The Importance of Social Relations for Well-Being Change in Old Age – Do Game Preferences Change As Well? Maximilian Altmeyer Pascal Lessel DFKI GmbH DFKI GmbH Saarland Informatics Campus Saarland Informatics Campus maximilian.altmeyer@dfki.de pascal.lessel@dfki.de ABSTRACT Gamified systems may help older adults to remain physically, cognitively and socially active, which has positive effects on well-being. However, social aspects of psychological well- being change during life course, i.e., the importance of positive social relationships for well-being increases between young or middle aged persons and seniors. In this paper, we explore whether these changes are reflected in the game preferences of seniors aged 75 and older. We report findings of a semi- structured interview and a preliminary player classification survey (N=18, mean age=84.61). We found indications that there are differences in game preferences and the perception of game elements that are related to the increased importance of social relationships for well-being in older ages. ACM Classification Keywords H.5.m. Information Interfaces and Presentation (e.g. HCI): Miscellaneous Author Keywords Older adults; gamification; game elements; interviews Figure 1. Gamification User Types Hexad by Andrzej Marczewski [8] INTRODUCTION Ryff [14] proposes self-acceptance, positive relations with to contribute. Even though there are gamified systems target- others, autonomy, environmental mastery, purpose in life and ing seniors (e.g. [10]), most of those systems do not account personal growth as essential features of psychological well- for age-related changes [5] and are designed for a young au- being. It was shown that the perceived importance of these dience [17]. However, there seems to be huge potential in features differs in old age [12, 14, 15]. One interesting finding designing gamified systems supporting seniors: Besides the is that positive relations with others are found to be signifi- fact that playing digital games was shown to be associated cantly more important for well-being of seniors [14,15]. Since with successful aging [9], gamified systems may help older social game elements like competition or collaboration are adults to remain physically, cognitively and socially active [2], widely used in the domain of gamification [17], where game which has positive effects on health and well-being [7]. elements are used in non-game contexts [1], we aim to inves- In this paper, we report preliminary findings from a study with tigate in how far the perception of game elements or game the goal to find differences in the perception of game prefer- preferences changes in older ages. ences between a younger sample and seniors by comparing Investigating these game preferences is an important step to- the player type distribution of these samples. We moreover wards implementing gamified interventions supporting pos- report findings from semi-structured interviews with seniors, itive psychological outcomes for seniors, to which we want in which we wanted to learn more about their game experi- ences, what affects them positively when playing and whether there are changes in these aspects throughout the life-span. Our findings suggest that the increased importance of positive social relationships is reflected in seniors’ game preferences. We first provide background information about Marczewski’s Gamification User Types Hexad Model [8]. Afterwards, we Positive Gaming: Workshop on Gamification and Games for Wellbeing present related work and provide information about the study A CHI PLAY ’17 Workshop October 15, 2017, The Netherlands design. Finally, we report and discuss results of our user study. ©2017 Copyright held by the authors/owners. HEXAD MODEL RELATED WORK To assess participant’s player type, we used Marczewski’s Isselsteijn et al. [3] point out several opportunities and benefits Gamification User Types Hexad Model [8], consisting of of designing digital games suited for seniors and outline that six player types that differ in the degree to which they are there is a great need for research targeting the motivations driven by intrinsic or extrinsic factors (as defined by the Self- of them. This is supported by [2] pointing out chances and Determination Theory [13]). Figure 1 illustrates the model and considerations when using gamification for elderly people. which underlying motivational factors are relevant for each The authors emphasize the positive impact of gamified systems user type. Below, we explain these user types based on [8, 19] encouraging physical activity, social relatedness or supporting shortly and exemplary list an incomplete set of relevant game cognitive functioning on well-being of older adults. elements based on findings from Tondello et al. [19]. Exploring the exercise motivations of older adults was the goal Philanthropists of Kappen et al. [4]. As a result of their findings, the authors Philanthropists are socially-minded players, who like to bear gleaned several design strategies for creating meaningful and responsibility, take care of and share knowledge with others. playful applications supporting physical activity. They empha- They are altruistic and strive for goals having deeper meaning. size the need to consider the life stage without exploiting fears, The most important motivational factor is purpose. to explore ways to provide meaningful feedback to the users as well as to support socialization around physical activity. Game elements: Collecting and Trading, Gifting, Knowledge Sharing, Administrative Roles De Schutter [16] reports findings from an online study in which playing motives of elderly players were investigated. Socializers Results indicate that a majority of them are solitary players Like Philanthropists, Socializers are socially-minded. How- who like to play casual games. Concerning playing motives, ever, they are much more interested in interacting with others, results revealed relatively low scores for nearly all motives i.e. they like to create relationships and compete or cooperate. that were considered. The most popular motive was challenge The most important motivational factor is relatedness. and the most important predictor for the time players invest in playing games was shown to be social interaction. Game elements: Guilds or Teams, Social Networks, Social Comparison, Social Competition, Social Discovery These findings underline that social relationships are partic- ularly important in old age. In this paper, we aim to learn Achievers more about whether this effect is transferable to the gaming Achievers are satisfied when perceiving progress towards context by investigating senior’s attitudes towards social game clearly communicated goals. They also like to prove them- elements such as competition and collaboration. selves by completing challenges and diving into complex tasks. Nap et al. [11] found that staying in touch with society and The most important motivational factor is competence. escapism are motivators for seniors to play. There also was a Game elements: Challenges, Certificates, Quests, Badges, strong indication that participants prefer solitary over multi- Progression, Learning, Anonymity player play, even though they appreciate socialization in gen- eral. As potential reasons, the authors mention the increased Free Spirits fear of failure seniors have as well as the unwillingness to be Free Spirits are satisfied when they are able to express them- dependent on other players and their availability. The fact that selves and have the opportunity to act without external control. participants value socialization relates well to the increased They seek for new, unconventional ways that can be explored. importance of positive social relationships for well-being in The most important motivational factor is autonomy. old age [15]. Since participants disliked multiplayer games, it seems like this change is not transferable to the gaming do- Game elements: Exploratory Tasks, Nonlinear Gameplay, main at first glance. However, it might also be the case that the Easter Eggs, Unlockable Content, Learning fear of failure, which was reported by the authors as a poten- Players tial reason, only affects competitive games. Potentially, older Players are more out for their own benefits. They are driven people are more inclined to collaboration than competition. by the will to win and will do their best (independent of the Analyzing this is part of our investigation. type of the activity) to earn rewards. The most important STUDY motivational factor is getting rewards. The goal of the study was to explore how gamified systems Game elements: Points, Prizes, Leaderboards, Badges need to be designed to engage elderly people and to find po- tential differences between seniors and a younger audience Disruptors that come from changes of relevant well-being aspects. To do This player type is driven by compromising or disrupting sys- so, we investigate the following research questions: tems. Disruptors aim to trigger changes (positive or negative) and test the boundaries of a system. The most important moti- • RQ1: What are underlying factors that motivate older adults vational factor is triggering change. to play games? Game elements: Innovation Platforms, Voting Mechanisms, • RQ2: Are game preferences of seniors related to the in- Development Tools, Creativity Tools creased importance of positive social relations? Procedure and Method was not wasted”1 (P3). Even those that do not play parlor We recruited participants from three nursing homes and partic- games regularly stated that this is mostly because they do not ipants that are living on their own. To ensure that they do not have people to play with: “When my children were younger suffer from severe mental diseases and are able to communi- we used to have a whole cupboard full of games and played cate without problems, we consulted the nursing management really a lot. Today I don’t have people to play with. [...] I (having access to disease-specific diagnosis of all residents), would definitely like to play more games again” (P16). that recommended participants. All participants agreed on The questions about reasons for playing revealed a clear pic- taking part in this study voluntarily. The study started with ture: The main reason (mentioned by all participants), is main- a short questionnaire covering demographical data and gam- taining social contacts or socializing with others (“I often play ing frequency (both for analog as well as digital games) with card games together with my roommate [...]. Most of the times statements to be answered on 5-point Likert scales. A semi- we play to spend time together and talk about our everyday structured interview followed to learn more about their gaming life” (P3)). They also reported seeing games as a starter for experience, their motivation for playing games and potential conversations and that playing games provides an opportunity age-related changes in these aspects. The semi-structured in- to meet new people (“The Bingo evenings here helped me to terviews were directly transcribed and were conducted in face- get in touch with other seniors living here” (P2)). We further- to-face conversations alone with the participants in separate more found evidence that elderly people have fun watching rooms (in the nursing homes) or in participants’ apartments others play and use the occasion to get in touch with them (for those living on their own). (reported by 5 participants): “Sometimes I just sit there and After the interview, we determined the player type of partic- watch others playing. It is fun to see their reactions and it ipants using Marczewski’s Hexad model [8] to get further offers me the opportunity to talk to them” (P9). insights about motivating factors for this age group and to learn more about suitable game elements. To do so, we used Social Aspects in Games (cf. RQ2) the German Hexad questionnaire of Korbas [6]. We addi- A vast majority of participants (16) reported not to be driven by tionally classified a much younger sample using the same winning the game in first place but instead enjoy spending time questionnaire. This was done to investigate whether there are with others: “It is not about winning at all, it’s about spending age-related changes in game preferences. The survey consists time together” (P3). While for 6 participants winning does not of 24 statements that are divided into four blocks consisting matter at all, 10 participants stated that they also like to win, of six elements, each representing one player type. We gave but that is not most important: “The main reason [to play] the printed statements in four blocks one after another to the for me is to avoid being alone and enjoy time with others. participants to not overwhelm them (following the recommen- However, winning a game is also nice sometimes” (P10). We dations from Smeddinck et al. [18]). also found that elderly people prefer collaborating in teams The study took approximately one hour per participant and instead of playing on their own: “We sometimes do teamwork was approved by the Ethical Review Board of the Faculty of when playing Skip-Bo. [...] Winning as a team makes me much Mathematics and Computer Science at Saarland University. happier than winning on my own” (P6). Since Skip-Bo is a During the study, drinks and snacks were provided to the competitive game in which players normally play against each participants and breaks could be taken at any time. other, this statement underlines the strive for collaboration even more. In addition, the aspect of taking care of others was mentioned by almost all participants (17). They indicated Results to have a better experience when all players are satisfied: “It In total, 18 German participants took part in the study (10 is not too much about winning, it is more about ensuring female, 8 male – 13 living in nursing homes and 5 living on everybody has a good time” (P9). their own) aged 84.61 years on average (Mdn=86, Min=75, 15 participants reported that they were more inclined to com- Max=93). Participants reported not to be familiar with tech- petition at younger ages: “When I was young I was a swimmer nology (M=1.5, SD=1.01, Mdn=1). However, they agreed and very ambitious [...]. Today I don’t want to compete against to being interested in accumulating more experience with others, those times are over” (P5). In addition, there is less technology (M=3.83, SD=1.12, Mdn=4). In addition, partic- pressure to win a game and a more relaxed atmosphere during ipants reported playing parlor games multiple times a week play: “I think what has changed is that we don’t take things (M=3.72, SD=0.80, Mdn=4) but never play video games too seriously when playing” (P4). A majority (14) of partici- (M=1.39, SD=0.83, Mdn=1). One notable outlier is P15, who pants stated that they value social contacts and communication reported being experienced with digital technology and is used with others much more than in their younger years: “You get to playing digital games. more relaxed with increasing age and value different things. I cherish social contacts or getting in touch with others much Game Preferences and Reasons to Play (cf. RQ1) more today” (P9), “Once you are old and live alone you real- In the interview, participants reported to enjoy playing card ize that having people around you is the most valuable thing games like Rummy or Skip-Bo, followed by the lottery game you can have” (P18). Bingo and board games like Ludo, Merels or Checkers. They emphasized to enjoy and value the time spent playing: “After playing games, I have the feeling of accomplishment, that time 1 All statements were translated from German to English Figure 2. Distribution of primary player type classifications in different populations. a) Player type distribution among elderly people (N=18). b) Player type distribution in the younger age group (N=31). c) Player type distribution reported by Korbas [6] (N=121) Player Types (cf. RQ1, RQ2) We moreover found indications that the importance of games Considering the player types of seniors, the large majority as catalyzer for social relationships increases in older ages and of them (83.3%) were classified as philanthropists, equally that winning the game is not as important as it is in younger followed by socializer (5.6%), player (5.6%), achiever (5.6%) ages. These changes are very transferable to the changes of and no participants being classified as free spirits (see Fig- well-being aspects that were reported. The increased impor- ure 2a). To investigate age-related changes in game prefer- tance of positive relationships relates well to the importance of ences, we compared this distribution to a much younger sam- games to build social relationships, to the aspect of care-taking ple consisting of 31 participants that were recruited from our and to the strive to ensure all players feel well. The changes are university (20 male, 11 female) having a mean age of 25.61 also reflected in the distribution of player types in our sample years (SD=4.64, Mdn=24). The player type distribution of as a vast majority is classified as philanthropists, a socially- the younger sample was much more diverse than in the older minded, altruistic player type that loves to share knowledge sample (supporting findings from Korbas [6] and from an on- and take care of others. Since socializers are motivated by line survey using a different player type instrument2 both also competition, this player type seems to be the most appropriate considering a younger sample, see Figure 2c). 29.41% of the one regarding the results we have from the interviews. The younger sample were classified as philanthropists, followed by altruism and care-taking aspect underline the requirement to free spirits (20.59%), players (17.65%), achievers (17.65%) build positive relations with others even more. and socializers (14.71%) (see Figure 2b). Given that the younger sample we considered showed a much more heterogeneous player type distribution, it would be in- Discussion teresting to investigate reasons for this as we cannot reliably Overall, results suggest that when conceptualizing gamified in- say whether people turn into philanthropists with increasing terventions aiming for positive psychological outcomes among age, whether the difference is attributable to the generation in seniors, changes in relevant aspects of well-being and the spe- which participants were born or whether the instrument we cific needs of this audience should be considered. used to determine the player type is not suitable for older popu- We learned that socializing is a core motivator for seniors to lations. Given our current results, we think that the perception play. More specifically, we found that seniors play to commu- of certain game aspects changes during life-span, as a majority nicate and maintain social contacts and not to win the game of participants explicitly stated that they were more ambitious in first place. In addition, they considered taking care of and in games and that the aspect of social relationships in games collaborating with other players to be very important, as they was reasonably lower when they were younger. do not want to make other players feel sad. These findings in- Important to note is that the results are preliminary and should dicate that the importance of positive relations for well-being, be seen in this light as more studies with larger sample sizes that increases with older age [14,15], also plays a major role in are needed ultimately draw conclusions. Moreover, the fact the gaming context. We therefore suggest using collaborative that a huge majority of participants were recruited from nurs- game elements over competitive ones (which is also reported ing homes might have an impact on their attitude towards in an online study with 140,000 gamers3 ) and integrating com- social aspects in games, additionally affecting the generaliz- munication capabilities to support the need for social exchange ability. Nevertheless, we argue that the presented investigation when aiming for positive psychological outcomes. provides interesting insights into game preferences of seniors 2 https://gamified.uk/UserTypeTest2016/ and how changes in well-being aspects might be transferable user-type-test-results.php, last accessed September 15, to the gaming domain that open up questions and directions 2017 for discussion and future work such as considering reasons for 3 http://quanticfoundry.com/2016/02/10/gamer-generation/, changes of game preferences in old age. last accessed September 15, 2017 CONCLUSION 8. Andrzej Marczewski. 2015. Even Ninja Monkeys Like to Although there is huge potential in improving well-being Play: Gamification, Game Thinking and Motivational of older adults through gamified systems [2], these systems Design. CreateSpace Independent Publishing Platform. mostly do not account for age-specific changes [5]. To in- 9. Anne Collins Mclaughlin and Maribeth Gandy. 2013. form the design of such systems, we investigated attitudes Successful Aging Through Digital Games: towards game aspects and changes of game preferences of Socioemotional Differences Between Older Adult seniors. Results suggest that changes in well-being aspects are Gamers and Non-Gamers. Computers In Human reflected in the gaming context, i.e. we found that seniors value Behavior December 2016 (2013). DOI: communication and collaboration much more than winning http://dx.doi.org/10.1016/j.chb.2013.01.014 the game and strive to ensure every player enjoys the game equally. These changes are supported by differences in the 10. Alberto Mora, Carina González, Joan Arnedo-Moreno, player type distribution between seniors and a younger sample, and Alexis Álvarez. 2016. Gamification of cognitive suggesting that game preferences change throughout the life- training: a crowdsourcing-inspired approach for older span. Thus, we conclude that these specific needs should be adults. Proceedings of the XVII International Conference considered when creating gamified interventions supporting on Human Computer Interaction - Interacción ’16 ’16 psychological well-being in old age. (2016), 1–8. DOI: http://dx.doi.org/10.1145/2998626.2998663 For future work, it would be interesting to investigate rea- sons for the differences in the player type distribution and 11. H.H. Nap, Y.a.W. De Kort, and W.a. IJsselsteijn. 2009. to validate our findings with more participants in order to Senior Gamers: Preferences, Motivations and Needs. derive guidelines supporting the design of gamified systems Gerontechnology 8, 4 (2009), 247–262. DOI: encouraging well-being for seniors. http://dx.doi.org/10.4017/gt.2009.08.04.003.00 12. Gary Reker, Edward Peacock, and Paul Wong. 1987. REFERENCES Meaning and Purpose in Life and Well-Being: A 1. Sebastian Deterding and Dan Dixon. 2011. From Game Life-SPan Perspective. Journal of Gerontology (1987), Design Elements to Gamefulness: Defining 44–49. "Gamification". Proceedings of the 15th International Academic MindTrek Conference. ACM, 2011. (2011), 13. Richard M Ryan and Edward L Deci. 2000. 9–15. DOI:http://dx.doi.org/10.1145/2181037.2181040 Self-Determination Theory and the Facilitation of Intrinsic Motivation, Social Development, and 2. Kathrin Maria Gerling and Maic Masuch. 2011. Well-Being. American Psychologist 55, 1 (2000), 68–78. Exploring the Potential of Gamification Among Frail Elderly Persons. Proceedings of the CHI 2011 Workshop 14. Carol Ryff. 1989. Happiness is Everything, or Is It? Gamification: Using Game Design Elements in Explorations on the Meaning of Psychological Non-Game Contexts (2011), 1–4. Well-Being. Journal of Personality and Social Psychology (1989), 1069. 3. Wijnand Ijsselsteijn, Henk Herman Nap, Yvonne Kort, and Karolien Poels. 2007. Digital Game Design for 15. Carol D Ryff and Corey Lee M Keyes. 1995. The Elderly Users. Proceedings of the 2007 conference on Structure of Psychological Well-Being Revisited. 69, 4 Future Play (2007), 17–22. (1995), 719–727. 4. Dennis L Kappen, Lennart E Nacke, Kathrin M Gerling, 16. Bob De Schutter. 2010. Never Too Old to Play: The and Lia E Tsotsos. 2016. Design Strategies for Gamified Appeal of Digital Games to an Older Audience. Games Physical Activity Applications for Older Adults. Hawaii and Culture (2010), 1–16. DOI: International Conference on System Sciences (2016), http://dx.doi.org/10.1177/1555412010364978 1309–1318. DOI: 17. Katie Seaborn and Deborah Fels. 2015. Gamification in http://dx.doi.org/10.1109/HICSS.2016.166 Theory and Action: A survey. International Journal of 5. Jonna Koivisto and Juho Hamari. 2014. Demographic Human-Computer Studies 74 (2015), 14–31. DOI: Differences in Perceived Benefits From Gamification. http://dx.doi.org/10.1016/j.ijhcs.2014.09.006 Computers In Human Behavior 35 (2014), 179–188. DOI: 18. Jan Smeddinck, M Herrlich, and M Krause. 2012. Did http://dx.doi.org/10.1016/j.chb.2014.03.007 They Really Like the Game?–Challenges in Evaluating 6. Sebastian Korbas. 2015. Gamification User Types zur Exergames with Older Adults. CHI 2012 Workshop on Unterstützung der Konzeption in der Game User Research: Exploring Methodologies (2012). Softwareentwicklung. Mensch und Computer 2015 - 19. Gustavo F Tondello, Rina R Wehbe, Lisa Diamond, Marc Workshopband (2015), 367. Busch, Andrzej Marczewski, and Lennart E Nacke. 2016. 7. Bruce W Lemon, Vern L Bengtson, and James A The Gamification User Types Hexad Scale The Peterson. 1972. An Exploration of the Activity Theory of Gamification User Types Hexad Scale. The ACM SIGCHI Aging: Activity Types and Life Satisfaction among Annual Symposium on Computer-Human Interaction in In-Movers to a Retirement Community. Journal of Play (2016). DOI: Gerontology 27, 4 (1972), 511–523. http://dx.doi.org/10.1145/2967934.2968082