to do, he said. I would love to be able to sit in a formula, one race car.

30
00:06:44.810 --> 00:07:03.029
So the volunteer went into the VR program to find an application that would would suit this interest. He found a formula. One race car put the gobbles on the Resident, and he did a lap at the track in Germany, hollering at the top of his voice, whooping and hollowing, having such a ball.

31
00:07:03.050 --> 00:07:16.769
and it's something that he still talks about with his family because he got to live that dream. And I really love the way that description really describes that moment of joy. And that's what we mean by enrichment using technology for enrichment in aged care.

32
00:07:17.030 --> 00:07:30.919
Another example comes from the use of video calling. And this this data was collected before COVID-19. So this example comes from before video calling was introduced more broadly in aged care homes to connect residents with family members.

33
00:07:30.980 --> 00:07:38.160
and in this particular example the person we spoke to was responsible for pastoral care.

34
00:07:38.480 --> 00:07:42.050
and she had been asked to visit a resident who was upset about something.

35
00:07:42.140 --> 00:07:57.860
so she visited the Resident, learned what was upsetting her. She was upset because she wasn't going to be able to attend her grandson's wedding as the matriarch of her family. She'd always been involved in all the important family events, and so she was really upset that she wasn't going to be

36
00:07:57.910 --> 00:08:00.689
flown into state to attend the wedding.

37
00:08:01.110 --> 00:08:04.050
The staff member

38
00:08:04.280 --> 00:08:13.269
decided that they would try to bring the wedding in to the care home through Skype. So I said to her, Look, what we can do is maybe we can bring the wedding to you here.

39
00:08:13.310 --> 00:08:26.789
So, to cut a long story short, over a few months, they prepared the whole gathering where we would start the wedding in, and she agreed that all of the residents would be invited to the wedding, so we set up the whole place as a high T,

40
00:08:27.000 --> 00:08:32.209
and the overall experience was very positive, and when we turned off the the call

41
00:08:32.550 --> 00:08:52.910
everyone then reminisced, everybody started talking about their wedding experiences. And again, this is another example I really love, because it shows not just the technology, but also the social setting in which it was being used and the the care that went into making sure that was that was a community event.

42
00:08:53.520 --> 00:09:04.870
But it's not all good news. So there are. You know, there are risks with using technology in care, home environments. and this example comes from our research. Looking at

43
00:09:05.020 --> 00:09:13.519
immersive virtual reality used in aged care, one staff member that we spoke to, talked about in a situation in which a resident had

44
00:09:13.640 --> 00:09:17.780
the hand controllers and was able to maneuver himself around on a

45
00:09:17.920 --> 00:09:21.899
an explorer kind of

46
00:09:22.320 --> 00:09:30.420
activity. And he put himself on the Grand Canyon or somewhere high. and he was terrified. He had a panic attack.

47
00:09:30.600 --> 00:09:35.949
Because it's an immersive experience. It's a 3D. Environment. It can feel very much like you're really there.

48
00:09:36.290 --> 00:09:38.810
That's one of the things people

49
00:09:39.100 --> 00:09:55.469
appreciate about virtual reality in aged care, because it really does give people the sense that they're being. They're leaving the the room and the environment that they're in and travelling to another world. But of course it can create these sorts of environments where you might feel quite frightened by what you're experiencing.

50
00:09:55.490 --> 00:10:06.250
And what's interesting here is the staff member didn't know that he'd had that fright until later. So it wasn't until later that he mentioned that he'd found it quite frightening.

51
00:10:08.050 --> 00:10:32.940
So if I was to to sum up the key learning from this research. It's this quote that one of my participants shared. It's not about the technology, it's about people. So we saw an example of virtual reality and an example of video calling. There's a range of other technologies that are being used. But really it's about making sure they're used in a way that they that it responds to the needs of the individual residents being supported in these homes.

52
00:10:32.950 --> 00:10:38.370
it. It also means making sure that those experiences are enriching and joyful.

53
00:10:38.410 --> 00:10:44.399
and that you don't have that that frightening experience that we saw a moment ago.

54
00:10:44.570 --> 00:10:52.139
And what this means really is that the care staff play an absolutely crucial role in introducing the technology and making sure it works well.

55
00:10:52.420 --> 00:10:56.099
So this is a paper I've actually provided a

56
00:10:56.350 --> 00:11:07.639
I've provided a copy of this paper on the app. So if anyone is interested, you can download it. But this is where we really focus on the role of staff in facilitating immersive virtual reality

57
00:11:07.720 --> 00:11:14.150
for enrichment in aged care. And this is where I brought in this ethic of care perspective which helps to kind of frame

58
00:11:14.470 --> 00:11:16.200
the role staff are playing.

59
00:11:16.660 --> 00:11:23.830
So I now want to talk about this ethic of care framework. I've drawn very heavily on Joan Toronto's book, Moral Boundaries.

60
00:11:23.870 --> 00:11:48.880
a political argument for an ethic of care. 90, 93. And what I found really valuable about this book is that it? Toronto talks about 4 phases of care, and they line up, not quite nicely with what I could see happening in the aged care homes. So these 4 phases are caring about so noticing the need for care, and this requires being attentive to the the residents and to the need for care

61
00:11:49.340 --> 00:12:01.149
taking care of. So that's assuming some responsibility and actually making sure that care happens. caregiving. This requires competence, and being able to to give the care well

62
00:12:02.230 --> 00:12:09.089
and care receiving. And this actually refers to knowing how the care is received, so knowing that

63
00:12:09.220 --> 00:12:14.640
how the cared for people or things respond to the care.

64
00:12:17.030 --> 00:12:25.319
So if we map these phases into some examples from from the research we've done. you can really see

65
00:12:25.380 --> 00:12:40.070
see that care staff were following these phases intuitively. So they, you know, they weren't using the language of care ethics. But it was clear that they had a a care ethics approach in and the way they were doing their work.

66
00:12:40.170 --> 00:12:50.440
So caring about so noticing the need for care. There was a really strong emphasis on trying to individualize experiences to make sure they responded to people's

67
00:12:50.470 --> 00:12:59.490
particular needs. So the quote here comes from our VR study. How do we individualize it? For the people that are in that experience?

68
00:12:59.560 --> 00:13:05.349
We have to be quite neutral when engaging people in VR. And what he meant there is that you can't necessarily

69
00:13:05.720 --> 00:13:11.150
introduce an activity that you're interested in as the care care staff. You have to

70
00:13:11.200 --> 00:13:20.290
make sure the activities respond to the needs of the of the people that you're caring for, so we can't take them on our journey. We have to allow them to promote their journey to us.

71
00:13:20.430 --> 00:13:22.339
and I don't go into detail about

72
00:13:22.420 --> 00:13:39.479
the challenges of doing that here, but in an aged care home where people might be experiencing dementia and other challenges. It can be quite difficult to make sure you are responding to those individual needs and and really noticing what people need.

73
00:13:40.890 --> 00:13:49.010
So phase 2. Taking care of this means, you know, responding to those needs and choosing the action that needs to happen.

74
00:13:49.130 --> 00:13:59.590
and the staff we spoke to talked about how they felt like it was their responsibility to provide these experiences, to take people out of their reality. For a little while.

75
00:13:59.610 --> 00:14:01.179
and it's

76
00:14:01.580 --> 00:14:08.860
a sad reflection on this, on the care home environment. But this person says, because their reality is not very nice.

77
00:14:08.890 --> 00:14:17.939
and that's part of our job to make them feel happy in the moment with what we're doing and distracting them with something that interests them and something that they enjoy

78
00:14:20.180 --> 00:14:25.170
caregiving. So this is where we see the the actual active care

79
00:14:26.150 --> 00:14:27.360
and

80
00:14:27.640 --> 00:14:33.949
virtual reality is a really interesting example, because it requires quite a lot of care, and I think we might be hearing more about

81
00:14:34.000 --> 00:14:46.979
such a reality later, when Rayleine talks But it does require a lot of hands on care because somebody is in this immersive environment where they can't see what's going on in the physical world around them.

82
00:14:47.150 --> 00:14:52.429
as we saw before, they might experience a fright in that immersive, threed environment.

83
00:14:52.780 --> 00:15:04.569
And it's important that the facilitator is there guiding them through that experience. But there's this challenge of being there and guiding them through the experience, but not being in the experience with them. And so

84
00:15:04.720 --> 00:15:06.700
there's that difficulty of of

85
00:15:06.730 --> 00:15:14.650
making your presence known, but not frightening somebody who is immersed in this 3D virtual world.

86
00:15:16.530 --> 00:15:22.010
 says for care receiving, and that refers to.

87
00:15:22.280 --> 00:15:23.190
you know.

88
00:15:23.450 --> 00:15:29.599
being able to notice how this person is responding to the care, responding to the activity and making sure the activity

89
00:15:29.720 --> 00:15:41.339
is You know the right activity for them in the moment, and that might mean abandoning the activity if if somebody's thank you, if somebody is experiencing distress.

90
00:15:42.000 --> 00:15:53.309
But again, virtual reality creates this tension where it might be more difficult to see how somebody is responding to the activity because they are wearing this headset that covers

91
00:15:53.320 --> 00:16:00.959
their face. So the controllers, I think I need to move the controllers. How do I do that?

92
00:16:04.130 --> 00:16:16.040
There we go. So creating that environment where you are not in that world with people is extremely challenging, because, you know, agitation, anxiety, and all of those things can be displayed in completely silent ways.

93
00:16:16.490 --> 00:16:19.329
So without having communication through eye contact.

94
00:16:19.350 --> 00:16:29.759
it's very difficult to know if they are frozen through terror or relaxed. And so we could see in that example about the the person who ended up on the edge of a cliff

95
00:16:29.890 --> 00:16:42.949
that the care giver wasn't able to know that he was experiencing a fright. But then we also had the example of the man who was doing the

96
00:16:43.140 --> 00:16:48.110
racing car experience where there were really obvious signs that he was enjoying the activity.

97
00:16:48.340 --> 00:16:57.390
So in some cases it's going to be obvious, and in some other cases it requires a lot of care to make sure. People are aware of

98
00:16:57.410 --> 00:16:59.730
how people are experiencing the activity.

99
00:17:00.890 --> 00:17:01.830
Okay.

100
00:17:02.280 --> 00:17:07.520
I'm having some trouble moving my slide.

101
00:17:12.430 --> 00:17:15.140
Okay, I'm just going to move the

102
00:17:19.030 --> 00:17:19.720
okay.

103
00:17:20.020 --> 00:17:32.600
So this is kind of my summing upside. So I think I'm okay with time. So technology based experiences need to be carefully selected, deployed, facilitated, and monitored when used for personalised enrichment in aged care

104
00:17:33.570 --> 00:17:34.580
and

105
00:17:34.670 --> 00:17:51.629
an ethic of care framework, I think, can help us to identify lessons for good practice in this area. So we can draw on those those 4 phases of care to say, to identify, you know how we can do care well when introducing technology for enrichment in aged care.

106
00:17:51.880 --> 00:18:10.959
 That's it. Oh, there's some sorry I forgot about that side, some a list of papers that you might be interested in. I have provided a QR. Code which probably isn't going to work. If

107
00:18:12.290 --> 00:18:14.349
now, I can actually move the

108
00:18:18.260 --> 00:18:22.389
hide it. Yeah, how do you hide it? Where's the hide

109
00:18:24.700 --> 00:18:26.499
to be me? And

110
00:18:27.190 --> 00:18:30.440
thank you. Thank you.

111
00:18:30.480 --> 00:18:32.820
so

112
00:18:32.950 --> 00:18:39.129
I think this one was the Care Ethics paper that I've already put up on the app, anyway. And this one, I think, is the

113
00:18:39.610 --> 00:18:45.480
technology mediated enrichment in aged care, survey and interview study. So they're the main

114
00:18:45.680 --> 00:18:49.880
papers that I drew on in presenting this work. But thank you very much.

115
00:18:49.900 --> 00:18:50.910
Thank you.

116
00:18:58.450 --> 00:19:23.789
Perfect. Thank you so much for taking us on a trip into the world of virtual reality technology. And, as you mentioned ethical aspects already, and this lead to our. This leads to our next presentation, which will be held by Microsoft's Passion, and colleagues from Lynn shaken University in Sweden, and is about care. Give us practical, social, and ethical competence when using robotic animals.

117
00:19:41.680 --> 00:19:42.430
Yeah.

118
00:19:45.880 --> 00:19:47.510
thank you so much.

119
00:19:48.590 --> 00:19:59.120
Hi, everyone. I'm Marcus Parson, a Lynn shopping university. And I'm going to talk about social robots, or most precisely robotic animals in dementia care.

120
00:19:59.840 --> 00:20:03.439
And me see if I cannot.

121
00:20:06.800 --> 00:20:08.590
How do I switch? Sorry

122
00:20:09.420 --> 00:20:14.700
they are. Also. yeah. yeah.

123
00:20:16.880 --> 00:20:17.560
just

124
00:20:22.750 --> 00:20:24.040
okay. Yeah.

125
00:20:24.530 --> 00:20:25.440
All right.

126
00:20:26.230 --> 00:20:35.069
I have too many slides into little time. So some slides I'm going just can only skip. So you you you know what's happening

127
00:20:35.890 --> 00:21:01.219
for those who haven't means that's familiar with robotic animals. He has a short background social robots are designed to resemble animals built to use sound or movement to attract user to interactivity. And it was like in the middle 90 middle of the nineties. You know the the start with robot robotic seal power in Japan, and but thereafter it has more or less exploded. It's a huge market right now.

128
00:21:01.220 --> 00:21:06.130
and in Sweden, where this study, which I'm going to report on is

129
00:21:06.150 --> 00:21:09.230
situated, the most common

130
00:21:09.250 --> 00:21:15.510
robotic animals is cats, and a few dogs are found, but mostly cats.

131
00:21:15.890 --> 00:21:18.330
looking at previous

132
00:21:18.970 --> 00:21:20.390
research

133
00:21:20.680 --> 00:21:41.149
about robotic animals, they tend to focus on the well-being of the elderly, the the dyadic relationship between the user and the robot. The robots. Yeah. Effect on the user, so to speak. And they they can show us a calming effect, providing companionship and distraction

134
00:21:41.150 --> 00:21:56.859
can also also provide stimulating effects through conversations and triggering memories. For example, so the previous research research has found both passivating activating effects. You can say.

135
00:21:57.850 --> 00:22:18.329
however, it's a quite of going through previous research. You'll find quite a mixed results. And most of the time the most research agrees upon. It's not for everyone. Some people reacts positively to this use of of social robots or robotic animals. Some people don't react at all, and some react negatively.

136
00:22:18.700 --> 00:22:19.850
So

137
00:22:20.210 --> 00:22:29.119
adding a piece to this puzzle, this project has focused on the caregivers involvement an ability to create a side effects on users.

138
00:22:30.100 --> 00:22:34.449
In other words, we are focusing on the triadic relationship.

139
00:22:34.540 --> 00:22:40.349
the caregivers working with robots, trying to

140
00:22:40.510 --> 00:22:45.860
affecting or stimulating the elderly holy juices.

141
00:22:49.800 --> 00:23:04.060
We are doing so, and me and my colleagues and I forgot to mention their names, and David Redmond from Maladora University, Clara Iverson, Epsilon University, and Lisa firm at interoping university

142
00:23:04.710 --> 00:23:20.179
together. We have done ethnographic field work for the last couple of years in dementia, care facilities during participating observations, seam instructed interviews, and also some video recordings of robotic interactions

143
00:23:20.440 --> 00:23:22.669
which I'm not going to show you today.

144
00:23:23.030 --> 00:23:31.659
But we have inductively worked inductively, being spending a lot of time at these institutions

145
00:23:32.110 --> 00:23:37.540
and inductively trying to figure out what it is the categories are doing

146
00:23:37.580 --> 00:23:49.520
and to make it work to make it a good introduction and create the good interactions between the residents, the venture care residents, and the robots.

147
00:23:50.790 --> 00:24:01.700
So through observations and interviews, we have identified inductively 3 broad categories of competences embodied social and ethical, and I'm going just going to go through them

148
00:24:02.280 --> 00:24:05.070
quite briefly with a few examples.

149
00:24:05.100 --> 00:24:07.700
First of all, embodied competence.

150
00:24:07.930 --> 00:24:37.159
People with dementia do not always request the robots on their own initiative, which is an aspect of dementia. You have to understand this as well. It's not just use of robots in elderly carry. This is specifically in dementia care people in the late stage of dementia. Often they tend to lack the ability to take initiative on themselves. So it is the caregiver who most often must make the robot relevant to the user. To act upon

151
00:24:37.610 --> 00:24:47.279
this requires bodily competence, that is to say, knowledge of how the robot should be handled in order to make it evocative for the user to act towards it.

152
00:24:47.550 --> 00:25:11.080
And they can be they can't they? Some body compounds can be performed in many very different ways. But we have witnessed the most often. We're in different ways of the caregivers, ways to position the bodies, ways of moving, patting the robot in certain ways, lifting and caring practices. You might think it's easy or self explaining to to us carrying a robot. It's really not

153
00:25:11.640 --> 00:25:12.570
now.

154
00:25:13.100 --> 00:25:22.829
typically caregivers demonstratively carry the robot animals in their arms, slow down the pace and start the device as they approach the patient

155
00:25:23.140 --> 00:25:28.289
by adopting a slow approach. Caregivers have time to start the robot using a button on the valley

156
00:25:28.570 --> 00:25:36.829
for this model of cat, anyway, and by patting it, having it's having sensors on its back, it starts making sounds as they

157
00:25:36.850 --> 00:25:40.139
approach the user. This gets time.

158
00:25:40.220 --> 00:25:46.279
This gives the resident time to observe and recognize the caregiver as well as the robot, and understand what's about to happen

159
00:25:46.420 --> 00:25:47.910
preparing themselves.

160
00:25:48.800 --> 00:26:01.499
If you just throw it forward, you're just putting it in a lap without giving them time to realize what's about to happen. It's it's bound to malfunction, so to speak. You create a failed interaction.

161
00:26:04.570 --> 00:26:20.839
Oh, yes, and it's I call this the colic car. It's also a notion used by Fahrenheit and the cart in a previous study. It's the way you're carrying a baby with a college with a belly on a but belly down, and you know, in the crook of your arm, trying to get to birth

162
00:26:21.160 --> 00:26:24.960
the same thing here, really using the robotic, animal

163
00:26:26.560 --> 00:26:28.319
social competence, then

164
00:26:28.650 --> 00:26:39.730
it's about knowing your residence. Which of the residents are receptive to robot animals, in what situation they are receptive, and they must also know how the residents prefer to use them.

165
00:26:41.540 --> 00:27:00.230
Different residents wants different things, have different needs, different preferences. Some restaurants want to use these robot animals in their own room at night in bed, providing comfort. Other residents wants to use these robots in a common room, the day room, together with other people, other residents.

166
00:27:00.670 --> 00:27:06.079
They have often personal nicknames on the cat or a dodge.

167
00:27:06.200 --> 00:27:15.030
The caregiver. The caregivers must know this. They're not calling their their pet, so to speak their cat by the wrong name.

168
00:27:15.140 --> 00:27:20.770
create a confusion or irritation. Some use the

169
00:27:21.430 --> 00:27:29.439
some residents like the sound on some off, as you see, down at the bottom. This is a quote from one of the caregivers.

170
00:27:31.880 --> 00:27:39.459
her her cat. We couldn't have it on audio, because then she got worried. God. The cat needs help, and he's hungry.

171
00:27:39.810 --> 00:27:53.479
you know a concern when it me outs all the time. So then we had it silent. Then it worked great. The calculus. In this example the audio itself creates anxiety. So it's not. But you like the the doesn't really like the cat.

172
00:27:53.830 --> 00:27:56.920
but not just the sound, the meowing sound of the cat.

173
00:27:57.010 --> 00:28:09.069
so it's not either you like it or you don't like it. You have to know how to use it for making the residents, or or or enhancing

174
00:28:09.359 --> 00:28:13.730
the possibility, make them the the restaurant. I like it and use it.

175
00:28:15.850 --> 00:28:17.570
I'm going to give this one

176
00:28:18.600 --> 00:28:29.260
the third category of competence is ethical. As I already mentioned, it's an important issue in this regard in using technology and robots in all lily care.

177
00:28:30.580 --> 00:28:36.520
And the question here is, should the caregivers treat the robot as a machine or a living animal? I mean, there is a

178
00:28:36.600 --> 00:28:46.209
there is really a built-in deception in in the robotic animal. It's designed to look like some some way behave as a real animal.

179
00:28:46.439 --> 00:29:09.679
Otherwise, what's the point? And according to Swedish, medically at the Council? And that really does a lot of different national ethical councils, saying that basically the same thing, they advice. You always tell the truth and give uses complete information about the robots, capabilities, in short, don't lie and inform the residents what it is that it's a machine. It's a toy.

180
00:29:10.890 --> 00:29:21.680
however, in practice issue is more complex. A person with dementia may not remember what you informed them about from, you know, from day to day, or just from morning to evening. It's

181
00:29:21.830 --> 00:29:24.000
things happens all the time.

182
00:29:24.109 --> 00:29:42.689
and and you cannot just go about all the time just informing them. This is a machine. You remember, this is a machine. This is a toy. it gets weird. After a while. Also, the caregiver must ensure that the information about the nature of the robot does not create concern and anxiety.

183
00:29:43.360 --> 00:29:51.720
For instance, if a resident is treating or perceiving the robot animal as a living animal, a living cat, how many do

184
00:29:52.020 --> 00:29:53.179
many do that?

185
00:29:53.860 --> 00:30:00.590
Should then the caregiver approach them and say, You know, dear, this is this is a machine, this is not living

186
00:30:00.670 --> 00:30:04.480
that will cause confusion in the mind of every person with dementia.

187
00:30:05.310 --> 00:30:14.190
It's because then, what's happened then? I've been in situations where the person reacts horribly, horribly. I was like, what is it? Dead? Have you killed my cat.

188
00:30:14.770 --> 00:30:21.889
and that's that's not a good care. That's not according to good standards in dementia care, so

189
00:30:21.930 --> 00:30:26.850
you cannot always tell the truth in an informed manner.

190
00:30:27.040 --> 00:30:32.999
So what do they do, these very competent caregivers that we have observed? They

191
00:30:33.290 --> 00:30:37.790
most often follow along. They try to

192
00:30:37.900 --> 00:30:51.589
pitch this social robot, so to speak. They try to attract the interest of the residents, making them interested, and if they succeed in that, introducing the robotic animals and the residents gets interested

193
00:30:52.390 --> 00:31:00.020
the caregivers, read them up, read off them, read them their, how their perception of reality

194
00:31:00.990 --> 00:31:05.269
do they treat the cat as living or as a toy?

195
00:31:05.460 --> 00:31:11.269
And then the caregivers follow in their perceptions instead of trying to push their perceptions

196
00:31:11.590 --> 00:31:12.560
on 2,

197
00:31:12.690 --> 00:31:13.820
the restaurants.

198
00:31:16.640 --> 00:31:25.010
All right. This is an example of the multimodal transcripts which I'm not going through, and it's also in Swedish, so it won't make sense to. Most of you

199
00:31:25.700 --> 00:31:26.670
was.

200
00:31:27.630 --> 00:31:30.019
oh, here we go.

201
00:31:30.160 --> 00:31:45.369
So these 3 3 types. Our categories of competence that we have identified, embodied social and ethical competence needs to be acknowledged within the research of robots in dementia, care.

202
00:31:45.620 --> 00:31:58.770
embodied competence is really oriented towards the material object, the social competence, audience towards the subject user and ethical contents oriented towards the values in care.

203
00:31:59.330 --> 00:32:19.030
however, there is no real formal. It's not in Sweden, anyway, a formal education, or on site learning programs or anything. There are some, of course, instructional manuals and and so forth. But you know how many, how many of us read instructions that point. So it's basically it's up to the caregivers to learn each other

204
00:32:19.190 --> 00:32:26.500
through practice, trial, and error. who need your learning process to make this work

205
00:32:29.280 --> 00:32:30.730
for last of time.

206
00:32:31.900 --> 00:32:46.090
That's great. A few of these, most of this example I've showed you so far they so it's all the best practices. How do they do to make it work to me to attract the interest of the the residents.

207
00:32:46.110 --> 00:33:04.649
But of course, in everyday care there is also a lot of failed interactions. And this is like the last slide I'm going to show you, because the failed interactions are as important, really, as the succeed successful interactions.

208
00:33:04.750 --> 00:33:09.020
So this is just a short example of

209
00:33:09.110 --> 00:33:13.570
one of my visits at the okay, our home.

210
00:33:13.670 --> 00:33:24.529
The caregiver approached a resident who was just woken up after an app in the wheelchair, and places the robot cat in the restaurant's lap, and says you can pet it like this, and these residents really like the cat

211
00:33:25.080 --> 00:33:32.489
and caregivers, shows how to get it. But the Resident, who is newly awake doesn't want to pair the robot right now. It's disgusting. She says

212
00:33:32.920 --> 00:33:36.100
the kag ever tries again. No, he wants you to pet him

213
00:33:36.490 --> 00:33:49.109
and starts getting the role with herself. But the Resident does not want to, and shouts no, and you take it away. And well, of course, their caregiver says, Okay, okay. And the do that takes it away backs off.

214
00:33:49.740 --> 00:33:51.519
So just in this short

215
00:33:51.560 --> 00:34:07.669
example, we see how the caregiver does not use any of the embodied or social competences to initiate an interaction. If it doesn't give her the the user, the the restaurant, any time to prepare for this meeting. It just happens, yes, a robot cat in your labs newly awake.

216
00:34:09.230 --> 00:34:10.550
a.

217
00:34:10.910 --> 00:34:23.439
And the residents encounter with the robot is forced rather than encouraged, and in in addition, the ethical competence of the caregiver is actualized when she tries to make the restaurant believe that a robot cat is a living cat that wants to be better.

218
00:34:23.560 --> 00:34:24.980
He wants you to pet him.

219
00:34:25.270 --> 00:34:35.389
I mean, the robot doesn't want anything, and it's not even a he. So the caregiver tries to push on her perception of reality onto the

220
00:34:35.620 --> 00:34:42.920
the Resident. In this situation. It doesn't work. It seldom work when you work like that when you do it like that.

221
00:34:43.110 --> 00:34:46.379
So you have to be much more

222
00:34:46.740 --> 00:34:48.040
smooth.

223
00:34:48.980 --> 00:34:52.339
and I think that by that I think my time is up.

224
00:34:52.460 --> 00:35:04.480
If you want to know more about that, and we have a put down a few references here. The first one is, yes, the newly published on this topic in Nordic journal of working lifestyles. Thank you so much.

225
00:35:14.810 --> 00:35:27.770
Yeah, thank you so much, Marcus Person, for this very interesting talk that probably also provoked some thoughts and questions, and again I ask you to spare them, to write them down to note them and ask them later on the discussion.

226
00:35:27.810 --> 00:35:49.959
and we stay a little bit longer in this field of residential care, and I would now like to welcome Loretta Badass, and from the University in Perth and Australia the edit Cone University, who will give a presentation on virtual visits home belonging and home, making in and across place in residential care. Everyone welcome to you as well.

227
00:35:55.660 --> 00:36:01.080
You know. We can hide again this that's nothing.

228
00:36:03.150 --> 00:36:04.420
Just enter.

229
00:36:04.800 --> 00:36:26.830
I think, for some reason it just works. Okay, thank you very much for that kind introduction. So this presentation, our virtual visits home reports on a pilot study project conducted in a residential care. Facility in Australia, and this facility is particular because it has a high proportion of residents

230
00:36:27.050 --> 00:36:37.319
from Southern European from Southern Europe, who migrated in the 50 s. And 60 s. The 1950 s. And 60 s. From Southern Europe, and who have grown old in Australia.

231
00:36:37.970 --> 00:36:43.799
It is one of several what we're calling social care interventions

232
00:36:43.910 --> 00:36:56.070
being developed in a newly established researched entity in the School of Arts and Humanities at Edith Cowan University, called the social aging or sage futures lab.

233
00:36:56.500 --> 00:37:01.000
and the focus of our work is on aging and migration, or aging and diversity.

234
00:37:01.240 --> 00:37:03.600
And

235
00:37:04.860 --> 00:37:06.000
I'm not

236
00:37:08.010 --> 00:37:18.900
before presenting the details of the project. I'd like to begin by reflecting on some of the key concepts that guided the development of the virtual visits Pilot.

237
00:37:19.060 --> 00:37:21.880
which is still very much a work in progress.

238
00:37:22.120 --> 00:37:40.390
 so we are interested in complementing what we find is the most common type of care in this facility, which we would call person-centered models of care. This is what the facility talks about. The staff. Talk about person-centered care.

239
00:37:40.440 --> 00:37:48.810
and we're interested in shifting that framing to relationship-centered care approaches which really is similar to the triadic

240
00:37:48.910 --> 00:38:12.649
approach that the former presenter talked about so person-centered care models tend to be informed by medical approaches that focus on the needs of the individual patient while relationship centered. Care models shift the focus from being on the person receiving care to creating an enriched environment which supports relationships, including with staff and family.

241
00:38:13.200 --> 00:38:31.799
One such example is the census framework which argues that relationship centered. Care can only be delivered when the senses are experienced by all parties, including the sense of security belonging continuity, purpose, achievement, and significance. But I don't actually have time to talk much about that framework. In this project.

242
00:38:32.280 --> 00:38:47.200
To these concepts we add 2 notions developed from my research on transnational families with Rayleine Wilding from La Trobe University, including digital kinning and digital homing. And some of you were in our presentation

243
00:38:47.200 --> 00:39:04.719
yesterday, was it yesterday? It's all a blur where we talked in more detail about digital killing which refers to the inherently relational practices and processes of caring through the use of new technologies which constitute, build and maintain kinship relations

244
00:39:04.720 --> 00:39:32.300
for older people in particular, these digital kidding practices often require facilitation by others, further emphasising their social, relational nature and digital homing, which comprises digital media engagement and practices that help migrants feel a sense of belonging in the country of settlement, as well as maintain their sense of connection with places and communities in the country of origin. So we're interested in exploring these ideas in this project.

245
00:39:32.940 --> 00:39:35.090
The other

246
00:39:35.600 --> 00:39:46.419
background to mention is that the idea of virtual visits was inspired by my career-long interest in the role of visits in the migration process.

247
00:39:46.550 --> 00:39:59.009
and a central theme of the return visit in the migration process has been the experiences of migrant belonging through the practices and imaginings of visits home.

248
00:39:59.190 --> 00:40:02.040
And here I can talk about method

249
00:40:02.070 --> 00:40:28.999
which is primarily ethnographic, participant observation, life, history, interviews, and what I call ethnographic, returning or working with the same communities over many years. So the residents in this facility were known to me, and they knew me, or they knew my parents or grandparents. So they're kind of my village in the anthropological sense, even though it's a transnational sort of village

250
00:40:29.150 --> 00:40:39.850
and in this previous body of work. I it it. There's quite a bit to sort of summarize, and I'm just going to focus on 2 points.

251
00:40:39.890 --> 00:40:45.789
The visit home is experienced by many migrants, including the ones that participated in this study.

252
00:40:45.800 --> 00:40:53.270
a deep nostalgia and longing, best described as a sense of belonging or sense of obligation, rather

253
00:40:53.300 --> 00:40:55.640
a sense of obligation to return.

254
00:40:56.240 --> 00:41:11.189
that operates at 2 levels, cultural and familiar at the cultural level. Visits home are a kind of secular pilgrimage for cultural and spiritual renewal, where the sense of ethnic identity and belonging is nurtured, renewed, and revitalized

255
00:41:11.230 --> 00:41:23.640
at the familiar level, visits home are an extension of familiar habitus to nurture, renew, and consolidate family, and consociate ties. And this graph is taken from early work on visits home.

256
00:41:23.850 --> 00:41:26.110
of one

257
00:41:26.780 --> 00:41:45.859
town in the Venet, or region, which is where most of these residents are from, and it shows that prior to the revolution in affordable travel, people were visiting home, you know just once, maybe, to get married or to to attend a funeral. But as

258
00:41:45.960 --> 00:41:56.370
Travel, aeroplane travel became more affordable, you can see that they started visiting as often as possible, including every year or every other year. So that's their history of visit experience.

259
00:41:56.640 --> 00:42:03.109
 and what I was interested to examine is what happens in the migrant

260
00:42:03.510 --> 00:42:14.309
experience when you can no longer visit home, when you're too old to visit, or you're now in residential care, and you you can't fulfill that set of obligations.

261
00:42:14.380 --> 00:42:24.199
 and and also moving into a residential care. Facility is, in a way, another kind of migration into a new place with new

262
00:42:24.430 --> 00:42:33.969
language and new practices, so it can be very dislocating. So I was also interested in notions of belonging and home making, in that.

263
00:42:34.570 --> 00:42:45.760
in addition through the notions of kidding and homing. I'm also drawing on the ais project in collaboration with Rayleen.

264
00:42:45.840 --> 00:43:03.349
and and we had actually been doing the interviews for this project in the facility for 6 months before we had the idea to do the visits home. So I want you to get a sense that we were quite embedded in this facility before we attempted the pilot.

265
00:43:03.580 --> 00:43:06.570
okay, so

266
00:43:08.690 --> 00:43:20.329
our aim was to better understand how technology can be used to safeguard cultural identity and sense of home and increase social interaction in engagement, in residential care for people from migrant backgrounds.

267
00:43:20.400 --> 00:43:34.780
and we knew from the literature review that social engagement and meaningful relations have a positive impact on physical health. But that residential care work tends to prioritise physical care. There's actually no specific funding for social care.

268
00:43:35.070 --> 00:43:50.180
But we know that social care is very important to well-being. But most importantly, there's a lack of resources and and and interventions targeted to the needs of culturally and linguistically diverse residents. So we were wanting to respond to that gap.

269
00:43:50.910 --> 00:44:12.640
 So our methodology was, we we got consent from the participant family care, staff, and management. We ran the sessions as part of the weekly afternoon tea and biscuit, making activity that was already established in the facility which Staff reported was not successfully facilitating social interaction and engagement.

270
00:44:12.670 --> 00:44:16.120
because participants tended to be passive observers

271
00:44:16.420 --> 00:44:24.680
watching the volunteers make biscuits rather than being actively engaged, and they'd sit around and not do much. There was not much talking.

272
00:44:24.770 --> 00:44:53.939
so using the afternoon. T. Activity was handy because the residents were already coming together at that time. So we so it's not very technological. Really. We set up this large touch screen visible in the photo, and we ran 10 weekly sessions where we introduced the technology using Google Maps and other Geo. Browser apps and invited residents and staff to visit places of interest, you know. So we said, struct yourselves in. And you know, Google Maps go zooms you over. And it's kind of nice feeling you feel like you're you're moving

273
00:44:53.980 --> 00:45:21.530
and many residents found the technology quite magical and in sport, or in spying in a wow! And they had not encountered anything like it before. So we invited them to be transported to places around the world, and not surprisingly, they wanted to visit their hometowns. So we conducted the sessions as participant observers, facilitating group discussion with residents, family visitors, and staff, and I want to share 3 case studies.

274
00:45:21.550 --> 00:45:26.010
The first is increased engagement and belonging, and it

275
00:45:26.140 --> 00:45:54.780
focuses on the experience of Francesca, who was described described by Staff as very quiet, withdrawn, and reserved, who came along to Biscuit Maid King, but did not talk to any one. His mood often seemed low, and he did not engage with other residents or staff unless directly spoken to, and he was one of few men in the facility. It was mostly women. So Francesco enjoyed the virtual session from the beginning. He was the first to want to be involved.

276
00:45:54.820 --> 00:46:05.789
and was the first to approach the screen to physically participate in the activity we didn't ask them to. He people just simply got up and came to the screen to look more closely, and to touch

277
00:46:06.130 --> 00:46:12.110
the images. By the third session he started bringing in photos of his own to share with others.

278
00:46:12.130 --> 00:46:21.579
and he became this transformed sort of historian. We were all surprised at his level of historical knowledge. He was something of a local historian.

279
00:46:21.600 --> 00:46:42.310
and he shared the history of his hometown in detail, pointing out famous landmarks, wanting to take us to specific places, to show us these landmarks and generally enjoying sharing his life experiences. He became interested in the stories of other residents and staff, and actively encouraged others to so participate. Why don't you have a term?

280
00:46:42.450 --> 00:46:51.559
Staff reported that residents discussed the activity at other times outside the session with him, and this helped build their relationship with him.

281
00:46:52.490 --> 00:47:10.579
The second case study is an intergeneration or visit home, which was unexpected and unplanned, but really beautiful. Maria, a 92 year old Italian, born President resident, invited her daughter to the sessions. The daughter had grown up in Perth, and had never visited her mother's hometown.

282
00:47:10.610 --> 00:47:20.379
When the images of the old church and the piazza appeared in street view, Maria shouted excitedly, I have never been at that place again. I've never seen it again since I left.

283
00:47:20.400 --> 00:47:45.360
Maria began talking to her daughter, recollecting and telling her about her childhood and life in the town, and it was an emotional moment for both of them and for all of us participating. The other participants, including Staff, were similarly moved to witness this mother, daughter, conversation, and this created a space of connectedness, empathy, and identification among the group, and the daughter said it was very emotional seeing Mum so excited

284
00:47:45.400 --> 00:47:55.740
to show me her hometown. I didn't expect to be so overcome with emotion. It was a very special visit. I haven't enjoyed being with mum at that level before in the home.

285
00:47:56.660 --> 00:48:16.630
The third one is a bit of a failed example, and it's interesting. Both the previous presenters dwelled on the failed example. this is an example of nostalgia and loss. So there were many mixed emotions associated with the activity, including the potential to bring up feelings of sadness and loss.

286
00:48:16.780 --> 00:48:30.039
After attending the sessions for several weeks, Tina decided to have a turn to visit her hometown. We realized that she probably hadn't volunteered sooner, because she could not recall the exact address of her home, and she was embarrassed about that.

287
00:48:30.110 --> 00:48:56.149
Instead, she could only remember the name of the street and nearby streets. It was clear that the experience of seeing the streets and looking for her former house was exciting for Tina, but also frustrating because she had difficulty finding her place, she kept commenting how much everything had changed, and she couldn't really recognize the houses, and, you know, 5 min became 10 min became 15 min, and we were all becoming anxious for her.

288
00:48:56.170 --> 00:49:00.650
And she was reluctant to give up. and we had to sort of

289
00:49:00.660 --> 00:49:19.960
say, Look, we'll search together at the end of the session, and and and and and and move on. So Tina's experience was bittersweet. a mix of recollecting and acknowledging loss and change, and it was clear the activity was about finding cultural and personal history connected to place that didn't quite work

290
00:49:20.180 --> 00:49:29.580
So she took pride in pointing out beautiful landscapes, but also shed tears when she could not find her place or recognize the streets.

291
00:49:29.840 --> 00:49:37.150
Those of us facilitating the session took care to help Tina manage. processed the emotions, and we got in touch with her

292
00:49:37.230 --> 00:49:44.169
family to find the exact address, and and we redid it later with more success.

293
00:49:44.200 --> 00:50:10.329
So just some unexpected outcomes was that the staff really loved it, and they really loved being engaged, and they also visited their hometowns. Most of the staff were themselves of migrant backgrounds. And so these are the some of the comments that they made about the activity. And so I'll just leave you with some findings. the most important one, because I'm out of time is the third one.

294
00:50:10.520 --> 00:50:21.680
And what we found was that unless these facilitated activities are written into staff duties or care plans. and unless you give some training to staff.

295
00:50:21.820 --> 00:50:24.540
it's really not

296
00:50:25.120 --> 00:50:35.109
fair to expect that they will continue, even though the staff loved them, they needed permission from management to actually use them, and they often

297
00:50:35.210 --> 00:50:54.819
sort of said things like I'm not sure we should be doing this, I'm not sure, because they had very strict care plans, right? Which were all physical and personal care, feeding, bathing, toileting, but no social care. So I think that's probably my most important finding that I wanted to share

298
00:50:54.860 --> 00:51:12.170
 And there were 2 levels of home making that we could identify reconnecting to homelands. So continuity with culture and life history, but also establishing meaningful relationships in the new home, which was another form of home making.

299
00:51:24.180 --> 00:51:44.100
Yeah, thank you so much for these insights into the important practice of home visits that can be realized in the visual way nowadays, and I now have the honor to introduce Matthew La Rivier from the University of Bristol, who might offer a more mid-level perspective

300
00:51:44.100 --> 00:51:55.949
to the 3 previous presentations by presenting his paper on the Digital care promissory, unresolved contemporary care problems and imagine techno futures.

301
00:51:56.270 --> 00:52:01.990
The microphone is yours. As soon as I started your presentation.

302
00:52:06.720 --> 00:52:08.490
Okay, here we go.

303
00:52:10.710 --> 00:52:13.990
Is that yep. great.

304
00:52:17.980 --> 00:52:19.389
I just to make sure this is

305
00:52:19.550 --> 00:52:35.429
right. Thank everyone. It's getting used to doing this again face to face. Isn't it a bit of a bizarre place to be in right now. thank you. Guys being a so so special organizer today as well for him coming out today, Myelina, for chairing as well at Myra also here in the front, too. So.

306
00:52:36.480 --> 00:52:59.340
as you know, just introduce me. My name is Matthew Leviere. I want to talk today about digital care promissory. And it's kind of reflecting on Mike Spears during document analysis and social policy for the last few years, but also more probably not my ethnographic engagement as anthropologists working in this sphere as well. So get another kind of impostor in this space. with my sociologists into locators as well.

307
00:52:59.670 --> 00:53:03.789
So the first I want to talk about is what we mean by care, and this string upon

308
00:53:03.850 --> 00:53:14.480
care predominantly in the English British context as well. Looking at the role of social care systems. So if you examine a newspaper, this is the Guardian in the Uk.

309
00:53:14.750 --> 00:53:36.620
we also see frequent mention of care being in crisis. Here you can see illustration from age Uk and their current campaign about social care crisis. and it's tied to challenges within our social care system in the Uk research report from skills for care, for instance, highly that there's a 29% annual turnover of care workforce in that system alone.

310
00:53:37.240 --> 00:53:48.020
Additionally, there are issues with financial and security for the system. it is a means tested system similar to other systems and liberal welfare regimes like Australia, I believe, as well.

311
00:53:48.350 --> 00:53:49.870
and so it really creates

312
00:53:50.420 --> 00:54:15.069
issues with the continuity of Sis services and systems within it will, I see, with outcomes for the care workforce will actually provide and care and also the continuing of that system as well. And of course, addition to the kind of more bureaucratized for my systems of care, also implications for informal caregivers or carers. We call them in the Uk and the role they have providing kin based forms of failing and care as well.

313
00:54:20.050 --> 00:54:47.319
So in this paper today is really kind of tracing a social history, if you will. And I use that in a very broad sense, and as a policy of practice arrangements over the last 15 years. So it's been since about 2,008 to illustrate how the possibilities of technology within adult social care predominantly in the Uk has been continuously reframed within and for kind of all adult service users in England predominantly, also more broadly within the Uk 4 nations approach.

314
00:54:47.690 --> 00:55:02.580
So the paper draws on ethnographic and document analysis from evaluations of telecare and digital care services, and also more recently emerging trajectories. since the formation of the Aging Society grand challenges, I'll talk to all about in a few slides.

315
00:55:03.080 --> 00:55:23.220
the kind of the central thesis of this paper really is that I argue that the Uk Government policymakers and industry leaders continue to mobilize a digital care promissory discourse to invoke, imagine futures of A to all jail care service, despite limited apparent evidence of their effectiveness to support older people, families, and also argue systems as well.

316
00:55:26.300 --> 00:55:42.370
so first, like, I think of social scientists to find our key concepts. so first, we have to our technology and care I draw upon. Originally a dot Dls kind of generational approach. So in their original paper they introduced 3 different generations.

317
00:55:42.370 --> 00:55:57.369
First generation is Telec. Almost penny alarms, push buttons, pull cords. Second generation is lifestyle monitoring systems, for instance, on called just checking which allows you to use kind of motion sensors in person's home. third generation is working

318
00:55:57.720 --> 00:56:02.909
past kind of traditional telephone-based analog systems and moratorium digital systems of

319
00:56:02.920 --> 00:56:26.970
for some broadband wireless smart technologies, and also the images of smart homes. And then, more recently, a fourth generation, we're actually has emerged as well. which my colleague, Kate Hamilton, at the University of Sheffield, and I have called fourth generation focusing on robotics, artificial intelligence, and virtual augmented reality, which, of course, a lot of our colleagues today have already discussed.

320
00:56:30.650 --> 00:56:35.140
so going back to digital Care promissory. What I have noticed to my review of the literature, both

321
00:56:35.220 --> 00:57:04.539
scholarly literature, probably within social sciences, also in Allied health research to, but also within policy. More broadly, it's kind of different features of the anticipated speculations about how technology will help to solve issues of care systems also supporting age to aging people as well. one is the idea of increasing efficiencies of managing care. Care whether this is professional forms of care or kin based family based forms of care, too.

322
00:57:04.670 --> 00:57:12.060
the promise of ubiquitous monitoring systems that will be able to activate responses during crisis. So, for instance, if a person has a fall.

323
00:57:12.120 --> 00:57:24.369
there'll be some sort of sensor that we take that out, if it's one on the person, or if it's somehow installed in the person's built environment, they'll be able to respond to the activation of that device to get first, responded first responder or family judge 10 to them.

324
00:57:24.490 --> 00:57:31.890
the other promise which is often quite conceptualized, especially in health sciences, is the idea of maintaining independent living at home.

325
00:57:32.090 --> 00:57:35.220
probably defined, and also delaying

326
00:57:35.480 --> 00:57:41.450
kind of the more euphemistic way of saying, delaying moves into permanent residential care, institutional settings.

327
00:57:41.940 --> 00:57:55.859
and then the final idea is having the carer and careful person not need to occupy the same physical space. So not all going to be co-present. the the promise of Kara distance, as Janet Poles, for instance, called it in her monograph.

328
00:57:58.420 --> 00:58:11.619
So the first kind of half of the findings retail or the which I'm drawing upon today. just larger with the first 3 generations of technology. So Telec and digital care products about again over the last 2,000 and age about 2,017.

329
00:58:12.930 --> 00:58:20.870
So the first context is the advent of the 3 million live project. So if you don't know what that is in the U. K.

330
00:58:21.030 --> 00:58:26.280
The then called the Department of Health, now Medical Department of health and social care.

331
00:58:26.380 --> 00:58:35.269
funded an 80 million pound program to accelerate the role of telehealth and telecare products. between 2,008 and 2,013. Really.

332
00:58:35.470 --> 00:58:57.040
the idea of that was to help support positive outcomes for service users and cares, combined with reducing costs, increasing efficiencies from a lot of those promises we just mentioned a couple of slides ago. also tied with. That was the role of the government in shaping marketplaces for these technologies. They wanted the Uk to be a global leader in the development

333
00:58:57.110 --> 00:58:58.370
proliferation

334
00:58:58.410 --> 00:59:03.810
and marketing and sales. Commercializing on these technologies as well to global marketplace

335
00:59:04.880 --> 00:59:10.459
associated with that program was the whole system demonstrator.

336
00:59:10.710 --> 00:59:24.149
So wholesome demonstrator was at the time, which is about 2,000, 12,013, the largest randomized control trial ever. It included 6,000 participants with either Co. Pd. So chronic, obstructive pulmonary disease.

337
00:59:24.210 --> 00:59:27.409
heart disease, or diabetes, or offered telehealth products.

338
00:59:27.520 --> 00:59:34.369
and then the broad category of on-met social care need while receiving telec.

339
00:59:35.030 --> 00:59:42.349
By the end of September 2,010, the Department of Health had a reported headline findings. It's just thing that telehealth

340
00:59:42.460 --> 00:59:44.370
reduce hospitalizations.

341
00:59:44.610 --> 00:59:52.430
reduced the cost of care and also help support people with these long-term conditions as well.

342
00:59:52.520 --> 00:59:56.859
There were not any headline findings published at that point in time for the Telly care

343
00:59:57.020 --> 00:59:58.819
aspect. So of that study.

344
00:59:59.340 --> 01:00:03.500
however, we have now learned since then that

345
01:00:05.120 --> 01:00:12.379
from the final findings published in about 2,013 from actual study team, independent from the government, that

346
01:00:12.620 --> 01:00:37.419
the economic evaluation actually turn up to be negative, and that it was much more costly to provide this technology rather than actually having it. cutting costs as well, which is not surprising, because it's not being treated as a replacement for care. But it's an additive form of care. So of course, it's going to be an additional cost. also, significantly, it's not reduced hospitalizations, and also it did not reduce people's access to other care services. Well.

347
01:00:37.730 --> 01:00:46.889
telecare, someone had very similar funds to first ambiguous. So the use of Telec, for instance, does not reduce participants use of health or social care services.

348
01:00:48.020 --> 01:01:00.560
There was no statistical significance, but the effect on reducing anxiety. So one of the other promises about reducing anxiety is for for either caregivers, errors, or for people. This is found not to be the case.

349
01:01:00.650 --> 01:01:09.060
and also, I expect again. It was not cost-effective, because it was an an additive form of kind of care embedded within wider kind of care, arrangements for older people as well.

350
01:01:12.830 --> 01:01:16.810
one thing, that kind of sticks out from the

351
01:01:17.210 --> 01:01:33.290
Wsd host and demonstrate trial, though, is that they purposely excluded people living with dementia from that. They thought that it was too complicated to involve that specific population with it. And indeed, when comes ethical guidance within the Uk. If you believe that you can

352
01:01:33.840 --> 01:01:35.359
carry out research

353
01:01:35.480 --> 01:01:44.900
that does not need to involve people living with dinosaur thing as you as unethical not to include into that research because of the different difficulties you may have with be able to consent to a participation

354
01:01:45.260 --> 01:02:02.229
that said immediately following, the end of the holidays and demonstrator. Indeed, before the publications were even published about the findings of it. A new trial was funded by the National Institute of Health Research, which is called Attila, which is a terrible name for trial.

355
01:02:02.590 --> 01:02:13.019
and it stands for assistive technology in telec to maintain independent living at home for people with dementia utila. I think we do love an acronym and health sciences, and I will say that you know.

356
01:02:13.130 --> 01:02:18.310
Mr. War, I was brought in a my role as then a Phd student researching.

357
01:02:18.480 --> 01:02:33.269
providing a nested ethnographic component to the wider kind of trial design, and we can talk at great length after the session about how you do naturalistic approach to a randomized control methodology very complicated, cosmologically. but

358
01:02:33.610 --> 01:02:38.350
one thing that has emerged from our findings with Attila is that

359
01:02:39.920 --> 01:02:43.269
of the 4 and 95 people with dementia included in that study.

360
01:02:43.670 --> 01:02:58.560
It again, did not reduce people's use of social care services that reduce hospitalization did not delay. It was permit move into residential care settings, and of course, as we all, as we can by guess, it was not cost-effective either. It was seen as an additional cost as well.

361
01:02:59.760 --> 01:03:05.230
One thing that I found through my research, though. the ethnographic aspect was

362
01:03:05.590 --> 01:03:20.660
 the promises of technology. And what's being evaluated for versus actually, what the outcome measurements for the technology, for the trial we're looking at. So, for instance, who offered traditional things like medication carousels.

363
01:03:20.680 --> 01:03:22.200
pendant alarms.

364
01:03:22.510 --> 01:03:26.450
That question we might ask because critical scholars in this field is well.

365
01:03:26.460 --> 01:03:43.630
because they have ever met the needs of delaying. Part of it's actually what they're designed for. Where are we asking the right kind of questions when we're actually evaluating these technologies at all. and as other colleagues, I mentioned today, too, the indispensable role of actually having a caregiver or a family member or close friend or associate.

366
01:03:43.630 --> 01:04:03.599
actually helping to be act as breek alerts, right? Or tinkers other than technology actually help them fit into both the person's kind of life world and how they want to live their lives. And I'm the one to be cared for. Also that built environment, too, and it has been installed in different things from a small flat in London to large military houses and kind of role parts of Norfolk, for instance.

367
01:04:07.440 --> 01:04:08.990
So following

368
01:04:09.120 --> 01:04:16.390
a string of failed trials. Now we had another project, fun to call Utopia, and what that looked at is

369
01:04:16.500 --> 01:04:23.339
trying to understand the politics of why, after nearly a decade of failed trials.

370
01:04:23.370 --> 01:04:27.359
our commissioners of services still provide telecare products.

371
01:04:28.010 --> 01:04:30.350
and what they found is that

372
01:04:30.750 --> 01:04:43.549
all the times it's due to the political expediency of having by and from the Government, having, you know, at that point in time, a decade of roll out of this sort of thing. So it's already embedded into their services, so that now.

373
01:04:43.790 --> 01:05:10.219
10 years after 3 million lines was first launched, or thing, they didn't have a way of kind of discontinuing these legacy services, but also what we call professional wisdom of social workers, occupational therapists, where she, from their own clinical perspective, they saw value in the lives people they were supporting, and how we support them as well, even if it didn't quite line up with, perhaps how it's being framed by National Institute for clinical excellence, or other people who are kind of evaluating these studies as well.

374
01:05:14.710 --> 01:05:38.749
So now, after the string of the third generation technology. We had a statement published by our then Secretary of State. We've gone. We've been through a few since then, of course. saying now, as the moment to put the failures of the past behind us. It's our our health and care being the most cutting age system, the world for the use of technology to improve our health, make our lives easier, make money go further harassing the amazing explosion of innovation, the technology

375
01:05:38.750 --> 01:05:52.790
and the connection of billions of minds through the digital technologies approach to this world. So, despite everything that's gone wrong, thank you. Over the last decade, there still is this hope being mobilized about we haven't got there quite yet. We now digital technology will be the solution for us all.

376
01:05:53.160 --> 01:05:58.089
So it's going to bring me to the final bit which I'll go through relative quickly, because I have 2 min left.

377
01:05:58.870 --> 01:06:18.860
so 2,017. The then Uk Government launched industrial strategy, focused on 4 grand challenges, 3 of them related to mobility. AI, and also clean growth kind of green economies. The fourth one is about aging society, and in that particular

378
01:06:19.010 --> 01:06:35.729
 framework. It mentioned missions tied to again market dominance for new technologies emerging in the field, the role of helping to support public health and social care systems and creating efficiencies there, reducing costs, and also

379
01:06:36.290 --> 01:06:54.679
the idea that through doing so the Uk given its eminent point in time removal from the European Union, of course. that it would be a way of kind of seeking it. It's predominant and leveraging. It's in focus on research development of technologies

380
01:06:55.660 --> 01:07:04.079
tied to that work. There was a large graph called sustainable care, which I think to be why, we were actually involved with to some extent, led by a college at the University of Sheffield.

381
01:07:04.210 --> 01:07:08.579
and tied to that work. There was work done on by Luke.

382
01:07:08.610 --> 01:07:11.079
defeat Sarah Abd and Mark Holly about

383
01:07:11.390 --> 01:07:23.709
anticipating, matching concurrent support domains to emerging technologies. Now, again, this is tied all to forecasting, and Delphi studies, I think, about the possibilities of this and what they found is that

384
01:07:23.720 --> 01:07:30.710
all? There are possibilities here again, it's still based on aspirations, but actually, evidence based on how it would work

385
01:07:32.030 --> 01:07:34.320
and tied. To this, we have roles of

386
01:07:34.530 --> 01:07:47.760
different robots. Here, Cyradine, it's creating new technologies like exoskeletons, lots of different robots as well like Pairo, but they've been as as markets to mention kind of ambivalent evidence to actually how it works or how it doesn't work.

387
01:07:50.940 --> 01:07:54.000
So just kind of close. Just remind you that.

388
01:07:54.060 --> 01:08:08.409
despite the province that's being mobilized so far is very unclear. Actually, how they are being met. And the challenge is that even with fortunately, it's kind of new emerging technologies like AI robotics and and artificial reality, and a virtual rally

389
01:08:09.210 --> 01:08:15.219
kind of the role that they actually have actually mean this digital care promissory are not. and that does lead us to the

390
01:08:15.630 --> 01:08:18.440
that some provocations for you to consider as well is.

391
01:08:18.750 --> 01:08:38.289
was the relationship between co-constitution of care and technology? Why, how can we inscribe sensibilities of care into emerging products and services, and where we're thinking about how we evaluate or do trials in the future, I think, are we asking the right questions about them. And person, let's focus on change management or risk mitigation outcomes instead of actually thinking about care more broadly, more holistically, too.

392
01:08:39.080 --> 01:08:40.109
Thank you.

393
01:08:50.930 --> 01:08:57.939
Yeah, thank you very much, Matthew, for this very critical thoughts also on the the care industry.

394
01:08:57.990 --> 01:09:10.629
and lastly, we come out to our last presentation. And lastly, we will listen to a paper of Rileyene Wilding, Jenny Weycott, and Barbara and Nevis, who is also here today.

395
01:09:10.860 --> 01:09:16.879
and colleagues on the vitro reality in aged care, a relation.

396
01:09:17.100 --> 01:09:29.969
a relational analysis of a technological innovation. I'm sorry for this complicated title. Yeah, I'm very

397
01:09:31.800 --> 01:09:37.390
really looking forward to this presentation as well. Let's see how we

398
01:09:37.440 --> 01:09:39.979
can get your slide started.

399
01:09:47.070 --> 01:09:52.290
Maybe just continue to the second

400
01:09:59.050 --> 01:10:07.260
getting there, and we're also very good time-wise. So I really hope we will have a nice discussion after this presentation.

401
01:10:07.390 --> 01:10:23.360
And here we go the microphone.

402
01:10:23.830 --> 01:10:34.720
 thank you first of all to the organizers for this great panel. I don't know about anyone else, but I'm having a great time, because I'm seeing all of the themes that thread

403
01:10:34.910 --> 01:10:48.530
these papers together, and I'm hoping that you'll see the ways in which this paper links with everything that has come before, and hopefully extends the thinking a little bit, or at least into sex with that thinking that's happened there.

404
01:10:48.770 --> 01:10:54.779
So this particular project that I'm reporting on today. And 2 of my collaborators are here with me.

405
01:10:54.950 --> 01:11:12.280
We actually not all of the collaborators are listed on this slide. There are others. I think there was a limit to the number of co-authors we could put on an Isa paper, so everyone else is not quite listed there. But it would actually take up 2 pages. This is a very collaborative project.

406
01:11:12.520 --> 01:11:25.010
and what we were aiming to do was to explore virtual reality in what in Australia was called residential aged care facilities. So let me tell you a little bit about

407
01:11:25.830 --> 01:11:29.109
what we did all right. So

408
01:11:29.230 --> 01:11:36.809
our project builds on what has been happening over the last 5 and more years, 5 plus years

409
01:11:36.860 --> 01:11:55.960
of a growing number of studies that are exploring the benefits that virtual reality can bring into residential, aged care facilities, and for older adults. And this is where I really value that last paper, because the promissory discourse that underpins those studies is striking, and it's strong.

410
01:11:56.200 --> 01:11:57.720
And

411
01:11:57.860 --> 01:12:22.650
the papers have been discovering. So there! There is some evidence for this. Unlike some of the last studies, there is some evidence that if you bring virtual reality into an aged care setting, you will see evidence of an enriching and stimulating experience. You'll see the ways in which the residents are introduced to opportunities to explore the world, and we saw that with the virtual visits paper as well.

412
01:12:23.300 --> 01:12:45.990
We see the ways in which virtual reality can be used to support memory activities, and that this can have positive outcomes for mental health. And there was even some attempts to use virtual reality to improve physical health outcomes, you know, actually getting people to move because they're engaging with a a virtual context. That's a bit more stimulating than the sorts of

413
01:12:46.360 --> 01:13:00.169
sorts of tools that were otherwise used in order to stimulate physical activity. So there is some interesting suggestion here that actually virtual reality is great for older adults, and we should be implementing it in more detail.

414
01:13:00.530 --> 01:13:15.860
But there are some limitations to these studies. So if you have a look at the broader range of the studies, what you'll see is that most of them are actually very short-term initiatives and introductions, so they might be there for a couple of weeks, or for a few sessions.

415
01:13:15.890 --> 01:13:28.979
They tend to be about researchers coming in and introducing material, although that is shifting, we are seeing. And we've seen some examples of that today. More attention to the ways in which care staff in

416
01:13:29.210 --> 01:13:34.549
residential, aged care facilities are driving and provoking

417
01:13:34.630 --> 01:13:36.869
engagement with virtual reality.

418
01:13:37.160 --> 01:13:57.099
But they are all. And I think this goes to that promissory discourse analysis. They are a sort of techno-solutionist. And at my my cynical moments, I feel like it's a technology seeking a problem to solve. It's almost like, you know, we've got this great new technology. We need to introduce it into this context. What's the problem we're solving?

419
01:13:57.870 --> 01:14:04.100
It's loneliness. Or, you know, looking at the various problems to do with residential, aged care that might be focused on

420
01:14:04.730 --> 01:14:07.220
at my more

421
01:14:07.600 --> 01:14:27.110
more generous moments, my less cynical moments, I tend to think well, actually, in the health care. Context, one of the logics at play is the constant effort to work with whatever new resources are available to improve the lives of people. So we can go on so on a spectrum, we can be more or less cynical about the sorts of things that are going on there.

422
01:14:28.180 --> 01:14:51.120
So in this context, what we were exploring was the what would happen if you actually had staff in a residential, aged care, facility taking responsibility for introducing VR. From go to. So we provided. And and one of the things we were interested in is.

423
01:14:51.260 --> 01:15:04.429
is it actually worthwhile having there? Is it desirable what challenges are staff going to encounter when they're responsible for bringing it into play? And is it actually a sustainable activity? So these were some of the questions we were exploring?

424
01:15:04.940 --> 01:15:08.640
Now it actually comes out of a two-stage project.

425
01:15:08.910 --> 01:15:18.139
What happened was our team in Queensland began, and this was during Covid. So actually in Victoria we were delayed. And this was this contributed to the project design

426
01:15:18.220 --> 01:15:43.589
in Queensland, where lockdowns were not nearly as intense as they were in Melbourne. The team there were able to Go out into residential aged care facilities. Introduce VR. See how it worked, and develop what they what we've called a VR transformation toolkit. And this is a tool that's available online. It's freely available to all aged care facilities that are considering introducing VR.

427
01:15:43.700 --> 01:16:02.459
and it aims to provide them with a full set of instructions and resources, with beautiful illustrations and and various elements that can help any aged care, facility to explore festival, whether they want to introduce VR. and then, if they do what they're going to do with it, and how they're going to do it most effectively.

428
01:16:02.940 --> 01:16:12.410
So this was the toolkit that we provided along with VR headsets that are the property now of the aged care facilities.

429
01:16:12.560 --> 01:16:20.919
This is what we did in Victoria was. We introduced all of that material and said. What do you think is this something that you would like to do in your setting?

430
01:16:21.050 --> 01:16:39.739
So over a nine-week period of time we offered first of all, a 4 to 5 week. There was a one week of meeting talking about the project, 4 weeks of weekly meetings where we supported the aged care facilities in introducing VR. And then Not on site, but through virtual meetings.

431
01:16:39.760 --> 01:17:05.030
and then a four-week period where they went away and just did it. And then we had a final meeting at the end, and all of these meetings were recorded. They were the primary method of data collection. The researchers to the care staff in each of the 3 facilities that were involved were doing data collection. They were taking field notes. They were taking photographs. They were taking videos, and they were reporting back to us on a weekly basis how it was going, what was happening, and

432
01:17:05.810 --> 01:17:09.669
letting us know what they thought of virtual reality.

433
01:17:09.730 --> 01:17:22.329
And then we've done some thematic data analysis. And now I'm going to share with you some of our preliminary findings after I introduce to you our primary conceptual framework. Now, we were thinking about.

434
01:17:22.360 --> 01:17:26.320
how how do we make sense of this body of data that we now have

435
01:17:26.600 --> 01:17:36.689
we explored a few different options, but the one that is really emerging as most useful is Ann Marie Moles, work back from 2,008 on the logic of care.

436
01:17:37.960 --> 01:17:48.700
And what she says about care is that care is that set of efforts, that attention to making things better for the people who are being cared for.

437
01:17:48.720 --> 01:18:16.659
There's no such thing as good or bad care in and of itself, but rather that it's situational. It's something that gets determined by the particular constellation of people and factors and technologies and situation that is at play, and that it's active. So care is activated through practices and those practices might be about observing. So we've heard earlier about the in the ethics of care those 4 phases of care

438
01:18:16.980 --> 01:18:41.660
it it intersects with that. But the sorts of practices that are being talked about are, you know, the observations so observing when care, when care is needed, and what sort of care is needed engaging in touch, engaging in communication and consultation, trying constantly trying out new things, and tinkering and playing and adapting to new situations, and not assuming that you've reached good care because you've never reached it. It's always something that you're seeking to achieve.

439
01:18:42.210 --> 01:18:53.050
And one of the things that Mole is really interested in highlighting is that the logic of care, although, should be understood as informing everything

440
01:18:53.260 --> 01:19:11.810
actually often gets silence, or is not particularly loud. It's not very good at selling itself, so other logics tend to overtake it, and I suspect this might be a little bit at play in terms of introductions of virtual reality. The the the market logics and the healthcare logics and the technology logics are all

441
01:19:11.980 --> 01:19:21.989
becoming much more visible and and evident, and the logic of care gets downplayed and overlooked. in all of these discussions.

442
01:19:23.260 --> 01:19:24.440
So

443
01:19:25.640 --> 01:19:29.500
what male is interested in is the ways in which

444
01:19:29.930 --> 01:19:50.109
everything, including technologies, become involved in the logic of care. And this is what I find really useful about that approach is that we're not saying that technology is opposite to care. What we're saying is, how does technology play a role in the logic of care? And and what are the particular dimensions that

445
01:19:50.130 --> 01:19:55.240
are that are, I guess, most interesting to us. So let's have a look at

446
01:19:55.420 --> 01:20:01.389
what are some of the findings that came out of this? First of all, very pleased to report

447
01:20:01.670 --> 01:20:19.030
staff and residents loved having virtual reality in their aged care facilities. And this is something that we hear over and over again, isn't it? There's like this excitement, there's a sense of enjoyment. There's a such a sense of pleasure, there's a sense of stimulation, and the world becomes a more interesting place.

448
01:20:19.350 --> 01:20:34.059
But what I think was really interesting in quote, such as this one is that it's not just the care recipients. It's not just the aged care residents who are enjoying this experience. It's the aged care staff.

449
01:20:34.160 --> 01:20:58.000
And in fact, they're they're saying, you know, I really enjoyed helping to implement this and what I'm seeing there is a logic of care that they're so deeply embedded in that they were caring for us as researchers like, you know, we really want to make sure you have good data. They were caring for residents, but also what we were seeing is that residents were caring for staff, and I think that's something that often gets overlooked.

450
01:20:59.930 --> 01:21:09.889
One of the things that also became clear was that virtual reality is not a cheap thing to introduce. And I think this goes back to the point about the promissory discourse

451
01:21:10.130 --> 01:21:18.090
people get so caught up in what's going to be so amazing about introducing a new technology that they don't think through all of the diverse costs.

452
01:21:18.270 --> 01:21:40.170
So in this case the facilities didn't have to pay for the headsets. We provided headsets. However, they did have to make sure that they had appropriate Internet connections. They had to make sure that they had enough data access. They had to make sure they had it support, because there are all sorts of firewalls and things put in place that limit the capacity to introduce a new technology into a place like this.

453
01:21:40.250 --> 01:21:46.010
So there's a lot of time spent in actually connecting the headsets to the Wi-fi.

454
01:21:46.410 --> 01:21:57.360
They had to make sure that they had a Facebook account, because the the this was a project funded by Facebook as it was then, so they had to make sure they had

455
01:21:57.410 --> 01:22:00.080
in order to run our oculus headsets

456
01:22:00.090 --> 01:22:04.030
a Facebook account which meant that you needed to have it attached to

457
01:22:04.100 --> 01:22:16.600
a person which doesn't really work in the residential aged care facility. So Staff are often using their own personal sets. They needed an email account. They needed to have a phone or some other device to connect the

458
01:22:16.780 --> 01:22:21.850
oculus device, too. So there were all of these sort of hidden costs of introducing VR,

459
01:22:23.440 --> 01:22:32.910
and then one of the other hidden costs is actually the amount of time it requires to become familiar with the technology and to feel comfortable in introducing it to other people.

460
01:22:33.100 --> 01:22:39.889
And this is where we start to see the relational elements and the care elements coming through again invisibly.

461
01:22:40.270 --> 01:23:04.399
What we saw was that the staff who were implementing VR. In the settings didn't just use their work time in order to get to know this equipment, and in order to introduce it they took it home. They played around with it so their weekends were taken up in learning. VR. so that they could then bring it back into the care facilities, and not just their weekends, but their families weekends, so their partners, their teenagers. The

462
01:23:04.400 --> 01:23:15.109
so in some cases, siblings and and other people. We're all involved in coming in and learning how to use VR and working out just how to

463
01:23:15.110 --> 01:23:21.840
create the connection, what sorts of activities to have a look at and how to make sure that it ran smoothly.

464
01:23:22.620 --> 01:23:39.389
They presented this as being a really positive experience. Like, Wow, we get to use. VR. On the weekend. I, on the other hand, with my critical sociologist gaze on, was going, this is unpaid labor, Georgia, in your weekend without it being acknowledged. So hidden costs once again.

465
01:23:40.900 --> 01:23:42.000
All right.

466
01:23:42.690 --> 01:23:54.749
Number 4. And this is the thing that I think really gets overlooked is the it's not just about the setup the setup was challenging. It's also about the ongoing demands of caring for the technology.

467
01:23:54.770 --> 01:23:59.340
So they reflected. By week 9 it had become evident that

468
01:23:59.570 --> 01:24:19.729
a lot of time was spent making sure that it was plugged in, because sometimes they'd go ready to do a session and realize. Oh, no one plugged it in last time. Okay, I'm going to have to plug it in, and then I'll do something else, and I'll come back to it. They had to update the software. There might be all ready to start a session, and oculus says, No, I need an update, and that would take time to connect to the Wi-fi. Make sure, anyway, all of those

469
01:24:19.730 --> 01:24:30.719
finding new experiences, because you can't just keep replaying the same experiences over and over again. So once again it gets taken home for the weekend. Hey? What do you think we we find new experiences that suit these residents.

470
01:24:30.720 --> 01:24:35.829
cleaning and maintaining, finding a storage space that's secure and effective, and so on.

471
01:24:36.010 --> 01:24:39.579
So virtual reality is not cheap by any means.

472
01:24:40.600 --> 01:24:48.359
Now, one of the things that I so I'm going to wrap it up here because one of the things that I just want to leave us to think about

473
01:24:48.620 --> 01:24:55.120
is coming back again to the logic of care that cares about those improvements that we make

474
01:24:55.190 --> 01:25:02.229
in other people's lives by paying attention, by engaging, by supporting people in having a better life.

475
01:25:03.170 --> 01:25:10.000
What we noticed was that the staff in the aged care facilities were doing a lot of that work

476
01:25:10.040 --> 01:25:20.279
for their residents. Residents were doing that work for staff staff were also doing that work for the virtual reality. Tools itself. They were constantly looking after the tools.

477
01:25:20.550 --> 01:25:31.539
What I didn't see was the virtual reality tools, giving that care back necessarily. And so I think it's really important that we acknowledge that

478
01:25:31.600 --> 01:25:37.819
the assumptions the logics built into the technology play a role here. So

479
01:25:37.990 --> 01:25:47.889
 Not only was there some waning interest over time amongst residents by week. 9. Some people were just like, Yeah, I'm not that bothered, actually.

480
01:25:47.950 --> 01:25:48.980
but

481
01:25:49.310 --> 01:26:06.409
what we have to recognize is that technologies are not neutral, but they bring with them a whole sort of a whole set of their own logics, the market logic, the technology logic, the efficiency, logic, the you know, logic of requiring additional health enhancements, and so on.

482
01:26:06.520 --> 01:26:12.119
that are not actually conducive to good care in all cases.

483
01:26:12.200 --> 01:26:13.440
So

484
01:26:13.510 --> 01:26:23.110
I'll just leave those questions with you about the extent to which VR. Is actually overall. A useful thing to be introducing into aged care. Thank you.

485
01:26:32.200 --> 01:27:01.530
Okay, thank you so much for this very thought, provoking insights and this contribution to the research on virtual care technology and residential homes, and I'm very excited because we have 25 min left for discussion, for questions. And, yeah, this leads me to the invitation of all the contributors to the stage. It might be nice that you come to the front and sit down so that we can have a proper discussion and collect questions.

486
01:27:01.570 --> 01:27:18.969
I think it was a very great session. I have written down a lot of questions and notes, and I guess that also the audience has probably some questions, and I will give space to the audience first before. I will ask my questions.

487
01:27:19.320 --> 01:27:23.360
So are there any comments or questions?

488
01:27:24.010 --> 01:27:27.280
to the contributors. One of them are all of them.

489
01:27:31.390 --> 01:27:32.410
This piece?

490
01:27:32.520 --> 01:27:33.190
Sorry.

491
01:27:41.130 --> 01:27:55.380
Okay, so yeah. My question is to to Matthews, thank you for this on the full presentation. I see actually a lot of overlaps to our research. But at the Technical University of Berlin, when we do

492
01:27:55.600 --> 01:28:07.430
research on care robots. And also we do research on the promise of care robots for solving the nursing crisis.

493
01:28:07.720 --> 01:28:08.810
And

494
01:28:09.050 --> 01:28:11.080
I want to ask you

495
01:28:12.330 --> 01:28:18.809
which reasons do you see why this promises of technology and care

496
01:28:19.460 --> 01:28:32.240
gets. We renewed every time. And what are the mechanisms behind it? Why is it it? It's like we. We see those technologies failing for years.

497
01:28:32.300 --> 01:28:34.969
But we we also see

498
01:28:35.000 --> 01:28:40.110
new projects in this topic every year, and.

499
01:28:40.690 --> 01:28:43.220
like our explanation, was that

500
01:28:43.630 --> 01:28:54.140
certain narratives are responsible for this continuous of these promises.

501
01:28:54.370 --> 01:28:57.000
And yeah, thank you. Please listen

502
01:29:02.230 --> 01:29:07.720
it on there. Cool. thanks. That question.

503
01:29:07.860 --> 01:29:17.250
One thing I didn't mention, so I round time, as my best is that tied to the initial strategy actually was funded for 3 year innovation fellowship to explore some of those issues

504
01:29:17.270 --> 01:29:29.579
looking at the kind of the market push about. Why are we so offering technologies? Despite what appears to be limited evidence at a very macro scale? Right? You know, looking at population level stuff from trials

505
01:29:29.610 --> 01:29:32.819
to show how they can solve these issues when it comes to

506
01:29:33.050 --> 01:29:38.000
long-term or social care systems. It does seem to be based upon.

507
01:29:38.420 --> 01:29:58.409
There's a lot of investment in it from European Union, for instance, they have a massive robotics facility. There's a 100 millions of euros into it. without asking first for more people talking to commissioners of care services talking to frontline. Remember it, work the fun like workforce as well as feel like we actually would benefit you. So I think you know, it's very kind of

508
01:29:58.740 --> 01:30:03.370
top-down approach dominating about how one and the social measuring of what

509
01:30:03.470 --> 01:30:17.490
what it means to be an older person and have an in an aging body also. Therefore, how one also imagines caring for people in the circumstances as well. It doesn't seem to be a lot of obviously actually have conversations with people more relying on. Kind of.

510
01:30:17.490 --> 01:30:34.829
okay, our own kind of sustainable imaginary about what is possible. I think. So that's one of the issues. But I think again, it's about largely investing money in it to then commercialize it and be able to sell, if not locally within country to their own kind of health or aged care services. They're sending globally to emerging markets as well

511
01:30:38.890 --> 01:30:39.900
the health.

512
01:30:40.570 --> 01:30:45.719
If anyone has a warning question, because I'm part of one of the

513
01:30:46.860 --> 01:31:06.400
I always have questions. thank you so much. It was a fantastic session there, I say, the best session I've attended here, except the ones I've presented. thank you so much. It was really thought provoking. I was just wondering, because I I see all those intersections that we're lean was mentioning.

514
01:31:06.450 --> 01:31:34.089
And I was just thinking, you know, for those of us who work or worked in computer science, it's really hard to publish on Failures, and Jenny and I have a paper on Failures. But it was really, it's really hard to publish on failures. But I also I was thinking about the interdisciplinary approach to this in terms of how do we think, oh, how do we approach those interdisciplinary aspects in the work that we do? But also, how do we bring in discussions of trust

515
01:31:34.090 --> 01:31:45.170
trust in technologies, trusting care and trusting colleagues that work across different? I mentioned. This is just a general question for all of you, and it's a very complex question. So take it as you see fit. Thank you.

516
01:31:48.200 --> 01:31:50.210
One. My.

517
01:31:52.570 --> 01:32:02.410
I don't think I can answer it. But I just wanted to say it's a really good question, and I think it's something that we're constantly grappling with that issue of. You know. How do you write about? I think it's really important to

518
01:32:02.490 --> 01:32:16.620
acknowledged that when we're introducing technology, sometimes things don't work the way they're expected, and sometimes it goes against these these promissory discourses. You know all the the benefits people think they're going to get from technology. And

519
01:32:16.810 --> 01:32:31.190
there's some ethical challenges there in terms of what we're doing as researchers. If we're if we're involved in trying out the technology. And it's introducing challenges. And I actually wanted to ask Loretta actually a bit more about that example you had of

520
01:32:31.880 --> 01:32:43.249
of of the the example of the the faded or the the person who didn't get benefit from it. Did did she feel like she had failed because there were other really positive experiences in that

521
01:32:43.440 --> 01:32:44.370
session.

522
01:32:47.290 --> 01:32:49.749
my my other person in the conversation.

523
01:32:50.110 --> 01:32:56.059
But yes, I think she did. I think she thought it was her fault that it didn't work.

524
01:32:56.380 --> 01:32:57.310
Yeah.

525
01:32:57.920 --> 01:33:01.139
But if I can just respond. I mean, I haven't.

526
01:33:02.600 --> 01:33:11.330
So for me the big issues in the residential care home were the expectation that the technology would somehow fix things, which is what

527
01:33:11.480 --> 01:33:13.360
we've all mentioned, but

528
01:33:13.470 --> 01:33:28.319
underlying. That was just a complete lack of interest in supporting what was needed to integrate it for these interventions. To be so, to have a chance of being effective. So you know.

529
01:33:28.320 --> 01:33:46.279
it was going to be volunteers. It was volunteers who made the biscuit so it could be volunteers who done the session, and that's just not sustainable. So the funding model which only funds care that is, physical care or personal care and doesn't have a social care. Dimension is

530
01:33:46.600 --> 01:33:50.129
this is the problem in in that sense.

531
01:33:55.200 --> 01:34:09.550
Yeah, the failures is really interesting. And I think we are all yapping on that one for me. I'm thinking you mentioned publication. How do you publish failures?

532
01:34:09.700 --> 01:34:11.220
I'm thinking.

533
01:34:11.580 --> 01:34:18.900
focusing on the meteorological aspects of failures. I mean, that's been a worked by. Have a golfing or

534
01:34:19.140 --> 01:34:22.619
Goffman, Northern Goffman. And stuff like that.

535
01:34:22.710 --> 01:34:31.640
So I'm I'm working on. How fail you are right now. Actually, I'm not going to be great to do something more on that. I mean failures to what?

536
01:34:31.750 --> 01:34:33.189
Because failures

537
01:34:33.410 --> 01:34:44.790
visualize the habits, behaviors, nords, or promise. I read of scores, even on the reality of what we are, think as small

538
01:34:44.810 --> 01:34:46.210
situations.

539
01:34:46.530 --> 01:34:48.199
So the failures

540
01:34:48.440 --> 01:34:53.659
more interesting for me, really, than the successful practices

541
01:34:56.860 --> 01:35:10.890
I just want to pick up on that point about like why it is that we keep on doing this when there are clearly failures there, and I can't help thinking that it's to do with the but

542
01:35:10.990 --> 01:35:17.739
picking up on the argument that we were making in this paper, that because the logic of care gets downplayed the

543
01:35:17.900 --> 01:35:29.729
constantly, it's not necessarily seen as a failure, because the success is, we've spent money on new technology. So the the market logics and the technology logics are the ones that are given priority.

544
01:35:29.850 --> 01:35:34.830
And as long as the government is continuing to spend money on innovation that's seen as investment

545
01:35:35.140 --> 01:35:45.259
rather than investing in care. And so I think there's something about the ways in which we think about care and the ways in which we think about markets and technology

546
01:35:45.730 --> 01:35:55.490
that allows us to overlook the requirement, to invest in care which actually brings tangible benefit. Right? It actually brings people. Well, we but it doesn't.

547
01:35:55.730 --> 01:36:24.029
You can't commercialize that well-being. You can't say, Okay, we're going to sell that well-being to other people in a way that makes sense to the people who hold the market logic and the technology logic so dearly. And as the priority, it's like they're always the things that come first. Care is the thing that gets pushed down to the bottom. So I guess I would like us to start trying to change the discourse and constantly work towards shifting the narrative away from

548
01:36:25.059 --> 01:36:35.489
spending money on new technologies. That that's success. But yeah, we're doing that here. We've spent a whole lot of money on new technology. It doesn't really matter what the care outcomes are, because no one can measure it. So it doesn't count.

549
01:36:37.170 --> 01:36:39.220
I just wanted to pick up on that.

550
01:36:39.340 --> 01:36:52.049
that well-being goal, because it is really difficult to measure And what you talk? You asked before Barbara about interdisciplinary work. But another part of the interdisciplinary work that happens in this space is working with

551
01:36:52.200 --> 01:36:59.379
people who come from more of a medical model of, you know, evaluating success, and so

552
01:37:00.090 --> 01:37:15.650
trying to find, you know, measures of well-being outcomes that that can be kind of pointed to and say, You know, this is our evidence base. And this is why we're going to spend money on this technology because we know it's going to increase people's quality of life indexes.

553
01:37:15.809 --> 01:37:25.159
And that's it's really challenging to to work with that logic. In the more social science, perspective on technology and care.

554
01:37:26.370 --> 01:37:27.629
we.

555
01:37:29.730 --> 01:37:35.169
I think I think we can engage with, too, is reflecting on what you marry, fail, or who is defining that, too

556
01:37:35.209 --> 01:37:40.790
writing kind of hierarchies of knowledge or production that may be mobilized there. To reach that conclusion, you know

557
01:37:41.440 --> 01:37:59.629
my critique of perhaps also demonstrated in the until I mentioned my thing. It's like, well, why are they asking my questions? Basically, I just even designed to play residential care move. So they meant to reduce people's use of social care system usage. Or because, if not, why are we evaluating, based on those outcomes? Right? So actually.

558
01:37:59.809 --> 01:38:20.750
maybe it's options for us to think about like well, rather repeating the same trials and the same. I commissions over and over again, and getting the same results on surprise like negative findings I should be thinking about like well, maybe, would you reframe what we mean by failure, what success means, and how we kind of evaluate the role of evaluation, and what kind of biases are being built into those assumptions about how we do that kind of mythological work, too.

559
01:38:24.670 --> 01:38:26.509
Okay? So then I,

560
01:38:26.549 --> 01:38:30.699
you have a look at the audience. And there's one more question of a hip.

561
01:38:31.219 --> 01:38:34.330
and you can also introduce yourself a bunch of

562
01:38:34.670 --> 01:38:38.129
Yeah, Hi, I'm I'm Mark Hudson from University of Pittsburgh.

563
01:38:38.340 --> 01:38:55.079
I just incidentally, I have a aged parent in a dementia care home. And one of the things that I've been looking at is robot animals and working with a startup. But I just as a kind of preface comment. I haven't seen as many photographs

564
01:38:55.190 --> 01:38:58.340
of older people wearing

565
01:38:58.370 --> 01:39:10.619
VR headsets. It's almost like a meme, actually, isn't it? There must be whole websites to vote to this. It's going to be quite interesting. But my question actually really is, I suppose this to do with Marcus

566
01:39:11.160 --> 01:39:16.910
initially. I've been working with a little startup in Edinburgh, actually

567
01:39:17.059 --> 01:39:23.869
companion who have produced a three-dimensional printed skeleton. So it's kind of soft robotics.

568
01:39:23.980 --> 01:39:27.450
They also have something to do with

569
01:39:28.510 --> 01:39:35.100
different morphology, a kind of robot Zimmer frame, which guides people around

570
01:39:35.310 --> 01:39:55.999
place and also leads people to water, you know, to hydrate, and so on. So there's a kind of practical benefit. But there's no necessarily practical benefit with the We xiomorphic robot. Now, the the question of the physical morphology of the robot is kind of where I'm going with this, because

571
01:39:56.260 --> 01:40:04.150
so you're talking about a kind of embodied  competence and embodied orientation.

572
01:40:04.200 --> 01:40:10.730
But but this might be a completely different thing than what you're looking for in your ethnography. But it was very.

573
01:40:10.840 --> 01:40:16.290
I would be very interested in your remarks on what the people were doing with the cats

574
01:40:16.490 --> 01:40:27.130
and how the cats are responding, because I've seen some footage. They don't look particularly unnaturalistic in terms of their behavior. So there's a set of

575
01:40:27.260 --> 01:40:29.320
animatronic behaviors.

576
01:40:29.560 --> 01:40:33.940
It's not necessarily an AI in terms of

577
01:40:34.150 --> 01:40:35.660
of write a different

578
01:40:35.730 --> 01:40:47.919
responses and movements, and so on. I I'm just guessing just from my observation. So I'm just interested in terms of this kind of idea of the embodied observer and their embodiments as well

579
01:40:48.050 --> 01:40:55.080
what is actually going on between them and these robotic animals?

580
01:40:55.150 --> 01:41:09.849
It's very limited in the number of movements as well. So it's at the same kind of deal is basically that kind of promissory note of what the next perrow will be. Is everyone going for that and going for that? Because that could be a lot of

581
01:41:10.190 --> 01:41:12.429
success and funding. And so on.

582
01:41:13.970 --> 01:41:14.810
That's 2,

583
01:41:15.180 --> 01:41:23.039
yeah, great. And as we have 5 min left, maybe if there's one more question. We can take another one, just if there is one more.

584
01:41:24.710 --> 01:41:43.320
So. A good question, I will check that while you are answering, maybe I will add one more question because you talked a lot about competences and all the other presentation also highlighted, that the role of the caregiver is really crucial and central, and I was wondering, where do they get gained the competence? Where do they gain the knowledge about these

585
01:41:43.410 --> 01:41:47.000
technological innovations and how to use them?

586
01:41:49.460 --> 01:41:53.820
I start with a morphology.

587
01:41:53.870 --> 01:42:01.500
Well, that's a really good question and a difficult one, because

588
01:42:01.550 --> 01:42:09.970
I think this has a lot to do on which is the target group here, I mean for people with

589
01:42:10.260 --> 01:42:11.690
late dementia.

590
01:42:12.540 --> 01:42:31.599
It doesn't have to be that realistic animal-looking robots, because that you you have to have those these essential features. I mean, what's what makes a cat? A cat? What's the at the base? The core of animality in a and a robot cat?

591
01:42:31.600 --> 01:42:49.040
It has a sound like a cat. It has to have these cat features of court of soft fur. You have to be able to cover with it. Have it in your knees in me, and but it doesn't really have to do very much. And of course we can play with the idea of maybe

592
01:42:49.070 --> 01:42:50.659
able to all get

593
01:42:50.760 --> 01:43:03.210
jump and do a lot of things. I'm not so sure it's actually contributing with so much. There, also a dog which I didn't speak of, and as much it barks, and it

594
01:43:03.530 --> 01:43:04.970
I think it can.

595
01:43:05.430 --> 01:43:13.210
stands up on its hind legs. It just has a basic feature, but it it is essential features that

596
01:43:13.340 --> 01:43:17.090
can convince the user that it's it's

597
01:43:17.170 --> 01:43:26.719
signaling. This is a dog. This is what dogs do, or this is what cats do. It doesn't really have to do very much more. Horror is very announced and very expensive.

598
01:43:27.100 --> 01:43:45.829
And and looking at previous research, it's not entirely convinced, sure that it's actually contributing with so much more, I mean in in terms of care or well-being. I mean, so what's the point of putting in a really expensive technology if it doesn't really contribute to this

599
01:43:46.070 --> 01:43:47.380
hands out hooks.

600
01:43:47.730 --> 01:43:59.110
So I think. And this is just my personal hope. But I don't think it has to be really that realistic. But then, again, I'm speaking of how the group

601
01:43:59.250 --> 01:44:06.360
elderly with dementia. So perhaps you have to also have to think about. Who are you using it

602
01:44:07.600 --> 01:44:14.990
in relation to. And there are attempts trying to use these robotic animals to children.

603
01:44:15.140 --> 01:44:20.710
hospitals, and so forth, and I'm not quite sure that he would accept

604
01:44:21.130 --> 01:44:32.499
this animal of robotic camera, I think they will have a higher expectation of. So I think it's a question of who is a target group. This is this as well.

605
01:44:34.860 --> 01:44:36.750
Yeah.

606
01:44:37.050 --> 01:44:42.329
I add to that, because I've done some work on robots in agriculture as well, and I think

607
01:44:43.060 --> 01:44:55.750
they're they're often used as an object for the older person to care for. So if they feel like they're caring for the robot, I think that's that's where it's achieved its goal. Yeah.

608
01:44:55.820 --> 01:44:59.189
And so it doesn't need to necessarily do a lot.

609
01:45:01.510 --> 01:45:13.850
I've been really interested because you've both done some work in this space. What's the evidence that the robot animal actually brings any more sense of well-being or care than a stuffed toy.

610
01:45:14.020 --> 01:45:17.509
Is there, has anyone done any of that sort of research. Yeah.

611
01:45:18.270 --> 01:45:23.979
I don't know. But there's also a dole. Therapy is used a lot in each.

612
01:45:30.810 --> 01:45:33.050
There are some solid stones.

613
01:45:33.160 --> 01:45:34.449
What about the name now?

614
01:45:34.480 --> 01:45:43.490
But the the comparing stuff that I did animals to. I mean, it's the to to to, to, to to digital ones. And we're moving parts and stuff and and the.

615
01:45:43.660 --> 01:45:48.569
And then during I think it was pilot study, something not long.

616
01:45:49.010 --> 01:45:51.580
but That this.

617
01:45:52.220 --> 01:46:01.580
that the robot, the movement of the rule which actually around small interactivity. It's more

618
01:46:01.740 --> 01:46:03.549
provides more stimulation.

619
01:46:03.700 --> 01:46:08.540
It is actually, even though it's programmed to do so. Just basic movements is

620
01:46:08.610 --> 01:46:15.739
somewhat, it caused force, a stimulating effect in. So I mean, like

621
01:46:15.850 --> 01:46:19.970
on your mobile phones, just give you a sense you notices.

622
01:46:20.010 --> 01:46:22.199
And we like to react to that

623
01:46:22.300 --> 01:46:28.840
stuffed animal doesn't do that. So a really basic scheme of

624
01:46:29.170 --> 01:46:35.210
there is one more comment. And can you maybe go to the screen so that the desk?

625
01:46:39.110 --> 01:46:40.540
This is a

626
01:46:40.650 --> 01:46:49.900
it left field. Really, in responding to Valen's question, does it make a difference if it's a toy or a robot? After a year of

627
01:46:50.450 --> 01:47:10.120
real kind of participant observation in a care home going in every day, and we did interventions. On a Wednesday one woman took my hand. She had some cognitive decline, but it was one of those moments where she was really clear. She took my hand, and she looked into my face very earnestly, and she said.

628
01:47:10.190 --> 01:47:17.470
It doesn't matter what you did. What you do, dear. The important thing is that you come and you do something with us.

629
01:47:17.570 --> 01:47:26.830
and I think for me, whatever we were doing. It was the actual people engaged. So maybe the robot has more people excited.

630
01:47:27.060 --> 01:47:43.140
you know, among the staff than a stuffed toy. So actually think it's the social engagement that is relayed social relation, or that increases people's relationships and identities, social relation on identities and mutuality of being.

631
01:47:43.220 --> 01:47:52.559
whether you're using high-tech expensive tech or low tech, or any tech. I think that's actually what's important. From

632
01:47:52.780 --> 01:47:53.680
my

633
01:47:57.920 --> 01:48:12.969
thanks for those wonderful presentations. I just, I have a question really for all of you what stimulated it was raise discussion about time. The time involved in

634
01:48:12.990 --> 01:48:19.269
the implement is the successful implementation of these technologies.

635
01:48:19.530 --> 01:48:36.779
And it struck me because of the extreme rationing of time in the aged care sector, both in the residential aged care settings in which there are real time constraints on the way the staff operate, but also in the community based aged care settings, in which, you know, time is highly

636
01:48:36.870 --> 01:48:48.609
rationed and increasingly so in the way that people manage their aged care packages and so on. And in fact, part of the promissory discourse is around the potential technologies to reduce time.

637
01:48:48.630 --> 01:49:03.149
and so I just wonder if you have any reflections on the kind of the way in which the dominant, I guess temporal structures in the way we organize aged care can inhibit the potentials of new technologies.

638
01:49:06.190 --> 01:49:14.359
In my setting there was just no time provided for social care at all. It wasn't funded, so it was meant to be volunteers who were doing it.

639
01:49:14.410 --> 01:49:16.810
So it was infected in at all.

640
01:49:23.920 --> 01:49:24.620
Yeah.

641
01:49:24.880 --> 01:49:36.220
I just wanna to say it's a really good question. And again, I don't have an answer. But sometimes when I'm presenting about this work, sometimes I end with a question that the question is.

642
01:49:36.240 --> 01:49:39.100
 how can we.

643
01:49:39.290 --> 01:49:42.930
I use technology for enrichment and aged care when

644
01:49:43.030 --> 01:49:55.769
doing it well requires more staff time. And that's the one thing that just is not available in aged care. So it's a really important point, and I don't know how to address it. But it is absolutely a barrier.

645
01:49:55.830 --> 01:49:59.290
You know the examples that we have in our research are all

646
01:49:59.530 --> 01:50:13.749
 they're not normal. They're not usual examples. There are examples of people going above and beyond in their work to make the technologies work well and make the experiences for the residents with really positive experiences.

647
01:50:13.780 --> 01:50:17.880
But that's not a sustainable situation. Yeah.

648
01:50:20.470 --> 01:50:23.060
I would just add to that from

649
01:50:23.370 --> 01:50:37.920
my perspective. I think Loretta is absolutely right. What matters is time spent with the residents? It's about the time that people spend with people, and I think this is why, you know, I started this project

650
01:50:37.940 --> 01:51:00.909
in our team feeling quite optimistic about the role of virtual reality in aged care. And I ended up feeling very pessimistic about it, because what I was observing was time being taken away from people and invested in the technology because the technology required so much care. So what we were seeing was that we've got data in our

651
01:51:01.150 --> 01:51:17.480
from that project that's showing people saying, Oh, yeah, I had to just go and knock myself away in a room for a few hours to work on the technology and to set up the technology and to care for the technology. That's time that that person has now had taken away from

652
01:51:17.500 --> 01:51:27.430
their capacity to engage with the residents in the aged care, facility, and that to me rings huge alarm bells. And you've already got a sector that has incredible resource.

653
01:51:28.110 --> 01:51:39.739
and the introduction of technology on the basis of a promissory discourse is actually detracting care from the people who mend it. It's problematic.

654
01:51:43.000 --> 01:51:44.650
Very short.

655
01:51:49.280 --> 01:51:54.120
Yeah, thanks, Mayor, for that question. I think when it comes to the English social care system.

656
01:51:54.320 --> 01:51:55.430
which in

657
01:51:55.710 --> 01:51:59.460
because it's not just kind of social engagement sort of thing. Most of things like

658
01:51:59.600 --> 01:52:06.480
toiletting, bathing email sort of thing, is deliberate in commission, based upon time and test. Right? You have a certain number of minutes

659
01:52:06.520 --> 01:52:09.499
to do a task sort of thing. No. What Mike says

660
01:52:09.520 --> 01:52:22.849
is there a constraint difference between what we're expressed earlier, and let's say, between care, right and support, right? Where actually made the or the caring, the caregiving aspect is going on by Joan. Trump doesn't work right? This is kind of more kind of

661
01:52:22.940 --> 01:52:40.400
emotional kind of way of doing things that you maybe technology is not quite able to transition that that said once the person leaves our my work has all been don't don't sorry care. It works for people living in the community, not residential institutional settings. one person leaves. They might still have access to

662
01:52:40.450 --> 01:53:02.569
video screens to call people. You might have access to make a hair cells from them to take medicine. they might have access to things that still help them in other ways. Where a person is not physically co-present with them, help them engage with other facets, other activities of living. If you want to do a kind of very codified way, or just kind of their everyday kind of sensibilities, and what they want to achieve in their own personal life. Sort of thing. So I think there is.

663
01:53:03.670 --> 01:53:17.960
There's tension with there between how it's currently being commissioned within service sorting. Also, I guess there are still opportunities, I guess. More promissories, maybe. Who I say that about how things are still challenging that, or or create new opportunities. Still, in that space, too.

664
01:53:22.840 --> 01:53:26.430
not just the

665
01:53:27.560 --> 01:53:37.810
 narratives impacting the sector, but also other disciplines. So, working with the health sciences. I find that they

666
01:53:38.080 --> 01:53:48.360
really not interested in the social care and social network support interventions that I suggest, which are really basic and simple, like, bring a buddy or talk to the family.

667
01:53:48.620 --> 01:53:52.649
They they're much happier to spend a lot of money on a

668
01:53:52.680 --> 01:54:02.450
tool and a digital tool that you know, is going to require a lot of effort and expense. But but even in the academic

669
01:54:02.490 --> 01:54:04.030
field there's this

670
01:54:04.550 --> 01:54:13.150
magical thinking around what technology will deliver and a lack of understanding about how it needs to be embedded in social relationships for it to be any

671
01:54:13.210 --> 01:54:14.610
use it all

672
01:54:15.050 --> 01:54:16.280
sorry I

673
01:54:16.300 --> 01:54:19.149
tired of talking to

674
01:54:20.650 --> 01:54:21.360
and

675
01:54:26.490 --> 01:54:49.939
well, on behalf of Matthew and myself, who organised the session. We just wanted to thank everyone for coming both in the room and online. Thank you to Melana for fabulous job of chairing, and thanks most of all to our amazing speakers for such a a wonderfully thought-provoking session, and we hope that we can continue this conversation beyond the end of this session. It would be a shame to stop here. So thank you very much.