Below are descriptions of three of the main research projects I have worked on since 2001.
CIRCA (Computer Interactive Reminiscence and Conversation Aid) is a multimedia computer system developed to support and promote communication between people with dementia and caregivers. CIRCA is based on reminiscing, which is a popular activity in dementia care services. Reminiscence refers to the process of recollecting memories from one’s life, for e.g. about work or hobbies, and speaking about these with one or more other people. The process of recollecting personal memories can be prompted by various stimuli including photographs and artefacts. Engaging in reminiscing is considered to contribute to well-being and provide a positive activity for people with a diagnosis of dementia. In dementia care settings reminiscing is typically carried out as a group activity with one or more care staff acting as facilitators. To prompt reminiscing the facilitator(s) may bring along photographs or other items such as post cards that are passed around the group. Such sessions require care staff to generate themes and find and organise materials to prompt reminiscing and discussion within the group. Due to time constraints and the need to find stimuli, reminiscing is rarely carried out as a one-to-one activity. CIRCA was developed to provide a broad range of stimuli to prompt reminiscing among people with dementia, both in group and one-to-one sessions. CIRCA utilises hypermedia to address the memory and conversation maintenance problems experienced by people with AD. Two features of hypermedia make it particularly suitable for people with dementia. First is its inherent flexibility. Users of the computer have the freedom to move between interconnected but individual items as they choose. This is beneficial for people with memory loss as it does not put any penalty on ‘losing the place’ in the system. Whatever place the user is in is the right place to be and exploring and ‘getting lost’ are actively encouraged as strategies to enjoy experiencing the material. Second hypermedia provides the opportunity to link items from a range of media in a dynamic way. Text, photographs, graphics, sound recordings and film recordings can be seamlessly intertwined to present an inviting and lively activity for people with dementia and caregivers to explore and discuss together. CIRCA contains photographs, music and video clips to provide an engaging reminiscence experience.
Living In the Moment (LIM) has been developed by the CIRCA team which investigates
the efficacy of computer-based pastimes/activities for people with dementia. The multidisciplinary team brought together researchers from applied computing, the psychology of dementia, and computer aided design from the universities of St Andrews and Dundee.
The team aimed to find ways to engage and stimulate people with dementia and to produce a computer system that they could interact with independently, without the presence of another person. This would be beneficial to them, and to their caregivers, and could offer insights into mechanisms for maintaining cognitive functions despite the lack of key components. The designed system aims to capitalise on the preserved skills of people with dementia whilst at the same time circumventing or compensating for diminished abilities.
LIM is a series of bespoke computer games with an easy-to-use and engaging interface designed to accommodate first-time users. The innovative computer system, which utilises a large format touch screen and multi-media techniques, provides the user with engaging, stimulating and enjoyable activities.
The team used a human-centred approach to the design process, and actively sought input from various stakeholders including people with dementia, local government departments, personal and professional care providers and national charities like Alzheimer’s Scotland, Action on Dementia and the Alzheimer’s Society, UK. The team field-tested many different types of games including navigable 3D environments, interactive QTVR and traditional games like pinball and ten-pin bowling. During user-testing, several fairground themed games proved popular, as did a number of more ambient, creative activities. The first commercial iteration of the system contains six games including, musical chimes, a shooting gallery, a painting activity, an interactive bubble-maker, beat-the-goalie and a coconut shy.
The intention of the project was to create a system in which the user is actively engaged, not passively immersed. The person with dementia is prompted to interact and explore the system stimulated by the multimedia, allowing them to keep using their remaining cognitive facilities to the best advantage. In addition, the system prompts continued interaction when the person is unable to take it further themselves.
COBALT is a collaborative research project engaging with older adults, health and social care professionals, commissioners and industry to explore and provide solutions to the social and behavioural barriers to ALT adoption.
Older adults are happy to adopt new technology to help them live their lives new research shows. However, there is currently a huge gap between developments of technology and the number of people using it in their everyday lives. The COBALT research project has been working with a wide range of older adults across the UK to look at why this gap exists.
One reason for the gap is the idea that older adults are ‘techno-phobic”. But when asked to describe technology they love older adults frequently mention mobile phones, computers and digital cameras. Their reasons include that the technology is easy or convenient to use, it enables them to keep doing things that are important to them and meets their needs. When asked about things they have abandoned their reasons are that the technology was difficult to use, cumbersome or did not meet their needs.
The COBALT research suggests that the reasons for low uptake of technology have more to do with lack of availability of information, lack of awareness of what is available and knowledge of how to get it. There is also a gap between the mainstream technology that anyone can use, such as i-Pads and smart phones and technology provided by statutory services. The latter tend to be prescribed in response to specific health and social care needs such as pendant alarms after someone has had a fall or medication reminders for people with mild memory problems. Some of these items are seen as stigmatizing or marking people out as vulnerable.Yet the COBALT research shows that older adults have a thirst for technology that can make their life better.
As part of understanding the barriers to getting technology out to people COBALT has also worked with health and social care staff, service commissioners and providers and a person with dementia and his wife. By gathering knowledge and experiences from all these groups COBALT aims to help the ALT industry take advantage of the current gap in the market and place the UK at the forefront of developing technology for older adults.