SaTC: CORE: Small: Negotiating Cyber Systems Access for Older Adults with Mild Neurocognitive Disorder

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Older adults are rapidly increasing their use of online services such as banking, social media, and email -- services that come with risks around security and privacy. These risks may be especially important for older adults who suffer from mild neurocognitive disorder (miNCD), which can reduce their ability to recognize scams such as email phishing, follow recommended password guidelines, and consider downstream implications of sharing personal information. One way older adults with miNCD cope with their impairments is through the help of caregivers, including partners, children, and professional health personnel, when using and managing online services. This, too, carries risks: sharing personal information with caregivers can raise questions of embarrassment, agency, autonomy, and information leakage; caregivers also do not always act in their charges' best interest. Through a series of interviews, design work, and evaluation, this project will study the issues that arise around caregivers helping older adults with miNCD use security- and privacy-sensitive online services, and how new system designs can reduce the privacy, security, and relational risks involved while increasing older adults' autonomy and access to online services. Beyond that specific context, the work will deepen understanding of both how cognitive impairments affect technology use and how to design accessible technologies that people with impairments use through collaborating with others -- a common situation for people with a variety of physical and mental impairments. The work will also inform interdisciplinary course materials aimed at technology and aging and provide both undergraduate and graduate students research experiences working with these populations.The work is organized around three main activities. The first aims to determine how older adults with miNCD and their caregivers currently manage access to such services, and problems with current practices. To do this, the team will study pairs of caregivers and older adults (both with and without miNCD, to isolate whether findings are related to age versus cognitive disorder), using a person-centered design approach that combines short-duration interview and observational work in comfortable environments and is well-suited to working with both older and cognitively impaired individuals. These findings will be used to develop requirements for the second main activity, a participatory design (PD) process aimed at designing interaction mechanisms for cooperative negotiation around access to online banking, social media, and email accounts. The PD process will also follow the person-centered philosophy, using an "invisible device" paradigm that prompts participants for design ideas by showing video scenarios in which actors use and discuss unspecified devices to address issues identified in phase 1. The team will then synthesize ideas generated by caregiver-older adult pairs into user interaction prototypes for each of the three domains and test them for basic usability. The third main activity is a six-month longitudinal deployment of these prototypes to 40 older adults (20 with and 20 without miNCD). Participants will keep a diary of adverse events and their reactions; the team will analyze these, along with surveys, interviews, and video observations, to assess how the technologies affect participants' perceptions of their caregivers and autonomy, their involvement in and satisfaction with decision-making around online access, and their ability to manage risks around security and privacy.