Background

A Person with Dementia, or PwD (See ontology), generally forgets information about their relatives and other close persons in their environment. It has been reported that a PwD can feel anxious when querying their relatives for information and have a sense of over-reliance on those around them [1][2].

The PwD expresses this reliance through the repetitive need to ask for information about others in their environment. This burden, as perceived by the PwD themselves, can lead to feelings of disconnectedness, separation, and loneliness.
According to the self-determination theory, a PwD benefits from autonomy, connectedness, and competence to improve their motivation for engagement with activities [3]. Han et al. [4] expanded on connectedness and determined that connectedness is to self, to others, and the environment is important for participating in activities. For the PwD to actively maintain relationships and engage with their relatives through social contact, the three named factors must be stimulated.

Socio-Cognitive Support

The task of increasing autonomy in a PwD can consist of remembering information about relatives without having to prompt the relatives in question. According to Vygotsky [6] interacting with another entity through knowledge exchange contributes to knowledge creation. So to realize this task we develop the NAO with the functionality of a personal encyclopedia, containing information on relatives and other loved ones. The PwD is then able to consult this encyclopedia verbally.
This solution requires at least some retention of information. As the cognition of the PwD depends on the progression of the dementia [5], it will be limited to those with early-stage dementia.

There are some important values to be considered in the development of the above solution. From the basic human values given by Schwartz [7], we gather key values such as security, freedom, autonomy and comfort. The challenge is to find a balance between these values. A way to look at this question is through the balance between information given by the encyclopedia and the emotional response the given information elicits. What information could compromise these values? Vygotsky’s Zone of Proximal Development (ZPD) [6] and the related Scaffolding Theory [8] may provide a guide in establishing this balance.

The Zone of Proximal Development defines a ratio between skill level and content difficulty in which a child can learn from information. The closely related Scaffolding Theory underlines the importance of proper assistance for a novice in achieving some goal. Although both theories are usually called upon in the context of children's development, they certainly have some relevance in memory regression. From both theories, we learn that it is important to not only support the PwD in their goal to maintain memories about loved ones, but to also do it at an appropriate pace to avoid confusion and the negative emotions that come with that.

References

[1] Eriksen S, Helvik AS, Juvet LK, Skovdahl K, Førsund LH, Grov EK. The Experience of Relations in Persons with Dementia: A Systematic Meta-Synthesis. Dement Geriatr Cogn Disord. 2016;42(5-6):342-368. doi: 10.1159/000452404. Epub 2016 Nov 19. PMID: 27866199.

[2] Han A, Radel J, McDowd JM, Sabata D. Perspectives of People with Dementia About Meaningful Activities: A Synthesis. Am J Alzheimers Dis Other Demen. 2016 Mar;31(2):115-23. doi: 10.1177/1533317515598857. PMID: 26340962.

[3] Ryan, R. M., & Deci, E. L. (2000). Self-determination theory and the facilitation of intrinsic motivation, social development, and well-being. American psychologist, 55(1), 68.

[4] Areum Han, Jeff Radel, Joan M. McDowd, Dory Sabata (2016). Perspectives of People with Dementia
About Meaningful Activities: A Synthesis

[5] (Week 3.1b -PwDcognitonMusic_Schaefer2023, slide 4)

[6] Vygotsky’s (1896–1934) theory (“an inherent social nature of learning”)

[7] Basic Human Values Schwartz, S. H. (2012). An overview of the Schwartz theory of basic values. Online readings in Psychology and Culture, 2(1), 11.

[8] Wood, D., Bruner, J., & Ross, G. (1976). The role of tutoring in problem solving. Journal of Child psychology and Psychiatry, 17, 89-100.