Problem
Research questions and friction points this paper is trying to address.
Generative AI
Cognitive Impairment
Safety and Autonomy
Accessibility-Oriented Interventions
Decision-Making
Balancing Safety and Autonomy: Accessibility-Oriented Interventions in Generative AI for Cognitive Impairment
🤖 AI Summary
研究通过五种机制来平衡认知障碍者使用生成式AI时的安全与自主性问题，这些机制根据用户的损伤程度不同而对用户产生支持或限制作用。
📝 Abstract
Generative AI systems are increasingly used by older adults with cognitive impairment for everyday tasks such as information seeking, health management, and communication. While these systems provide flexible, language-based support, their open-ended outputs introduce risks of over-reliance, misinterpretation, and inappropriate decision-making. Prior work has focused on usability and adoption, with limited attention to how system design shapes users' participation in decision-making and the distribution of agency in care contexts. We present a qualitative study of 45 individuals with cognitive impairment and their caregivers. We identify five accessibility-oriented mechanisms: AI Capability Constraint, Human Oversight Embedding, Cognitive Engagement Maintenance, Human-AI Relationship Regulation, and Risk Transparency and Control, through which systems structure interaction. These mechanisms both support and constrain users by redistributing decision-making across users and caregivers. We show that their effects vary by impairment level: while protective mechanisms support users with severe impairment, they can restrict autonomy for those with mild impairment. As impairment progresses, tensions become less visible as user participation diminishes. Our findings highlight the need for dynamic designs that balance safety and autonomy in AI-supported care.
Innovation
Methods, ideas, or system contributions that make the work stand out.
Accessibility-Oriented Mechanisms
Cognitive Impairment
Generative AI
Safety and Autonomy Balance
Dynamic Designs
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