REIMAGINING LIFE WITH DEMENTIA

THE PROBLEM

As it is difficult to obtain detailed information from the main stakeholders due to their condition, it is particularly important to watch how they behave and interact, and speak to those around them. Caregivers also have many issues to tackle, including communicating with their patients, entertaining their patients, and providing medical treatment.

TIMELINE

1.5 Years

February 2018–
May 2019

TEAM

I worked with 5 others as part of Design For America:
Emma Abele, Glory Dang, Danny Lee, Claire Lin &
Zoe Beckman.

KEY GOAL

To develop a product 

to improve the quality of life for people living with dementia.

UNDERSTANDING THE USER

We began by looking into the characteristics of dementia, potential stakeholders, and various ways in which we could enhance the quality of life for our target users.

Problem Space Analysis

 

What Are The Characteristics of Dementia?

  • Memory Loss

  • Emotional Control

  • Lack of Self-Awareness

  • Difficulty in Communication

  • Anxiety and Depression

Who Are Our Stakeholders?

  • People with dementia

  • Their loved ones

  • Caretakers

  • Alzheimer’s “Activists”

  • Healthcare providers

  • Volunteers

Initial Focus Question: How can we make life more engaging for people living with dementia?

  • This focus covers areas such as combatting anxiety and depression and makes up for a lack of memories and strong interpersonal bonds.

Research Methods:

 

Our preliminary research involved online research, interviews, and user observations, focused specifically on people living with dementia in care homes in the local Providence area.

Online Research and User Observations

We conducted online research and visited two care homes (Wingate Residences and Arbor Hill) to establish the most effective ways to make life more engaging for people with dementia.

This is a summary of our interview findings:

Care Home Volunteers

  • Enjoy responsibility

  • Love human interaction

  • Individualize activities 

  • Importance of integrating music 

Care Home Nurses

  • Music triggers and brings back memories 

  • Independence and Individuality

  • Validation therapy - empathy

  • Happiness

  • Pets, babies/children and exercise increase happiness in patients

Combining these findings with our online research, we concluded that the four most effective ways to make life more engaging for people with dementia would be:

  • Music

    • Music has emotional and behavioral benefits, working almost like magic in motivating people to open up and be lively. It is also linked to bringing back memories.

  • Dance

    • Physical activity, including dancing, has been scientifically proven to improve brain functioning. The act of dancing is also an easy way to connect with one another.

  • Visual Arts
    • People with dementia are more interested in color and other visual stimuli than problem-solving activities.

  • Communication

    • Communication is difficult for those with dementia, but storytelling and conversation are especially important for their happiness and well-being.

 

BREAKING DOWN THE PROCESS 

We then ideated and tested some initial ideas. After the first round of testing, we made a fairly significant pivot, before coming up with our final product ideas.

Initial Ideation

After conducting our preliminary research, we came up with the following four potential solutions and presented the ideas to the care home nurses for feedback.

Initial Ideas.png
  • Digital Dance Toy

    • Idea: By syncing hi-tech LEDs to music in a new product, we could create an interactive tool for collective exercise and fun.

    • Feedback: Such products already exist, and the digital aspect of the product will probably be too overwhelming.

  • Mixed-Generation Gardening Activity
    • Idea: By collaborating with local care homes and elementary schools, we could build community through creating a landmark greenspace.

    • Feedback: The idea is good, but the care homes involved would have to sustain it after our initial implementation in order for it to be meaningful, which is not something they could necessarily commit to.

  • Memory Book Template

    • Idea: A digital memory book template can be filled out by families as a group activity, and they can order a physical copy to keep and reflect on.

    • Feedback: Most residents don’t have photos or active family members, but they do like telling people stories.

  • Sensory Relaxation Room

    • Idea: Residents of care homes can use this space to calm down and relax during episodes of conflict, frustration or stress.

    • Feedback: The idea is good, but this would involve dedicating a specific room for the activity, which is not currently feasible. Patients also have to be supervised at all times and the staff would not be able to take individual patients into the room whenever they wanted.

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Alexa Skill.png

Refined Focus Question, Prototyping & Testing

Refined Focus Question: How can we facilitate a meaningful storytelling activity for high-functioning dementia residents?

Refined Solution: Storytelling Workshop

We went to Arbor Hill to gather information about how the residents would respond to music and storytelling. We took a speaker to play 50s and 60s music, category cards to promote stories from their past, famous photos to use as prompts for fictional stories, and craft materials (colored pencils, scissors, clay…) We found that the residents were less interested in organized activities and preferred to just make conversation and tell stories organically. We also noticed how starkly different the personalities in the room were and realized that our final solution would have to be adaptable and not ‘one size fits all’.

MIT Critique

We partnered with MIT for a joint critique and received the following feedback:

  • Think about people around those with dementia and not just the patients themselves as they all affect each other. For example, if you make it easier for nurses to keep track of patient needs, they can care for the patients in a more personalized and meaningful way.

  • Think of people with dementia as complex individuals and do not assume they all want the same thing.

Pivot – Technology & Communication

After our critique, we made a significant change in direction. We decided that as most of us want to go into technology-related careers, that we wanted to create a digital product or experience. We felt that the best way to maximize the potential of a digital solution was to focus on communication between patients, families, and caregivers.

 

Problem Spaces – Technology and Communication

 

We narrowed the problem space down to two areas:

  • Creating a device that relieves some of the work of care home staff, and also allows those living at home to live more independently 

  • Facilitating matching people with dementia to volunteers with whom they can meet up on a regular basis and participate in an activity that interests both parties

Ideation

 

We came up with two solutions to the issues we were exploring:

  • A new skill for the Amazon Alexa that would remind people with dementia to carry out specific daily tasks and also respond to specific questions that they would ask on a regular basis

  • A website that allows both potential volunteers and those with dementia to create profiles detailing their likes, dislikes and needs and matches people accordingly, allowing them to schedule a regular time to meet and do an activity that lines up with their shared interests

Nurse Interviews

We pitched the two ideas to nurses at both Arbor Hill and Wingate Residences care homes and received the following feedback:

  • Alexa Skill

    • Some residents can use technology better than others

    • Cost may be an issue (AH); Cost is not an issue (WR)

    • Reminders would be incredibly helpful

    • The addition of lights would also be a good idea – lights that simulate sunrise/sunset are good for calming residents down

    • Could also be used for entertainment and companionship – could be used to help high-functioning residents fill out trivia games or crossword puzzles

  • Website

    • This is really helpful as it means that residents are getting one-on-one attention and are doing activities tailored to their interests

    • The staff would probably have to set up the profiles on behalf of the residents

    • Volunteers would need BCI and Flu Vaccine checks

    • The resident profiles should include their level of functioning and whether they would be able to leave the care home or not

  • Overall

    • Neither idea is ‘better’ than the other, both are promising, and some residents would be better suited to one in particular. It would be a good idea to develop both.

Idea Development

We took the feedback from the nurses on board and made adjustments to our designs accordingly, as well as considering some of our earlier research findings.

 

De-Stress

A digital solution for calming down Alzheimer’s patients during moments of high tension

*NB – All illustrations and coding were done by me. 

Problems To Solve

  • Mood Swings and Tensions

    • One issue that seems to arise in care homes sudden mood swings that can lead to arguments among residents.

    • We have also learned that music is always a good way to calm down residents, but that light also has a powerful effect. 

    • In particular, lights that emulate sunrises or sunsets cause a positive reaction. 

  • Forgetting Daily Tasks

    • An obvious symptom of dementia is memory loss. This means that those with the condition often forget little things that they need to do throughout the day, such as showering, going grocery shopping or participating in a scheduled activity. 

Idea 1 – Alexa Skill

 

We would create a new skill for Amazon’s Alexa aimed specifically at those with dementia:

  • In response to a rise in noise levels, Alexa would play relaxing music and also cause a color-changing LED attached to the device to emit calming colors. One the noise levels drop, the music and lights would fade down after 10 minutes.

  • Alexa is also able to remind people of different tasks they have to complete or activities they have to attend and could be linked to the ‘CareHome Connections’ website. 

  • Residents can also ask it the same questions repeatedly and it will continue to answer without frustration. We would, therefore, program it to have answers to a range of questions that patients are likely to ask.

  • The Amazon Echo or Dot would either be placed in common areas of the care home, or in individuals’ rooms if finances allow.

  • Alexa would keep track of every time the lights and music are triggered, and would also record the types of questions that residents are asking in order to inform caregivers of any issues that may need to be addressed.

Idea 2 – Standalone Smart Device

 

We would create a standalone product aimed specifically at those with dementia:

Standalone.png
  • Powered by a microcontroller, the device will detect noise levels in the room. When the noise levels rise above a certain point, the device will emit calming colors and will play calming music. This will distract residents from the current tension and will help them to relax. Once the noise levels have dropped, the music and lights would keep going for 10 minutes before fading down.

  • The hardware would be hidden under a cloud-like structure – made from stiffened fabric or similar:

  • The music would be generated by a Teensy board and played through a speaker

  • The light would come from a strip of LEDs

  • The noise levels would be detected by a sound sensor

  • This would either be placed in common areas of the care home, or in individuals’ rooms if finances allow.

  • It would also make a note of every time it is triggered and this information would be accessible to the caregivers in the home so that they can monitor behavioral issues.

  • This could also be linked to the ‘CareHome Connections’ website and Alexa in order to provide daily reminders.

Final Product: Standalone Smart Device

Ball.png
Diagram Non-Transparent.png
  • We ended up opting to prototype a standalone smart device as it was a cheaper and more accessible option as it did not require the user to already own an Amazon smart product.

  • We prototyped a digital stress ball that, powered by an Arduino microcontroller, would light up in different ways determined by where the user touches it using capacitive sensing.

CareHome Connections  

A Platform For Matching Volunteers With Care Home Residents According To Their Shared Interests

*NB – While the user flow was discussed as a group, the final wireframes created made by my teammate, Emma. Prototyping was done as a group on Figma, based on a style guide that I made.

Homepage

Homepage WFs.png
  • This is a rough wireframe of the homepage. 

  • Users will be presented with the option of selecting ‘Volunteer’ or ‘Caregiver’, which will take them to the relevant pages. 

  • They will also see some sample profiles of residents which will display a photograph and a snippet of their personal story.

Volunteers

Volunteer WFs.png
  • This is a rough wireframe of the volunteers' section of the website.

  • Users will be able to: 

    • Create a profile

    • Search for and select residents

    • View and accept their requests and matches

    • Schedule meeting times with their confirmed partner

Caregivers

Caregiver WFs.png
  • This is a rough wireframe of the caregivers' section of the website.

  • Users will be able to:

    • Create profiles on behalf of residents

    • Search for and select volunteers 

    • View and accept requests and matches

    • Organize meetups

    • View all scheduled meetups on a calendar

Final Prototype

We made an interactive prototype of CareHome connections on Figma.

 

A video walkthrough of the prototype can be found below.

User Testing

Out of the two products, we felt that CareHome Connections was stronger as it emphasized the human connection that we established was very important during our research.

 

We struggled to find a test group to follow through the entire volunteer process, but we presented the functioning prototype to our main community partner, Arbor Hill. Nurse Joann walked through the website and gave comments as we observed. We also personally introduced our project to the residents for the future run of the test service.

The project was also presented to other DFA participants at the end of semester critique.

 

Feedback

  • Arbor Hill

    • Schedule organization is needed to help nurses plan ahead

    • Meeting in person is necessary for nurses to receive a physical copy of medical records and get to know the volunteer

  • Design For America Critique

    • HIPAA regulations must be adhered to

    • People were very interested in the testing results of De-Stress

KEY TAKEAWAYS

This project was my first experience of working in an interdisciplinary group over an extended period of time and I learned a lot about leadership, communication, time management, and task delegation.

It also gave me the opportunity to work with community partners and have frequent in-person interviews, observations and testing sessions.

Being part of Design For America also formally introduced me to the human-centered design process and the practice of design thinking.

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