Can design make life easier for people living with dementia?

1. Can design make life easier for people living with dementia? Dr Hazel Boyd , User Interface Engineer Nina Evans, Occupational Therapist BIME Wendy Harkness, Dementia Adviser Manager Alzheimer’s Society www.bime.org.uk

3. 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

4. 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”

5. 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

6. 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…

7. Task Sequencing The Challenge • People with dementia typically have short-term memory problems What sort of task prompting works best? Dunhill Medical Trust

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

9. 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??

10. 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. (Person with dementia) …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. (Partner of person with dementia)

11. Overview Design Approach Areas of Need Design Concepts Development Keeping “InTouch” The Challenge • Dementia -> Social isolation socialtechpop.com

12. Keeping “InTouch” Our approaches • 3 focus groups • Iterative design in day centre • Home testing BIME + RICE + University of Bath

13. 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

14. Keeping “InTouch” Our findings Features • Picture in picture • Camera pan and zoom • Mobile camera Coming up… Home testing phase in pairs Real-life testing!

15. “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 The challenges of using the TV remote 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

16. The challenges of using the TV remote

17. 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

18. The challenges of using the TV remote 69% of all respondents watched 5 or fewer channels

19. The challenges of using the TV remote 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

20. 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) Acknowledgements