1) The document discusses using chatbots to provide support for palliative caregivers and those with dementia. It proposes a system that would sense caregiver needs, provide essential information through a chatbot, and offer emotional support. 2) A specific chatbot called DORI is proposed for dementia patients and caregivers. DORI would discreetly monitor patients, provide activity monitoring, telepresence, and access to information. It could also help patients communicate needs and issues they may be uncomfortable discussing with family. 3) DORI aims to improve social care, reduce costs, and help with remote monitoring, support, and emergency response. It could act as a "m

1. CHATBOTS FOR ELDERLY CARE
Dr Tan Jit Seng
Senior Home Care Physician
Lotus Eldercare Health Services
Lotus Eldercare Private Limited

2. USE CASE 1 – CHATBOTS FOR
PALLIATIVE CARE
Palliative caregiving is stressful, but caregivers are often neglected. An effective
patient care involves the loop of care (patient, health services and caregiver).
The stress level is even higher for non-professional (eg: family members)
palliative caregivers because they are not trained.
The strain on nursing home have also been increasing and home care will be
increasingly important.
Providing care for the palliative caregivers will:
1) improve the effectiveness of palliative care;
2) decrease the stress on non-professional caregiver; and
3) potentially decrease or delay the sending of patient to the nursing home.

3. THE GRAND IDEA WITH CHATBOT AS
ONE COMPONENT
A chatbot system for palliative care proposes an approach to care for the non-
professional palliative caregivers. To achieve this, the team intends to first
perform a study on the needs of palliative caregiver in the Asian context. After
which, this project intends to focus on:
1) sensing of the caregivers;
2) providing essential information; and
3) providing emotional support. These components will link to third parties
service providers to complete the care for the caregivers.
Such a model will also contribute in the long-term self-sustainability for the
society to enjoy the benefits.

4. THE COMPONENTS
As illustrated in Fig. 1 , the team intends
to first perform a study on the needs of
palliative caregiver in the Asian context.
After which, this project intends to focus
on: 1) sensing of the caregivers; 2)
providing essential information; and 3)
providing emotional support. These
three components will be linked to third
parties service providers as illustrated in
Fig. 1 to complete the care for the
caregivers. Finally, trials with user will be
conducted to test the feasibility.
Fig. 1

5. WORK PACKAGE (3): DESIGN AND
DEVELOPMENT OF CHATBOT FOR
CAREGIVERS
• A chatbot will also be designed and developed for the caregivers. As
illustrated in the overview shown in Fig. 1, the chatbot will cover another
two aspects that is critical to the caregivers, namely: 1) information; and
2) emotion. The non-professional caregivers are typically not trained and
requires additional effort to handle palliative care.
• One of the leading stress contributors to non-professional caregivers is
the lack of knowledge to handle various issues relating to palliative care
as they do not have or have limited prior experience. As illustrated in Fig.
4, there are many instances where the caregivers need help in providing
information.

6. USE CASE EXAMPLES:
One example is what they should do
after the patient passes away. The
emotional stress is already heavy when a
family member passes away, so helping
him/her with the after death matters like
death certificate and funerals will be
extremely helpful. Hence, this work
package aims to reduce the stress in
looking for information by providing a
chatbot to help them with various
issues.
Fig. 4

7. THE CHATBOT SUPPORT
The palliative care chatbot can also help the caregiver with ensuring the necessary
matters are performed For example, the chatbot can provide a checkbox to ensure the
necessary actions have been taken. This will relieve them the stress of remembering all
the required items.
Emotional support is often required for the caregivers too. This work package also
includes a chatbot to provide emotional support. Unlike other current chatbot that
provides emotional support, this work package focuses on the caregiver. Past research
has shown that patients were very happy to talk with a computer about their stress.
One of the possible reasons is people feels uncomfortable talking about death with their
peers. The same is applicable for the non-professional caregivers and they need a venue
to handle their emotion. The chatbot can be very explicit in talking to the caregivers
about related issues which their peers will generally avoid. Studies have also shown that
some people demonstrate true feelings when talking to a robot on certain sensitive
topics and death is one of them.

8. STAY CALM!
Fig. 5: A chatbot is used to provide emotional
support as human are more inclined to talking to
computers on palliative care related issues

9. USE CASE 2 – CHATBOTS FOR DEMENTIA
CARE

10. POTENTIAL PROJECTS IN THE PIPELINE
Depending on the stages of dementia, chatbots can be used in different
type of care models
Mild to Moderate – Chat Yourself type of self help chatbots
Moderate to Advance – Dementia Orientating Robotic Interface or DORI
Advance to End stage – Dementia Caregiver Chatbot Support

11. DEMENTIA CARE IN PLACE – A NEEDS MODEL
• Preventative -
1. Tele Remote Vitals monitoring
2. Tele Presence for isolation and loneliness
3. Verbal controls of appliances like lighting, TV
and air con etc.
• Supportive -
1. Quick access to information for problem
solving
2. Tele consultation
3. Day to day assessment and monitoring for
deterioration and identifying reversible issues

12. MAIN USES:

13. DORI – COMPANION ROBOTICS
• Advantages/Uses
 Discrete monitoring of cognition consistently
in daily conversations
 Similar to “ Amazon Alexa” “Siri” “Kotana” but
with the machine coming to the seniors to
initiate
 Activity monitoring services
 Tele presence services which has not yet gain
popularity
 Tele monitoring services which has not yet
gain popularity
 Tele consultation services for more
comfortable home medical services esp. for
patients with mental conditions or severely
dependent
• Advantages/Uses
 Seniors are more able to tell the machines
some issues which they might not be
comfortable with loved ones
 Using voice command activation through
DORI can empower the seniors to take back
control of his environment to foster more
independence – asking DORI to make a call or
to find information or read latest news etc
 Provides timely activation for calls of help at
home and have emergency services monitor
the home situation before activation e.g. fall
signals picked up by DORI can be confirmed
by family using DORI’s tele presence function

14. DORI – COMPANION ROBOTICS
• Advantages/Uses
 Major advantage can be seen using
machines for dementia/autistic
individual since they will not be
frustrated with repetitive requests or
demands:
http://abcnews.go.com/GMA/video/you
ng-boy-autism-good-friends-siri-
26316448
 Facial and emotional analysis to give
timely support
• Advantages/Uses
 Will be a “mothership” on which all
services like info-tertainment etc and
monitoring support can be done in
just 1 piece of technologic
equipement can run through
remotely.
To support Maslow's Hierarchy of Needs

15. • In the Marvel world, Iron man has
Jarvis.
• In the real world, I have
Dori.

16. SUMMARY OF DORI – THE DIFFERENCE
• Predictive Analytics with A.I. from data mining gained through daily
routines with potential to institute supportive/treatment services
How does it help in the whole scheme of things?
1. Aim to improve social care support and reduce the manpower
needed, hence reducing cost to government spending and the
society at large
2. Immediate remote data feeds to decide on next course of action
during emergencies or after a period of event and health monitoring.

17. LINKS -
• Chat yourself : https://youtu.be/WMTBzX-EZ7g
• DORI : https://www.opengovasia.com/articles/7358-addressing-
eldercare-challenges-at-mit-hacking-medicine-robotics-singapore-2017
• Dementia Caregiver Chatbot Support
https://www.messenger.com/t/484562455274495

18. THANK YOU!
Dr Tan Jit Seng
drtanjitseng@lotuseldercare.com.sg
Twitter @LEGeriatronics
https://twitter.com/LEGeriatronics
Linkedin
https://www.linkedin.com/in/drtanjitseng/