Intelligent Assistive Technology and Systems Lab - click to go to homepage
IATSL develops assistive technology that is adaptive, flexible, and intelligent, enabling users to participate fully in their daily lives. Learn more about our research

Visit us:

Room 438

500 University Ave.

Toronto, Canada

P 416.946.8573

F 416.946.8570


Send us mail:

160 - 500 University Ave.

Toronto, ON, M5G 1V7



email us!


Follow IATSL on Twitter


Co-designing ambient assisted living (AAL) environments: unravelling the situated context of informal dementia care

Keywords: Dementia, Alzheimer’s, assistive technology, intelligent technology, ambient assisted living, informal care, caregivers, participatory design, co-design, prototyping.

Overview of Research

Ambient assisted living (AAL) aims to help older persons “age-in-place” and manage everyday activities using intelligent and pervasive computing technology.  AAL research, however, has yet to explore how AAL might support or collaborate with informal care partners (ICPs; see Figure 1), such as relatives and friends, who play important roles in the lives and care of persons with dementia (PwDs).  In a multi-phase co-design process (Figure 2) with six (6) ICPs, we envisioned how AAL (e.g., COACHFigure 3) could be situated to complement their care.  We used our co-designed “caregiver interface” artifacts (Figure 4) as triggers to facilitate envisioning of AAL support and unpack the situated, idiosyncratic context within which AAL aims to assist.  Our findings suggest that AAL should be designed to support ICPs in fashioning “do-it-yourself” solutions that complement tacitly improvised care strategies, and enable them to trial, observe, and adapt solutions over time.  In this way, an ICP could decide which activities to entrust to AAL support, when (i.e., scheduled or spontaneous) and how a system should provide support (i.e., using personalized prompts based on care experience), and when adaptations to system support are needed (i.e., based alerting patterns and queried reports).


Schematic of the cirucular relationship of the three research question components (described in caption)

Figure 1. Our research question: how do ICPs envision specifying, delegating, and obtaining support from an AAL system in providing support/care to a PwD? (click to enlarge)

Flow diagram of design stages

Figure 2. Our multiphase co-design method adapted from the USAP design model [1]. Phase 0 and Phase 4 indicate our additional/adapted stages from the original USAP model (click to enlarge).


Storyboard of animation of handwashing scenario

Figure 3. An animated video of COACH [2], used in this study to trigger the co-design process with participants.  The video demonstrates how an AAL system might guide a PwD in independently completing an activity (i.e., hand washing) while his ICP is freed up to perform other tasks (click to enlarge).

Flow diagram of tea making task
Figure 4. Image of a paper prototype co-designed and evaluated (in Phase 3) with participants, illustrating how we explored with participants how they envisioned specifying and delegated activity support to an AAL system (click to enlarge).

Funding Sources

Canadian Institutes for Health Research (CIHR)

Everyday Technologies for Alzheimer Care (ETAC)

Toronto Rehabilitation Institute (TRI)


  1. O. Demirbilek and H. Demirkan, “Universal product design involving elderly users: a participatory design model,” Applied Ergonomics, vol. 35, no. 4, pp. 361–370, Jul. 2004.
  2. Mihailidis A, Boger JN, Craig T, Hoey J. The C.O.A.C.H. prompting system to assist older adults with dementia through handwashing: an efficacy study. BMC Geriatr. 2008 Nov 7;8:28.


  1. Hwang, A., Truong, K.N., Cameron, J.I., Lindqvist, E., Nygård, L., & Mihailidis, A. (submitted, 2014). Co-designing ambient assisted living environments: unravelling the situated context of informal dementia care [manuscript]. Biomed Research International: Special Issue on New Technologies for the Rehabilitation of Chronic Diseases.
  2. Hwang, A., Truong, K.N., Cameron, J.I., & Mihailidis, A. (2014). Designing to support caregiving in ambient assisted living environments [conference oral presentation]. Technology and Dementia Pre-conference Workshop at Alzheimer’s Association International Conference (AAIC 2014) at Copenhagen, Denmark, July 12-17, 2014.
  3. Hwang, A. and Hoey, J. (2013). DIY Smart Home: Narrowing the gap between users and technology [extended abstract].  Interactive Machine Learning Workshop, International Conference Intelligent User Interfaces, March 19, 2013 at Santa Monica, California, USA.
  4. Hwang, A. and Hoey, J. (2012). Smart home, the next generation: closing the gap between users and technology [full paper]. AAAI Technical Report FS-12-01, AI for Gerontechnology, 2012 AAAI Fall Symposium, November 2-4, 2012 at Arlington, Virginia, USA.
  5. Hwang A., Truong K., & Mihailidis A. (2012). Determining the needs of informal caregivers for smart home user interfaces: a first look. 2012 Alzheimer’s Association International Conference (AAIC 2012), July 14-19, 2012 at Vancouver, Canada.
  6. Hwang, A., Truong, K., & Mihailidis, A. (2012). Using participatory design to determine the needs of informal caregivers for smart home user interfaces [full paper]. 2012 6th International Conference on Pervasive Computing Technologies for Healthcare (pp. 41-48), May 21-24, 2012 at San Diego, California, USA.

Research Team

Amy Hwang, University of Toronto

Khai Truong, University of Toronto
Alex Mihailidis, University of Toronto
Jesse Hoey, University of Waterloo