Addressing the Black Box of AI - A Model and Research Agenda on the Co-Constitution of Aging and Artificial Intelligence.

Algorithmic technologies and (large) data infrastructures, often referred to as Artificial Intelligence (AI), have received increasing attention from gerontological research in the last decade. While there is much literature that dissects and explores the development, application, and evaluation of AI relevant for gerontology, this article makes a novel contribution by critically engaging with the theorizing in this growing field of research. We observe that gerontology's engagement with AI is shaped by an interventionist logic that situates AI as a black box for gerontological research. We demonstrate how this black box logic has neglected many aspects of AI as a research topic for gerontology and discuss three classical concepts in gerontology to show how they can be used to open various black boxes of aging and AI in the areas: a) the datafication of aging, b) the political economy of AI and aging, and c) everyday engagements and embodiments of AI in later life. In the final chapter, we propose a model of the co-constitution of aging and AI that makes theoretical propositions to study the relational terrain between aging and AI and hence aims to open the black box of AI in gerontology beyond an interventionist logic.

[Age assemblages : Sociotechnical innovations and successful age(ing) from the perspective of material gerontology]. / Altersassemblagen : Soziotechnische Innovationen und gelingendes Alter(n) aus der Perspektive der materiellen Gerontologie.

BACKGROUND: Individual-centered approaches have for a long time defined the gerontological involvement with technology. Despite an approach that expands in terms of space (e.g., neighborhood approaches) or social networks (e.g., caring communities), these approaches are characterized by centering on people as working alone. Material gerontological approaches attempt to theoretically and empirically address this entanglement of humans and technology by decentralizing the human and conceptualizing agency as being distributed among human and nonhuman agents. OBJECTIVE: Drawing on ongoing debates in material gerontology a concept of age assemblages is developed with which age(ing) can be understood as a process distributed between older people, objects, technologies and spaces. At the same time this involves how such theoretical concepts can be applied in the practice of sociotechnical innovations in order to promote successful ageing. MATERIAL AND METHODS: Based on various empirical research studies, the article exemplifies a material gerontological perspective. RESULTS AND DISCUSSION: It is shown how an expansion of gerontology towards more than human worlds of age(ing) can be conceived. The focus is on (1) a decentralization of age(ing) towards "age assemblages", (2) a broadening of the individual human to a distributed more than human agency and, as a result, (3) a shift in the boundaries of research phenomena in gerontology. The article closes with reflections on what the developed concept of age assemblages means for gerontological research and practice.

Toward Responsible Artificial Intelligence in Long-Term Care: A Scoping Review on Practical Approaches.

BACKGROUND AND OBJECTIVES: Artificial intelligence (AI) is widely positioned to become a key element of intelligent technologies used in the long-term care (LTC) for older adults. The increasing relevance and adoption of AI has encouraged debate over the societal and ethical implications of introducing and scaling AI. This scoping review investigates how the design and implementation of AI technologies in LTC is addressed responsibly: so-called responsible innovation (RI). RESEARCH DESIGN AND METHODS: We conducted a systematic literature search in 5 electronic databases using concepts related to LTC, AI, and RI. We then performed a descriptive and thematic analysis to map the key concepts, types of evidence, and gaps in the literature. RESULTS: After reviewing 3,339 papers, 25 papers were identified that met our inclusion criteria. From this literature, we extracted 3 overarching themes: user-oriented AI innovation; framing AI as a solution to RI issues; and context-sensitivity. Our results provide an overview of measures taken and recommendations provided to address responsible AI innovation in LTC. DISCUSSION AND IMPLICATIONS: The review underlines the importance of the context of use when addressing responsible AI innovation in LTC. However, limited empirical evidence actually details how responsible AI innovation is addressed in context. Therefore, we recommend expanding empirical studies on RI at the level of specific AI technologies and their local contexts of use. Also, we call for more specific frameworks for responsible AI innovation in LTC to flexibly guide researchers and innovators. Future frameworks should clearly distinguish between RI processes and outcomes.

From Mattering to Mattering More: 'Goods' and 'Bads' in Ageing and Innovation Policy Discourses.

This paper provides an empirical ethics analysis of the goods and bads enacted in EU ageing and innovation policy discourses. It revolves around a case study of the persona Maria, developed as part of the EU's Active and Healthy Ageing Policies. Drawing on Pols' empirical ethics as a theoretical and methodological approach, we describe the variety of goods (practices/situations to be strived for) and bads (practices/situations to be avoided) that are articulated in Maria's persona. We analyse how certain ideas about good and bad ageing-those associated with the use of sophisticated technologies-come to matter more in the solutions proposed for Maria and the framing of her unmet needs, while others which were initially seen as relevant and that describe her dreams, fears and interactions, are marginalised. The paper adds to existing studies of ageing and technology by analysing specific practices that render visible how the idea of technology and data sharing as evidently the right path towards futures of (good) ageing, comes to prevail.

Innovation Pathways for Age-Friendly Homes in Europe.

A variety of innovative pilot projects are being implemented to improve the life-course resilience of existing and newly built home environments. We refer to these projects as "socio-technical experiments" that embody different kinds of promising futures and provide direction to current developments in the emerging domain of age-friendly homes. To take stock of this diversity within Europe; this paper provides an overview of 53 ongoing socio-technical experiments that are being conducted in the Netherlands, France, Ireland and Poland. We find that, besides the variation between European countries, there is a more important type variation in terms of the character of the experiments themselves and the differences in development direction that they propose. Our findings suggest that most of the innovations tested in these experiments are not primarily material or technical but primarily social or conceptual in character (i.e., new organizational modes or everyday practices that re-arrange social relations or new housing concepts that bridge the divide between ageing in place individually and a nursing home). This variety of innovations tested in the experiments can be categorized into seven distinct innovation pathways: (1) Showcasing Technology, (2) Innovation Ecosystem, (3) Sheltered Elite, (4) Specific Community, (5) Conscious Retrofitting, (6) Home Sharing and (7) Retrovation Challenge.

Of robots and humans: Creating user representations in practice.

In this study, we explore the constitution of user representations of robots in design practice. Using the results of ethnographic research in two robot laboratories, we show how user representations emerge in and are entangled with design activities. Our study speaks to the growing popularity of and investment in robotics, robots and other forms of artificial intelligence. Scholars in Science and Technology Studies (STS) have shown that it is often difficult for designers and engineers to develop accurate ideas about potential users of such technologies. However, the social context of robots and design settings themselves have received significantly less attention. Based on our laboratory ethnographies, we argue that the practices in which engineers are engaged are important as they can shape the kind of user images designers create. To capture these dynamics, we propose two new concepts: 'image-evoking activities' as well as 'user image landscape'. Our findings provide pertinent input for researchers, designers and policy-makers, as they raise questions with regards to contemporary fears of robots replacing humans, for the effectiveness of user involvement and participatory design, and for user studies in STS. If design activities co-constitute the user images that engineers develop, a greater awareness is needed specifically of the locales in which the design of robots and other types of technologies takes place.

DIY gerontechnology: circumventing mismatched technologies and bureaucratic procedure by creating care technologies of one's own.

This study analyses 'Do-It-Yourself' (DIY) gerontechnologies and shows that they can be viable and valuable alternatives to 'ready-made' gerontechnologies. Using the concept of innosumption, we analyze the work of care workers in gerontechnology showrooms in Norway. We show how and why care workers will sometimes advice older adults to assemble DIY-gerontechnologies. Such DIY-gerontechnologies are not high-tech solutions made by technology producers, but creative solutions that older adults' suit to their specific needs and assemble for themselves from mundane objects that are available in shops. So far, analyses of the design, implementation and use of gerontechnologies have almost exclusively focused on professionally designed and produced 'ready-made' gerontechnologies. But for various reasons, ready-made gerontechnologies often do not fit in well with the lives of older people. In such cases, care workers guide older people to the innosumption of DIY-gerontechnologies that offer workable solutions that are useful, quickly implemented, easily understandable and often cheap. We show that and how the existence of DIY-gerontechnologies questions the reasons behind the strong and widely accepted assumption that only high-tech innovations are a proper solution to the needs of older people.

The Importance of User Involvement: A Systematic Review of Involving Older Users in Technology Design.

BACKGROUND AND OBJECTIVES: There is a lack of understanding of how older adults' involvement and participation matters in actual design practice. This systematic literature review investigates existing empirical studies involving older users during the design of technologies and explores the nature and consequences of involving older people. RESEARCH DESIGN AND METHODS: Our literature review is informed by the guidelines of the PRISMA statement. We examined the included studies by means of thematic content analysis to identify the nature of older users' involvement and existing evidence on what consequences it has. RESULTS: In total, 40 empirical studies published in the period 2014-2018 are included in the review. Most empirical studies involve older people from local networks, with underlying stereotypical images and at lower levels of participation. The results reveal three main consequences of involving older users: learning, adjusted design, and an increased sense of participation. Furthermore, we found that user involvement is a structured process whose outcomes are contingent on a range of premises. DISCUSSION AND IMPLICATIONS: Synthesizing the results, we develop the concept of user involvement and present an analytical framework. Our results have implications for researchers and policy makers, since they throw into question the widely held assumption that involving older people inevitably yields beneficial outcomes.

The Co-Constitution of Health Systems and Innovation Comment on "What Health System Challenges Should Responsible Innovation in Health Address? Insights From an International Scoping Review".

Lehoux et al provide a timely and relevant turn on the broad and ongoing discussion around the introduction of health technology and innovation. More specifically, the authors suggest a demand-driven approach to health innovation that starts from identifying challenges and demands at the health system level. In this commentary, I review a number of underlying implications of their study in relation to positions of technology push and techno-optimism, and to the narrow focus on health technology assessment on economic and clinical values. While Lehoux et al's scoping review provides very relevant insights with the potential to drive further empirical research, it is less clear about its conceptual basis. In particular, the somewhat artificial distinction between health innovations and health systems is worth further scrutiny. I discuss some potential risks of this separation, and propose to more openly address the co-constitution of health, health systems and technology in future research along the lines suggested by Lehoux et al.

From Intervention to Co-constitution: New Directions in Theorizing about Aging and Technology.

We propose directions for future research on aging and technology to address fundamental changes in the experience of later life that come with the "digitization" of societies. Our argument is contextualized by the massive investments of policy makers and companies in gerontechnologies and their failure to create scale and impact. Partly this failure is due to an interventionist logic that positions new technologies as interventions or solutions to the problems of aging. What has been overlooked - at least theoretically - is how aging is already co-constituted by gerontechnology design, the socio-material practices it enacts, and the policy discourse around them. Goals are (a) reviewing elements of the current aging and technology agenda, (b) demonstrating how the interventionist logic has hampered theory development (and practical impact), (c) pulling together key insights from the emerging body of empirical literature at the intersection of social gerontology and Science and Technology Studies (STS), with the objective of (d) providing directions for future research on aging and technology. Our argument presents the theoretical gains that can be made by combining insights from STS and social gerontology to research the co-constitution of aging and technology.

Challenging Incommensurability: What We Can Learn from Ludwik Fleck for the Analysis of Configurational Innovation.

This paper argues that Ludwik Fleck's concepts of thought collectives and proto-ideas are surprisingly topical to tackle some conceptual challenges in analyzing contemporary innovation. The objective of this paper is twofold: First, it strives to establish Ludwik Fleck as an important classic on the map of innovation analysis. A systematic comparison with Thomas Kuhn's work on paradigms, a concept highly influential in various branches of innovation studies, suggests a number of pronounced yet under-researched advantages of a Fleckian perspective in the context of technological change and innovation. Secondly, the paper links these advantages to some recent changes in the organization of innovation. Due to the rising pervasiveness of Information and Communication Technologies (ICTs), configurational innovation has become commonplace that cuts across the boundaries of established trajectories of knowledge generation. Fleck's graded understanding of the closedness of thought collectives and his weak notion of incommensurability provide powerful metaphors to grasp the peculiarities of configurational innovation.