Design of a device to assist with repetitive questions in patients with Alzheimer’s Disease (AD)

1. Contact Information: Kirstie Hawkey PhD Candidate Faculty of Computer Science Dalhousie University hawkey@cs.dal.ca Acknowledgements: This work is conducted with the guidance of Drs. Jacob Slonim, Kori Inkpen, Michael McAllister, and Kenneth Rockwood, MD. Assistance with study recruitment is being provided through the Memory Clinic (Veteran’s Memorial Building, Halifax) and the NS Alzheimer’s Society. This study is funded in part by NSERC and PRECARN. Design of a device to assist with repetitive questions in patients with Alzheimer’s Disease (AD) Repetitive Questioning Behaviour (RQB) Preliminary Device Requirements & Design • Research Questions • What role can technology play in improving quality of life for AD patients and their caregivers? • Is there a willingness to use technology? • What are the barriers to the use? • Can a technological intervention be effective at relieving some of the caregiver stress associated with RQB? • Causes of RQB • Short-term memory loss and lack of recall • Boredom • Feelings of insecurity about ability to cope • Anxiety about future events • Declining Abilities Over Time • Cognitive impairment • Short-term memory • Task sequencing • Time sense • Language problems • Word substitution • Stammering • Incomplete sentences • Object naming • Normal aging effects • Vision • Hearing • Fine motor skills • Personal Information Appliance • Requirements • Hide complexity with limited functionality • Low cognitive load, particularly for memory • Build on familiar metaphors • Personalize content and functionality • Must be easily updateable by caregiver • Should be mobile or moveable in home • Issues of weight, durability, power, size of • display, connectedness • Limitations of PDAs as solution • small screen size • elderly user may have poor vision • hidden functionality • small buttons, stylus require fine motor • skills • Multimodal Interface • Input • Speech input could be problematic • Need to remember what to say • Elderly can be feeble in voice • Touch screen • One touch interactions • Large target to assist with hand tremors • Output • Literacy issues for text • While ability to read endures, reading • comprehension declines • Audio/video may be better understood, • but temporal in nature • Use simple sentence structure • Provide alternative modes of information • Study Design • Phase 1: • Semi-structured interviews • of 24 dyads (AD patients • & their caregivers) • Daily diaries of RQB • Phase 2: • Paper prototypes for • feedback • Phase 3: • Implementation of one design • In-home study of effectiveness of device • Information Gathering • Interviews • Interaction abilities of dyad • General patterns of RQB • Types of questions asked • Location(s) of RBQ • How to best represent time • Daily Diary • Record questions asked, answers given, time of day, and number of repetitions • Speech Analysis • AD patient’s speech will be analyzed for suitability as an input modality • Personal Interaction Vocabulary • Problem • Vocabulary problem with speech interfaces • AD patients have short-term memory problems, difficulty remembering new skills • Proposed Solution • Allow specification of a personal vocabulary to be used as their interaction 'language'. • This vocabulary can include: • the commands used to invoke and control the applications • the terms used on buttons, menus, within text, and in documentation • the images and icons used by the application. • Potential Interface Components • Event driven information • Timeline/calendar of day’s events • Customize representation of time • Customize viewing window • Information about friends/family • Pictures could be touched to get a video • /voice recording • Personal story or message • Information about the next visit • Allow remote update via phone • Other information • Static “Top X” most common questions • Caregiver will need area to update, • organize & represent changing info needs Current Practice http://comm2.fsu.edu/programs/commdis/caregivers/memorybook.html