Design × Health

Designer Sha Yao: People with dementia need to feel empowered too, and design can be of great help

Good design is more powerful than you think. The designer of a special tableware product explains how a simple idea can change the daily routine of disabled people.

Inspired by her grandmother who suffered from dementia, Sha Yao from Silicon Valley’s Sha Design was intrigued by the idea of making the lives of people with cognitive disabilities easier. After years of research, months of volunteer work at adult daycare centres and hundreds of prototypes, she created a wonderful way of helping the disabled and their caretakers – with assistive tableware Eatwell. Because everyone, no matter their health condition, needs to feel empowered.

As a designer, it is natural for you to think in terms of design when solving problems. But when it comes to Eatwell, there is a deep personal story behind it. What was the point in your life, especially concerning your grandmother, that you decided to combine your job and your personal experience?

I was really close with my grandmother, she took care of me and my sister when we were children, as both my parents had to work. She passed away a couple of years ago and I still miss her very much. When she was diagnosed with dementia, it was very frustrating for me. I saw her gradually become unable to take care of herself, but there wasn’t much I could do to help. And I really wanted to. Not only to her but also to her caregivers, who were my mum and my uncle. That is how it all began. 

As you’ve mentioned, I am a designer – an industrial designer. So I know how to develop products from idea to the market. Back then, I was still in training: I was in graduate school specialising in industrial design. For my thesis project, I could choose any topic I wanted to work on and fully develop it, and I came up with the idea for Eatwell. 

People with dementia face many specific problems. Why did you decide to solve eating difficulties?

Yes, people with dementia need all kinds of help during the day. They may wander off on the street, they may lose their ability to do daily tasks. But eating is something so seemingly ordinary, and people need to eat every day at least a couple of times. 

I read many papers and talked to numerous caregivers, and the feedback they all gave me was that there are many things you can work on, but eating is definitely one of the most basic and fundamental things they will need more help with. If a person doesn’t eat well, it impacts their overall health condition as well. So, for the caregivers, once a person with dementia, like my grandmother, is not able to eat by themselves and needs the help of an assistant, it costs much more time and energy for the caregivers. 

“We have many cases in which Eatwell has helped people with Alzheimer’s and other kinds of dementia, it’s helped people after injuries or strokes, and people who are almost blind.”

You’ve mentioned that you consulted many caregivers. Some of them were your family members, but some were professionals. How did you find a way to get the information you needed?

My mum and my uncle were not professional caregivers, but they definitely spent a lot of time with my grandma. I also reached out to professionals who take good care, really, really good care of people similar to my grandmother – those who have difficulties, challenges, in daily living. 

While I developed the project, I volunteered in adult daycare centres for almost a year. It was actually quite hard for me to talk to the caregivers directly, because they are busy at work, which is why I chose to volunteer. And it was a good decision, because being there, I could do one-on-one observations. I could talk to them and help them in their jobs and I also got a closer look at the daily lives of other people with dementia.

So you saw the problems with food intake firsthand.

Yes. That is a very essential thing to do. To observe, and also to directly work with these people. Then it is not only about reading and research, but about personal experience. 

We talk primarily about people with dementia, but who else could benefit from this tableware?

After the product had hit the market, we started to receive a lot of feedback from caregivers, and not only people who suffer from cognitive impairment, but also people with motor impairments or low vision problems, also benefit from it. 

So we have many cases in which Eatwell has helped people with Alzheimer’s and other kinds of dementia, it’s helped people after injuries or strokes, and people who are almost blind – the special shapes and colour contrasts help them eat independently.

When it comes to your product, design is not only nice to have, but is actually the only way that the product can serve its use. What process led to the final design of the product?

The design itself isn’t a problem for a designer; the difficult part was to understand the challenges for people during mealtime. So, for a full process of eating, you need to break it down to a few small steps. 

For example, you may find out that picking the right utensil to use can be a big challenge. Or maybe the designs on a plate can sometimes look like food. Hand-eye coordination might be a problem, meaning patients are unable to finish the food, unable to scoop up the leftovers in a bowl for example. 

So, I thought that maybe it would be a good idea to design a bowl in a way that food would gather on one side so it will be easy to scoop up. Some spoons have sharper ends and the curvature of the bowl is more rounded, and again, it’s difficult to get to the food. I saw my grandma try to scoop the food, but she just couldn’t get it and she tried so hard. Every motion took her about one and a half minutes. And sometimes she would manage it, but then the food would fall off so when she put the spoon to her mouth, it was empty. That is very difficult to watch. So really, I have listened, and I have observed, and I wrote these problems down one by one.

“The report [of Boston University] says that putting food in a solid colour dish like red or blue can increase food consumption by 24% and liquid intake by 84%.”

And all these observations led to the ideas about colours and shapes?

Yes. I started with the colours. Those are the results of the research I came across from Boston University. It states that most people with dementia have visual impairment. So the colours are very important to them. 

Let’s take oatmeal. Oatmeal is a beige colour, almost white. So if you put oatmeal on a white plate, or a white bowl, they’re not able to see it. Or they can’t see it clearly. That’s why the colour is so important. The report says that putting food in a solid colour dish like red or blue can increase food consumption by 24% and liquid intake by 84%. Quite shocking numbers. 

There are about 20 more features I added to the design like this one. And about the shapes, well that was primarily the result of observation and testing. 

Apart from the Boston University study, did you use or conduct any other research?

We mostly experimented. After the observations and interviews with caregivers I came up with the sketch. I created more than ten models at a time and would bring them to the daycare centres and experiment. Again and again. It was a back and forth process. 

Did you have support from a team during the whole process or did you work alone?

I wouldn’t be able to do everything by myself. I had a team of people from different fields that have helped me. From marketers, planners and sales people to manufacturers. 

“Eatwell is not only about food. It is about empowering people to do things by themselves. It’s a very simple concept.”

And how long did the development take?

From the ideation to the design, it took about three years. I spent half a year preparing for fundraising, because back at that time, I didn’t have many resources. And I decided to run a crowdfunding campaign that raised over $100,000 to run the production. 

Then, I spent another six to eight months in production. I also flew overseas to stay in factories, and to work with the manufacturers. And it has been on market for about four years now. 

So, it has been roughly six years that you have been working with caregivers and people with mental, cognitive or motor impairment. We may be talking about the food intake, but from your point of view, what does helping these patients really mean?

I think people need to feel independent. Eatwell is not only about food – it is about empowering people to do things by themselves. It’s a very simple concept. For example, as you get older, you wouldn’t want somebody else to have to help you in daily life; you would want to do it by yourself. You want to stay in your own home, and you want to do everything by yourself. And that’s the goal for most people; they want to age in peace. To be as normal as possible, as independent as possible. 

Professional cleaning for everybody.

CURAPROX Hydrosonic Easy is a significant help for people who have difficulty with fine motor skills.

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What is the next step for you? Do you want to use your designing skills for healthcare again?

Our ultimate goal is to develop something like the whole package for dementia care, including furniture for example. But that will be a much bigger project.

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