Negotiating Relation Work with Telehealth Home Care Companionship Technologies that Support Aging in Place

In response to a perceived caregiver shortage and need to support aging in place, telehealth home care systems are being developed to provide remote care and monitoring to older people. Though research has examined the experiences of teleoperators delivering care through these systems, we know less about the experiences of older adults receiving this care. We report findings from a three-month study of a tablet-based telehealth home care system that provides support for aging in place. We find that there is a mismatch between the designer's conception of how care should be delivered and the ways that participants were interested in using the system. This mismatch exists in four areas: participants' interest in getting to know the human teleoperators and rejecting the virtual avatar, interrogating the interface to figure out the inner workings of the platform, pushing for a more symmetrical relationship, and negotiating the relation work that they were willing to perform in the "sacred space" of their homes. We draw on the concept of heteromation to understand the political dimensions of telehealth aging in place technologies. We also provide implications and future directions for technologies requiring relation work as well as the design of avatar-based remote companionship.