COGKNOW: Assistive Technology for people with Mild Dementia;

a User Centered approach

Rose-Marie Dröes, Dept of Psychiatry, VU medical center, Amsterdam, Netherlands

Maurice Mulvenna, University of Ulster, Belfast, Northern Ireland

and Franka Meiland, Stefan Sävenstedt, Marike Hettinga, Ferial Moelaert, David Craig, Johan Bengtsson, Halgeir Holthe, Anna-Lena Andersson, Suzanne Martin, Richard Davies, Mark Donnelly, Susanne Andersson,

Christopher Nugent

STREP FP6-2005-IST-5

COGKNOW Consortium Sep 2006 - Aug 2009

11 organisations in 8 countries

Aims

To develop and evaluate a user-validated remotely configurable cognitive prosthetic device with associated services for people with mild dementia

To help people to experience greater autonomy

and feelings of empowerment, and to enjoy an enhanced quality of life

To get knowledge and better understand the

actual use of cognitive assistive devices To identify important factors for consideration in

the process of delivering assistive devices to persons with cognitive impairment caused by dementia

Dementia

A progressive, chronic disease •  5% of all persons above 65 •  over 40% of people above 90

About 1.9 million elderly people in Europe experience mild dementia, the target group of COGKNOW. In 2050 this figure will be redoubled to 3.8 million due to the aging population. Most experienced unmet needs: memory, social contact, daily life activities, feelings of anxiety (vd Roest et al., 2007; van der Roest et al., International Psychogeriatrics, in press)

COGKNOW Focus 4 Need areas that are most frequently unmet

Remembering Maintain social contacts

Perform daily activities

Enhance feelings of safety

Workshops with PwD’s & carers (15 dyads)

Technical Development Field test #1 and Evaluation

Equally

Equally

Results from Field test #2 are input for 3rd stage of Technical development

User centered approach • . Users: 45 people with dementia

(GDS 3-5/MMSE 17-25)

45 informal carers ± 12 professional carers •  Needs inventory workshops and

individual interviews • . Functional requirements list • . Technical development • . Field testing prototype •  Evaluation • . Updating requirements

Developmental design

Results from Field test #1 are input for 2nd stage of Technical development

2006-2007

2007-2008

2008-2009

Three iterative cycles

COGKNOW Day Navigator

Reminding function

•  Day, time, reminders

Picture dialling

Activity support

•  Media control function

•  Activity assistance

Safety warnings (door/fridge open and outdoors navigation)

•  Users perspective Insight into user needs; evaluate the user-friendliness, usability, usefulness and the impact of the cognitive prosthetic device in the four selected need domains, and on autonomy and quality of life

–  Research methods

User workshops and individual Field tests at user homes (prescribed tasks, observations, semi-structured interviews, in-situ measurement, inventory of bottle-necks)

•  Technical factors perspective •  Business factors perspective

Evaluation strategy

Results User Evaluation

COGKNOW Day Navigator V3 Overall •  judged as useful by PwD and Carers, especially the reminding

functionality and picture dialling. The safety function needs to be further developed (in home and outdoor Take me home service). People appreciate the personalisation. General wish for dynamic adaptation of reminders

•  some people found it not directly useful for their present situation •  most PwD and carers found CDN, user friendly, easy to operate

and easy to understand •  Too early to draw firm conclusions on impact on daily life, but

users expect the device to be supportive, both for the autonomy and quality of life of people with dementia and the burden of carers

•  FILM COGKNOW (6 min)

•  Approach adopted was to utilise off-the-shelf technology and develop a suite of personalised software services.

•  Technical development was iterative and driven by three cycles of

user need assessment and evaluation

•  Technological development focused on advancing state-of-the-art

in the following areas:

-multi-modal interfaces -context awareness -systems integration -data storage and exchange

Network

Door Sensor

CogKnow Sensorised Home

GPS

CogKnow Web Interface

CogKnow Home Hub

CogKnow Cognitive Assistant

FridgeSensor

CogKnow Server

GPRS

Patient

Carer

Technical factors perspective

Technical evaluation

•  Overall functional system produced which reflected the views of both: –  User perceived needs –  Adaptation following usage of the system

•  Final solution was technically complex and it was challenging to hide this from both PwDs and carers.

•  Clear benefits from avoiding new device/hardware development and focusing on personalised suite of services.

•  The above have identified further areas for consideration: –  Improved means of remote support required. –  Assessment of usability over longer periods of time. –  Scalabity issues surrounding large scale deployments.

Business perspective

Internal workshop

Country Workshops

OpportunityWorkshop Trial 2 Trial 3

April 08 Summer 08 Fall 08 Spring 09 June09

Market factors •  Target group

•  Context of use

•  Value proposition

Business factors •  Business roles

•  Actors

•  Scenarios

Partnerships •  Customer reach

•  Value network

•  Profit Potential

Aim: To check the viability of COGKNOW business opportunities, and identify critical business success factors

Business evaluation

Some country workshop findings: Value proposition for care provider •  increased care quality and

capacity •  cost reduction •  economies of scale and scope

through more integrated systems

Potential PwD benefits •  continued independence •  feelings of autonomy •  increased activity ability •  increased self-esteem •  enhanced quality of life

Potential Carer benefits •  peace-of-mind when not present •  decrease of burden

Opportunity workshop findings: Critical issues Customer reach •  acceptance of ICT •  raising sufficient awareness

Value network •  create viable partnerships in the

field of care, welfare and comfort Profit Potential •  Capture sufficient users from

potential target group •  Define a viable business scenario

–  COGKNOW services positioned as comfort services

vs –  COGKNOW services positioned as

care services

Recommendations

•  Further technical development (e.g. stability, open standards, improved means of remote support)

•  Field testing with users on a larger scale and for a longer time

period •  Investigation of scalabity issues surrounding large scale

deployments •  Designing a viable business model

Read All About It – Academic Journals

•  Aging & Mental Health •  Journal of Technology and Disability •  IEEE Pervasive Computing •  Journal of Dementia Care •  The Journal on Information Technology in Healthcare •  Ageing Research Reviews •  Studies in Health Technology Informatics

Visit us... http://www.cogknow.eu/

Thank you for your attention!

Correspondence rm.droes@vumc.nl

md.mulvenna@ulster.ac.uk