Hugging Heart Caretaker Vest
Dementia Care × Research-Driven Product Design
Imagine forgetting someone's face 100 times a day.
Now imagine being the face that's forgotten.
At the height of the COVID‑19 outbreak, when every caregiver's face was hidden behind layers of protective gear, at Baycrest Health Centre, dementia care brings two strangers together dozens of times a day. The resident looks up from a bed or chair at a masked figure, name tag far above their line of sight, and asks "Who are you?" And the caregiver, hearing that question for the hundredth time, slowly stops feeling like anyone at all.
Baycrest gave us an open brief: explore unmet needs in geriatric and Alzheimer's care through human-centered research. No predefined problem, no assigned solution.
Research surfaced a disconnect running in both directions. Residents, most strongly connected to memories from ages 16 to 25, often couldn't recognize the person caring for them: seated or lying down, they met a masked figure in identical scrubs. And the caregivers, exhausted thin by COVID routines, were losing something too: their identity, worn down shift after shift into frustration and drudgery. Two people from different generations, different cultures, different worlds, meeting dozens of times a day with no common ground to stand on.
- The Brief: support both sides equally, the person receiving care and the person giving it.
- The Aim: help patients and caretakers live in the moment, not in the routine.
- The Bridge: connect two lived experiences that share no common ground, and make the connection uplifting.
A wearable system that turns a caregiver's uniform from an identifier into a bridge, connecting two people with nothing in common, and giving both a moment of recognition, conversation, and fun in the present.
A name tag the resident can actually see
Repositioned to a seated patient's eye level, with oversized high-contrast type and a large photo of the caregiver's unmasked, smiling face: recognition without a single word.
A badge that meets them in their era
Modular daily badges (mid-century icons, Jewish cultural symbols, holidays) pitched to the years residents still live in. Not a memory test; a shared object two people can react to and enjoy together.
A ritual that gives the caregiver back some self
Overwhelmed and masked through COVID, caregivers lost their identity on shift. Choosing the badge of the day is a small daily act of play: a way to feel like a person, not a uniform.
Before speaking to a single participant, TCPS 2 ethics certification was completed in a population this vulnerable.
Five voices across three kinds of knowledge: clinical (a Baycrest SME), family caregivers, and a long-term-care resident, plus literature and environmental scans. Small by design: depth across every role in a single care moment was prioritized over statistical weight. Interviews were coded into an affinity map, which fed the personas and journey map.
Affinity Map
Coded fragments from five interviews, clustered into the insights that drove every design decision: recognition, cognitive load, cultural memory, caregiver identity, and workflow fit.
Journey Map
Patient–caregiver journey map, tracing the emotional arc of a single care interaction from both sides.
Personas
Resident and caregiver personas, grounded in cultural context, cognitive needs, and daily workflow.
Coded Interviews
Interview transcripts coded for recurring themes across clinical, family, and resident perspectives.
"Connection doesn't come from recall, it comes from presence. And presence needs common ground: something both people can react to, right now."
Memory anchors live in youth and culture: people with dementia connect most strongly to ages 16–25, the world they still recognize.
Caregivers lose themselves in the routine: repeating the same care tasks all shift leaves them worn out, frustrated, and feeling invisible.
Recognition fails at seated eye level: most care happens with patients seated or lying down; chest-level tags sit out of sight.
One thing at a time: competing stimuli upset and confuse patients living with dementia. Focus works one task at a time.
Letting Go to Move Forward
In phase one of the project, we researched as equals and prototyped in four parallel directions. Two of the four ideas and prototypes were mine, including the one we let go, and the one whose insight became the badge system.
Mobile App
A digital assistant with audio, text, and visual prompts to support autonomy in early-stage dementia.
Busy Treasure Box
A fabric sensory box built on 1960s cultural cues, the thinking that later became the badge system.
Preference Board
A visual board of patient preferences and routines to help caregivers interact more thoughtfully.
Caretaker Vest
Kai's first iteration, refined by the team. A wearable that communicates recognition passively, inside the interaction itself.
In our Phase 2 review, the Baycrest SME named what breaks down in care: patients not recognizing caregivers.
The feedback on cognitive load was direct: even a simple interface assumes memory, attention, and willingness to interact, all unreliable in dementia. An app meant to restore autonomy was one more demand on the person it was meant to free. It didn't fail as an interface. It failed as a premise.
I let the concept go, not because my observation was wrong, but because the vest answered it better: passively, at the exact moment recognition matters, asking nothing of the patient.
Neither concept shipped; neither died. The Treasure Box's insight became the badge system, and the app's goal, independent daily living, carried into every decision after.
The Vest, Decision by Decision
Every material choice had to answer to two people.
Once the team aligned on the vest, every choice had to serve two people at once: the resident, who needs to recognize, and the caregiver, who needs to be recognized. Each decision below cites the research insight behind it.
What we chose
Baycrest blue linen
Calm and familiar, not attention grabbing. The vest's form does the communicating, so its color should not compete.
Name tag and photo at seated eye level
Placed where a seated patient actually looks. Recognition happens before a word is spoken.
Wrap-around form
The shape echoes a hug: presence and reassurance built into the silhouette, for both people.
Velcro badges
Pins are sharp and buttons are slow in a care setting. Velcro swaps daily without disrupting the routine or risking a patient.
What we rejected
✗ Oversized pockets
They broke the vest's fit and visual clarity. We scaled back to lightweight essentials, keeping it wearable and dignified.
✗ Multiple badges at once
Too many visual cues at once upset and confuse. One badge at a time keeps the interaction calm and easy to read.
Iteration 1: Muslin Mock-ups
Tested draping and form. Cut, pinned, and taped to understand fit across body types.
Iteration 2: Blue Linen Build
Moved to Baycrest's brand color. Final pattern cut with adjusted arm holes for comfort.
Iteration 3: Feature Additions
Eye-level name tag placement, badge system, wrap-around pockets, sensory elements.
Iteration 4:
Refinement
Reduced badges from 7 to 3 or 4 plus holidays, based on feedback. Added Jewish cultural symbols and adjustable straps for body diversity.
From muslin mock-up to finished prototype, a look at the vest across every stage of build and wear.
The Badge Answers What the Name Tag Cannot
The name tag handles recognition. The badge handles connection.
A name tag solves one problem: a resident needs to see who is standing in front of them, while they are lying on the bed or in sitting position, at their eye level, in a single glance. It does not solve the other half of the disconnect. A caregiver who has masked and gowned through two years of COVID routine is not short on information, they are short on self. The badge is built for that gap.
For the resident: recognition
Each badge carries an image or symbol from the decade a resident still lives in, ages sixteen to twenty five, so recognition does not depend on memory that dementia has already taken.
For the caregiver: connection
The same badge works as an icebreaker, a small prompt to step outside the routine and start a conversation that is not about medication or meals.
Neither person is asked to remember anything. Both react to something in front of them, right now.
A badge changes hands four times before it does its work.
From the supervisor's calendar to the moment of recognition, here's how the ritual carries the badge through a shift.
Sets the rotation
Plans two weeks of themes at a time, assigning a celebrity to each day of the week and checking the calendar for upcoming holidays.
✓ Two weeks planned
Today's theme is set
Each day of the week carries one badge, a celebrity from residents' formative years. If a holiday falls on that day, the holiday becomes the theme instead.
✓ Theme confirmed
Checks the board
At the start of the shift, the caregiver looks at the wall-mounted board to see which badge is live that day.
✓ Shift ready
Wears it into every room
The badge is attached to the vest once and carried through the full shift, becoming a natural icebreaker at each visit.
✓ Icebreaker ready
Recognition opens the door
The resident notices something familiar on the badge, a flicker of recognition, not memory. The caregiver sees the reaction, and the visit opens with a conversation instead of a task.
✓ Connection made
"Some of the competencies we are looking for in the staff we hire is around flexibility and being able to have fun at work."
SME contact at Baycrest
Good design is restraint.
We tested the vest with two classmates as proxies, COVID prevented testing with actual caregivers. The goal was to assess comfort, fit, ease of use, and basic movement, not clinical effectiveness, but wearability in everyday care.
Testing revealed that the vest retained its form across body types, but longer strap slack was needed for larger bodies, and a softer hem would reduce neckline pressure. We also confirmed that wearing multiple badges at once reduced clarity. One badge at a time was the right constraint.
Strong design doesn't begin with an object. It begins with understanding the system the object lives inside.
The vest worked because we designed the daily ritual around it, not just the garment itself. Recognition in dementia care is deeply tied to culture, early-life experience, and personal history. What seems universal from one perspective may not be recognizable to someone else. Design tools have to reflect lived experience, not assumptions.
Signals of success
If piloted at Baycrest, three signals would show it was working: fewer "Who are you?" moments per shift, caregivers reporting it easier to start a conversation, and longer engaged interaction during routine care.
Beyond the signals, success would sound like a resident recognizing their caregiver's name for the first time in weeks.
Honest limits
The vest cannot reverse memory loss, eliminate behavioral symptoms of dementia, or solve staffing shortages. It does not fully address residents with severe visual impairment or late-stage cognitive decline. Being honest about these limits was part of the design process: built for what we could meaningfully improve, not what we wished we could fix.
"I thought you arrived at a thoughtful product that considered both the resident and staff well. It's also a product that hasn't been redesigned in a long time. Good opportunity and good work. Also, congrats on being chosen to show at DesignTO."
Baycrest Family Member
This project was an academic collaboration, not a commissioned implementation. The Hugging Heart Vest was showcased at DesignTO 2022, where it received recognition for its human-centered approach and dual-sided empathy. While it hasn't been implemented at Baycrest yet, the design exists as a proof of concept: a demonstration that recognition and identity can be supported through thoughtful, low-tech interventions.
If implemented tomorrow, the roadmap would start with a small-scale pilot: volunteer caregivers in one unit testing the vest in real clinical conditions over four to six weeks. We would partner with a healthcare garment manufacturer to refine materials and durability, work with a graphic designer to standardize the badge system, and collaborate with Baycrest administration to ensure compliance with uniform policies and infection control standards.
Beyond Baycrest, this model could adapt to other care settings: children's hospitals, rehabilitation centers, memory care facilities. The badge themes would shift to reflect different communities and age groups, but the core insight remains:
recognition is a two-way street, even when memory is one-way.
"The vest is not a cure. It is a support tool: a small but intentional intervention within a much larger care system."
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