Rethinking participation and knowledge: Reflections on qualitative research in technology development for dementia care

The past two decades have seen an intensification of research and development in assistive technologies for people living with dementia. While many of these projects emphasize inclusion, participation often takes place under restrictive conditions: through structured evaluations, usability testing, or proxy-based design feedback. This paper argues that such frameworks limit what kinds of knowledge are recognized as valid and what forms of expression are rendered legible. Drawing on multi-site participatory research projects, the author reflects on moments in which inherited benchmarks of coherence, reliability, and evidence strain against the realities of the field. In these spaces of epistemic friction, where memory fragments, timelines collapse, silences carry meaning, names shift, or questions fail to land, what emerges is not less knowledge but knowledge of another kind. These claims are illustrated through four scenes of epistemic friction drawn from the author’s fieldwork. The paper develops a methodology of shared presence: a research stance grounded in attunement and epistemic reciprocity, valuing responsiveness over analytic control and relation over extraction. By treating repetition, silence, ambiguity, and reframing as epistemic resources, this orientation contributes to the rethinking of qualitative inquiry in technology development for dementia care. It also addresses technology development more directly, arguing that when such forms of knowledge are ignored, the results are often technically sophisticated but socially unanchored unusable products. The article thus speaks to broader debates about voice, vulnerability, and epistemic responsibility in the context of health, care, and innovation. • Participation in technology projects often occurs through structured, extractive modes of engagement • Epistemic friction becomes visible in repetition, silence, misnaming, and reframing • Tacit expectations of coherence, reliability, and evidence are critically re-examined • Shared presence is proposed as a relational, responsive research stance • Resonance, uncertainty, and vulnerability are framed as epistemic resources, not deficits