× Healthcare Strategic Design

Everyone deserves a second

A caregiver-first platform for people coordinating dementia care, often without training, shared information or support.

0M
people worldwideliving with dementia, per WHO estimates
0M
Americansproviding unpaid dementia care, alz.org 2025
0B
hours a yearof that care given unpaid, alz.org 2025
0%
of family caregiversrate their emotional stress as high or very high
Role
Product Designer
Team
Surbhi Lahoti · Shriya Agarwal · Aditya Kharial · Shrishti Sahani
Duration
16 weeks
Programme
M.S. Strategic Design & Management
The problem

Caregivers hold the system together, yet remain outside its design.

Family caregivers coordinate routines, appointments, behavioural changes and emotional support, often without formal training or a shared source of information. They are expected to understand the condition while already managing its effects.

That pressure intensifies during sundowning, when confusion and agitation can increase as daylight fades, often when the caregiver's own capacity is lowest.

  • Sundowning, roughly 4 to 7pm

Second - Introduction

Beyond memory loss

Dementia affects communication, behaviour and relationships, not memory alone.

Continuous responsibility

Care extends across interrupted nights, shifting routines and daily decisions, without a formal handover.

The overlooked decision-maker

Most tools centre the patient, although caregivers decide what enters and remains in the care routine.

The product

Three strategic decisions shaped the product.

Each research finding shaped the product strategy and the features that followed.

Strategy 01

Design for the primary coordinator

Caregivers manage daily routines and determine which tools are practical to use.

So we builtOnboarding that begins with the caregiver's context.
Strategy 02

Personalise beyond the diagnosis

Needs vary by individual, environment and stage of care, making a standard care plan insufficient.

So we builtSeca, an assistant that learns routines and preferences.
Strategy 03

Integrate support into existing routines

Caregivers need guidance that can be accessed without stepping away from the care situation.

So we builtVoice interaction and short, contextual lessons.
Second: an AI powered intervention for caregivers of dementia, developed with Microsoft
Take a second
01 · Context

The research shifted our focus from the condition to the caregiving system.

The initial brief explored neurodivergence broadly before narrowing to acquired neurodivergence and dementia. Research then revealed a more consequential gap: family caregivers were coordinating much of the care but were rarely treated as the primary users of dementia support products.

Where we started
Started hereNeurodivergent individuals
NarrowedAcquired neurodivergent individuals
NarrowedIndividuals with dementia
Landed hereCaregivers

“A caregiver wakes up with a whole list and an agenda for their person. That's like having an agenda for a pinball and a pinball machine.”

Paula · Care Partner
What we assumed going in

Four assumptions shaped the initial brief. Research challenged each one and shifted the focus from the individual diagnosis to the wider caregiving system.

01
Dementia is a natural part of ageing.
What we found

Dementia is a progressive condition with changing care needs, much of which is managed at home by family members.

02
People with dementia behave in the same way.
What we found

Symptoms, routines and care needs vary significantly by person and change over time. Personalisation became a requirement.

03
The person with dementia is the source of the care difficulty.
What we found

Many difficulties emerge from changing relationships, limited support and the challenge of interpreting unfamiliar behaviour.

04
People with dementia choose to withdraw socially.
What we found

Isolation is often created by inaccessible environments, stigma and disrupted routines, and it affects caregivers as well.

What care partners told us

Across four households, caregiving responsibility was distributed informally, and the person carrying most of it was not always recognised as the primary caregiver.

First help should be given to the caregiver rather than the patient.

Kavita · Daughter, 50

Dementia affects everyone even if only one person has it.

Saniya · Granddaughter, 27
02 · Methods

Research across the care system

We combined secondary research, netnography and conversations across the care system to understand how responsibility was distributed, where coordination broke down and what support caregivers would realistically use.

The three methods
Literature reviewCare trajectories and the scale of unpaid care
NetnographyCaregiver forums and support communities
Field researchInterviews and contextual observation
Four learning goals
Daily care routinesHow responsibility is organised
Breakdowns in careWhere coordination becomes difficult
Emotional pressuresWhat remains unsupported
Technology adoptionWhat caregivers would realistically use
Ten conversations
Organizations3
Experts3
Care partners4
Remote interview with Mary Mittleman of NYU School of Medicine and the team Remote interview with Michael Tranquilli, occupational therapist at NYU Steinhardt
Expert interviews ran remotely: Mary Mittleman above, Michael Tranquilli below.
Organizations3
  • Joon HerAlzheimer's Association
  • Leah DalyAlzheimer's Foundation of America
  • Melpo VoulierisSocial Worker, AFA
Experts3
  • Michael TranquilliOccupational Therapist, NYU Steinhardt
  • Mary MittlemanNYU School of Medicine
  • Paula LevyNever Alone Consulting
Care partners4
  • KavitaDaughter, 50
  • SparshGranddaughter, 23
  • RituGranddaughter, 25
  • SaniyaGranddaughter, 27

“Is the system designed to help the individual, or is the system designed to help the system?”

Michael Tranquilli · Occupational Therapist, NYU Steinhardt
03 · Synthesis

The caregiver was the missing centre of the system.

Three findings remained consistent across interviews, expert input and secondary research.

01

Care must reflect the individual

Needs vary by person, routine and stage of care, making generic schedules and guidance insufficient.

02

Care information is fragmented

Appointments, observations and decisions are distributed across people and channels, leaving caregivers to reconstruct the full picture.

03

Caregivers determine adoption

Caregivers decide whether a tool fits the routine and continues to be used, making them the primary adoption decision-makers.

04 · Opportunity areas

Three opportunities emerged from the research.

1 Practical education for caregivers 2 Personalised care for the individual 3 Time and capacity for caregivers

Together, these opportunities defined a caregiver-centred product that combines personalised guidance, practical learning and support that fits within daily routines.

Our design principles

Balanced

Support care responsibilities without reducing the relationship to tasks and symptoms.

Adaptive

Respond to changing needs, routines and caregiver capacity, not diagnosis stage alone.

Simple

Keep information clear and usable during stressful, interrupted moments.

05 · Co-ideation

Care partners shaped our product.

Rather than designing for care partners and validating afterwards, we built the concept with them in the room.

5participants
4co-ideation workshops
3opportunity areas
2prototype testing workshops
1solution
An in-person co-ideation session around a table at Parsons, with a care expert and the design team
Mapping daily care routines during an in-person workshop at Parsons.
A remote co-ideation session on Miro with Paula Levy and the team
Organising intervention ideas through the What, How and Where framework.
A remote co-ideation session on Miro with care partners Kavita and Sparsh and the team
Care partners prioritising concepts during the idea-generation workshop.
The process, in the room

Second · Co-ideation process

06 · Solution

One platform, four connected forms of support.

The workshops converged on a system combining care coordination, contextual guidance, peer support and learning. Together, the four features create a connected support system: onboarding establishes the care context, Seca provides contextual guidance, the Learning Module builds caregiver confidence, and Second Community extends support through shared experience.

The logo

The logo is constructed from twelve clock segments, with the evening hours shifting to peach to reference the period when sundowning commonly intensifies. The visual language was designed to feel supportive without resembling a clinical interface.

The animated logo introduces the visual language of Second.
Four connected features across the care journey

Onboarding

Captures the caregiver's context, the individual's routines and the wider care network before establishing a shared care profile.

Seca: AI Smart

A voice-first assistant that uses recorded care history, routines and preferences to provide contextual guidance.

Second Community

Connects caregivers through shared circumstances and responsibilities, with group and one-to-one support.

Learning Module

Provides short lessons linked to recent care activity, making guidance relevant to the situation at hand.

Learning Module library screen with progress and recommended lessons
07 · Testing and iteration

Two rounds of testing changed both priority and scope.

Concept testing determined what to build. Wireframe testing revealed what was missing. Eight unique participants took part across the two rounds.

Round 01 · Concept testing
5 participants

Which concept offered the most immediate value?

What we tested
Concepts generated through co-ideation, reviewed with the same participant group.
What we heard
Participants prioritised immediate practical value over breadth or novelty.

So we changedWe narrowed the product around the highest-priority concept and used it to structure the wireframe flow.

Round 02 · Wireframe testing
3 participants

The flow exposed two missing requirements.

What we tested
The prioritised flow, evaluated from onboarding through everyday use.
What we heard
Caregivers needed preferred-language interaction and guidance specific to the person, not only the condition.

So we addedMultilingual voice interaction, an adaptive Learning Module and a physical handbook for guidance beyond the screen.

Both requirements carried into the final concept. The Learning Module became a core feature, while the handbook extended the service beyond the screen.

What round one prioritised
The full ideation board after prioritisation, with numbered stars marking the ideas that carried through, grouped under the three opportunity areas
Participant prioritisation after round one determined the build sequence.
What round two tested
Wireframe: Seca suggesting a study session, with go to library and schedule later actions Wireframe: basic information onboarding, capturing name, age and relationship to the care recipient Wireframe: a community page with about, feed and sessions tabs
08 · Impact and measurement

What the prototype established, and what it could not.

4features in the final prototype
10research conversations
4co-ideation workshops
8testing participants
What research and testing indicated
  • Participants prioritised immediate, practical support over broader concepts.
  • Preferred-language interaction emerged as an important adoption consideration.
  • Participants expected guidance to reflect the individual, not only the diagnosis.
  • Caregivers emerged as the primary decision-makers in whether a tool entered the care routine.
Not yet measured
  • Whether continued use reduces caregiver stress or burnout.
  • Whether Seca's recommendations remain accurate and useful over time.
  • Whether families continue using the shared care network beyond initial adoption.
Future scope

What the next phase would require

Sustained engagement. Evaluate how Second can support repeated use without becoming another administrative responsibility.
Clinical assurance. Work with dementia-care experts to define accuracy, safety and escalation boundaries for Seca.
Institutional partnerships. Partner with hospitals and caregiver organisations to validate content and reach families earlier in the care journey.
09 · Reflection

What did I learn

  • Sensitive recruitment requires trust. Careful outreach and clear boundaries made meaningful conversations possible.
  • Facilitation shapes the outcome. Leading the workshops helped turn lived experience into shared product priorities.
  • Reframing was the critical design decision. The project shifted from treating dementia as an individual condition to understanding caregiving as a distributed system.
  • Clinical boundaries should have been defined earlier. Introducing an AI assistant raised questions around recommendation accuracy, escalation and caregiver reliance that required clinical expertise from the outset.
Second logo mark

At Second, care partners come first

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