Weaning from the mechanical ventilation poses substantial physical and psychical stress to the patients which is intensified by the obstruction of verbal communication. Hence, during the weaning phase, ICU patients often cannot impart their basic needs adequately. A prolonged healing process, delirium, and complications are possible consequences. The research project ACTIVATE aims to develop an interactive system to support communication and re-orientation in weaning patients and to allow them early autonomous control of ambient devices. The system will include an innovative ball-shaped interactive rehabilitation device (BIRDY), designed for weaning patients bound to the bed to control the proposed system. As a result of the development process including two studies, several workshops and a comprehensive user and context analysis, non-functional and functional requirements for the overall system, consisting of BIRDY, the system’s architecture and human-machine interfaces were determined. The target group requires a particular focus on usability aspects addressing patients’ cognitive and physical impairments. To save nursing staff time resources, the system should function as automatically as possible. Besides, safety and security by design, meeting infection control regulations, multilingual system dialogues and a multimodal presentation of information are crucial aspects.