Can design make life easier for people living with dementia?

Dr Hazel Boyd , User Interface Engineer Nina Evans, Occupational Therapist

BIMEWendy Harkness, Dementia Adviser Manager

Alzheimer’s Society

www.bime.org.uk

• Time orientation• Task sequencing• Keeping “in touch”• The challenges of the

remote control

• Novel application of technology

• Research led – understanding needs, new applications of technology

• Team approach involving individuals, children & families, professionals and special interest groups

• Working with commercial partners to take designs from concept to production

DevelopmentDesign ConceptsOverview Design Approach Areas of Need

Time Orientation

“ an elderly person I know seeks reassurance many times a day if I am there

to ask what day it is”

“ I am a carer for my wife with mild vascular dementia. Her frequent question is to ask

for what day what time”

“ I am an OT working with people with dementia who get confused at 5 o’clock

particularly during the winter not knowing whether it is early morning or evening”

DevelopmentDesign ConceptsOverview Design Approach Areas of Need

Time Orientation

• Ability to tell what time it is • Distinguish between day and night• Link time to routine• Anxiety / distress

Features rated most useful to least useful• Day of week (most useful)• Time of day eg. morning / afternoon etc• Day or Night• Date• Link to calendar events

DevelopmentDesign ConceptsOverview Design Approach Areas of Need

Time Orientation “looks at it daily & knows

routine”“when he is arguing about what

day it is, we refer to it”“helps him to know what day it

is when he gets up” “she rang him (her son) to tell

them about the clock in her kitchen, she does not know where it came from but it is wonderful”

“ a great help to my dad who struggles to understand the concept of day or night- now he can be sure .. most of the time…

DevelopmentDesign ConceptsOverview Design Approach Areas of Need

Task Sequencing

The Challenge•People with dementia typically have short-term memory problems

What sort of task prompting works best?Dunhill Medical Trust

DevelopmentDesign ConceptsOverview Design Approach Areas of Need

Task Sequencing

Our approaches•Observing people with dementia carrying out tasks in their own homes•Scoring system to compare types of prompting

DevelopmentDesign ConceptsOverview Design Approach Areas of Need

Task Sequencing

Our methods•Compare prompting formats during standard tasks

– audio, picture, text, video, line animation, line drawings

•2 individual tasks

•Standard tasks -> knowledge -> individual tasks– Emptying dishwasher, locking door, making tea… trivial tasks??

DevelopmentDesign ConceptsOverview Design Approach Areas of Need

Task Sequencing

Findings•Text and audio work well•Individual tasks => complexity!•People can read, and can learn!•Simple prompts can be the answer, e.g. door locking:

…And if you lose the flow do you think to press the button?

……Yes I know that that will always do it. Yes I know that that will always do it. (Person with dementia)

……I used to always have to explain it …I'd go back and check it …now I I used to always have to explain it …I'd go back and check it …now I actually …[do] not have to think about it. actually …[do] not have to think about it. (Partner of person with dementia)

DevelopmentDesign ConceptsOverview Design Approach Areas of Need

Keeping “InTouch”

DevelopmentDesign ConceptsOverview Design Approach Areas of Need

The Challenge•Dementia -> Social isolation

socialtechpop.com

DevelopmentDesign ConceptsOverview Design Approach Areas of Need

Keeping “InTouch”

Our approaches

•3 focus groups

•Iterative design in day centre

•Home testing

BIME + RICE + University of Bath

DevelopmentDesign ConceptsOverview Design Approach Areas of Need

Keeping “InTouch”

Our findings•Others worry that it will be confusing

•People with dementia can use it!

•Waving; being seen

•Telephone + touchscreen + clear, simple choices

DevelopmentDesign ConceptsOverview Design Approach Areas of Need

Keeping “InTouch”

Our findingsFeatures•Picture in picture •Camera pan and zoom•Mobile camera

Coming up…Home testing phase in pairs

Real-life testing!

DevelopmentDesign ConceptsOverview Design Approach Areas of Need

The challenges of using the TV remote

“can't remember what the buttons mean - plus there are too many buttons. The buttons are too small The TV appears to do things I haven’t told it to do I don't understand the TV guide” Quote from questionnaire respondent

Postal questionnaire 2011

99 completed responses

70% very important to be able to watch TV independently were experiencing moderate to severe difficulty doing so

“ ..once dementia became very obvious the television (became) more and more important until it is left on all day. At the same time his ability to operate the television declined and became impossible..” Quote from

respondent

DevelopmentDesign ConceptsOverview Design Approach Areas of Need

The challenges of using the TV remote

DevelopmentDesign ConceptsOverview Design Approach Areas of Need

The challenges of using the TV remote

Enjoyment ranged from active participation

“I like quizzes to keep brain active like countdown” Quote from respondent

to more passive enjoyment“ she laughs at the

children’s programmes- seems to respond to animation ,colours,

sounds… the tv is company in her room” Quote from

respondent

DevelopmentDesign ConceptsOverview Design Approach Areas of Need

The challenges of using the TV remote

69% of all respondents watched 5 or fewer

channels

DevelopmentDesign ConceptsOverview Design Approach Areas of Need

Develop the interface• Iterative user driven design process• Greatest ratio between functionality & simplicity• Meet changing needs to suit user profile• Personalised choices • Facilitate sequencing of task • Automation

Engage with manufacturers

The challenges of using the TV remote

DevelopmentDesign ConceptsOverview Design Approach Areas of Need

Acknowledgements

• BIME Network of research participants and their carers• Alzheimer’s Support Wiltshire• Peggy Dodd Centre / Polebarn Club• Wendy Harkness & Alzheimers Society Midlands Central• Sam Hawksley Mechanical Design Engineer Bath University • Research Institute for the Care of Older People (RICE)

OUR FUNDERS• Dunhill Medical Trust

• Sobell Foundation / Sir James Reckitt Charity / D’Oyley Carte Charitable Trust / Philip King Charitable Trust

• Research Councils UK (Digital Economy)