The 100 Year Life Project will exploit and advance the role of design research in enabling older people to lead longer, more productive lives – the longevity effect. Lab4Living has been awarded funding by Research England through their Expanding Excellence in England (E3) fund to support the strategic expansion of research in this area.
Funded by: Research England
Due to higher life expectancies the number of people expected to live to be 100 will increase significantly by 2066. The changing demographics and structure of the population will bring many challenges to society, the economy and services. However this will bring new opportunities for the emergence of new markets, increased involvement in volunteering, longer working lives and possibly providing care for family members. Individuals will need to plan their life and retirement differently with existing ideas of ageing being replaced with models of a multi-stage 100 year life (birth, education, work, education, training, work, career break, education and training).
Age related products, new housing models and care technologies which enable older people to lead more independent fulfilled lives will be considered within this project answering questions on what these products are, how multi-sectorial groups of people will work together, what standards and quality assurances are required for these products and services and how this knowledge is shared across sectors.
“One in three children born in the UK today can expect to live to be 100 – and by 2066 one in two children will reach this milestone. We need to look at what this expanded life-span will mean for where and how people live; what products will they use; what the implications are for health care, communities, and, of course, the home.”
Prof Paul Chamberlain
Focusing on informing the scale and scope of the Future Home, the project will generate ideas for new aspirational products, protocols and interventions which meet the physical, cognitive and emotional needs of an ageing population within the Future Home.
Lifestyle Matters is a research based intervention which equips community living older people with the skills to re-design their day to day lives.
Funded by Medical Research Council Partnered with University of Sheffield & University of Bangor
Team Lead: Claire Craig
Global ageing has been described as the greatest triumph and challenge of the twenty-first century (World Health Organisation). There is strong evidence to suggest that when older people are supported to engage in meaningful activity they experience increased quality of life and mental wellbeing.
Lifestyle Matters is an intervention aimed at helping older people to help each other to live life to the full. Comprising of group and individual sessions, community living people are enabled to explore the relationship between meaningful activity, health and wellbeing and redesign their lifestyle to embed health-promoting changes into everyday routines.
Research was undertaken in 2005 to build understanding of the experiences of older people, and the intervention was co-designed with older people (Craig and Mountain). Findings of an initial study based on this research showed that the approach empowered community living older people to examine their lives and to re-design the way that everyday activities were undertaken to accommodate some of the physical, emotional and cognitive challenges they faced as a consequence of ageing.
Between 2011-2015 the intervention was the subject of a pragmatic, two arm parallel group individually randomised controlled trial (RCT) (Lifestyle Matters vs standard care). In addition to quantitative health outcomes, a purposeful sample of 13 participants aged between 66 and 88 years from the intervention arm of the RCT were interviewed.
“Lifestyle Matters for me was a pointer, a signpost to my future as a single older person giving me some answers to what I might do and what I could do and I would recommend it to anyone.”
(Lifestyle Matters intervention interviewee)
The interviews revealed that the majority of interviewed participants were reportedly active at 24 months, with daily routines and lifestyles not changing significantly over time. All participants described benefit from attending Lifestyle Matters, including an improved perspective on life, trying new hobbies and meeting new friends. A number of intervention participants spoke of adapting to their changing circumstances, and there were significant and lasting benefits for a number of the intervention participants interviewed.
Cited as the intervention of choice
The intervention was cited in the National Institute of Clinical Health Excellence Guidelines (2008 and 2015) as the intervention of choice to promote mental well being in community living older people.
Commissioned in the UK, used world-wide
The programme is commissioned by mainstream services in the UK and is used all over the world
Related research on Sheffield Hallam University’s Research Archive
The aim of the research is to co-design a multi-dimensional, cross-disciplinary and personalised coaching system. Leveraging ICT social connectivity, NESTORE will support older people to sustain independence. The system will operate through tangible objects as well as software and apps.
Funded by Horizon2020.
Partners: Politecnico di Milano (Polytechnic University of Milan), AGE – Age Platform Europe AISBL, Consiglio Nazionale delle Ricerche (Italian National Research Council), EURECAT – Fundacio Eurecat, FLEX – Flextronics Design S.R.L, FSIE – Fundacio Salut i Envelliment
Project Team: Lead – Paul Chamberlain Claire Craig, Nick Dulake, Kathi Chamberlain
The ageing population is growing fast in the EU. ICT can procide solutions for Active Ageing, however the success of novel ICT solutions depends on user perception about their efficacy to support toward health promotion and global wellness.
NESTORE will develop an innovative, multi-dimensional, personalized coaching system to support healthy ageing by: 1) Generating and sustaining motivation to take care of health; 2) Suggesting healthy nutrition and personalized physical and mental coaching, as well as social interaction, to prevent decline and preserve wellbeing.
Lab4Living is part of the NESTORE consortium which comprises 16 partners from 8 European countries.
Through co-creation workshops with community living older people, the Lab4Living team are building understanding of the hopes and aspirations of participants to gain insights as to what individuals find meaningful, in order to inform the types of activities that NESTORE may offer to engage and motivate end users of the product. The workshops have explored what is meaningful in people’s lives and adopt the ‘exhibition-in-a-box’ co-design methodology developed and facilitated by the Lab4Living design research team. The methodology uses a collection of carefully chosen objects designed to stimulate and prompt conversation, and enable participants to share their experiences.
“Using the ‘Exhibition in a Box’ methodology has enabled the participants to share in detail some of the factors affecting their perceptions and acceptance of technology, which informs how NESTORE might support older people’s engagement in health promoting activities.”
(Claire Craig, Lab4Living)
A key strength of the methodological approach followed in NESTORE is the engagement of end-users at all stages of the design process. Participatory methods permeate every aspect of the research in order to ensure that the end-product reflects the community’s needs and perceptions.
Working with Lab4Living researchers, the ‘expert-by-experience’ (‘EBE’) group, a group made up of ten older people whose ages ranged from 54-93, have analysed the workshop findings and are recording and sharing their experiences of technology in their every day lives.
The shared findings will inform the content of the technological development of the system through an iterative process and ongoing dialogue with the ‘EBE’ group.
The research is building understanding of user requirements of the technology and the factors that promote and inhibit use, and will explore other potential contexts where the technology may be used.
The Starworks Network is a young people’s prosthetics research collaboration. It has taken a co-design approach to bringing children and families together with experts from healthcare, academia and industry, to creatively explore and address the unmet needs in this area.
Funded by The UK Department of Health / National Institute for Health Research (NIHR)
Project led by NIHR Devices for Dignity MedTech Co-operative, Sheffield Teaching Hospitals.
The Lab4Living team was led by Joe Langley and Gemma Wheeler.
There are an estimated 2000 children in the UK living with a form of limb loss and many will use upper and/or lower limb prosthetics from an early age. However, product and service provision for these children is usually based on scaled-down versions of adult prosthetics, which often do not meet their unique functional, social and emotional needs.
In 2016, the Department of Health released £750,000 to build a network of clinicians, academics, industry experts, and crucially, children and families, to support research in this area. It aimed to ensure a balance between ‘clinical pull’ and ‘technical push’ in translating much-needed innovation in child prosthetics into everyday use.
Our regular collaborators, Devices for Dignity (Sheffield Teaching Hospitals) invited Lab4Living to bring a co-design approach to the building and maintenance of this network. We have played a key role in the design, facilitation and reporting of each stage of the project, ensuring that children’s voices were central throughout.
“The Child Prosthetics Research Collaboration led to inventions and optimizations that reflected what children and families need. The experts and academics who develop prosthetics would probably never have heard from families and children how a poor-fitting or unattractive limb can limit a child at home, in the classroom and in the playground.”
(Gary Hickey, INVOLVE)
Needs assessment We engaged children and families across the country through workshops, phone calls and postal activity packs tailored to a range of ages.
Sandpit events A series of four one-day workshops in Salford, Bristol, London and Sheffield, brought the key stakeholders together to creatively and collaboratively explore key challenge areas emerging from the initial needs assessment. We designed a set of bespoke tools to support activities in problem definition, inspiration, ideation, prioritisation, development, pitching and network-building.
We have continued to provide design support to these projects and the Network as a whole, and are pleased to announce that it has been awarded follow-on funding from the NIHR to continue supporting research and innovation in this important area. Starworks 2 has begun and will further engage with all stakeholders to bring new innovations and technologies to children with limb difficulties.
“This, to my knowledge […] is the first of its type in scale and content and hopefully will produce some exciting, useful and relevant developments […] for our paediatric clients, who have sadly, by nature of their relatively small numbers and even smaller voices, been largely ignored by industry and the profession. Empowering the client group that you are trying to help and allowing them a voice in what is being developed for them is surely the best way forward.”
Rose Morris, Clinician, in ‘Attracting innovation in child prosthetics’, The Clinical Services Journal, February 2018, p56-58.
Devices for Dignity MedTech Co-Operative has announced the funding of 10 Proof of Concept projects, addressing a variety of needs for children using prosthetics.
Starworks has raised awareness of co-production methods through coverage in a Nature special issue on Co-production of research, published on 3rd October 2018 and in an upcoming guidance document by Involve (www.invo.org.uk).
A recent article in a clinical journal raises awareness and demonstrates recognition of the potential of the Starworks research collaboration. Raj Purewal, business development and partnerships director at NHS innovation specialist, Trustech, discusses how the project aims to increase progress in innovation in child prosthetics even further in an article for The Clinical Services Journal, February 2018, p56-58.
The Starworks project has supported the formation of collaborations between researchers across the country through Industry Forum events.
Related research on Sheffield Hallam University’s Research Archive
This project used creative methods to engage children with continence issues, alongside their parents and/or siblings, in discussing the challenges they face in daily living and in ideating potential solutions.
Project funded through Engineering and Physical Sciences Research Council (EPSRC). Both groups are National Institute for Health Research Healthcare Technology Co-operatives (NIHR-HTC).
Partners: Devices for Dignity (Royal Hallamshire Hospital, Sheffield); IMPRESS (Incontinence Management & PRevention through Engineering and ScienceS)
Project Team: Project lead – Dr Joe Langley
Researchers: Dr Gemma Wheeler (Lab4Living); Nathaniel Mills (Devices for Dignity); Sarah King and Dr Peter Culmer (IMPRESS, Leeds); Chris Redford (Freelance Illustrator).
Approximately 900 000 children and young adults are affected by incontinence in the UK (BBC 2015), whether as a result of medical problems or issues with toilet training. Although children represent a smaller percentage of the population with continence issues, the impact upon them should not be underestimated. The effect on a child’s wellbeing at school (risk of bullying, potential lack of confidence in participating in social or sporting activities) may have lasting implications for the rest of their lives. Despite this, the effects of incontinence are not well understood and require further research.
To respond to this challenge, a partnership between Devices for Dignity and IMPRESS (Incontinence Management & PRevention through Engineering and ScienceS; funded through the EPSRC) was formed. Lab4Living researchers Joe Langley and Gemma Wheeler were invited to join the team to help design and facilitate a bespoke Family Day event, using creative methods to learn about the lived experiences and unmet needs of children living with incontinence, and their families. The aim of this workshop was to inform future innovation of relevant medical technologies in this area, to better support these families in their day to day lives.
The stakeholders were children with continence issues, their parents and siblings, healthcare professionals, engineers and researchers looking into incontinence and its effects.
A conference paper, Child-led, Creative Exploration of Paediatric Incontinence, has explored the methods and impact of this project.
A range of bespoke tools was developed in collaboration with an illustrator to creatively and collaboratively explore the challenges faced by children with incontinence issues. These tools aimed to place the young people as the experts in the rooms, reflecting on their wider life (i.e. their hobbies, friends, family) and took an asset-based approach to highlight the skills and resources they already leverage to address their personal challenges. Later, ideation activities were used to empower the families as inventors to highlight and address any unmet health needs.
“What can I say, but ‘what a team!’ I was really overwhelmed by the response from the families – the kids were fantastic and the parents engaged and obviously committed to supporting this in the long term.”
(Dr Peter Culmer, project partner at IMPRESS)
During the workshop, the illustrator visualised emerging findings on a live mural in order to demonstrate progress made through the session and to highlight the value placed on the participants’ input. Central to each of the activities was the aim to reframe a traditionally ‘taboo’ topic as something that is safe, and even fun, to explore through creative means.
A range of ‘blue sky’ ideas generated at the workshop, in response to the challenges identified, was incorporated into a comic (available at: https://tinyurl.com/ToiletTalkComic). Based on this input, two further workshops have been organised by the project partners (including Lab4Living) with children and families to develop a smart watch app to help children develop regular toileting behaviours. Early feedback has been extremely positive; we are currently seeking an industry partner to take this forward.
This first phase of funding drew to a close at the end of 2018 but the work of IMPRESS continues via the Surgical Medtech Cooperative under their Colorectal Theme.
The Design to Care Programme seeks to rethink how palliative and end of life care can be provided equitably, efficiently and sustainably for future generations. The Life Café Kit is a result of the programme, and is designed to promote and support conversations about what individuals find meaningful in life and in care. For more information visit www.lifecafe.org.uk
Funded by Marie Curie Partnered with University of Cambridge
Team: Helen Fisher, Claire Craig, Paul Chamberlain
Drawing on long-established ethical principles, the UK General Medical Council articulates good end of life care as that which ‘helps patients with life-limiting conditions to live as well as possible until they die and to die with dignity’ (GMC 2009 p.3).
The last decade has witnessed a demographic change on unprecedented scale.
People are living longer and with more complex, long term conditions such as cancer and dementia. Our palliative and end of life care services will be required to meet the needs of our ageing population under increasing pressure.
The Life Café is one of the outputs of the Design to Care programme which seeks to rethink how palliative and end of life care can be provided equitably, efficiently and sustainably for future generations.
The community engagement aspect of the Design to Care programme focuses on understanding what is important to different individuals in life, in care, and towards end of life. A methodology has been developed by researchers at Sheffield Hallam University’s Lab4Living, to enable research to be gathered in an informal, comfortable manner within existing community groups and familiar environments. This has been named the Life Café.
“This has made an incredible difference to me today to share these things and listen to you all.”
Life Café Participant
“Good care is ‘talking, listening, communicating, trusting, consistency, choice and time.”
Life Café Participant
Taking the method of ‘exhibition in a box’, a form of object elicitation developed by Chamberlain and Craig (2013) as the starting point, this study curated a series of creative activities, to scaffold thinking and to prompt conversation. The Life Café is comprised of a variety of critical artefacts, activities and resources, co-developed with community members, that have been used to gather stories, experiences and ideas to support the design phase of the project.
Our iterative methodology of using resources and artefacts, analysing data, generating themes, then modifying the resources has been a form of behind-the-scenes co-design. Participants have shaped the contents of the Life Cafe and enabled others to talk about sensitive topics more easily, without really realizing. This iterative co-design process has occurred through every element, activity and resource included in the Life Café Kit, even the graphic design and the packaging design.
11 Life Cafés facilitated 141 participants
In the first phase of the Design to Care Programme, 11 Life Cafés have been facilitated with a total of 141 participants (from groups including chaplains, faith groups, coffee morning socials and mixed community groups), using convenience sampling.
The Life Café Kit
Life Cafés were continued to develop a kit for independent facilitation. The life café has since been independently facilitated within 2 community groups, a care home and a hospice. The feedback from this will be consolidated and incorporated into the final version of the Kit. We have increasing interest in the Life Café Kit, not only for community groups but for use in schools, carer groups, staff training etc. to open the conversation up and bring awareness to organisations.
The Life Café as a method of eliciting the experiences of individuals in the context of meaning and care has been very successful. Particularly notable was its ability to enable community groups through this process to identify strength and mobilise knowledge and action. This sits well in the context of building compassionate communities.
The Life Café has elicited insights into how individuals conceptualise and describe good care, and a recognition of the pressure points in relation to delivery. The research offers glimpses of what better care might and could look like in the future. Future research will continue to utilise this method with other groups (health and social care staff, trusts and CCGs, carer groups, community groups etc.) to continue to build understanding in order to inform the redesign of end of life care provision. For more information or to order a Life Cafe Kit please visit www.lifecafe.org.uk.
Related research on Sheffield Hallam University’s Research Archive
Radiotherapy treatment for breast cancer requires precision and accuracy. This research builds understanding and has developed a novel solution for safer breast radiotherapy through the creation of a support bra, enabling reproducible positioning of tissue during breast irradiation treatment and helping maintain modesty and promote dignity.
Funded by National Institute of Health Research.
Partners: Sheffield Hallam University: Faculty of Health & Wellbeing Sheffield Teaching Hospitals NHS Trust Panache Lingerie Ltd
Project Team: Design Lead – Heath Reed Prof Heidi Probst, Andy Stanton
Breast cancer symptoms affects a substantial proportion of the population and state-of-the-art radiotherapy approaches require increasing precision and accuracy to avoid long-term side effects.
There is evidence that immobilising the breast during radiotherapy following a diagnosis of breast cancer is problematic. Patients with larger breasts are particularly difficult to position. This decreases the accuracy of treatment and the process can increase levels of emotional distress and compromise dignity.
This bra has been designed specifically so that it doesn’t absorb too much of the radiation beam and therefore doesn’t increase the skin dose.
(Dr. Heidi Probst)
This research seeks to develop a novel solution for safer breast radiotherapy through the creation of a support bra. This will enable reproducible positioning of tissue during breast irradiation treatment, help maintain modesty and promote dignity.
A mixed methods approach has been adopted to build understanding of patient and staff requirements and develop insights into the materials that could potentially be used.
Very few centres will cover the patient during radiotherapy so this is unique – it allows the patient to be covered during the treatment.
(Dr. Heidi Probst)
The inquiry is ongoing. To date a number of prototypes have been created and are currently being tested. The research raises further avenues of investigation in relation to methodological approaches and ways of testing designs.
I’ve been clear 9 years now. Being able to wear a bra while you’re having radiotherapy treatment would be very helpful for women as they go through the treatment, make them feel much for comfortable at a time when you feel very vulnerable.
Motor Neurone Disease (MND) is a rapidly progressive neurodegenerative disease, with individuals developing weak neck muscles, leading to pain, restricted movement.
This research built understanding of optimal requirements for a supportive neck collar with flexibility to allow functional head movement. Through an iterative prototyping process the HeadUp Collar, a class one medical device, has been patented.
Funded by: National Institute of Health Research NIHR Devices for Dignity Motor Neurone Disease Association
Partners: University of Sheffield SITraN (Sheffield Institute for Translational Neuroscience) NIHR Devices for Dignity Motor Neurone Disease Association Sheffield Teaching Hospitals NHS Foundation Trust Barnsley NHS Foundation Trust TalarMade
Project team: Heath Reed – Team lead Joe Langley, Andy Stanton
Co-design workshops brought together people living with MND, carers, clinicians and designers. Participatory methods, including qualitative interviews, 2D visualisation and 3D mock-ups, helped build understanding.
The study is an example of collaborative, interdisciplinary research and new product development underpinned by participatory design. The NIHR i4i funding enabled the team to iteratively develop and detail the product over a 24-month programme.
“This is a product that can be completely customized to the patient’s needs and requirements – that’s the huge benefit and the beauty of the collar and its design.”
(Liz Pryde, Devices for Dignity)
The proof of the pudding for me was that they were coming to clinic wearing the collar, it wasn’t in the drawer with the other collars.
(Chris McDermott, Consultant Neurologist)
Following the iterative prototyping process the HeadUp collar, a class one medical device, was patented. It has undergone multi-centre clinical evaluation with results indicating that the product meets user requirements and showed an increase in the number of hours the collars are used, compared to existing neck orthoses.
It looks like clothing, really, rather than a medical device. Without the collar, I wouldn’t be able to drive and that makes a huge difference. With a rigid collar, you can look ahead but you can’t turn your head to see the traffic, but with this collar you can do that. It’s life-changing really.
(Philip, wearer of HeadUp Collar)
Over 1500 units sold in the first year
That’s 1500 people now able to get on with their lives with the support of this simple collar. Talarmade were shortlisted for the Partnership with Academia Award at the Medilink North of England Healthcare Business Awards 2019.
The collar, now known as HeadUp, is available to purchase from local manufacturing company TalarMade, who have more than 30 years’ experience in developing clinical innovations for use in rehabilitative and orthotic practice.
Related research on Sheffield Hallam University’s Research Archive
Parkinson’s Disease (PD) is a highly complex progressive neurodegenerative disease. Individuals experience PD in a wide variety of ways, leading to difficulty in diagnosis, acceptance and on-going management. Service provision is complex and varied depending on provider. This project utilised a participatory design methodology to identify patient and provider needs for PD services in the South West Peninsula. Then used co-design to develop tools, resources and service structures to meet these.
Funded by : Bial Pharmaceuticals University Hospitals Plymouth NHS Foundation Trust Sheffield Hallam University
Partners: University Hospitals Plymouth NHS Foundation Trust Sheffield Hallam University Livewell Southwest People living with Parkinson’s Disease and their family’s/carers Parkinson’s UK
Project team: Joe Langley Rebecca Partridge
Parkinson’s occurs when a small group of nerve cells in the brain no longer produce enough dopamine. This is a chemical that transmits messages from the brain to other parts of the body, enabling people to perform smooth, coordinated movements. Insufficient dopamine messes up these transmissions. Although typically associated with tremors, muscle stiffness and slower movements, it is also associated with a wide range of other symptoms including nightmares and night sweats, hallucinations, reduced facial expressions, depression, loss of taste and smell and ‘freezing’ (where someone suffers a temporary lack of ability to take a step, speak or communicate).
This highly individualised experience leads to difficulty in diagnosis, acceptance and on-going management. There is currently no cure for Parkinson’s so symptoms are managed through a combination of drugs and self-management (exercise, sleep hygiene etc.). The first year following diagnosis is involves many different healthcare professionals such as; Speech and Language Therapists, Dietitian’s, Occupational Therapists, Physiotherapists, a Parkinson’s Nurse Specialist and Neurology Specialist Consultants.
The provision of Parkinson’s services is complex and varied depending on provider. Services in the South West Peninsula cover acute and community settings, cross multiple regional and budgetary boundaries, cover a large geographical and rural area and have staffing pressures from unfulfilled roles, long term sick leave and increased patient numbers.
People living with Parkinson’s and their families and carers
Parkinson’s Specialist Nurses
Community care teams
Parkinson’s UK Charity representative
To improve the patient and staff experiences of using and delivering services in the South West Peninsula, this project utilised a participatory design methodology to identify patient and provider needs and generate a series of solutions to these needs. A wide range of design research techniques were implemented that included; Lego® Serious Play®, Persona creation, Service Mapping and Prototyping.
Five full day workshops explored
What are staff and user experiences?
How is the service currently run?
What could be different?
Prototyping and Testing
As a result of these workshops, five concepts are currently in development: A Parkinson’s Patient passport; New service and local information; a media campaign; a card deck to support therapeutic sessions; a self-management support and general information package. In addition further funding has been secured through The health Foundation to progress the development of a Home based Parkinson’s care service.
An evaluation is currently being undertaken with participants from both sites to explore whether there was a difference in the experience and impact between wards engaged in the creative practice and co- design of the critical artefacts in comparison to the ward that was not. It will reflect on how the artefacts had been utilised and any possible strategies that the wards have found useful in relation to identifying and implementing positive deviant behaviours