Contact Information:
Design of a device to assist with
repetitive questions in patients with
Alzheimer’s Disease (AD)
Kirstie Hawkey
PhD Candidate
Faculty of Computer Science
Dalhousie University
[email protected]
Repetitive Questioning Behaviour (RQB)
Research Questions
Causes of RQB
• What role can technology
play in improving quality of
life for AD patients and
their caregivers?
•Short-term memory
loss and lack of recall
• Is there a willingness to
use technology?
•Feelings of insecurity
about ability to cope
• What are the barriers to
the use?
•Anxiety about future
events
•Boredom
• Can a technological
intervention be effective at
relieving some of the
caregiver stress associated
with RQB?
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
Study Design
Information Gathering
Interviews
• Interaction abilities of dyad
Phase 1:
•Semi-structured interviews
of 24 dyads (AD patients
& their caregivers)
•Daily diaries of RQB
Declining Abilities
Over Time
Current Practice
Phase 2:
•Paper prototypes for
feedback
• 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
Phase 3:
•Implementation of one
design
•In-home study of
effectiveness of device
Speech Analysis
• AD patient’s speech will be
analyzed for suitability as an
input modality
http://comm2.fsu.edu/programs/commdis/caregivers/memorybook.html
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.
Preliminary Device Requirements & Design
Personal Information Appliance
Multimodal Interface
Requirements
Input
• 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
• 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
Limitations of PDAs as solution
• small screen size
• elderly user may have poor vision
• hidden functionality
• small buttons, stylus require fine motor
skills
Personal Interaction Vocabulary
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
Potential Interface Components
Problem
Event driven information
• Vocabulary problem with speech interfaces
• AD patients have short-term memory
problems, difficulty remembering new skills
• Timeline/calendar of day’s events
• Customize representation of time
• Customize viewing window
Proposed Solution
Information about friends/family
• 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.
• 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