Caregiver: An Exercise in Lean & Agile Design & Development

Bringing the Human Element
of Happiness to Home Care

A Hackathon

A month ago, PhillyCHI teamed up to promote Drexel University’s Philly Codefest, a three day hackathon in Drexel’s URBN Center. Of course, some of us also wanted to participate, so PhillyCHI board alum Matt Thomas, 50onRed dev ‘n design players Patrick Smith, Matthew Parke, Andrew Christiano, and myself created a team to make some cool stuff.


It was a fun weekend of camaraderie, coding and creating. Each of us got to know each other better, some of us stayed up all night and we did our best to create a lean, functional application with thought out, well designed accouterments (as our judging requirements suggested we do.) In the end, though quite a positive experience overall, we were unable to present any of it to anyone at the event. Thusly, I’ve taken the opportunity to showcase the raw materials of our efforts here.

With our diverse backgrounds, we decided to utilize the data provided us to create something useful for a growing constituency: caregivers in the United States. Welcome to our organized notes for our app, Caregivers.

(The slidedeck is broken up into parts below, but for a continuous look: Slidedeck)


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Summary

As life expectancy increases, so too, will the need for caregivers. Searching for home care services is challenging for a caregiver already managing a multitude of care-tasks.

The senior demographic is an emerging market for social innovation. In 2013, the oldest baby boomers (depending on birth years used) reached a common retirement age in the United States—67 years. This demographic also sits in what is called the “sandwich gap,” meaning they act both as caregivers for their parents while simultaneously caring for both the X-gen and the ever popular millennial.

Cornered into this unique position, a baby boomer, the average caregiver, is faced with managing a full-time job (remember, baby boomers aren’t retiring anytime soon), caregiving on either end, which deals with a multitude of logistics ranging from setting appointments, scheduling medication intake, transportation, other activities for daily living (ADLS).

Our solution looks to streamline this finding process with a unique score/comparison algorithm vetted by a unique Happiness Index. To enhance care-recipient safety and quality of life, when an appropriate home care service is located, the solution will act as a mediator to create a symbiotic relationship between caregiver and home care providers.

Persona

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John Michaels is a 56 year old caregiver for his mother, Sarah, who is 84 years old. She has dementia which causes her to have difficulties with her Activities for Daily living (ADLs).

John works full time as a high school teacher in Philadelphia. His wife passed away several years ago leaving John as the sole caregiver for Sarah. He also has a 31 year old daughter, but his daughter lives in San Francisco.

Individual is a inspector-provider personality type.

Inspector (ISTJs) are responsible organizers, driven to create and enforce order within systems and institutions. They are neat and orderly, inside and out, and tend to have a procedure for everything they do. Reliable and dutiful, ISTJs want to uphold tradition and follow regulations.

Provider (ESFJs) are conscientious helpers, sensitive to the needs of others and energetically dedicated to their responsibilities. They are highly attuned to their emotional environment and attentive to both the feelings of others and the perception others have of them. ESFJs like a sense of harmony and cooperation around them, and are eager to please and provide.

John has a inspector-provider personality type, which means John prefers organization, having a procedure for his day-to-day while also having a high level of compassion and sensitivity.

Working long hours, John is looking for a home health care provider to send an aid with occupational therapy and nursing care capabilities to help out with his mother’s ADLs. Attempting to search online, John finds he must navigate to too many sources for quality assessment of home health care services. Furthermore, he is shocked at the information overload and that these sources do not talk to one another.

Despite being an organizer and planner, John is easily overwhelmed with too much input of information, but does his best to organize information to provide the best care solutions for his mother.

Overwrought with work, his personal life and other care-tasks, John’s pain points are as such:

Painpoints:

  • No quality assessment of existing home health care services (HHCS)
  • Information overload (when researching resources)
  • Fragmentation: all resources do not communicate together
  • No voice compared to HHCS
  • No community with other individuals in need of HHCS
  • Overwhelmed with other care-tasks (full-time job, scheduling, care-recipient’s activities for daily living

John owns an iPhone 5 and is proficient with email and word processing. He navigates the web for resources dealing with dementia, but his searching acuity is low.

Experience

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John uses CAREGIVER’s geotargeting to find all of the home care services in his area. John then selects search filtering options appropriate to the needs of his mother and then CAREGIVER feeds medicare feedback data into a proprietary algorithm to provide John with a list of the best home care services.

Having selected a home care service, the aid visits Sarah every day, providing 5.5 hours of service including weekends. John rates his and his mother’s experience through CAREGIVER’s Happiness Index data, compiling this information into an overall score for the home care provider.

Hacking

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Happiness Index

Our solution innovates by streamlining the process of finding home care services with a unique score/comparison algorithm vetted by a unique Happiness Index. When an appropriate home care service is located, the solution will act as a mediator to create a symbiotic relationship between caregiver and home care providers. This in turn will enhance care-recipient safety and their quality of life, while also providing much need respite for the caregiver.

We are taking data provided by medicare.gov relating to home health care resources and aggregating this into an easily digestible format for the caregiver. A caregiver, using our solution will be able to locate and bridge into the best home care aid to assist the care-recipient.

In addition to indexing nearby facilities, we’re also feeding medicare feedback data into our proprietary algorithm, where it’s aggregated with our Happiness Index data, and compiled into an overall score for each in-home healthcare facility.

This in turn adds to the home care provider’s overall score for other users. John is able to go back and look at the trends of his and his mother’s experience to ensure an additional way to aid in the caregiving responsibilities and expectations for Sarah.

Presentation

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As stated earlier, for a variety of reasons, not everyone who created something at the hackathon was given a platform to present. While unfortunate, we are glad to have put this much thought and effort into our presentation. The broken up slides throughout this writeup made for a five minute presentation with a demonstration of our app. For an uninterrupted, undivided look at our presentation, check it out over here.

By Weekend’s End

By the end of it, we were all pretty tired, but built some great camaraderie and friendships. Honestly, these guys are great. If you have the honor of knowing them or working with them, pat them on the back. We all chose a topic that we hoped would benefit a needing population and we all did it with agility, ingenuity and a helluva lot of fun.

Mid-Autumn Rising

There is no shortage of good days. It is good lives that are hard to come by. —Annie Dillard

Watching a sunrise is breathtaking. Not actively watching it, mind you, but witnessing it unfold as a backdrop to the daily activities of people rising to greet the dawn, or with the pattering raindrops of sneakers, listening to those on their early runs, steam swirling from the cold air touching their radiated heat.

Watching a sunrise solely focused on the sun itself is to witness only the composer, the cacophony of sound comprising life unheeded. The mundane details no longer seem so mundane when orchestrated together with the rising tide of light that greets the early morning’s day. That is truly the sunrise.

Formations

On teamwork and individualism


Shield to Shield

While working today’s social hour, I flipped through a few pages of a book entitled “A Study of History” by Arnold J. Toynbee. It was here that I came upon a part in particular speaking of the evolution of the Spartan phalanx. 1

A phalanx is a general term for military infantry formation. The popular construction of the word describes a military arrangement of tightly packed soldiers armed with spears and interlocking shields. The shield of your colleague’s protected your exposed right side and your shield in turn protected your fellow teammate’s right side. The dense nature of the arrangement provided a compact defensive structure within an offensive mobile force. The Spartans in particular were able to maintain flexibility in this arrangement due to their single-handed dory spears (as opposed to the Macedonian double handed spears) and their short iron xiphos swords, thusly able to function as a single unit while maintaining some autotomy of the individual.

“One-against-one, they are as good as anyone in the world. But when they fight in a body, they are the best of all.” 2

While Tonybee chronicles the evolution of the basic phalanx into more sophisticated military formations, the modern analogy here is less to the lasting integrity of these specific strategies in an ever evolving battlefield and more on the fundamental component of their value: that each individual member is an integral component to the overall integrity of the unit.

Collaboration today is similar. A part of the usefulness in collaboration is the trust in your team and the ability to defer to their various disciplines of expertise . Relinquishing control doesn’t mean catering to your team’s whims, but rather placing trust in why you have a team in the first place. Each member has his and her strong attributes, each is capable of catching any holes you or any other member may make, and each reinforces the movement forward through tightly formed strategy. Like the phalanx.

Transcend Yourself.

There is strength in vigorous individuality. The composite of the whole is completely dependent upon the constitution of each individual member. And this is where disruption, the positive kind, can come into play, where diverse individuals challenge one another to provoke invigorating new solutions. This is the crucial spice in the recipe of innovative culture.

It can take a single idea to spark action, but it takes action to keep that spark burning. IDEO’s one tenant for Human Centered Design is to compose a team of varying abilities and disciplines.3 This diversity creates a breadth and depth of experience, but provides lateral thinking that enables the connection of a variety of dots—dots which likely may not exist without a particular member in the fold. Consider a melting pot of the strongest points of culture, perspective and skillset—this is innovative teamwork, when one’s individual value reinforces something greater than himself. When one can, for the moment, put his own individualism aside for the common strength of a greater goal.

“The most effective moral communities – from a well-being perspective – are those that offer occasional experiences in which self-consciousness is greatly reduced and one feels merged with or part of something greater than the self.”4

Our relentless individualism shades the fact that everything we do affects our society, the people around us, the people in our lives. Strengthen oneself to strengthen those around us. That’s why many of us got into the fields we got into in the first place; to make the world a better, more interesting place. And I believe that if we, from time to time, realize that our individualism is stronger when applied to the benefit of the formation, of the goal, of the pursuit, of the good for our constituents, that we can very rarely go wrong.


1. A Study of History, Volume V, The Disentigrations of Civilization; Arnold J. Toynbee
2. Herodotus vii (trans. G. Rawlinson)
3. HCD Tool Kit; IDEO.org
4. “Hive Psychology, Happiness & Public Policy“; J. Haidt, P. Seder & S. Kesebir (as quoted from Why Teams Make Us Happy; Scott Belsky)

 

Light Magic

Bus rides are usually hectic. By the time the public’s leviathan scoops me up at my stop, I can barely inch over the yellow “DO NOT CROSS” line that demarks the start of the aisle and the end of the driver’s zone.


I don’t mind standing as I’ll be sitting most of the day anyway. But the weight I see on the sullen faces around me forebode their 9-to-5-gruel. And this tempts the phantom knots I can feel in our collective shoulders.

This morning it’s different. While it started with a leaden gloom, the sun’s peaking over and out from it’s five-day hiding. The bus is empty and I have a seat. I actually have a lot of seats. I choose to only occupy one.

The mothers beside me speak with light, accented notes. Their intonations are from two different regions of the world. The little boys with them have none.


Moments earlier, clomping up onto the bus from Green Street and striding gallantly down the aisle, the one boy cried, “It’s magic!” Grinning, he was clearly excited to see he’d somehow synchronized his commute schedule with his morning friend yet again.

“There is no such thing as magic honey,” chides his mother as they sit down across from the first mother-son pair.

The boy continues to speak. He tries to spell on the bus. He doesn’t get it right, but he’s determined to wrestle through breaking down “ingredients.” After a couple of “i” and “n’s” he stops.

“We could look it up in a dictionary you know. Oh! I know how to spell ‘dictionary’!”

Alas, before he can provide adequate solutions for either of those words, his stop arrives. “We should ask Google how to spell them,” he claims as he gets up for the door. “It’s not the smartest person. Google’s not a person. But it’s the smartest network.”

He slides down the seat and stubbles down the steps firmly grasping his mother’s hand.

“You become the smartest person by working hard like you just did,” says the other mother. Her and her son wave goodbye with big smiles.

He gets off the bus with his mom that told him magic doesn’t exist and they both continue on their way.

“See,” says the other mother to her own young boy, “he does not know how to spell those words, but yet he tries and tries. There should be no fear to learning.”

Now that is magic.

Welcome Home

“It is a strange thing to come home. While yet on the journey, you cannot at all realize how strange it will be.” Selma Lagerl

I’ve been attempting to adequately describe what it’s like leaving Matthew to continue the journey while I head home to start new things, meet new people and yet continue where I left off in July. It’s proving difficult.

Being home… well Lagerl says it best. But maybe the photos below can help.

While trying to figure how to best write my experiences of being back…

…I’ve attempted to re-familiarize myself with the city, biking to and fro…

…engaging local establishments, meeting up with old friends…

I’m still working on my thoughts.

I’m still lost in them.

I feel lonely.

I feel astray.

I’ll continue to sort this out. In the meantime, welcome to Philly. Welcome home.

Photo Synopsis

To call this a photo essay may be misleading. It’s more apt to being called a photo synopsis.

The snapshots were chosen to give a quick overview of the variety of scenes and scenarios I encountered. There are interesting events that aren’t depicted below. For example, we had a wonderful dinner at the home of a Grosse Pointe, MI art center director and some of her best friends/colleagues. And I spoke at length with a Doctor of Social Psychology and his niece at the park.

With this past week of travel, encounters and workshops, there’s too much to give a thorough description of things learned, things seen and people met. I wager you can get a better sense of that over here.

But, for those of you that want to see what my eyes saw through the lens of a camera, here’s a glimpse of the sights from the road.

Toledo, OH

Toledo was a great city for us. We came into it late. These grainy, streaked photos best depict our state of mind. Hungry, we drove to Maumee Bay for some food. Had we felt better, we probably would’ve enjoyed some of their unique brews too.


On our way to Toledo earlier that day, this is a view from the Domonkas Public Library.

The hearty bread prepared by the personable folks at Country Grains Bread & Deli was a nice respite from the more urban setting of Toledo the following day.

Towards Detroit

The transformation along Lake Erie is at once beautiful, awing and sad. Along the edge of the water from Cleveland to Toledo (and even a bit past Toledo), parks, trees and the water offered serene solace. As we got closer to Detroit, the remnants of industry, vast architectural artifacts from a lost civilization, began to emerge.

Detroit, MI

Within Detroit, we saw the same remnant buildings, sights of the industrial grandeur that once was. Where industry left, the arts filled in. Detroit is an insightfully artistic community, with vast amounts of opportunity for the public to learn, appreciate and share art.

Beauty of Detroit

This is Edie Hardy, a veteran of the Korean War. He’s a kind, quiet man, who was interested in submitting his postcard to the project.

His friend, Roy Adams, wondered if his story would be adequate for the archive.

I was in college and a few people told me I should go marching with this man I didn’t know. We were in Washington D.C. and I got swept up with the march. People were yelling at us and the guards wanted to unleash their dogs on us. And then I understood what this man, who I didn’t know, was trying to do. Martin Luther King Jr. just wanted everyone to accept who we were.

Detroit Industry by Diego Rivera

We were given a special tour of the Detroit Institute of Art and came upon the Rivera Court. Wall frescas by Diego Rivera, the murals “depict industry and technology as the indigenous culture of Detroit.”1

“Rivera completed the twenty-seven panel work in eleven months, from April 1932 to March 1933.”1

Ann Arbor

Everyone we met pointed us to Ann Arbor. I handed out close to 100 postcards to receptive individuals and even got a chance to play capoeira with some of the folks at the Diag.

After a successful start in Ann Arbor, we rounded out the night with a film we never heard of: The Intouchables. Shown at Michigan Theater, a historic non-profit venue, the film was everything good about storytelling and humanity.

1 Art at the DIA: Industry and technology as indigenous culture of Detroit, Detroit Institute of Art

Speculative Query

There is a proclamation that states people in public space need reconnecting.

This remains true. There is absolutely no better feeling than connecting with a complete stranger, in the end both agreeing that we’ve connected with our fellow man. Breaking through that barrier of mistrust, that thin veil of viscous armor, creates a connecting point. And relating begins. For me, however, the trip hasn’t simply been about the golden virtues of our mission. Nor has it simply been a tale of adventures, whether rough or with ease. It’s made me ask tough questions and personally inquire.

While we’re walking around Central Park on an afternoon, why are we quick to point out the people on their smartphones or with their headphones plugged, but pass by—sans comment—those reading their paperbacks or perusing articles in a (hardcopy) magazine? Are we more comfortable with “traditional” media in public space now that there’s been a century of precedence? Or is our discomfort with the on-demand nature of current technology that can spiral a person ever inward making them lose sight of the world around them? I have my guesses, but no substantive answers. What I do know is that while engaging a human being one-on-one is far more rewarding, having done so, following up with them is far more conceivable with the current technology available. “You want more information on our project? Sure, below is our web address, but if you provide me your email, I can also shoot you a one page overview of what we do.”

Could it be that engaging in public space changed, because the multicultural landscape changed? Perhaps engaging in public space became so difficult, because every culture on American soil came from a culture that engaged in public spaces differently?

How about the idea that there was a time when Americans connected better, that golden era of trust and community? What changed? Was it the Red Scare and then the Cold War that altered the American perception of trust? Or the technology that came with it?

Perhaps it was easier for Americans to stay connected before the 1940’s and 1930’s because America was more homogenous than it is now. There was a time when, while we fought the good fight overseas, we locked up any Japanese-American into interment camps due to mistrust.1 That was the 1940’s. So was the trust and community only for a particular concept of America?

Then came a wave of social change during a time when we were at war against Communism and terror causing the Second Red Scare, McCarthyism.2 Change scared folks. War scared folks. Misinformation and ignorance scared folks. Maybe this affected our perceived notion of trust and engagement in public spaces as much as the rapid adoption of digital technology.

I don’t believe we’ve become disengaged so much as we are in the midst of learning how to engage with a diverse pool of merging identities, values and shared enrichment.

More importantly, as the United States grew to become the melting pot, answering the call for opportunity and freedom, possibly so too came the freedom and opportunity of differing cultures, of differing practices. Could it be that engaging in public space changed because the multicultural landscape changed? Perhaps every culture on American soil came from a culture that engaged in public spaces differently? If this is so, I don’t believe we’ve become disengaged so much as we are in the midst of learning how to engage with a diverse pool of merging identities, values and shared enrichment.

These, of course, are speculative queries, quasi-hypotheses constructed after 17 days of being on the road, four of which carried a headache swollen and sodden. Cause and effect of today versus yesterday is too easily assumed. And I only have questions. I could consider Jürgen Habermas’ concept of public sphere3 and the role of the Internet affecting it and I could address how developed discourse communities4 affect communication in public space. The chance of answering the questions above along with their relation to the topics stated are currently beyond my scope of research, but certainly within my interests to further pursuit in the future.

So my personal mission isn’t so much reconnecting a la the “good ‘ole days” before technology and before people stopped talking to one another. Those were different days with different rules and different cultures. With the Union being a diverse, multifaceted nation full of diverging and converging ideas, our postcards give us a reason to engage strangers within a public space. A peace offering to gain trust and thereby connect with the various communities we encounter.

After the growing pains of the 20th Century, I believe that the SBYF Project’s aim to join together a large tapestry of what America is today is noble. It challenges the difficulties the nation had in the past and looks towards an intergenerational connectivity. Engaging with the unknown, with strangers, with the strange and new, this is good. It’s a part of what makes travel so compelling, about learning from cultures, histories and experiences different from our own so enriching. Who would have thought we’d have that opportunity right in our backyard, with our fellow countrymen? Perserving these stories is what draws me to the project.

Perhaps one day we’ll still continue sharing postcards, preserving memories and connecting generations, but no longer need them as a tool to meet a stranger. A genuine “hello” and a sincere smile should do.

1 Children of the Camps, PBS
2 Senator Joseph McCarthy, McCarthyism, and the Witch Hunt, The Cold War Museum
3 The Structural Transformation of the Public Sphere: An inquiry into a category of bourgeois society, Jürgen Habermas, 1991
4 Discourse Community, Erik Borg, 2003