With the increasing adoption of action-centered research methodologies by designers, the landscape of communication design has changed from a simple designer/client relationship where solutions are generated in the studio to a more complex situation where the use of field ethnography and participatory design with end users has become accepted practice. As Sanders and Stappers note in their 2013 seminal text titled Convivial toolbox: Generative research for the front end of design, this signifies a shift from product design to purposeful design. This case study describes a design methodology that involves the end user as a design participant by asking the question ‘How can design facilitate a behavior change in the use of ceiling lift equipment by Residential Care Aides (RCAs) in an extended care facility?’ Focusing on the front end of the design process or the generative space, residential care aide research participants were asked to visualize their work patterns in real and ideal terms. Mood boards, collages, and keyword articulation were used to describe the context of their roles and responsibilities as residential care aides. Other primary research involved preliminary user testing of a range of proposed visual communication designs for the final campaign. Using a collective creativity mind-set, the visualizations produced by the residential care aides during the co-creation and user-testing sessions offered the design team rich insight into the participants' work lives, which radically affected the development of the final campaign.