Charging-up People with Dementia: The Power of Technology

By Bahar Golbon

Approximately 55 million individuals around the world are living with dementia, and this number is expected to reach 139 million by 2050 due to the growing elderly population.1 Dementia is defined as cognitive deterioration beyond the expected effects of biological ageing, affecting many functions including thinking, learning, orientation, social behaviour, and emotion.1 According to current research, a challenge for people living with dementia and their caregivers is identifying engaging activities that are both familiar and understood by the individual.2 Participating in activities can demonstrate these individuals’ capabilities, shocking both caregivers and the patients themselves.

Dr. Arlene Astell has been tackling this problem for more than 20 years. Dr. Astell is an Assistant Professor at the University of Toronto’s Institute of Medical Science (IMS) and the Faculty of Occupational Science and Occupational Therapy. Additionally, she is the director of the Dementia Ageing Technology Engagement (DATE) Lab at the KITE Research Institute.

Naturally, participating in entertaining activities can decrease boredom and encourage positive emotions.3 A study completed in 2016 by Dr. Astell’s lab states that “there is no reason to believe that a diagnosis of dementia should alter people’s interests and hobbies.” Although this is a very simple statement, it holds immense power. The public seems to believe that a dementia diagnosis is equivalent to a death sentence, but this could not be further from the truth.

The DATE Lab focuses on “promoting positive ageing” by employing technology to engage older adults. One of their projects uses Xbox Kinect to involve older adults in a game of virtual bowling. The Kinect does not have a controller –the player makes movements with their hands and arms to control the action on the screen. This is straightforward and user-friendly making it an ideal tool to introduce to a generation who tend to be unfamiliar with new-age technology. Importantly, this device employs the use of both visuals and sound effects to acknowledge the user’s interaction and accommodate possible comorbidities such as hearing or vision loss. This activity provides socialization with new groups, a light workout, but most significantly, a fun experience. Dr. Astell recounts how successful this activity has been because of the encouragement players receive from their fellow competitors and the confidence it instills; to the point where they forget about their walker, eagerly waiting for their turn!

Another tool that the lab often employs are tablets. Similarly, devices with touchscreens have simple controls that make them suitable for this population. An innovative venture initiated by the DATE Lab is Accessible Touchscreen Apps for Dementia, otherwise known as ‘AcTo Dementia’. The project’s goal is to improve accessibility of digital activities to adults with dementia by providing recommendations of preexisting apps that are appropriate for this population. On their website, one can find an abundance of information to assist caregivers in selecting and tailoring games to the needs of their loved one or patient. The website includes over 60 tablet game recommendations that have been selected using an evidence-based review criteria, strengths and limitations of each activity, and recommended app settings. Encouraging individuals with dementia to participate in appropriate and independent activities can be highly beneficial as it promotes autonomy and minimizes dependence on others, catering to a very important need in the community.

A challenge that many encounter, especially in culturally diverse areas like the Greater Toronto Area, are language barriers. AcTo Dementia has attempted to mitigate this issue by concentrating on popular games that many would have played prior to the onset of dementia, such as sudoku and tic-tac-toe. AcTo Dementia also provides information on available languages offered by each app. Impressively, most of the information found on the website is available in Spanish and some is also available in Chinese.

Part of the reason behind AcTo Dementia’s broad and effective considerations are due to the fact that it was designed alongside people with dementia to maximize

Dr. Arlene Astell

Assistant Professor, Institute of Medical Science, University of Toronto. Director, DATE Lab, KITE Research Institute

accessibility and meet these individuals’ unique needs. Dr. Astell explains that the DATE Lab heavily relies on feedback from people living with dementia, families, and other caregivers to improve how technology is used and formatted for this patient population. In fact, their research into investigating the potential of tablet use was inspired by “an Alzheimer's Society members survey highlighting the need for stimulating recreational activities for people with dementia.”4

Technology is more accessible now than ever before. However, it can still be very costly for families to dedicate a device to a single user strictly for entertainment purposes. The DATE Lab is striving to resolve this concern through the ‘Let’s Connect’ project by providing devices and activity sessions at long-term care homes and adult day programs. During these sessions, individuals participate in engaging activities on tablets, both independently and in pairs. People living with dementia tend to have difficulty socializing because of their disease impediments or simply because they are out of practice. But, contrary to popular belief, the computer plays a vital role in facilitating connections. Dr. Astell notes, “the computer plays an interesting part, it is like a third-party in the interaction. If people can’t think of something to say, having this thing that you can both look at, this shared focus, provides a very good medium in the conversation.” After participating in the sessions, families can also take a Let’s Connect kit to test out at home. One of the main drawbacks is extending this activity format to remote, rural areas with limited access to Wi-Fi and learning facilities. Hopefully, spreading information about projects done by researchers like Dr. Astell and her team diminishes the stigma surrounding the capabilities of dementia patients and expands funding for the distribution of technology to a greater population.

Most people with dementia quickly transition from living independently and taking care of themselves to having to solely rely on others for every aspect of their life. This little bit of alone time and control, provided by the techniques employed by the DATE Lab, has made a substantial difference in the lives of many. Dr. Astell continues to empower elders with the goal to maintain happiness and autonomy in the ageing population.

If you would like to learn more about Dr. Astell’s work, please visit:

DATE Lab website: https://www.date-lab.com/

AcTo Dementia website: https://www.actodementia.com/

References

1. Dementia https://www.who.int/news-room/fact-sheets/detail/dementia (accessed Nov 9, 2022).

2. Joddrell, P.; Astell, A. J. Studies Involving People with Dementia and Touchscreen Technology: A Literature Review. JMIR Rehabil. Assist. Technol. 2016, 3 (2). https://doi.org/10.2196/rehab.5788.

3. Leng, F. Y.; Yeo, D.; George, S.; Barr, C. Comparison of IPad Applications with Traditional Activities Using Person-Centred Care Approach: Impact on Well-Being for Persons with Dementia. Dementia 2014, 13 (2), 265–273. https://doi. org/10.1177/1471301213494514.

4. Joddrell, P. Investigating the Potential of Touchscreen Technology to Create Opportunities for Independent Activity with People Living with Dementia. 2017