This pilot project, which builds on the Objects of Escape initiated during Tangible Memories, explores the therapeutic potential of cutting-edge technologies, to bring nature and natural environments into healthcare settings to enhance well-being.
Using sound and image archives from the BBC Natural History Unit, we are exploring multi-sensory and immersive experiences, such as Virtual Reality, tactile ‘Mutual Instruments’ and a rocking chair that transports the sitter to the natural world through evocative soundscapes.
This collaborative project is working alongside healthcare practitioners, families, and teenage and young adult patients at the Bristol Oncology Centre, and older people living with dementia, and their families and carers at Brunelcare’s Deerhurst home.
Helen Manchester (Social Scientist)
Kirsten Cater (Computer Scientist)
Heidi Hinder (Artist, Designer, Maker)
Steve Symons (Creative technologist and sculptor)
Esther Ingram (Archives Manager, BBC Natural History Unit)
Ailish Heneberry (Commercial and Business Manager, BBC Natural History Unit)
Sam Hume (Producer, BBC Natural History Unit)
Joe Hope (Researcher, BBC Natural History Unit)
Lesley Hobbs (Manager, Deerhurst care home)
Jamie Cargill (Lead Nurse, Teenage Cancer Trust, Teenager and Young Adults cancer service South West)
Fran Hardman (Well-being co-ordinator, Teenage Cancer Trust)
Hannah Lind (Youth Support Co-ordinator, Teenage Cancer Trust)
There has been a great sense of expectation on the Teenage and Young Adult cancer ward at the Bristol Oncology Centre, surrounding the start of our Virtual Reality trials in partnership with the BBC Natural History Unit. We have been working with Esther Ingram, Archives Project Manager, to share some of the BBC’s phenomenal natural history programming in this new context, with a new audience. Together, we are keen to find out if bringing nature into the TYA cancer ward through technology such as Virtual Reality (VR) can help to improve patients’ and supporters’ well-being during long-term hospital stays.
A group of 30 patients, relatives, friends and staff gathered over a two day period, to take part and try out the 360° immersive virtual reality experiences, often for the first time, or simply to watch these sessions in action.
There were a variety of technologies and films on offer, including the HTC Vive headset with bluetooth sensors and hand controllers for a more physically active VR experience. This was set up in the social space of the Chat Room to give people the chance to move and walk around in their virtual worlds.
Once this tech was rigged up, which takes about an hour, the VR experiences were ready to play. Patients could choose whether they wanted to immerse themselves underwater and visit a coral reef or a shipwreck, watch a Blue Whale swim past, or try and touch virtual jellyfish. These particular VR films are freely available online (cost-effective for charities like the Teenage Cancer Trust, should they wish to access them in future), and have been produced using computer generated imagery. Our teams are interested in the difference between people’s perception of ‘real’ nature (as filmed by the BBC) and digitally mediated nature through these CGI animations (produced by WEVR). Which is more effective in this context?Does it make any difference?
As we compared and contrasted versions of nature and VR, and interviewed participants about their experiences, all the volunteers became fully immersed in their virtual landscapes:
Alongside the more complex, expensive and physical HTC Vive VR kit, the BBC team set up an alternative using the Samsung Gear. This has the advantage of being completely portable, requiring only the virtual reality headset, headphones and a smart phone. As a result, we were able to share these VR experiences with patients who were unable to join in the communal Chat Room session while they were currently bed-bound and isolated in their bedrooms.
On the second day of our VR trial, the Samsung Gear headset was on offer again to the wider group and included a selection of quieter, more therapeutic nature films in VR. There was a sub-aqua diving experience in the tropical waters of Costa Rica, a jungle documentary, a 360° woodland dawn chorus and an immersive guided tour of a pre-historic dinosaur presented by David Attenborough, each lasting about five minutes. Although it’s not possible to experience virtual reality without the appropriate technology, here’s a hint of what people were watching:
Here is some of the patients’ and supporters’ feedback from their first experiences of Virtual Reality:
‘I can see [VR] being something that if you’re stressed or anxious, just pop this on and get away, to feel like you’re somewhere else – that would be when I would use it. I think that would be quite a good thing to do’. (Holly, patient)
‘I didn’t really know what to expect, then when I put it on, I was like, whoa! I’m under the sea!’ (Laura, patient)
‘You do lose yourself. You definitely lose yourself. Which is important being on this ward, and going through what the kids have got to go through. … To be honest, it just enables you to get away from this clinical environment which is paramount.’ (Suzie, parent)
‘I could just zone out completely and watch [VR] for a good hour or two or something like that. It’s so good, it’s amazing. … I’m well into it! I am ridiculously stressed out and anxious, so this has been really helpful. … This has real helped today. I’ve been mad stressed all day … so this has been real good to come and just chill out for a bit. So yeah, thank you.’ (Matt, patient)
After such positive responses, we look forward to continuing our valuable collaboration with the Teenage and Young Adult cancer service, the Teenage Cancer Trust, and the BBC Natural History Unit, for the well-being and benefit of those in long-term hospital care.
Following on from our pop-up exhibition of audio stories, produced from our winter visit to the MShed (see Memories and Museums) we have been developing another auditory experience using chairs, and inspiration drawn from venturing outdoors. Here I introduce the concept of a therapeutic rocking chair for older people with dementia.
Early on in the Tangible Memories project, we recognised that access to the outdoors, and specifically to the natural world, was very limited for many care home residents, often due to a decline in their physical mobility, or particularly if they were suffering from the more advanced stages of dementia. Equally, when we asked ourselves as a team, ‘what would we want in a care home of the future?’, we identified the simple routine of being able to go outside and experience the elements as something that would be of great importance to us all.
So throughout the project, we have been seeking different ways to incorporate aspects of life outside the care home environment into our technologies and prototypes, for those who are not able to venture out independently, or as often as they might like.
To begin with, we explored virtual travel using the Oculus Rift VR headset (see Virtual Reality Storytelling), with 360˚ stitched photographs of local places and museums:
We also offered VR experiences using moving imagery, sending residents to a virtual Tuscan villa, up in a hot air balloon, and even into the solar system on an animated space journey. Closer to home, we had previously recorded a kind of video postcard that reflects on the beauty of springtime in the countryside:
In this short film, as we focused on the many calming and uplifting effects of nature, such as birdsong or the sound of a river, we felt that adopting such a therapeutic approach would be particularly beneficial to residents living in the specialist dementia care home. Anxiety, agitation and memory loss are recurring symptoms of advanced dementia, so rather than placing the onus on an individual to remember past realities, we wondered whether it would prove more positive to provide an evocative soundscape of the natural world, without visual stimuli, where a person’s imagination could wander freely, and enjoy fact or fiction, in a peaceful listening experience.
With this in mind, the concept of a therapeutic rocking chair evolved, and was partly in response to Pete Bennett’s brilliant Resonant Bits harmonic user interface. This app triggers sound content on an iPhone or an iPad using a kind of rocking movement from simple subtle gestures and a slow meditative motion response. In his research, Pete asks:
How can interfaces support slow and meditative interaction in a fast paced world? How would it feel to be able to ‘tune in’ and interact directly with digital ‘bits’ of data?
Thinking about the meditative field recordings that I had already captured from nature, and wanting to combine these with Pete’s app to create a calming user experience and interaction, the traditional rocking chair seemed like an appropriate medium for a therapeutic listening experience, simply by embedding some speakers in the headrests. Rocking chairs can be a familiar item of furniture for many older people, the type of chair which provides an opportunity to dwell, ponder and relax, with its motion considered to be very comforting. (Perhaps why babies and young children are typically rocked to sleep).
In essence, this therapeutic rocking chair would play calming, comforting sound content triggered by the rocking motion. The soundscapes of nature, poetry or music would fade away and change track as the rocking motion stops and starts again, making the interaction as simple and intuitive as possible. (The chair would be silent when it was not moving). Here’s a quick demo, using just the app on an iPhone:
The rocking chair would offer this spontaneous and relaxing listening experience through hidden stereo speakers in the headrests, connected to the Harmonic User Interface app on an iPhone.
Alongside this concept development, what a bonus it was to discover a medical study published in the American Journal of Alzheimer’s Disease and other dementias which cites the psychosocial and physical benefits for dementia patients who regularly rock in a platform rocking chair:
The US study used traditional platform rocking chairs and their rocking motion alone as a form of therapy, which researchers found could improve balance, muscle tone, emotional well-being, and resulted in a reduction in the number of requests for medication to treat aches and pains in the majority of older people they tested.
If such results could be achieved with support and persistence, using a traditional piece of furniture, what more might we be able to offer residents by embedding therapeutic sounds triggered by the rocking motion? One of our key aims on the Tangible Memories project is to develop assistive technologies that enhance the social, personal and emotional well-being of older people, in addition to addressing their physical needs.
So I set to work, hacking an existing platform rocking chair in order to integrate stereo speakers into the headrests and create a quick iteration of our initial prototype so we could test the idea and get it working:
The next step required uploading an adapted version of Pete’s Harmonic User Interface app (currently called ‘SoundChair’) to my iPhone and then adding the sound content via iTunes.
The app can play any m4a, mp3 or aac file which is triggered by the rocking movement.
In addition to the sounds of nature, I’ve added other content known to be beneficial for dementia patients, which includes the rhythmic repetition of poetry, as well as classical music. Here are a few examples to give a flavour:
‘Sailing By’, Radio 4 shipping forecast theme:
The sound of waves on the seashore:
‘The Daffodils’ by William Wordsworth:
Next, the speakers were crudely connected to a battery power pack and my iPhone….
Recently, we held a group session with residents that focused on the theme of favourite walks. For some of the older people we are working with, access to the outdoors represents a physical challenge or a rare treat, while the residents of this particular assisted living location generally enjoy a much greater level of independence and freedom to go outside.
The participants in this lively group discussion came prepared with a significant walk in mind from any point in their lives, and seemed to relish sharing their experiences about a walk, or pattern of walks, that had memorable meaning. One gentleman remembered the familiarity of his walk to infant school, made suddenly dramatic one day in 1927, when a bi-plane landed in a field next to the primary school. This was the first aeroplane he had ever seen. One lady took the opportunity to advertise a sponsored walk she had planned for the very next day, to raise money in aid of the resident’s activity fund. She was hoping to make two circuits around the building where the group live, but promised that if she could get a skateboard, she would be able to make it three! There were reminiscences about walks in Blaise Castle and the Hamlet, that seemed ‘like walking in a fairyland’, while others fondly recalled walks with a husband or wife amongst snowdrops or bluebells in the Springtime. For another lady, walking on land was significant in itself, as she and her family had lived on board a boat and her daughter had learnt to walk while they were at sea.
One of the outcomes of this session, exploring favourite walks and nearby locations, was the desire to revisit some of these places in real life, in order to re-experience them and have the chance of uncovering more distant memories. Adopting the more curatorial approach on offer (see post re TopoTiles), the group decided that they would enjoy visiting the MShed, a local museum about Bristol, its places, people and their stories, which effectively seemed to represent several of the locations that they had been discussing.
As a result, one blustery cold morning, we gathered into a minibus and travelled to Bristol’s harbourside to explore the MShed, and the many intriguing objects on display there.
In addition to the curated exhibitions that stretched across three floors of the museum and were complemented by wintery harbourside views, the residents particularly enjoyed a guided tour of the museum’s stores, known as the LShed.
Behind-the-scenes, in a dimly-lit warehouse, these uncurated and large-scale artefacts seemed all the more enticing somehow, stacked on shelving, without labels or glass cases, or peeking out from underneath plastic sheeting and behind cupboard doors.
In this unordered space, it felt as if there was more to discover in a serendipitous way, and this led to a greater number of memories being evoked for the residents, in response to the historic objects they observed among the aisles of storage.
The spontaneous discovery and revelation of items within the LShed collections seemed to vividly reflect the way in which we store our memories, as well as the manner in which we tend to recall them. Jumbled and disorderly, sometimes hidden from view, our past is usually recollected in a non-linear fashion, leaping from one event to another, bounding across years and back again.
The visit to the MShed and LShed, and the stories which the day evoked, were captured through a series of photographic images and sound recordings. Initially, the residents have chosen to use this material in a temporary exhibition in one of the communal living areas at their home:
Five images were selected from the museum visit, with accompanying sound recordings that related to the objects in the photos.
Using three push-button sound systems already available in the foyer, we recorded short excerpts of narrative, into each of the three units:
Here is an example, featuring one of the LShed mangles:
The residents now have further plans to share different aspects of their museum visit, including a slideshow for friends and neighbours (to be held later this month) and the suggestion of a ‘virtual museum’ to be installed at the home. This would involve using some of the images of the objects in store, within the Oculus Rift virtual reality headset, so that those residents who are physically unable to travel to the museum itself, might be able to enjoy a similar, serendipitous discovery of the LShed and reminisce around the artefacts for themselves.
We played around with using the Oculus Rift today as a means for creating a virtual space for storytelling. Our first two testers M & B both enjoyed the experience. We firstly tried out stepping into a 3D snapshot of the Bristol Museum Foyer, and then took a trip up Cabot Tower. M had a look around a virtual Tuscan Villa whilst B opted for a whistle-stop tour of the Solar System. The next step is to customise the virtual scenes and introduce the possibility of handling objects relevant to the scene during the experience. An interesting finding was that binaural audio recordings played at the same time proved to be a distraction from the visual material.