‘Empowering’ the caregivers of toddler rehabilitation groups

Abstract

INTRO Rijndam is a rehabilitation centre in Rotterdam that is specialised in complex rehabilitation problems. Rijndam has different locations and different departments. At the Ringdijk there is a children’s department where the toddlers are supported by caregivers of rehabilitation daycare, social workers, psychologists, rehabilitation pediatricians, speech therapists, physiotherapists and an occupational therapists. This graduation assignment focuses on the therapeutic toddler groups (TTG) (age 2-4) treated at Rijndam location Ringdijk. IDENTITY & DISCOVER One of the TTG is Dikkie Dik, a group with children who have cognitive and physical limitations. During these toddler classes the caregivers and therapists play and exercise with the children. They change the childern’s diapers and feed them. The TTG takes places twice a week, for three hours. Due to all the different activities in this time frame a toddler at the Dikkie Dik group needs to be transferred by a caregiver approximately 8 times an hour. A lot of these activities are performed on the rehabilitation mat (on the floor). Lifting the children up and down from a low level so many times can cause back and knee problems for the caregivers and therapists. Observations and interviews showed that the lift from the mat (ground) is one of the most common lifts and also the heaviest lift. Although the caregivers suffer from knee and back pain, they only use muscle power to lift the toddlers. It is easier and much faster to lift the children than grabbing a lifting tool. It is important for the caregivers to stay close to the children. Due to the cognitive limitations it is very important that the (inter)action between the child and caregiver is familiar and pleasant. EXPLORE As concluded from the observations the caregivers want the transfer to be fast, personal and pleasant for the children. The available lifting equipment is not capable of these interactions. Especially for lifting from the ground no solutions that do not cost a lot of time to set up, are available. When designing a new product it is important that the caregivers are motivated and willing to use the product. Motivation is more easily triggered by tasks that are easy to perform. A good trigger could also be a product that benefits the rehabilitation of a child. It is very important to make use of the childern’s capabilities and possibilities. Otherwise the toddlers can be discouraged and this will also influence the caregivers use. DEFINE Out of the first phase some conditions for the design can be summed up. The caregiver should be triggered to use the design, it should be easy to set up and relieve tension from the knees and back. The child should have the ability to use the design. It is extra beneficial if the product stimulates the revalidation process of the toddlers. The interaction should be personal, empowering and clarifying. From this a design goal is formulated. DESIGN GOAL Relieve weight fast and easily for the caregivers during the transfer from the ground while lifting a toddler. The design should be able to support the childern’s rehabilitation process. This design goal should fit in the context of Rijndam. Rijndam is constructing a new building with an emphasis on different themes. Living Lab, Flex Workspaces and Healing Environment. These themes are important for the context of the design. DEVELOP & DESIGN With these findings and an ideation phase, the first concept direction was created. The concept direction of a mat that can move up and down was evaluated and iterated. This mat, named UP, is an adjustment of the current rehabilitation mat. The mat replaces the vertical lift from the ground. A scenario was presented to the employees of Rijndam and discussed. The main concerns of the employees were: being afraid that the child could fall; all the children have to go up and down at the same time; and the ability to reach each child. The caregivers from different TTG’s were positive about the concept direction. They could see themselves working with the product and found it useful. After the feedback and conversations with experts the design was iterated and the user tests where conducted. The users test tested a few interactions and gave an idea of the user scenario. With this information the UP was created. The UP, has a lifting system similar to an electric pallet lifter and a sensory screen to stimulate the rehabilitation of the toddlers. The mat is able to move to different heights. This makes it possible to not only work on the ground, but also at sitting and at standing height. By making the mat able to go all the way down to the ground the children are still able to crawl on and off the mat. The implemented railings with adjustable hinges on the sides of the mat can be put in an upward position to prevent the children from falling off. With the UP the vertical lift can be avoided for the caregivers, only horizontal lifts are needed. This can relieve the back and knees of the caregivers. VALIDATION A final user test was conducted with a prototype scale 1:1. This was done to find out if the measurements were right and how the product was used during different tasks. The working regulations were analysed and a safety risk matrix was made to make sure the UP meets these standards. A working height of 1.10 m and no sharp edges are of these standards. This information was processed in the design. CONCLUSION The design goal described the qualities the product should have. The interaction qualities describe how the use of the product should feel. With questions asked and tasks performed during the user test, there could be seen if the interaction qualities were triggered. Personal. Using the UP still feels personal. The design felt personal, because the caregivers are still able to feel and make contact with the child. The interaction is less personal than lifting the child. But this way is more personal than current solutions. Instantly clarifying. This quality was difficult to test. Only the main function of the UP could be tested. The fact that the UP can move up and down was instantly clarified and easy to use. The railing system was clear. Furthermore a child lock should be added to both the railing system and the controller. If this is instantly clear needs to be tested. Also folding the mat for storage and locking the wheels could not be tested. When the final prototype is made this can be determined. Empowering. The UP is empowering on different levels. The caregivers need less strength while transferring, during a rehabilitation class. It gives the caregivers more power during the classes for extra activities. If they suffer from less physical pain this can also be beneficial outside their working environment. The classes cost less physically effort this will benefit the working attitude. In another way it empowers the children by providing an extra stimulus with the sensory screen. During this project several tests were performed to try out the use and principle of the UP. The product still needs another iteration and testing round with a final prototype before the UP can be implemented. A safety expert should check the final design on different safety aspects. By finding a partner who is willing and able to develop the product, manufacturing of the UP could be realised.