1) The document evaluates the use of video reminders on mobile phones to support independence for people with mild dementia. 2) Testing involved 40 participants over 403 days and found that most reminders were acknowledged on the first attempt, with low numbers of missed reminders. 3) Feedback was generally positive, though some found the phone too heavy or embarrassing in public. Success depended on personalization and carer support.

1. Lessons Learnt from
the Evaluation of
Reminding Aids
C 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
activity
Activity 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 2
Longitudinal I 6 205 6-61
Longitudinal 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 Engagement
Patient 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 Don't
phone or Technology
personally calls to reminder Calendar need
TV (please
reminds remind note entry it
reminder specify)
Meals 4
Drink 4
Entertainment 2 1 1 1
Appointments 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 it
reminders 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 didn't do anything, I didn't hear the messages.”
“It was too much she couldn't 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