Remote monitoring of implantable cardioverter defibrillator (ICD) patients links patients wirelessly to the clinic via a box in their bedroom. The box transmits data from the ICD to a remote database accessible to clinicians without patient involvement. Data travel across time and space; clinicians can monitor patients from a distance and instantly know about cardiac events. Based on ethnographic fieldwork in two Danish hospitals, this article explores the configuration of the wireless ICD patient by following a number of patients through (...) hospitalisation, implantation, in-clinic follow-up, and remote monitoring. Wireless therapy, we argue, scripts the patient as data. In high-tech clinical encounters, data are enacted as extensions and copies of the patient, and even proxies that, in patients’ experiences, may turn into identity thieves. In illuminating the multiple positions that data take in such clinical encounters and in patients’ experiences we discuss the ambiguities that arise when patients go wireless. (shrink)

Discussing the workings of technology in care as aesthetic rather than as ethical or epistemological interventions focusses on how technologies engage in and change relations between those involved. Such an aesthetic study opens up a repertoire to address values that are abundant in care, but are as yet hardly theorized. Kamphof studies the problem that sensor technology reveals things about the elderly patients without the patients being aware of this. I suggest improvement of these relations may be considered in aesthetic (...) terms, for instance by developing the affective quality of people’s technological relationships. (shrink)

This article reports on ethnographic research into the practical and ethical consequences of the implementation and use of telecare devices for older people living at home in Spain and the United Kingdom. Telecare services are said to allow the maintenance of their users’ autonomy through connectedness, relieving the isolation from which many older people suffer amid rising demands for care. However, engaging with Science and Technology Studies literature on “user configuration” and implementation processes, we argue here that neither services nor (...) users preexist the installation of the service: they are better described as produced along with it. Moving beyond design and appropriation practices, our contribution stresses the importance of installations as specific moments where such emplacements take place. Using Etienne Souriau’s concept of instauration, we describe the ways in which, through installation work, telecare services “bring into existence” their very infrastructure of usership. Hence, both services and telecare users are effects of fulfilling the “felicity conditions” of an achieved installation. (shrink)

Population ageing and increased digitalization each constitute an ongoing and profound transformation within contemporary modes of living, as growing advances in technological development mix and intermingle with the lived realities of older people as the final recipients. It is against the backdrop of this interplay that user involvement has enjoyed ever-rising advocacy to an almost normative degree. Beyond articulating methodological principles, however, the literature has remained surprisingly vague as to the practical implementation of the approach. Less appears to be known, (...) both empirically and conceptually, about how design and user involvement are done in practice and how they would matter to bring about intentional or unintentional effects. To engage with these developments, this thesis aims at taking the practices of user involvement and design to the centre of its inquiry by adopting a perspective from Science and Technology Studies. Specifically, the thesis seeks to both build on and contribute to the established body of STS on the connection between technology design and older users and ask: What is there to learn about user involvement as a method, if we focus on the practices of doing user involvement? To answer this question, the thesis studies four different aspects of the practices of user involvement and design. In particular, the thesis reviews the literature on how user involvement mattered in previous empirical projects that include older people, it examines how different configurations of participation matter in design workshops, it scrutinizes the achievement of user involvement in corporate practices and it traces the circumstantial performances of such practices. The largest empirical piece comes from a two-year ethnographic study of a small- to medium-sized enterprise, the material from which informed Paper III and Paper IV. The findings highlight how user involvement in practice is both contingent and transformative, as it selectively enrols different participants and performs multiple realities. In practice, user involvement appears to be dependent on a set of underlying premises and socio-material conditions and thus is always a dynamic and momentary achievement. Furthermore, the thesis shows how the practices of user involvement themselves may bring into existence different realities, articulating and materializing particular versions of objects and images of ageing. Accordingly, the thesis contributes theoretically by illuminating the underlying socio-material facets of user involvement, and by emphasizing ageing as a particular object/image of design. Specifically, the appended papers encompass a conceptual framework, as well as three new concepts: design multiple, shifting interstices and viscous image landscape, in order to theorize the underlying conditions for user involvement, its relationship with design and its entanglement with ageing. Practically, the thesis enunciates three main implications regarding questions of goodness, politics and ethics. (shrink)