Recreating living experiences from past memories through virtual worlds for people with dementia

This paper describes a study aimed to understand the use of 3D virtual world (VW) technology to support life engagement for people with dementia in long-term care. Three versions of VW prototypes (reminiscence room, virtual tour and gardening) utilising gestured-base interaction were developed iteratively. These prototypes were tested with older residents (80+) with dementia in care homes and their caregivers. Data collection was based on observations of how the residents and care staff interacted collaboratively with the VW. We discussed in depth the use of VWs in stimulating past memories and how this technology could help enhance their sense of self through various means. We also highlighted key approaches in designing VWs to sustain attention, create ludic experiences and facilitate interaction for older people with dementia

An affective computing and image retrieval approach to support diversified and emotion-aware reminiscence therapy sessions

A demência é uma das principais causas de dependência e incapacidade entre as pessoas idosas em todo o mundo. A terapia de reminiscência é uma terapia não farmacológica comummente utilizada nos cuidados com demência devido ao seu valor terapêutico para as pessoas com demência. Esta terapia é útil para criar uma comunicação envolvente entre pessoas com demência e o resto do mundo, utilizando as capacidades preservadas da memória a longo prazo, em vez de enfatizar as limitações existentes por forma a aliviar a experiência de fracasso e isolamento social. As soluções tecnológicas de assistência existentes melhoram a terapia de reminiscência ao proporcionar uma experiência mais envolvente para todos os participantes (pessoas com demência, familiares e clínicos), mas não estão livres de lacunas: a) os dados multimédia utilizados permanecem inalterados ao longo das sessões, e há uma falta de personalização para cada pessoa com demência; b) não têm em conta as emoções transmitidas pelos dados multimédia utilizados nem as reacções emocionais da pessoa com demência aos dados multimédia apresentados; c) a perspectiva dos cuidadores ainda não foi totalmente tida em consideração. Para superar estes desafios, seguimos uma abordagem de concepção centrada no utilizador através de inquéritos mundiais, entrevistas de seguimento, e grupos de discussão com cuidadores formais e informais para informar a concepção de soluções tecnológicas no âmbito dos cuidados de demência. Para cumprir com os requisitos identificados, propomos novos métodos que facilitam a inclusão de emoções no loop durante a terapia de reminiscência para personalizar e diversificar o conteúdo das sessões ao longo do tempo. As contribuições desta tese incluem: a) um conjunto de requisitos funcionais validados recolhidos com os cuidadores formais e informais, os resultados esperados com o cumprimento de cada requisito, e um modelo de arquitectura para o desenvolvimento de soluções tecnológicas de assistência para cuidados de demência; b) uma abordagem end-to-end para identificar automaticamente múltiplas informações emocionais transmitidas por imagens; c) uma abordagem para reduzir a quantidade de imagens que precisam ser anotadas pelas pessoas sem comprometer o desempenho dos modelos de reconhecimento; d) uma técnica de fusão tardia interpretável que combina dinamicamente múltiplos sistemas de recuperação de imagens com base em conteúdo para procurar eficazmente por imagens semelhantes para diversificar e personalizar o conjunto de imagens disponíveis para serem utilizadas nas sessões.Dementia is one of the major causes of dependency and disability among elderly subjects worldwide. Reminiscence therapy is an inexpensive non-pharmacological therapy commonly used within dementia care due to its therapeutic value for people with dementia. This therapy is useful to create engaging communication between people with dementia and the rest of the world by using the preserved abilities of long-term memory rather than emphasizing the existing impairments to alleviate the experience of failure and social isolation. Current assistive technological solutions improve reminiscence therapy by providing a more lively and engaging experience to all participants (people with dementia, family members, and clinicians), but they are not free of drawbacks: a) the multimedia data used remains unchanged throughout sessions, and there is a lack of customization for each person with dementia; b) they do not take into account the emotions conveyed by the multimedia data used nor the person with dementia’s emotional reactions to the multimedia presented; c) the caregivers’ perspective have not been fully taken into account yet. To overcome these challenges, we followed a usercentered design approach through worldwide surveys, follow-up interviews, and focus groups with formal and informal caregivers to inform the design of technological solutions within dementia care. To fulfil the requirements identified, we propose novel methods that facilitate the inclusion of emotions in the loop during reminiscence therapy to personalize and diversify the content of the sessions over time. Contributions from this thesis include: a) a set of validated functional requirements gathered from formal and informal caregivers, the expected outcomes with the fulfillment of each requirement, and an architecture’s template for the development of assistive technology solutions for dementia care; b) an end-to-end approach to automatically identify multiple emotional information conveyed by images; c) an approach to reduce the amount of images that need to be annotated by humans without compromising the recognition models’ performance; d) an interpretable late-fusion technique that dynamically combines multiple content-based image retrieval systems to effectively search for similar images to diversify and personalize the pool of images available to be used in sessions

Interior Design as a tool for dementia care

This book investigates the role of interior design in the enhancement of the effectiveness of Non-Pharmacological therapies for Alzheimer’s disease care. The author presents the conceptual model for an environmental system called “Therapeutic Habitat”, meant as a system of environmental interventions, based on tangible and intangible aspects, products and furniture, objects and services. Its aim is to enhance the well-being of people with dementia and stimulate recognition and interaction with the surrounding environment

Interior Design as a tool for dementia care

This book investigates the role of interior design in the enhancement of the effectiveness of Non-Pharmacological therapies for Alzheimer’s disease care. The author presents the conceptual model for an environmental system called “Therapeutic Habitat”, meant as a system of environmental interventions, based on tangible and intangible aspects, products and furniture, objects and services. Its aim is to enhance the well-being of people with dementia and stimulate recognition and interaction with the surrounding environment

An e-health system for the ederly (Butler Project) : a pilot study on acceptance and satisfaction

The Butler Project is a technological e-health platform that uses the Internet to connect various users; it was designed to deliver health care to the elderly. The Butler platform has three levels of implementation: diagnosis (mood monitoring, alert system, management reports), therapy (training in inducing positive moods, memory work), and entertainment (e-mail, chat, video, photo albums, music, friend forums, accessibility to the Internet). The objective of this work is to describe the psychological aspects of the platform and to present data obtained from four users. Results show that after using the system, the participants increased their positive emotions and decreased their negative ones; in addition, they obtained high levels of satisfaction and experienced little difficulty in using the syste

Musiquence – Design, Implementation and Validation of a Customizable Music and Reminiscence Cognitive Stimulation Platform for People with Dementia

Dementia is a neurodegenerative disease that affects millions of individuals worldwide and is challenging to diagnose as symptoms may only perceivable decades later. The disease leads to a gradual loss of memory, learning, orientation, language, and comprehension skills, which compromises activities of daily living. Health-related costs caused by dementia will continue to increase over the next few years; between the years 2005 and 2009, an increase of 34% (from $315 to$422 billion worldwide) was observed in treating dementia-related issues. Pharmaceutical approaches have been developed to treat dementia symptoms; unfortunately, the risk of side effects is high. For this reason, nonpharmaceutical methods such as music and reminiscence therapies have gained acceptance as patients with dementia positively respond to such approaches even at later stages of the disease. Nevertheless, further research is needed to understand how music and reminiscence therapy should be used and to quantify their impact on individuals with dementia. The development of serious games has gained attention as an alternative approach to stimulate patients. However, the clinical impact that serious games have on individuals with dementia is still unclear. In this dissertation, we contribute with new knowledge regarding the usage of music and reminiscence approaches in people with dementia through a theoretical model. Based on Baddeley’s working memory model, our model aims to explain how the therapeutic properties of music and reminiscence can have a beneficial effect. To test our model, we developed a novel interactive platform called Musiquence, in which healthcare professionals can create music and reminiscence based cognitive activities to stimulate people with dementia. In this dissertation, we present the results from several studies about the usage and effects that music and reminiscence have on such a population. We performed two studies using Musiquence to study the feasibility of a novel learning method based on musical feedback to aid people with dementia during task performance in virtual reality settings. Results show that participants relied more on music-based feedback during the task performance of virtual reality activities than in other forms of feedback. Also, data suggest that the music-based feedback system can improve task performance, compensating for some dementia-related deficits. We also used Musiquence in a longitudinal one-month-long pilot study to assess its efficacy when used for a cognitive stimulation intervention in dementia patients. The results of the study are promising. The 3 participants showed improvements in terms of general cognition, quality of life, mood, and verbal fluency

The Connective Power of Reminiscence: Designing a Reminiscence-based Tool to Increase Social Interactions in Residential Care

Reminiscence powers therapeutic interventions such as Life review and Reminiscence therapy, with well known positive outcomes on the wellbeing of older adults. In particular, reminiscence therapy supported by technology can increase self-esteem, facilitate social interactions and increase opportunities for conversation. Much research on reminiscence technology has in fact focused on improving interactions and conversation, mainly for people with dementia. Nonetheless, the potential for reminiscence to discover common life points among residents in residential care facilities and especially to use this information to foster bonding between residents has been little explored. The focus of this thesis is to design a reminiscence-based tool, to be used in nursing homes to stimulate interactions among older adults, family members, and nursing home staff. We start by describing early work that reinforces the potential of ICT interventions on improving the wellbeing of older adults. These studies highlight the importance of social interactions on social wellbeing and of doing activities together in engagement and motivation. Through review works and exploratory studies we confirm the positive effects of social interaction on the wellbeing of older adults, the benefits associated to contributing, and the opportunities to improve social interactions, not only from distance but also in co-located settings. In nursing homes we find a context that requires improving social interactions, and in reminiscence we find an ideal activity to make contributors out of older adults, stimulate conversation, and possibly increase connectedness between older adults and their networks. A series of studies were conducted with nursing homes stakeholders to define and design a tool suitable to their current practices, that could be used and adopted in nursing homes to stimulate co-located interactions. In this thesis, we present the work carried out to define and validate and concept of a reminiscence-based tool, and describe how input from nursing home stakeholders has been integrated into the design of a tool to improve social interactions in residential care facilities