Considering People Living with Dementia When Designing Interfaces

Usability of web-based tools designed for communication and decision-making in dementia: Systematic review and design brief

INTRODUCTION

There is an increased number of web-based tools designed for people with dementia and their family caregivers and addressing communication and decision-making. The loss of cognitive functions associated with dementia can impact individuals' experiences and use of web-based tools. There is a need for high quality and user-friendly web-based tools that support communication and decision-making for people with dementia and their family caregivers.

OBJECTIVE

To identify usability requirements, usability testing methods, and design suggestions from studies focusing on web-based tools for communication and decision-making support in dementia care.

METHODS

We conducted a systematic review with narrative synthesis. Five databases were systematically searched in February 2023. The quality of the included studies was assessed using the Mixed Methods Appraisal Tool.

RESULTS

A total of 1,032 articles were identified and 7 fulfilled inclusion criteria. Web-based tools addressed technology usage, health promotion, home modification information, shared decision-making facilitation, information needs and social isolation. Methods to test usability included surveys, interviews, focus groups, cognitive walkthroughs and think-aloud procedures. Findings suggested reducing cognitive load, enhancing readability, providing clear language, and emphasising the need for additional support for people with dementia. Design recommendations include optimising information delivery and presentation, enhancing visual elements, streamlining navigation, providing concrete examples, using clear language, and offering training and tailored support.

CONCLUSION

Usability requirements ranged from visual appearance and navigation to delivery of content and support needed. This review contributes to efforts to improve design and development of web-based tools targeting communication and decision-making in dementia care. Further research should address tailored support to enhance usability for people with dementia.

New musical interfaces for older adults in residential care: assessing a user-centred design approach

Purpose:For older adults in aged-care, group music-making can bring numerous physical and psychological benefits, ultimately improving their quality of life. However, personalising music-making to optimise these benefits is often difficult given their diverse ages, experiences, abilities, cognitive and motor skills, and their experience with music technology.Materialsandmethods:In this study, we conducted a 10-week group music-making intervention with twenty participants in an aged-care home, using a prototype digital musical instrument that we iteratively refined by following a user-centred design approach from direct resident feedback. The prototype instrument adopted a novel method for errorless learning in music-making settings, which we also refined, by increasing the difficulty level of the instrument's operation. We also assessed the residents' engagement with the sessions by obtaining feedback from caregivers and facilitators.Results:Results show that residents' enjoyment decreased as the complexity (difficulty) of our errorless learning implementation increased. We also found that resident engagement increased when changes to the prototype digital musical instrument were provided, but not when residents were giving feedback. Results also found that participation over the course of the intervention, and the number of songs played during each session also enhanced engagement.Conclusions: Overall, our results show the intervention was beneficial to residents, although we note some areas of enhancement for further interventions in designing prototype musical instruments for group music-making in aged-care settings. IMPLICATIONS FOR REHABILITATIONOlder adults positively engage with novel music technology, and do so increasingly over subsequent sessions. Repeated sessions may have the potential to enhance longer-term adoption of technologies as well as any rehabilitative effects of the group music-making activity.There is significant potential for residents with different abilities to all make music together, although to maximise the sustainability of the devices, the sessions, and the subsequent rehabilitative benefits, residents must be given the right adaptation for individual interfaces that balances ambition and ability.Rapid DMI prototyping positively enhances engagement among older adults, suggesting that in the case of a custom DMI, an upgrade schedule should be aligned with key rehabilitative milestones. Similarly, in the case of pre-developed digital music systems, resident exposure to new features or functionality should be strategically introduced, so as to maximise engagement for key phases of resident rehabilitation.

Designing the ReACT App to Support Self-Management of People with Dementia: An Iterative User-Involving Process

BACKGROUND

Assistive technology (AT) has the potential to support and enhance self-management of people living with dementia. However, a range of special and heterogeneous needs must be considered when designing and deploying AT for people with dementia, and consequently the involvement of end-users throughout the design process is essential to provide usable and effective AT solutions.

OBJECTIVE

The ReACT study was conducted to investigate how a tailor-made app, the ReACT app, can be designed and deployed to meet the needs of people with dementia in relation to self-management.

METHODS

This paper presents 4 steps of an iterative user-involving app design process. In the first step, a pilot study was conducted to explore the potential benefits and challenges of using existing off-the-shelf apps to support self-management when living with early-stage dementias. In the second step, focus group interviews provided in-depth understanding of the perspectives and needs of potential end-users of the app. The third step was a product benchmarking process, which served to further qualify the design process. Finally, results from these first 3 steps were included in the fourth step where the ReACT app was designed through an iterative codesign process. In total, 28 people with dementia, 17 family caregivers, and 10 professional caregivers were involved through these 4 iterative steps.

RESULTS

The functionalities and the design of the ReACT app directly reflect the perspectives and needs of end-users in relation to self-management. Support of memory and structure in daily living were identified as main needs, and the ReACT app was designed as a holistic and adaptable solution with a tailor-made calendar as a key feature.

CONCLUSION

Based on this extensive iterative user-involving design process, the ReACT app has great potential to support and enhance self-management of people living with dementia. Further studies are needed to test and validate the usability and impact of the app, and methods for deployment and adoption of AT for people with dementia also need to be considered.