1. Lessons Learnt from the Evaluation of Reminding AidsC Nugent, S O’Neill, M Donnelly, L Galway, M Beattie, S McClean, B Scotney
2. Dementia• Dementia is a progressive, disabling, chronic disease.• 28 million people suffer from dementia worldwide.• By 2030 the numbers are expected to double and by 2050 they are expected to triple (Prince 2010).• The costs of care associated with those suffering from dementia were estimated at £400bn in 2010.• Typical symptoms include impairments of memory, thought, perception, speech and reasoning.• It is also common to witness changes in personality and behaviour in addition to exhibit symptoms of depression, apathy and aggression.
3. Medication Management Technology Aids Location tracking Robot assisted activityActivity Assistance Electronic Memory Aids Item locators
4. Mobile Phone Video Reminding Support persons with mild Dementia to improve independence and QoL. to reduce caregiver burden. Focused on using a truly ‘everyday’ technology: Use a familiar face to offer the reminders Provide a ‘virtual Caregiver’ throughout the day.
5. Evaluation Methodology Range (Days) # Participants Days of Usage Initial 21 79 2-5 ABA 9 18 2Longitudinal I 6 205 6-61Longitudinal II 4 101 12-34 Total 40 403
6. Evolution of Reminder Interface EVOLUTION
7. Evolution of Carer’s interface EVOLUTION
8. User Recruitment• Participants were recruited by clinical research staff at the Memory Clinic, Belfast City Hospital.• Inclusion criteria: – recorded as having mild dementia (MMSE >18), – who lived alone and/or with a wiling carer able to record video messages.• Both patient and carer were involved in the informed consent procedure.• Baseline measurements of cognition were made based on MMSE and the Disability Assessment for Dementia was used for functional ability.• Pre and post evaluation questionnaires were administered by a research nurse via face-to-face interviews.
9. User EngagementPatient Age Gender Length of MMSE DAD Carer Carer Relation Living ID condition Age Gender ship Arrangement C11 75 Female 2 years 26 78 45 Female Daughter Together in law C12 73 Female 2 years 18 68 77 Male Spouse Together C14 61 Male 4 years 27 60 58 Female Spouse Together C15 71 Female 2 years 25 63 73 Male Spouse Together Details of participants and carers engaged in evaluations
10. Identified Needs Mobile Other Carer Carer Post-it or Diary or Dont phone or Technology personally calls to reminder Calendar need TV (please reminds remind note entry it reminder specify) Meals 4 Drink 4Entertainment 2 1 1 1Appointments 2 2 3 Medication 2 1 1 Housework 4 Make calls 2 2 2 Other Summary of identified user needs based on pre-evaluation questionnaires.
11. In-situ measurements 1 0 1 0
12. Results The majority of reminders were Numbers of missed acknowledged the first time itreminders were low. was received Participant Duration No. of No. of No. of No. of No. of No. of reminders reminders reminders reminders reminders reminders recorded missed ack. 1st ack. 2nd ack. 3rd ack. 4th and attempt attempt attempt attempt delivered C11 34 days 145 8 108 17 7 5 C12 12 days / / / / / / C14 27 days 22 0 19 2 1 0 C15 28 days 49 10 34 2 0 3 Analysis of Results following evaluations
13. Analysis of post evaluation questionnaires• Overall the feedback from the participants and carers (based on set of 30 questions post evaluation) was positive: – It supported reminders for their necessary tasks. – The phone was easy to use. – The phone interface and button size was very usable.• Only 1 participant wore the phone around their neck others felt it was too heavy.• There was reported embarrassment about the reminder being delivered in public.• When asked about WTP, all dyads agreed that they would pay for the service.
14. Analysis of post evaluation questionnaires• Negative Comments “It didnt do anything, I didnt hear the messages.” “It was too much she couldnt manage it and got frustrated, she kept trying to listen like a phone to her ear” (Carer)• Positive Comments “Reminders very good especially re medication in middle of day.” “useful prompt, took time to get used to it, only getting real hang of it now”
15. Challenges• Internet access (Broadband / Dongle)• Personalisation – Level of detail shown on screen and on documentation – Mode of reminder delivery (text, video)• Data Management – Heartbeat – Activity / Acknowledgments – Battery level• Compliance – Compliance Assessment (Sensorised Environment) – Feedback Management
16. Conclusions• Although data was limited with 4 participants, a useful insight has been gained into the overall utility of the system. (Long duration and recording of video messages.)• Varying levels of personalisation should be offered.• Value the importance of technical framework to support deployments.• Support by carer is correlated with success of using the device.• Consider factors affecting technology adoption.
17. Acknowledgements• Kyle Boyd• David Craig• Dorian Dixon• Mark P. Donnelly• Leo Galway• Sarah Mason• Sally McClean• Brian Meenan• Chris D. Nugent• Sonja A. O’Neill• Guido Parente• Bryan Scotney