Problem Scenario

Context

People with dementia often live up in care homes where their caretakers can closely monitor them and help them go about their day without much issue. There are, however, people with dementia who live at home, which can happen for various reasons: they don't want to leave their home, they don't feel like dementia affects them enough to be worth moving, they want to retain their independence (and a first step is not moving closer to caretakers), etc.

If they live on their own, it is possible for them to forget daily essantial tasks such as eating. To us, such activities come naturally - we eat when we are hungry and we go to sleep when we are tired, but people with dementia, this is a bit more complicated. According to [1], it is not uncommon for people suffering from dementia to forget to eat and drink, leading to malnourishment. Additional tasks include going to the toilet, unusual sleep patterns, washing themselves, cleaning the house, shopping for groceries, etc.

The goal of the system is to help the patients remember these tasks. Since there are many tasks, some more complicated than others, we only selected a subset for this study: eating (which might also remind them of grocery shopping), drinking, going to sleep, going to the bathroom (which might also remind them to shower). One activity which was not mentioned in [1] is brushing teeth, but it is considered essential enough to also include. Additionally, exercise was included, as [2] highlights the importance of exercise for increasing cognitive function and slowing down the onset of dementia.

Problem scenario

Mary was recently diagnosed with early-stage dementia, which already affects her day to day life. She sometimes forgets to eat, while other times she forgets to brush her teeth, sometimes even forgetting to go to bed at a reasonable hour. This affects her health, beyond her dementia, and certainly doesn't help improve the situation. Her son, Matthew, and her healthcare professional, Dr. Jonathan, usually remind her of these dily activities, but this makes Mary feel like a burden to them, and also frustrates her when she did actually remember on her own. Sometimes, their attempts to remind her also end up failing, since she doesn't always remember if she ate that day, and then they have to help her try to remember what she ate, to make sure that she did. As Mary is retired, she doesn't have much to do during the day, so she sometimes visits the care home which Dr. Jonathan works at, and spends the day doing guided activities with the people who live there. All in all, the situation is manageable for now, but as Mary's dementia progresses, things might take a turn for the worse quickly. 

Design scenario

Matthew and Dr. Jonathan discuss and reach the conlusion that an autonomous assistant for Mary would be the best solution for the problems. They decide to use a humanoid robot, which would live with Mary and remind her of her daily tasks. As there are sometimes events that Mary needs to attend to, and days when she should do fdifferent activities, the reminders robot should be customizable. When the robot is first introduced to Mary, she has the opportunity to pick some music pieces to associate with the reminders. Rather than having someone (the robot) tell her what to do, this could be only implied by the music played. There is, of course, the issue that Mary now has to remember the music, but this can also happen over time, and the reobot will also try to help her make and reinforce this link. During the day to day life, the robot plays the music when the task needs to be done, and asks Mary about the corresponding activity, after which she can confirm whether or not she has done it already. Mary can also play with the robot, in order to get better at memorizing the music associated with tasks. As one of the activities is exercise, the robot can also exercise together with Mary.

References

[1] Theresa Thoma-Lürken, Michel H.C. Bleijlevens, Monique A.S. Lexis, Luc P. de Witte, Jan P.H. Hamers. (2018). Facilitating aging in place: A qualitative study of practical problems preventing people with dementia from living at home, Geriatric Nursing, https://doi.org/10.1016/j.gerinurse.2017.05.003
[2] Patricia Heyn, Beatriz C. Abreu, Kenneth J. Ottenbacher. (2004). The effects of exercise training on elderly persons with cognitive impairment and dementia: A meta-analysis. Archives of Physical Medicine and Rehabilitation, https://doi.org/10.1016/j.apmr.2004.03.019