PRE2019 4 Group7
Group members
Student Group
Name | Student number | Bachelor | |
---|---|---|---|
Eline Visser | 1375369 | e.a.l.visser@student.tue.nl | Applied Physics |
Metten de Lange | 1240902 | m.m.d.lange@student.tue.nl | Applied Physics |
Vera Holtmark van Dijkerhof | 1380893 | v.holtmark.van.dijkerhof@student.tue.nl | Applied Physics |
Sterre Cuppens | 1387790 | s.cuppens@student.tue.nl | Psychology and Technology |
Iris de Wit | 1258230 | i.c.d.wit@student.tue.nl | Psychology and Technology |
Problem statement
The current world population keeps expanding. In 1950 there were 2.5 billion people on Earth. In 2020 this number is 7.8 billion. [1] However, this is not the only change. There has also been a shift in the population age distribution. As can be seen in figure 1, there used to be a pyramidal distribution of age, where there are relatively a lot of young people, and fewer elders. But in data of later decades and estimations for the near future, this distribution becomes more and more "block like". This means that at some point, there will be almost the same amount of elders alive as there are young people to care for them. It is estimated that this trend will continue to grow.
![](/images/Population-Pyramid-1950-to-2100-793x550.jpg)
With that, the age-related decease rates will go up as well. Right now 50 million people are living with dementia. It is estimated that the portion of people over age 60 with dementia lies between 5 and 8 percent. The total number of cases is projected to grow to 82 million in 2030 and 152 million in 2050. [2]
This leads to all sorts of detrimental effects for the care industry. Since there will be less and less spots available in nursing homes, elders with dementia will be expected to live at home longer. This demands the invention of new technology to aid them in day to day life.
Not only activities such as eating, taking medicine and staying active require attention, also the social live of elders with dementia is of great importance. As the person grows older, a large part of their social live will cease to exist. This can cause severe loneliness and even depression.
Approach
We want to design an application for elderly with dementia. We started by coming up with different possibilities for functions. We thought about an interactive photobook, a cognitive game, a navigation app, a to-do list and task helper and communication. Eventually we decided to focus on a combination between a to-do list and an interactive photobook. Herefore, everyone came up with their own design. We decided to base our application on the design of Vera. This is a to-do list with a memory function. Where old photos will be shown of the user. Then we had to choose a program to build the app. First, we tried a few different possibilities and in the end we chose to use Kivy with a Python code to make the application. For the user tests we have contacted different care homes if they want to participate. We made a questionnaire for the carers to get more expertise on our application.
Objectives
The technology should be able to help older and demented people get through their daily lives. For them, many problems that most people never have to deal with are commonplace and they require lots of attention. However, giving this attention to everyone who needs it takes many people and much time, while it is not always possible to have enough caregivers for this. Technological solutions could provide an outcome.
Most importantly, the technology should be able to alleviate the loneliness of older or demented people. This is a problem that has been getting bigger and bigger, but technological solutions could provide an outcome.
Furthermore, the technology should be able to help demented people get through their daily lives. For them, even the most simple tasks like washing your hands require help from someone else. Robots or similar technology could help these people by guiding them through the process step by step, encouraging and correcting them where necessary.
Progress of Project
The Users
Primary users
The primary users are the elderly people with dementia. With an elderly population that is set to more than double by 2050 worldwide, there will be an increased demand for elderly care. The shift in societal proportions will place new pressures on all aspects of elderly care. Loneliness, for instance, is a consequence of social, psychological and personal factors. Over half of people over the age of 75 live alone and 17% of older people see family, friends or neighbours less than once a week. A recent meta-analysis showed that the impact of loneliness and isolation carries the same mortality risk as smoking 15 cigarettes a day. This poses several impediments in the delivery of high-quality health and social care.[3] We want to focus especially on elderly with dementia. Because people with dementia experience progressive cognitive impairments that typically commence with short term memory problems but can encompass language deficits, difficulties initiating tasks, planning, monitoring and regulating behaviour, and visuospatial difficulties, agnosia (loss of ability to recognize familiar objects or people and apraxia (loss of ability to carry out complex purposive movements) [4]. For people with dementia it is extra hard to keep social connections with other people. Therefore, we want to make elderly people with dementia less lonely with our device.
Secondary users
Secondary users are the caretakers of the elderly people with dementia. They will have to cooperate with the device for the ultimate care for the elderly. The device should be a supporting tool for the caretakers, which makes the worry and care on daily tasks less. And it should be an addition to the care of the caretakers with the social aspect. It can give the elderly people the extra social interaction what caretakers sometimes can't give.
Tertiary users
Tertiary users of the device are the companies that create the product. Eventually, if there is a high enough demand for the product, companies will be producing the device. New technologies such as the device may create good business opportunities for newer companies and for both well-established companies. The companies will have to take the price of the device in account for the elderly people. They have to find a balance between an affordable device for the elderly people with dementia to reach a high enough demand. And the companies will have to make enough profit of the device to keep the production going.
User requirements
The following points are the user requirements for the application with the to-do list and memories function. These user requirements are conditions or tasks that must be completed to ensure the completion of the project.
The App in General
• The app should only contain the functions that are necessary for the app to reach its goal. More functions than necessary will make the app more complicated to understand. In this project this means that we will have a to-do list and a photo display in order to achieve more independence and less loneliness.
• There should be consistency in the lay-out all throughout the app. One can think of always using the same fonts, colours etc. that make up the overall appearance of the app.
• The app should be able to remind the user of information with help of notifications. The amount of information given and the frequency of the notifications should be customizable.
• The app should have an option that provides help and support for using the app, for instance with a help button where information stands about how to use the application.
• The app should be simple and clear enough to be operated by an elderly with dementia without any help of other people/things outside of the app. There should be a help function at any moment if something isn't clear.
• The app should be able to make elderly with dementia feel at ease by having a relaxing and entertaining appearance. This means that no extra functions/buttons/objects/pop-ups etc. are visible other than the needed function at that moment. The text should be very big and the colors are not bright in order to have no overload of input. (see articles like 14) *Still have to include the right articles.
• The app should contain colors that can be used for elderly: colors of blue-yellow type are less well perceived by elderly.
To-Do list and task helper
• The app should have a daily to-do list.
• The to do list has customizable items in it. The user or caregiver can make a new item or delete an existing one.
• The app should be able to keep track of what tasks have been done and reset this progress at the end of the day.
• The app should be able to recommend a task to the user they have not done yet or remind them that they should still do it.
• The app should be able to choose its recommendations based on time or other factors that are relevant to the task (i.e. recommend the user to have breakfast when they have just woken up, or wash their hands if they are going to eat) This can be in the form of pup-up notifications.
Interactive Photobook
• The interactive photobook should contain pages with photo's organised in a way similar to a real photobook
• It should be possible to send new pages to the interactive photobook from other devices on distance
• There isn't an option to remove or edit already existing pages from the photobook in the app itself
• The interactive app should be able to show old postcards along side of the pictures
• It is possible to have text along side of the pictures and postcards
• It is possible to let the app read the message of the postcards/text, either with help of spoken audio or a computer generated voice
• The photobook should give notification about "anniversaries" of certain dates and pictures, for example "Last year around this time this happened, look at the pictures"
• The pictures should be in chronological order and the day/month/year should be alongside of the pictures
The following points are the other user requirements that we made for our ideal end product. These will not be used in this project furthermore.
Cognitive game
• The cognitive game should contain a word search puzzle
• The user should be able to play the game against another person online
• There should be a chat option to communicate with the other player
• The word search puzzle should change every new game
• The users should take turns in searching a word
• There should be a pass option when the player can't find a word
• There should be a stop option when the players want to give up the game
This is a feature that should make it possible for elders to use navigation apps.
• The app should show a route from the users location to the final destination.
• The app should be able to walk the route in real time.
• The UI should be clearer than existing apps such as Google Maps. It can be clearer by removing the option to choose a transportation device. (walk/bike/car) The home screen can be a collection of pictures of locations that the uses frequents. When the user clicks on a picture, the route and navigation start automatically.
• The app should have spoken instructions for the route.
Communication
• The interface should have no pop-ups or distractions
• The interface shows the faces with belonging names
• There should be an automatic synchronization between the contact list and the app
• The amount of contacts should be limited to a maximum of 24 persons to keep overview
• The icons of the contacts are placed around the videocalling icon
• When the user clicks on a person, the app should ring the other person
• When the responder responds, the screen displays the other person
• There should be a working microphone and camera connected
• The camera should always be turned to the user's face
• The user can be called as well
• When being called, one big green button appears on the screen with the name and face of the caller and an instruction to pick up
State of the Art
Current technology for elderly people
Dementia and technology
Loneliness and technology
Design end product
The ideal end product
Having difficulties with technology is very common amongst elderly users, and especially when the users suffer from cognitive impairments such as dementia. These days we see more elderly people using devices like tablets, but the normal interfaces for these devices are not build with the special needs of cognitive impaired in mind. For example a lot of the applications and functions of these devices aren't useful for these type of users and the large amount of options are confusing. Our ideal end product would be an interface that is designed with the special needs of users with dementia in mind that will cover everything that is useful for these users and nothing more.
Examples for the functions the interface/app could have
• Video calling - Technologies like Skype are widely used to keep in contact with family and friends, also by elderly people. But not every elderly person is capable of learning how Skype works. An example for how the layout of this communication function would look like is shown in figure 3. The pictures with the names of the contact would be easier to recognize than only the username of the contact.
• Cognitive game - Studies have shown that cognitive games could be benefitiel for patients with dementia and the concept of a tablet is suitable for games in general.
• Navigation - Some elderly people are still very mobile but they might be in need for a function that guides them on their way. Normal navigation applications have many different settings, like the option if one wants the route for a car or a pedestrian. These functions aren't necessary for elderly users who will walk everywhere. We think that the navigation function would only need preset addresses and routes for pedestrians.
• To do list - Users with dementia sometimes have trouble remembering basic daily activities. A normal agenda application isn't fit for remembering those tasks, a to do list would be more useful. The to do list would contain the normal daily activities like for example the three meals of the day and other, more personal, tasks could be added manually. It would be possible to "cross off" the tasks and at the end of the day the list resets so the tasks can be ready to be crossed off the next day.
• Interactive photobook - Looking at old pictures can be therapeutic and relaxing for people with dementia. Some families make photobooks for their relatives suffering from dementia. It would be a great addition to the app to have an interactive photobook function where families could make pages with photos and subscripts from other devices. An advantage of this interactive photobook would be the ease of use for the family and the additional function such as reading the text out loud.
The user requirements of these functions are all listed at 'User requirements'.
The lay-out of the photobook differentiates a little bit from the other applications in terms of the clock/date. This was chosen to make sure that there is enough space on the screen for the actual pictures. It could also be an option to completely remove the date, but it's important to make sure the users with dementia have an extra reminder of what is 'today' and what is 'the past'. Looking at old pictures might be a little bit confusing for them, so clearly stating the date and how much time has pasted since the picture would be a logical design choice.
Scope of this project
In this project we focus on the to do list and the interactive photobook application. We are programming those two functions in one app, that can be seen as an app all on its own. Therefore the home screen will look different from the home screen that the ideal interface would have. This will be shown by figure 5.
Because we want to make a fully functioning app, containing the to-do list function and the photobook function, it was decided to integrate the two functions in the home screen of the app. The app only has these two function for now and it is possible to display these two function within the same screen, minimizing the amount of menu's the user has to go throw for a specific function. With the five functions the ideal end product would have it is necessary to make an extra menu to organise the functions.
The button 'More functions' would bring forth the interactive photobook page as shown in figure 4.
Building an app
To build the app we looked at a few different options that are described below. Eventually, we decided to build the application with Kivy.
Snappy appypie
Snappy appypie is a free app developer wherefore you don't need to write a code. You can choose from different templates and there can be a lot of editing.[5]
It costs 18 euros per month to use and to develop your app in the App store or Google play. We thought it was a free app developer (apart from the App stores) but it turned out you have to pay 18 euros per month for just developing the app as well.
As stated in one of the articles we found, it is hard for people with dementia to remember how to use the technology. It should be designed as simple as possible. Therefore there should be a "simple" design. People with dementia are really sensitive to stress. The design should be as "calm" as possible with no jumping/moving or pop-up objects in the screen. It should be made as realistic as a physical button for example. So the user should get feedback as it pushes a real button. This could be achieved by changing color or sensation of the screen. It could for example vibrate and change color when the button is pressed. In the article this is stated as 'lack of embodiment of technology'. Older people for example are more used to the movement of writing a letter than typing on a keyboard.
These adjustments might be too hard to achieve in this app developer, because you cannot code it yourself. Therefore it might be more advantageous to work with an app developer that uses simple code.
Adobe Phonegap
Adobe Phonegap is an development framework for building mobile apps. In this video Cite error: Invalid <ref>
tag; invalid names, e.g. too many with explanation, the person uses Adobe Phonegap to make an app that you can instantly see on your device. You can edit multiple things and link it to a phone to download.
We tried downloading it twice and it was not working and the desktop application kept loading forever, so this is not an option in our opinion. We looked at different forums and a lot of people had the same problems so this seems like an unreliable program.
Good Barber
Good barber is a app maker similar to appypie. It seems to have more customizability though. There is a 30 day trail in which you can test the app and develop it. For us those 30 days are enough so we do not have to get the payed version. [6]
Kivy and python code
In our research, we found multiple sources that used Kivy and then used python code to code a mobile app. Kivy is an open source Python library for rapid development of applications that make use of innovative user interfaces, such as multi-touch apps. [7]
The advantages of coding your own app are that it is highly customizable and you do not have to deal with other parties like another app development website when making the app. An advantage of using Kivy is that is allows the app to display well on every screen size. You can alter the dimensions and the widgets will automatically stay centered. A disadvantage is that none of us have worked with this before. However, we took some time and found a couple tutorials that will help a lot.
The first video Cite error: Invalid <ref>
tag; invalid names, e.g. too many is part of a series by Tech with Tim on YouTube which takes you through all the little steps of app making. The second helpful tutorial Cite error: Invalid <ref>
tag; invalid names, e.g. too many helped in setting up the programs that you need and together the two tutorials allowed us to make the first steps of an app.
Details
We needed Python version 3.7.1 for this to work. We also downloaded Pycharm for the code. This is what both videos use. This is a texteditor where you can write the code. You need to know object oriented programming to do this. On the Kivy website there was some info about that and the first video from Tech With Tim mentions that he has some tutorials as well on his page.
Progress
At the end of the second tutorial we were able to make an app that allows the user to put in his or her personal information in text boxes. The following images show the app screen and the code.
Useful tutorials
These are some useful tutorials where someone is building a chat app, not exactly the same as we are trying to do but it explains a lot of codes such as buttons.
1. https://www.youtube.com/watch?v=FjwD0SOGQ1k&t=655s explains the first steps of making an app
2. https://www.youtube.com/watch?v=8I2fMqrruwc explains how to make buttons
3. https://www.youtube.com/watch?v=sJmkhV02lnM explains multiple screens and how to transition between them
4. https://www.youtube.com/watch?v=hsnch676Lco
5. https://www.youtube.com/watch?v=62LSK62Gudc
6. https://www.youtube.com/watch?v=lmWE2bydekk
7. https://www.youtube.com/watch?v=CIW0H70wo0M
8. https://likegeeks.com/kivy-tutorial/ offers some help with the different functions of Kivy.
Development in Kivy
We decided to work in Kivy as we want to make the system dynamic. That means it can be used by multiple users and should not only work for one person. How we coded the different functions is shown below:
Displaying pictures
It is important that the pictures are displayed in a specific manner, chronological and with dividing titles.[8] 'Screen Manager' makes it possible to connect multiple screens. This can be helpful with making scrolling through the pictures possible. A down side would be that the user is scrolling through multiple screens which contain pictures and through a list with all the pictures. [8]
Import photos
Two ways to display photos in the app. One way is to import photos from the system. { wimg = Image(source='mylogo.png'). The other way is importing from asynchronous loading. This is to load an image asynchronously (for example from an external webserver) {aimg = AsyncImage(source='http://mywebsite.com/logo.png').
In both options, the image title is called. This is not the same for every person. Hence, not dynamic. There is also a video that shows how to do it with one image.[9]
After discussing with some students from Computer Science it turned out that it is really hard to implement this function. First of all we would need a web-server. This is possible, but we also need multiple programs with all sorts of programming languages we haven't worked with yet. We could do research on this and make a list of all necessities, or it might be better for us to work with WordPress and transform it in such a way that it looks like an app. You can make an account, so that caregivers/family can log in to it and add photos. It then is easy to display and import them. However, only a gallery can be displayed, not one picture a day, which makes it less dynamic as well.
OPTION 1: IMPORT PHOTO FROM WEBSITE INCLUDING WEBSERVER
First of all, a website where the photos are uploaded should be used. This is a website called timetomato and it is made to upload photos from your pc.
In order to receive this picture from the website into our screen, the next codes are written. This is an easy way to take file 1, file 2 of the website and you don't need the title of the picture so that is easy.
An example of file 1 is shown here. So I uploaded this picture and then ran this code:
Same for file 2:
ADVANTGES:
+ Advantages of using this is that the pictures can be uploaded from every laptop from anywhere in the world.
DISADVANTAGES:
- In the Python file, there are not many options to edit the photo.
OPTION 2: IMPORT PHOTO FROM LOCAL PLACE, INCLUDING A KIVY FILE
This is the code and its outcome for the second option. With this option you can upload a photo from your computer, in the same directory as the python file.
The Kivy file can be read. This one is called by the code in the Python file.
ADVANTAGES:
+ A lot of edits can be done in the kivy file. The code in the Python file is general and the code in the kivy file is very specific; these are all modifications on the picture that is uploaded.
DISADVANTAGES:
- The code is very specific: the name of the picture should be written over precisely. Also, it can be uploaded only from the place where the code is written as well.
To-do list
There needs to be a to do list feature in the app. I found a video [10] that explains how to create a program that lets a user enter certain things (to do list items) and then the item is displayed in a list, the user can then also delete items from the list again when they are completed. Later it is found that this tutorial is outdated and uses a function of Kivy that is not available anymore, Listview. This function has been replaced with Recycleview instead. The website Like geeks[11] offered some help with the different functions of Kivy. Right now we are busy combining different functions to make a workable to do list. It has been a lot of trail and error up until this point. Now I have learned how to make buttons, change the colours and font colours, how to disable a button and how to make a scrollable list with the Recycleview.
We made a task list that can be saved between instances. It can be updated using the top buttons and the tasks can be checked off on the left
Template home screen
The Pong Game Tutorial introduces the fundamental design patterns and the application development process. As you follow the tutorial, you will create a simple app. You will also learn how to run the app on your OS. The simple steps in the tutorial introduce elegant, useful concepts that you will use over and over again in app development (https://kivy.org/doc/stable/gettingstarted/first_app.html).
The screen manager is a widget dedicated to managing multiple screens for your application. The default ScreenManager displays only one Screen at a time and uses a TransitionBase to switch from one Screen to another. Multiple transitions are supported based on changing the screen coordinates / scale or even performing fancy animation using custom shaders (https://kivy.org/doc/stable/api-kivy.uix.screenmanager.html).
The App class is the base for creating Kivy applications. Think of it as your main entry point into the Kivy run loop. In most cases, you subclass this class and make your own app. You create an instance of your specific app class and then, when you are ready to start the application’s life cycle, you call your instance’s App.run() method (https://kivy.org/doc/stable/api-kivy.app.html?highlight=app).
The Button is a Label with associated actions that are triggered when the button is pressed (or released after a click/touch). To configure the button, the same properties (padding, font_size, etc) and sizing system are used as for the Label class (https://kivy.org/doc/stable/api-kivy.uix.button.html).
The Home screen in kivy:
If you click on the buttons you go to the next screen where you can click on a button to go back:
The code of the Home screen in kivy:
Designs for a planning app with a social touch
Design Eline
Features that such an app should have
• A home screen with the current day and time and any special events that day: such as national holiday’s, birthdays or other anniversaries or people that the user knows. This way the user has more social contact with those persons. Also events for the next week.
• A daily schedule for that day. With times and activities on there. Things that count for the whole day (birthdays etc.) should also be included here. Furthermore daily routines should be on there, such as 3 meals a day, drinking water, appointments, medicine take-in. The activities on the schedule can be checked of off the list. o Goodbarber feature that might be helpful: You can create a Form where you can use checkboxes. o You can use a chat function, that way when the family has the app as well they can chat in there.
• When the user is late to checking off an item from the task list, they will receive a push notification reminding them of the task.
• When there is an event on the schedule where the user should leave their home, there should be a map function guiding them there. o This is what Goodbarber says about this: Itineraries. Thanks to event geolocalization, your users can create itineraries using external Map services such as Google Maps or Apple Maps.
• If we need any extra functions, we can add our own plugins. “If you are a developer, you may create one or several modules specifically designed for your app. Simply develop your plugin like a mini HTML/JS/CSS app and it will be embedded directly inside your app to function effectively, even without a network connection.” Goodbarder, section Developer/Plugins
Design focus
First, people over the age of 40 are more likely to experience presbyopia, or long-sightedness, which makes reading small text challenging. Second, colour vision, or the ability to distinguish certain colours, fades with age. Colour vision problems in the blue-yellow spectrum(link is external) are often detected among people in their mid-70s. (They struggle to distinguish between blue and yellow colors.) Keeping this in mind we should focus on: [12]
• Increase contrast
• Label Icons with text so they know what they mean
• Large text
• Arial and Verdana as fonts
• All-time visible navigation styles, avoid using slide-out menus
Final design
This is an example of how the app will look for the user. There is the ability to manage the tasks for that day and to look at certain appointments for that day. I made this design in Adobe Illustrator.
Design Metten
A quick mockup of a possible design for the app. It has a built in to-do list, which can give reminders. The list itself is divided in three categories: Tasks that are already done, tasks that have yet to be done and tasks that do not have to be done yet. The app also has reminders for upcoming activities and a button to call someone in times of emergency.
Design Vera
Features and Functions of the planner app
• Overall to do list called 'Daily Tasks', with recognizable icons
• A section with pictures called 'Memories'
• The app gives notifications about 'Memories' of certain dates or 'Daily Tasks' that have been "overdue"
Memory part
• A collection of pictures that can be a subpart of the planner app
In this section it wil be explained how the pictures are organised and what the memorie part of the app should do in detail.
• Every picture has a day-month-year attached to it. With this date it should be possible to put pictures in chronological order and to show how long ago the picture was taken.
• Pictures can have a caption that is show below the picture. If a picture has a caption that can be read out loud, a speaker icon is depicted on the picture or at the beginning of the text.
• The photobook is a big list with pictures that can be scrolled through and has big titles that state where a new month begins. The title states "Month - year". Important dates within the months, such as holidays and birthdays, have a smaller title in a different colour. It would be handy to make the background of these pictures a lighter shade of that colour to make clear when the pictures of that event are over and pictures of the normal month resumes. In the under titles is displayed how long ago the month/event happend.
• The Memorie part on the home screen of the app depicts a different picture every week (or three to four day maybe) with the title 'Memorie of the Week'. When the user clicks on "Show more pictures" the app will lead them to the beginning of the month or event where the picture belongs to.
• If the 'Memorie of the Week' has a caption, this caption is also show in the home screen of the app. There will be a limit on the amount of words of the caption that is depicted on the home screen and after this limit … will appear. The spoken audio will be played al the way through and will not end at this limit.
• The 'Memorie of the Week' picture is chosen from the pictures in such a way that the 'Memorie of the Week' pictures are also in chronological order. Every picture that is 'Memorie of the Week' is from a later point that the last. The new picture will also be of another month/event than the earlier one. When all months/events are represented in the 'Memorie of the Week' the 'Memorie of the Week' wil be chosen from the first month/event again.
Example of the Interface
The tasks become green when the user clicks on the square in front of them and will disappear from the list of 'Daily Tasks'.
The 'Memories' section could work according to the user requirements for the "Interactive Photobook' with spoken messages and pictures.
Example of the push notification that the app could give
Design Sterre
Features of the app
• A screen with the current day and the day planning, events, birthdays and holidays for that day.
• An option to go have an overall calendar to see the days per month
• A function called memories, where the memories of that day throughout the years are visualized. This means that photo's of that day that are taken through the years will be visual or stories about that day, that are written or spoken in by family members.
• The letters and functions should be big, so that they are easy to read and find.
• There should be a big contrast between colours
Design Iris
A very simple design is needed in order to not get distracted and keep in mind the function of the app. The most important aspect of this part of the app is that people can call their closest people. It works as follows: the family/caretakers can insert contacts with photos (to a max of 24 because of the design). In order to call the other person, the user has to click on one of the icons with the person's photo and name in it.
User Test
First, we made a test for our application to test the app with elderly people with dementia. This would be a good way to find out if people with dementia understand our application and how they use it. Then we would know how we could improve our application further. However, due to the COVID-19 situation it is not possible to do an user test with elderly people. Therefore, we decided to contact specialists and carers for elderly with dementia. We made a questionnaire to get expertise on our application and how we could improve it.
Test with users
Necessities
- Consent form
- Recording material
- At least one subject (more is better)
- A working app
- Something to make notes in for observations
Process
First the subject has to fill in the consent form and the experimenter has to ask for approval of recording the subject. Name will be anonymous. Then the actions of the subject with the app are recorded (sound and image). Different tasks should be given. The subject reads the exercise and carries it out, following a think-aloud process. Every little thing the subject thinks, should be said out loud. Also when they for example don’t really know what to do. In this way, it can be analyzed easily on what is not clear for the user and how to improve the app. Apart from the recordings, the observer has to write down things that are remarkable . For example, the subject frowns his/her eyebrows which could suggest he/she does not understand what to do. After the tasks, the subject fills in a questionnaire consisting of questions about the app.
Process in steps:
1. Consent form
2. Consent for recording
3. Recording starts
4. Subject does conducts tasks following think-aloud
5. Observer makes notes at the same time
6. Questionnaire for the subject
7. Thank the subject for cooperation
Tasks
1 → Imagine that you would need a guide in order to fulfill your daily tasks. You have brushed your teeth: what do you have to do now in order to show you have done the task?
2 → A photo is shown on the screen. You want to see what the story is behind the picture.
3 → What day is it? Where did you find this?
Consent form
USER-TEST TASK AND MEMORY INTERFACE FOR STARTING DEMENTIA IN ELDERLY
You have been asked to participate in a usability study. This document gives you information about this study and your rights as a participant. Please read it carefully.
About the study
The aim of this study is to discover faults in the app “NAME APP” in order to improve it. The study will last approximately twenty minutes. In this study, you will be asked to conduct a couple of tasks, formulated on the exercise sheet. You will be asked to say your thought process out loud and after the task fill in a questionnaire about the experience. During the study video and audio recordings will be made, as well as notations of other observations during the study. Furthermore the data of the questionnaire will be saved anonymously.
Voluntary
Your participation is completely voluntary. You can refuse to participate without giving any reasons and you can stop your participation at any time during the study. You can also withdraw your permission to use your data up to 24 hours after the study is finished. All this will have no negative consequences whatsoever.
Confidentiality
We will not be sharing personal information about you to anyone outside of the research team. Any audio or video recordings will not be distributed and will not be played back in the presence of persons other than the researchers. The material will be used only for scientific analysis. The information that we collect from this study is used for writing scientific publications and will only be reported at group level. It will be completely anonymous and it cannot be traced back to you.
Further information
If you want more information about this study you can ask Iris de Wit or Sterre Cuppens (contact email: i.c.d.wit@student.tue.nl; s.cuppens@student.tue.nl;) If you have any complaints about this study, please contact the supervisor, ..........
Certificate of Consent
I, (NAME) ………………………. Have read and understood this consent form and have been given the opportunity to ask questions. I agree to voluntarily participate in this study carried out by the research group of Project Robots Everywhere of the Eindhoven University of Technology.
Participant’s Signature Date
_________________________ ______________
Questionnaire for the specialists
1. What kind of technology do the people with dementia use nowadays?
2. How do people with dementia use the current technology?
3. What are the difficulties people with dementia have with using technology?
4. What difficulties do people with dementia have using a daily planning?
5. How do people with dementia experience seeing photos and memories from back in the days?
6. What are your opinions about an app that would have the daily planning with memories from back in the days for someone with dementia?
7. What kind of problems do you think that occur if someone with dementia would use this app?
8. Do you think that this app would help against loneliness among people with dementia?
List of carehomes in Eindhoven
Carehome | Sent mail | Contact over the phone | Participation |
---|---|---|---|
St. Annaklooster | Yes | Yes | We need to send an extra mail in Dutch and then they will talk about it |
Glorieuxpark | Yes | - | No |
Neos | Yes | - | - |
WoonincPlusVitalis | Yes | - | - |
Archipel Gagelbosch | Yes | Yes | Maybe, they are going to discuss it this week |
Archipel Passaat | Yes | Yes | Maybe, they are going to discuss it this week |
Archipel Eerdbrand | Yes | Yes | Maybe, they are going to discuss it this week |
Archipel Landrijt | Yes | Yes | Maybe, they are going to discuss it this week |
Vitalis Kronehoef | Yes | - | - |
Verpleeghuis de Weerde | Yes | - | - |
Brunswijck | Yes | - | - |
Planning
Week | Tasks to start | Intermediate Deadlines | All | Eline | Iris | Metten | Sterre | Vera |
---|---|---|---|---|---|---|---|---|
1 (20-4) / 26-4) | Articles - First plan | Articles - First plan | Read and summarize at least 25 papers, set up first plan | Wiki update | ||||
2 (27-4 / 3-5) | Research on app development - Research on ease of use for elderly | First plan worked out | Wiki update | Problem statement | Planning | Objectives | Users and requirements | State of the Art update |
3 (4-5 / 10-5) | Approach, milestones and deliverables - Developing App | Objectives worked out | Wiki update | Information and plan for building an app | Information and plan for building an app | Improving Objectives | Improving Objectives | Improving Objectives |
4 (11-5 / 17-5) | Preparations video | Approach, milestones, deliverables - Research ease of use for elderly | Wiki update | Research in navigation feature and app making with an app maker. | User-test | |||
5 (18-5 / 24-5) | Developing user test | Wiki update | Programming the To do list part of the app | Import photos with Kivy, contact with elderly homes | ||||
6 (25-5 / 31-5) | Analysis and improve app - Filming and later on edit | App finished - User tests done - Preparations video done | Wiki update | Programming the To do list part of the app | Import photos in Kivy | |||
7 (1-6 / 7-6) | Preparing presentation | Improving done, Video finished | Wiki update | |||||
8 (8-6 / 14-6) | Presentation | Wiki update |
Time management
Week 1:
Name | Student number | Time spent | Break-down |
---|---|---|---|
Eline Visser | 1375369 | 11 hours | Introductory meeting and study guide + group formation (2h) 2 group meetings (1.5h) Think of ideas and do research + read old wikis (2.5h) Learn how to edit wiki and make start on page (0.5h) 5 articles literary study and summary (4.5h) |
Metten de Lange | 1240902 | 11 hours | Introductory meeting and study guide + group formation (2h) 2 group meetings (1.5h), Researching ideas for the project (1.5h), Reading and summarizing 5 articles (6h) |
Vera Holtmark van Dijkerhof | 1380893 | 13 hours | Introductory meeting and study guide + group formation (2h) 2 group meetings (1.5h), reading wiki pages of previous groups (1.5h), reading 5 articles (6h), summarizing articles (2h) |
Sterre Cuppens | 1387790 | 11 hours | Introductory meeting and study guide + group formation (2h) 2 group meetings (1.5h), Literature research (5 h), Summarize articles, (2 h) Update wiki (0.5 h) |
Iris de Wit | 1258230 | 11 hours | Introductory meeting and study guide + group formation (2h) 2 group meetings (1.5h), reading wiki pages of previous groups (1.5h), reading 5 articles (6h), summarizing articles (2h) |
Week 2:
Name | Student number | Time spent | Break-down |
---|---|---|---|
Eline Visser | 1375369 | 7 hours | Summaries on articles (1h) Wiki problem statement (3h) Meeting tutor + Group (1h) Watch videos on how to make an app (2h) |
Metten de Lange | 1240902 | 5 hours | Meeting (1h), reading articles about the subject (2h), describing objectives based on articles (1h), updating wiki (1h) |
Vera Holtmark van Dijkerhof | 1380893 | 5 hours | Updating summaries and references of articles (2h), meeting with group and tutor (1h), reading article and rewriting requirements with obtained information (2h), |
Sterre Cuppens | 1387790 | 9 hours | Meeting (1 hrs), Updating references and summaries of articles (1 h), Types of users (3 h), User requirements (3 h), Update wiki (1 h) |
Iris de Wit | 1258230 | 6 hours | Meeting (1 hrs), Updating references and summaries of articles (1 h), making three different plannings (one over all, one for tasks and one scheme in Wiki) (3 h), Update wiki (1) |
Week 3:
Name | Student number | Time spent | Break-down |
---|---|---|---|
Eline Visser | 1375369 | 9 hours | Research on app making. (2h) Practice with python and Kivy (3h) Documenting the process (1h) Editing the wiki (1h) More research in appypie and app makers after the meeting with tutor. (2h) |
Metten de Lange | 1240902 | 6 hours | Meeting (1h), reading up on technology that helps demented people with basic tasks (3h), summarizing relevant articles (1h), constructing a set of requirements for to-do list and help app (1h) |
Vera Holtmark van Dijkerhof | 1380893 | 7 hours | Meeting (1h), reading up about dementia and Alzheimer (1,5), thinking about the concept of an interactive photobook (0,5h), writing requirements for interactive photobook (1h), watching tutorials about animation in preparation for the video presentation (3h) |
Sterre Cuppens | 1387790 | 8 hours | Meeting (1 h), Read articles again (2 h), Improve user requirements (4 h), Update wiki (1 h) |
Iris de Wit | 1258230 | 7.5 hours | Research on developing app (2h), Meeting (1h), Editing Wiki (1h), Research on how to use communication function, looking for articles and app-developers about this (3h), making template on communication (0.5), starting user-tests (1.5h) |
Week 4:
Name | Student number | Time spent | Break-down |
---|---|---|---|
Eline Visser | 1375369 | 11 hours | Research for a navigation app and requirements for it. (1h) Meeting with group Monday (1h), Research app makers (2h), Research apps for elders (1h), Designing app (3h), Editing wiki (1h) Goodbarber app making (2h) |
Metten de Lange | 1240902 | 6 hours | Meeting with group (1h). Study app designs (2h). Making design for app with planner (2h). Updating wiki (1h). |
Vera Holtmark van Dijkerhof | 1380893 | 7.5 hours | Meeting with group (1h), Looking for animation options for presentation (2h), Making design/concept for social planner app (2h), meeting with group and tutor (1h), working out the details of the memorie part of the app (1.5h) |
Sterre Cuppens | 1387790 | 9 hours | Research for a cognitive game (3h), Meeting with group (1), Research social planner app (3h), Designing social planner app (1h), Updating Wiki (1h) |
Iris de Wit | 1258230 | 7,5 hours | Meeting with group Monday (1h), Improving Communication (1h), Updating Wiki (1h), Making Start of User test (1,5), Designing app (1h), Research on communication (2h) |
Week 5:
Name | Student number | Time spent | Break-down |
---|---|---|---|
Eline Visser | 1375369 | 7 hours | Meeting group Monday (1h), Further programming in Kivy (2h), research to do list in kivy (1h), Editing wiki (1h), programming (2h) |
Metten de Lange | 1240902 | 4 hours | Meeting (1h). Installing Kivy (1h). Learning Kivy (2h) |
Vera Holtmark van Dijkerhof | 1380893 | 10 hours | Meeting with group (1h), installing kivy and start programming (3h), work on Memorie part of app in kivy (4), watching tutorials (2h) |
Sterre Cuppens | 1387790 | 7 hours | Meeting group Monday (1h), Finishing User Test (2h), Contact with carehomes (2h), Researching Kivy on template home screen (2h) |
Iris de Wit | 1258230 | 8 hours | Meeting group Monday (1h), Finishing User Test (2h), Contact with carehomes (2h), Researching Kivy on import photos (2h), update wiki (1h) |
Week 6:
Name | Student number | Time spent | Break-down |
---|---|---|---|
Eline Visser | 1375369 | 8 hours | Group meetings (2h), to do list programming (5h), wiki update (1h) |
Metten de Lange | 1240902 | hours | |
Vera Holtmark van Dijkerhof | 1380893 | 9 hours | Group meeting (1h), programming photobook (3h), writing for the wiki (1h), making visual content with illustrator (4h) |
Sterre Cuppens | 1387790 | 9 hours | Group meeting (1h), Updating Wiki (1h), Contact User tests (1h), Homescreen programming (6h) |
Iris de Wit | 1258230 | 9 hours | Group meeting (1h), Updating wiki (1h), Contact User tests (1h), Import photos in Kivy (6) |
Week 7:
Name | Student number | Time spent | Break-down |
---|---|---|---|
Eline Visser | 1375369 | 5.5 hours | Meeting Metten about to do list (1.5h) programming (3h), Meeting tutor (1h) |
Metten de Lange | 1240902 | hours | |
Vera Holtmark van Dijkerhof | 1380893 | hours | |
Sterre Cuppens | 1387790 | 10 hours | Programming Home screen (5h), Updating Wiki (5h) |
Iris de Wit | 1258230 | hours |
Week 8:
Name | Student number | Time spent | Break-down |
---|---|---|---|
Eline Visser | 1375369 | hours | |
Metten de Lange | 1240902 | hours | |
Vera Holtmark van Dijkerhof | 1380893 | hours | |
Sterre Cuppens | 1387790 | hours | |
Iris de Wit | 1258230 | hours |
State of the Art
Assistive technology in elderly care
Recent developments in new technology are the subject of intensive research destined to make an important contribution to the care of older people, both in institutions and at home. Electronic sensors, video-monitoring, remote health monitoring and equipment such as fall detectors, door monitors, bed alerts, pressure mats and smoke and heat alarms can improve patients’ safety, security and ability to cope at home. Since care in the community is preferable to most patients and is usually less expensive than in care homes, system using advanced technology to support people at home could benefit both patient and care provider. [13]
Loneliness and new technologies in a group of Roman adolescents
Those who use Internet most often declared having more friends who go on-line. This finding can be discussed in two perspectives. During adolescence friendship is often established on the basis of common interests and shared activities. In this case, the use of Internet could constitute an element able to launch and to facilitate the beginning of a friendship between two or more persons and to contribute toward greater cohesion in an already existing friendship. On the other side, the push toward homogeneity and similar behaviours, which often characterises groups of adolescents, could be considered a motivational factor in the use of this technology.It also emerged that those who use Internet more hold that as a result they neglect their friends and their scholastic commitments. A new technology may initially absorb time and attention usually dedicated to other things; the progressive disappearance of the novelty element could, instead,bring attention back to interests that existed prior to the new technology.The data from this research do not allow us to indicate a direction in the relationship between loneliness and the use of Internet. Due to the type of communication characterised by Internet, it could produce greater loneliness in adolescents who make greater use of it. However, it cannot be excluded that the large use of this technology is only an unsuccessful strategy put into action to face pre-existing loneliness, or that other variables intervene in the relationship between the use of Internet and loneliness. [14]
Socially Assistive Robots in Elderly Care: A Systematic Review into Effects and Effectiveness
The ongoing development of technology, specifically robots, against the background of a decreasing number of care personnel raises the question of what the potential contribution of robotics could be in rationalizing and maintaining, or even improving the quality of elderly care. Robots can contribute to health care support in terms of capacity, quality (performing very accurately and task specific), finance (support or even take over tasks of trained personnel), and experience (e.g., increased feeling of autonomy and self management). The idea of robotics playing a role in health care was launched some decades ago and has mainly been developed for physical training in rehabilitation as well as personal assistance for tasks of activities of daily living. Robotic applications supporting social behavior are a more recent development. So far, systems have been developed supporting child’s play and care for elderly with dementia. However, the uptake of these systems in care practice has been limited. One of the reasons is that there appears to be a mismatch between what is technically developed and the perceived needs within care environments.The term SIR was introduced to distinguish these robots from other robots that involve “conventional” human robot interaction, such as in tele-operation scenarios. In SIR, the robot’s goal is to develop close and effective interactions with a human for the sake of interaction itself. In contrast, in SAR, these systems are not designed to help the human being performing work tasks or saving time in routine activities, but to give assistance through social interaction to achieve progress in, for example, convalescence,rehabilitation, and learning. As such, SAR is a subsection of SIR. [15]
Scoping review on the use of socially assistive robot technology in elderly care
With an elderly population that is set to more than double by 2050 worldwide, there will be an increased demand for elderly care. The shift in societal proportions will place new pressures on all aspects of elderly care. Loneliness, for instance, is a consequence of social, psychological and personal factors. Over half of people over the age of 75 live alone and 17% of older people see family, friends or neighbours less than once a week. A recent meta-analysis showed that the impact of loneliness and isolation carries the same mortality risk as smoking 15 cigarettes a day. This poses several impediments in the delivery of high-quality health and social care. Socially assistive robot (SAR) technology could assume new roles in health and social care to meet this higher demand. These are robots adept at completing a complex series of physical tasks with the addition of a social interface capable of convincing a user that the robot is a social interaction partner. Five roles of SAR were identified: affective therapy, cognitive training, social facilitator, companionship and physiological therapy. [3]
Technology and loneliness in old age
In an attempt to contribute to a better understanding of the link between modern technology and loneliness in old age, this paper points to the vital role of individual dispositions. A construct sensitive to both technological as well as societal change, perceived obsolescence was shown to influence the way personal and telephone contacts were responded to. With low social contacts and high obsolescence being detrimental to feelings of social and societal integration in their own rights, their combination may compound feelings of loneliness far beyond additivity. Going further, feelings of being out of step with modern times were found to mediate the effects impact of low technological competence on loneliness. Given the accelerated obsolescence of both technological devices and user know-how, to keep up with technological progress may become a challenge not only for those persons who never learned how to use a computer. Thoughtful design and implementation of technology is needed to assure access to and orientation within modern society despite varying technological backgrounds and competences. [16]
Technology Implementation and Workarounds in the Nursing Home
As new systems have been explored to support medication administration, technology has become a critical part of these discussions. In response to ongoing patient safety challenges, health care organizations have implemented a variety of technological mechanisms to reduce medication errors such as computerized physician order entry, electronic medication administration record, and clinical decision support systems. However, implementation of technology has not been without risk. As technology has been developed and tested, new types of medical error and risk for error have occurred. Workarounds have been defined as “informal temporary practices for handling exceptions to normal work flow”. Exploration of WA, blocks, and the risk to patient safety is an important consideration as technology implementation moves forward in health care. As the literature has unveiled hidden risks associated with technology implementation, there is a need to understand the manner in which health care professionals interact with new technology and how work processes are adjusted as a result of technology implementation. Understanding these WA as a means of first-order problem solving is an important consideration to understanding the risk to medication safety. As new technologies are introduced, continued monitoring to identify work flow is needed so appropriate changes can be made to address the underlying problems that create work flow blocks ultimately leading to potential WA. Additionally, as technology is implemented, organizational processes that will interface with the technology must be carefully re-engineered to reduce the unintended consequences of change. [17]
Technology in dementia care
People with dementia experience progressive cognitive impairments that typically commence with short term memory problems but can encompass language deficits, difficulties initiating tasks, planning, monitoring and regulating behaviour, and visuospatial difficulties, agnosia (loss of ability to recognize familiar objects or people and apraxia (loss of ability to carry out complex purposive movements). Whilst drugs have for some time been used and approved by health organizations for the treatment of mild to moderate Alzheimer’s disease, these drugs do not cure, reverse or tackle the underlying root problem causing the dementia. Therefore in the absence of a cure, more innnovative approaches need to be developed to help promote independence and maximise quality of life. In this context, assistive technologies offer much potential and can make a very significant difference to the lives of people with dementia and to their primary caregivers. Indeed it has been noted that technologies should be part of a home package and should be provided in a thoughtful, sensitive ethical way. Technologies can assist people to maintain their independence improve quality of life. The overall opportunities technology can create for people with dementia however have to date not been fully maximised. [4]
Computerized multi-domain cognitive training reduces brain atrophy in patients with amnestic mild cognitive impairment
Multi-Domain Cognitive Training (MDCT) is a training programs that may protect people of the lost of grey matter volume in the brain. This could be a non-pharmacological intervention to slow the progress of dementia. The training program has two sessions a week and each session was 1h. Every session the tasks would challenge three out of the following six cognitive domains; reasoning, memory, visuospatial skills, language, calculation and attention. Every week every domain would be tested and trained within the tasks. At the end of two weeks of training, the grey matter volume of the participants was increases by 6.14% on average and a significantly positive correlation between the volume and scores on cognitive function tests was found. [18]
The Impact of Computer Technology on the Elderly
When designing technology for elderly users it is important to take some changes humans experience in mind. These changes are either sensory and motor changes, cognitive changes or social changes. Sensory and motor changes are the changes that the body experiences, such as decreasing in vision, hearing and motor skills. The cognitive changes cause the rate at which the users can learn and remember the new technology and “computer skill” to decrease. These changes cause elderly people to have difficulty with navigating through out the computer and remembering how to do things they have already done before on the computer. The social environment has a big influence in the technology that elderly people use. The traditional WIMP (Windows, Icons, Menus and Pointers) don’t consider these changes and when designing for elderly it is important to adapt the WIMP’s. [19]
Loneliness, health and social network among elderly people
Over a span of 10 years residents of nursing homes with a cognitive impairment where asked about feeling alone and the satisfaction with social contacts. There was an initial visit and three follow-ups after that. The people participating in the study where all cognitive impaired, which raised the question if it was ethical to use these participants for research while they didn’t understand the initial information of the study. The researchers included cognitively impaired elderly because it was important to the study and the end goal is to improve the future life quality of them. The questions asked in the interviews with the participants where about experiencing loneliness, being satisfied with social contact, living alone and having good friends to talk to. The percentage of the participants that said to not experience loneliness and where satisfied with social contacts increased over the follow-up visits. The percentage of people living alone steadily decreases over the course of the follow-ups, as could be expected. The percentage of people having a good friend to talk to decreased. Another inside that the study gave was that sever cognitively impaired participants experienced loneliness more often, while they more frequent visits then less cognitively impaired participants. [20]
Pain in Cognitively Impaired Nursing Home Patients
The findings of the study confirm that pain is common in cognitive impaired elderly homes. 60% of the patients that were able to make the complaints know said to experience pain. The participants of this study were disabled and most had difficulty performing daily activity, whether they did or did not experience pain. The results show that the pain management in skilled nursing homes is limited and only partially successful. 25% of the patients received physical therapy and apart from that only a few patients were given any other pain management. Cognitive impairment is a barrier in assessing and managing the pain complaints, 21% of the patients weren’t able to make their needs known. 17% wasn’t able to indicate the level off pain with the scales. This study concludes that pain assessment and management strategies for elderly with cognitive impairment need constant and frequent assessment of pain at that moment. The existing scales to measure the pain might need some adjustment to make up for the disabilities of the patient. [21]
Assistive Technology for Memory Support in Dementia
This review analyses the available Assistive Technology for elderly with dementia. A wide range of these Assistive Technology devices, that supports people with memory loss is commercially available nowadays. The only thing that is missing is a systematic review of studies that focus on the efficacy of these devices for supporting people with memory loss. The study primarily focusses on the efficacy of the assistive technology for memory support. This is researched in terms of level of dependency, daily performance of personal and instrumental activities of daily living and de admission to the care in the long term. The secondary objective that the review tests is the impact of the assistive technology on the users in terms of autonomy, usefulness and user-friendliness, adoption of the assistive technology. The conclusion of the review was that there needs to be more research about the effectiveness of the current assistive technology to support people with cognitive impairments with their memory loss. [22]
The use and acceptance of new media entertainment technology by elderly users: Development of an expanded technology acceptance model
Among older people, the barrier to start using technology is rather high, especially compared to younger people who grow up surrounded by technology. The two main factors contributing to the decision for older people to use a given technology are Perceived Usefulness (PU) and Perceived Ease of Use (PEOU). Previous experience with technology makes the barrier to start using it lower. It is important to note that the actual usefulness or ease of use is not that impactful, but rather how the user perceives it to be, even if they haven’t used it yet. Previous failures also contribute to the barrier for elderly people to pick up a new technology. [23]
Intelligent Assistive Technology Applications to Dementia Care: Current Capabilities, Limitations, and Future Challenges
Dementia is a growing problem in our society. Demented people are hard to care for and need lots of help with even the most basic tasks. This care is expensive and hard to provide, but technology may offer solutions. These solutions are broad in scope and range from sensors to memory aids. In the latter category the aids vary from cooking aids that guide the patients through a recipe to glasses that provide active reminders based on the surroundings or cameras that take photos that can later be used to remember things. The sensors are the most common can be divided into three categories: Physiological, environmental and advanced integrated sensors. The physiological sensors measure things ranging from the patients conditions or if they have fallen, based on which it can alert caretakers. Environmental sensors can be used to detect things that may be a danger to the patients. The advanced integrated sensors can help with the largest variety of things, from simply helping with home security to guiding a patient through washing their hands. While the technologies show promise, this is still an emerging research field and much work still needs to be done. However, these technologies could prove to be very useful in tackling dementia-related issues. [24]
The Use of Technology by the Elderly
The use of technology and its’ providing information allows the elderly to face more easily the difficulties of modern life, trespassing the limits of their social and emotional isolation, thus achieving a more qualitative living. The purpose of this research was to explore whether the elderly were familiar with modern technology. Education of the untrained elderly is the most essential step in order to become familiar with new technologies. More in detail, this can be accomplished through specifically designed education programs that teach elderly the way new technologies work. Furthermore, these programs should be also addressed to individuals who belong to the supportive environment of the elderly such as the younger members of the family. It would be beneficial if the younger helped them to familiarize with each object, removing fears of using high technology devices. [25]
The Use of Everyday Technology by People with Dementia Living Alone
While the technological development available to society is taking quantum leaps, we have little knowledge of how people with mild dementia manage to cope with familiar technology at home, such as television and electronic household machines, or new technology, such as remote controls, cell phones and computers. As this technology represents a potential problem area, the aim of this qualitative, exploratory study was to identify and characterize difficulties with and hindrances to using everyday technology, as they appeared in data, for persons with early stage dementia. The barriers to everyday technology use appeared in four domains: As interfering conditions related to the person, the context and the design of the artefacts, and as limitations in the participants’ knowledge of the technology and its potential, and as difficulties in direct technology use, characterized by communication problems both in understanding and in the administration of the technology. The participants’ use of instructions for use formed the fourth domain.[26]
Technology to Reduce Social Isolation and Loneliness
Large numbers of individuals, many of them senior citizens, live in social isolation. This typically leads to loneliness, depression, and vulnerability, and subsequently to other negative health consequences. This research focused on understanding the communication needs of people in environments associated with social isolation and loneliness, and how technology facilitates social connection. It consists of successive iterations of field studies and technology prototype design, deployment, and analysis. Particular attention is paid to seniors in retirement communities and in long-term care settings (nursing homes). [27]
Loneliness matters: A theoretical and empirical review of consequences and mechanisms
As a social species, humans rely on a safe, secure social surround to survive and thrive. Perceptions of social isolation, or loneliness, increase vigilance for threat and heighten feelings of vulnerability while also raising the desire to reconnect. Implicit hypervigilance for social threat alters psychological processes that influence physiological functioning, diminish sleep quality, and increase morbidity and mortality. The purpose of this paper is to review the features and consequences of loneliness within a comprehensive theoretical framework that informs interventions to reduce loneliness. We review physical and mental health consequences of loneliness, mechanisms for its effects, and effectiveness of extant interventions. Features of a loneliness regulatory loop are employed to explain cognitive, behavioral, and physiological consequences of loneliness and to discuss interventions to reduce loneliness. Loneliness is not simply being alone. Interventions to reduce loneliness and its health consequences may need to take into account its attentional, confirmatory, and memorial biases as well as its social and behavioral effects. [28]
What do community-dwelling people with dementia need? A survey of those who are known to care and welfare services.
The aging society will bring an increase in the number of people with dementia living in the community. This will mean a greater demand on care and welfare services to deliver efficient and customized care, which requires a thorough understanding of subjective and objective care needs. This study aims to assess the needs of community-dwelling people with dementia as reported by themselves and by their informal carers. The study also aims to give insight into the service use and gaps between needs and the availability of services. [29]
Intelligent Technology for an Aging Population: the Use of AI to Assist Elders with Cognitive Impairment
This article surveys new technologies that incorporate artificial intelligence techniques to support older adults and help them cope with the changes of aging, in particular with cognitive decline. [30]
Older Adults' Reasons for Using Technology while Aging in Place
Problem: the use of technology varies considerably among older adults. current models of technology acceptance are missing essential predictors specific to community-dwelling older adults. [31]
Problem: With aging, the risk of dementia, especially Alzheimer’s disease (AD), markedly increases (prevalence of more than 20% at age larger or equal to 80 years). Social activities are most heavily affected by spatial disorientation, which increases the risk of getting lost and exhibiting wandering behavior. Consequently, patients reduce outdoor mobility leading to a more sedentary lifestyle and social isolation, with a primary worsening of the quality of life and with a secondary negative impact on cognitive functions, cardiovascular tone, brain plasticity, and mood. A situation-aware Information and communication technology (ICT) requires a flexible fine-tuning by stakeholders of system usability and complexity of function, and of user safety and autonomy. It should operate by artificial intelligence/machine learning and should reflect harmonized stakeholder values, social context, and user residual cognitive functions. ICT services should be proposed at the prodromal stage of dementia and should be carefully validated within the life space of users in terms of quality of life, social activities, and costs. [32]
The effects of information and communication technologies on informal caregivers of persons living with dementia: A systematic review.
Up to 75% of people living with dementia in the United States are cared for by family members in their homes ICT interventions can improve decision confidence, reduce emotional strain, improve spousal relationship conflict, decrease activity restriction, increase self-efficacy, and decrease caregiver burden. A range of ICT interventions including, telephone-, video-, and computer-based interventions appear to be successfully targeting caregiver support for a range of affective caregiver outcomes, including burden, depression, and anxiety. Telephone technology can be used effectively as a stand-alone intervention or in tandem with other ICTs. [33]
The Use of Information and Communication Technology in Elderly and Patients with Dementia
The goal of this study was to summarize the most common ICT tools, and present the results of the most important clinical studies regarding the use of ICT methods in elderly and in patients with dementia. All findings are documented in two tables. Most notable for us (for reducing isolation/strengthening social network) [34]
References
- ↑ World Population Clock: 7.8 Billion People (2020) - Worldometer. (2020). Retrieved from https://www.worldometers.info/world-population/#:%7E:text=7.8%20Billion%20(2020),currently%20living)%20of%20the%20world.
- ↑ World Health Organization: WHO. (2019, September 19). Dementia. Retrieved from https://www.who.int/news-room/fact-sheets/detail/dementia
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- ↑ Pollack, M.E. (2005). Intelligent Technology for an Aging Population: The Use of AI to Assist Elders with Cognitive Impairment. Retrieved from AI Magazine, 26, 9-24.
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- ↑ Lucero, R. J., Fehlberg, E. A., Patel, A., Bjarnardottir, R. I., Williams, R., Lee, K., Ansell, M., Bakken, S., Luchsinger, J. A., & Mittelman, M. (2018). The effects of information and communication technologies on informal caregivers of persons living with dementia: A systematic review. Alzheimer's & dementia (New York, N. Y.), 5, 1–12. Retrieved from https://doi.org/10.1016/j.trci.2018.11.003 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6315277/
- ↑ Retrieved from https://www.researchgate.net/publication/326323900_The_Use_of_Information_and_Communication_Technology_in_Elderly_and_Patients_with_Dementia