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Nature, Technology and Wellbeing

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.

Team: 
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) 

Partners:
BBC Natural History Unit
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This pilot project has been supported by:
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BBC Natural History in 360 at the Teenage and Young Adult cancer ward

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.

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BBC Natural History Unit researcher Joe Hope testing the HTC Vive VR set up.

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:

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Caroline peeps over the edge of a coral reef
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Ellen prods a jellyfish with her controller.
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Teenage Cancer Trust staff Fran marvels at a stingray overhead.
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A patient’s father experiences virtual reality for the first time.

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:

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Patient trying out the Samsung Gear VR headset.
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Looking around the (virtual) woods for birds and listening to the dawn chorus.
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Parents were also interested to experience Virtual Reality
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Identifying snakes in the jungle

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.

Testing prototypes for dementia care

During the second day of our rocking chair trial at Deerhurst, we were also testing out a new handheld prototype, developed by creative technologist and sculptor Steve Symons. This wooden prototype plays nature sounds and music when it is picked up, tapped, shaken, smoothed and generally explored through touch. The top surface is embedded with pebbles and pieces of wood and conceals the network of electronics and programming that is hidden inside. Underneath, on the base of the prototype is a discreet speaker.

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Jane, staff carer at Deerhurst, holding the interactive audio prototype by creative technologist Steve Symons.

One of the first participants to visit us in the Garden Room this morning was a resident who is new to Deerhurst and just settling in. Betty was a very jovial character who really enjoyed shaking the handheld prototype and touching the different textures of embedded stone and wood. On contact with her hands and triggered by the movement, the sound of seagulls started squawking at Betty. She laughed and joked that the birds must be hungry ‘because we were mean and had forgotten to feed them!

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When Betty tried out the rocking chair for the first time, she put her head back, closed her eyes and started singing along to one of the songs that she recognized. She reminisced about her parents as she listened to the poems and nature sounds, and described her experience in the rocking chair as ‘lovely, very moving’ and commented that she ‘could stay here all day’.

Joyce was the only repeat resident who had tried out the rocking chair on my previous visit. On the first test day, Joyce had been upset and in tears before sitting in the chair, but after listening to the audio and rocking, she became very calm and left smiling, and generally seeming much happier. Today she closed her eyes and nodded off to sleep for most of the session.

Joyce’s goddaughter Beverly was visiting today and suggested that it would be good to have the option of an automated rocking feature on future versions of the chair, as she felt that Joyce’s condition and stage of dementia would mean that Joyce would forget to rock. Beverly also tried out the chair, finding it very comfortable and when asked about her preferred audio content, she said that she would choose to listen to poetry and short stories.

During the course of this short pilot study, thirteen different people have tested the rocking chair at Deerhurst, including care staff and family, as well as residents. We hope to secure further funding next year, in order to develop these prototypes and explore, in greater depth, the benefits of nature on well-being in dementia care.

 

Co-design and cake at the Bristol Oncology Centre

Today we facilitated a session called ‘Co-design and cake’ on the Teenage and Young Adult ward at the Bristol Oncology Centre.

With the support of the Teenage Cancer Trust’s Well-being Co-ordinator and Youth Support Co-ordinator, we gathered together as a group of patients, relatives and friends, in the bright environment of the ward’s Chat Room to enjoy afternoon tea. This was a chance for me to introduce myself and the project, and find out what the participants might think would benefit them during their hospital treatment, and what they would like to try out over the course of this pilot.

Nature is already well represented on the ward, and patients are provided with options for a range of activities when they’re feeling well enough. The Chat Room, where we were meeting, is a large, open plan communal space, with a kitchen area, table football, sofas, board games, pool table and a jukebox:

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The Chat Room, Teenage and Young Adult cancer ward, Bristol Oncology Centre
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The Chat Room, Teenage and Young Adult cancer ward, Bristol Oncology Centre

As shown in the photo above, along the main wall of The Chat Room there is a beautiful woodland frieze. These outdoor scenes also create a peaceful backdrop to the reception area, the seclusion of The Snug (for reading and quiet solitude), and the Games Room (complete with Smart TV, Xbox consoles, and a film library of DVDs):

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Reception area, Teenage and Young Adult cancer ward, Bristol Oncology Centre
The quiet space of The Snug, Teenage and Young Adult cancer ward, Bristol Oncology Centre
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Games Room, Teenage and Young Adult cancer ward, Bristol Oncology Centre

Elsewhere on the ward, there is a well-being room with mood lighting and a therapies couch for reflexology. The ward staff had previously highlighted to our project team, the well-being needs of visiting families and supporters, alongside the needs of patients themselves. Staff had talked about ‘occupational loss’ – referring to how parents, relatives and supporters would normally be spending their time, if they weren’t at the hospital. This occupational loss could quite literally be a loss of work, but also missed time with other children and family members, or the loss of holidays and so forth.

So the key research questions from staff on the TYA ward for our exploratory pilot study include these points:

  • Will the outcome be something that supporters could use, as well as patients? (For example, a recent reflexology trial, set up by the Teenage Cancer Trust, was found to benefit carers and family members almost more than the patients).
  • Can the project outcomes improve people’s experience during treatment?

The Well-being Co-ordinator recognised that it is difficult for patients to spend time out of their bedrooms for lots of reasons, but she felt there was a need to offer patients something else to do, other than to sit (or lie down) in the seclusion of their bedrooms, and in addition to the variety of activities already available. With this in mind, we decided that portability was an essential feature for any prototypes, alongside careful consideration and medical guidance regarding infection control.

Back with the group of patients and their supporters in The Chat Room, I introduced a series of questions to initiate our discussions around nature and technology, assisted by a collection of natural objects and materials, and a large selection of nature-themed images to serve as conversational prompts. Here is just a small selection of the objects and images shared today:
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Interestingly, almost as soon as the group began to talk about nature, they also started referring to the smells, sounds and other sensory aspects of being outdoors. Nearly all of the participants said that they experience nature most frequently through some kind of activity, such as walking, swimming, kayaking, sailing or sightseeing.

When asked the question, ‘Which natural world environment would you transport yourself to, if you could go anywhere?’ these were some of the group’s responses:

  • Desert – for the warmth (feeling relaxed in the heat)
  • Beach – going swimming, walking barefoot on the sand and paddling in the shallows (which was forbidden during treatment for one of the patients)
  • Woods – ideally a combination of forests, hills, meadows and freshwater lakes
  • Waterfalls and running rivers – a Canadian mountain landscape
  • Norway – snow, water, fjords, green landscape, peaceful, spellbinding environments with a chance to see the Northern Lights

With such a variety of choices for contrasting terrain, one of the patient’s fathers suggested that whatever nature and technology experiences we offer, these must be bespoke and personalised, as people’s opinions and preferences are always so individual.

The concept of nature as a means of ‘getting away from it all’ and as a form of escapism appealed to the whole group. One patient described how ‘the one thing you want when you are stressed and intimidated by all the hospital treatments and procedures, is to take your mind away from the present, so the escapism of Virtual Reality sounds very appealing’.

In discussing potential technologies, everyone in the group had said they were excited about the idea of experiencing Virtual Reality, while no one had yet had the chance to try it before…

So compelled by this really useful session, we look forward to returning to the ward in a couple of weeks time, when we will be able to offer the participants some immersive digital experiences of nature, and find out what they think of VR – in reality!

First visit to Brunelcare

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Exterior of Deerhurst care home in Bristol.

We are delighted to be working with Brunelcare, renowned South West regional care provider for older people, and today we had the pleasure of our first visit to Deerhurst in Bristol to meet with the manager and have a tour of the home.

As the photos below illustrate, this is a vibrant place to live, offering lots of stimulation for those living with advanced dementia, and a busy programme of activities including gardening, swimming, singing, music – and even the occasional ‘Deerhurst’s got talent’ contest!

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Deerhurst has a regular gardening club for residents with green fingers
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Trips to the coast are a regular feature of life at Deerhurst, but meanwhile, there is also a beach in the courtyard for residents, family and visitors to enjoy.
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The corridors at Deerhurst are decorated with lovely outdoor scenes.

The manager recommended the quiet Garden Room as the best place to install the Soundscape rocking chair, and had even arranged for some astroturf to be fitted instead of carpet, to help evoke the sense of being outside:

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The Garden Room at Deerhurst

It makes such a difference to be collaborating with such enthusiastic partners and we look forward to working towards a satisfying outcome for all.

Nature, technology and well-being: New funding awarded for rocking chair

Although the official timeline and AHRC funding for Tangible Memories has now drawn to a close, many of the team are still busy working with our Story Creator app in care homes, sharing our research through conferences and publications, and applying for funding to progress our work with older people, well-being and technology.

We are thrilled to share news that we have been awarded funding from University of Bristol’s Brigstow Institute to develop the Soundscape rocking chair and explore the use of technology in bringing the benefits of nature into healthcare settings.

For this phase of the project, we are really excited to be partnering with the BBC Natural History Unit to use their wildlife archives, and co-designing our prototypes with Brunelcare, the Teenage Cancer Trust and University Hospitals Bristol NHS Foundation Trust.  

Some of the research questions that we will be asking include:
Can technology and/or nature enhance well-being while a person, relative or carer is in hospital, visiting hospital, or in long-term care? If so, how?
What are the differences between experience of real world nature and a digitally mediated experience of nature? Which is more beneficial in a healthcare setting?
What sound would you miss, if you could no longer hear it? 

Our partners: 
BBC Natural History Unit
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Robots, research & rocking chairs: Computer-Human Interaction conference 2016

‘CHI’ Computer-Human Interaction conference, San Jose, California: 7th – 12th May 2016

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The annual CHI conference (pronounced ‘kai’) for Computer Human Interaction describes itself as ‘a place to see, discuss and learn about the future of how people interact with technology’. So on journeying to fabled Silicon Valley for my first experience of CHI and of San Jose California, I half-expected to be greeted by robots on arrival. As it turned out, I was not to be disappointed…

The theme of CHI 2016 focused on using ‘technology for good’, which resonated with my key reason for attending this year’s event. Over the past couple of years, I have been part of this collaborative research project called Tangible Memories, which has developed creative technologies to benefit older people in care. One of these technologies has included an interactive rocking chair for older people with advanced dementia, and who are not often able to go outdoors. The chair plays soothing nature sounds, such as the dawn chorus or crickets singing on a summer’s evening, through speakers embedded in its headrest.

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The sound content is triggered simply by the rocking motion of the chair; stop rocking and the sound softly dies away. Our aim was to design an intuitive interaction that did not require learning (or remembering) while providing an experience that was both calming, particularly for those with anxiety, and which could potentially enhance the well-being of the individual, by the soothing rocking motion and by rekindling the imagination through evocative soundscapes.

My colleagues and I had co-written a work-in-progress paper about this prototype and its test sessions that had been accepted into CHI 2016, so offering us the chance to share our research in person, with a specialist network of about three thousand conference delegates from all over the world. The opportunity represented a new prospect for my artistic practice, as well as occasion to receive valuable feedback on our concept, so I was delighted to be awarded a travel bursary from a-n The Artist Information Company in order to attend CHI 2016 as a freelance collaborator on this project, and to be able to accompany my colleagues from the University of Bristol Computer Science department.

Alongside two days of the conference where we presented our rocking chair research, there was a huge amount on offer throughout the conference programme. I enjoyed a group tour of Stanford University Design School in Palo Alto, and took part in a brilliant prototyping workshop hosted by a member of the School’s teaching staff there.

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This Open House event was also showcasing a number of Stanford’s collaborative projects through posters and demonstrations, which proved very intriguing and thought-provoking. Some teams were hypothesizing about the future, such as our increasingly close (even emotional) relationship with robots and drones, while others were in the process of developing new creative tools for education or entertainment.

Back in the San Jose Convention Center, I attended a Special Interest Group discussion that was reflecting on a variety of different approaches to the theme, ‘Technology for disabled and older people’. There was some acknowledgment of the importance of social interaction and the need to address well-being for people in this defined group, although more generally, it seemed as if the computer science sector tends to focus on designing assistive technologies in support of people’s physical needs, without the same degree of attention given to their emotional or mental health.

Speaking of assistive technologies, this was my first experience of an event where a group of robots casually roamed around the convention center, acting as mobile conduits for remotely-based conference delegates. Here are some of the robot delegates meeting for a chat, while recharging their batteries:

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Amid all the ultra hi-tech on display throughout the conference, and profound questions being asked about the impact of ubiquitous artificial intelligence on human society, it was somehow reassuring to see how much the robots had to rely on human help for basic tasks like pressing the button to call the lift, navigating narrow doorways and identifying which seminar room was showing the presentation that they were interested in attending. I found myself feeling rather affectionate towards them on account of their robotic clumsiness.

On the whole, the dense conference programme of formal paper presentations was mostly dominated by highly technical and academic computer science research, far exceeding my non-expert understanding. However there were two stand-out presentations in particular, that were much less abstruse to the lay delegate (but no less rigorous) and completely absorbing. The first was a scenario, brilliantly presented by Joseph Lindley from LICA at Lancaster University, about pushing the limits of design fiction, where he made a compelling case for fictional research papers. The second highlight paper for me was titled, ‘I don’t want to wear a screen’: Probing Perceptions of and Possibilities for Dynamic Displays on Clothing. This presentation shared the extensive research collaboration between UC Berkeley and Google Advanced Technology and Projects (ATAP). Together these two organisations have developed interactive digital textiles using conductive jacquard thread coated in thermochromic paints. Once made into garments, these dynamic textiles enable the wearer to send subtle social biosignals, or simply enjoy a versatile design.

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After five days of intense note-taking, discussion and mind-boggling thought about the seemingly infinite possibilities of technology, I found some artistic solace in the cool, reflective space of the San Jose Museum of Art, and in a chance meeting with another artist.

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Back in 2012, in Glasgow, I had met a San Francisco-based sculptor called Heidi Wastweet at an arts conference, and greatly admired her work. When I knew I would be visiting San Jose, I had contacted Heidi to see if she could work her schedule for a catch up while I was in the area. Thanks to the capabilities of Facebook technology (computer-human interaction at work) we met in person, via another conference, after four years, to talk patination and letter-carving techniques over lunch and then made a visit to the art and photography exhibitions in the Museum.

Following this delightfully serendipitous afternoon, I headed off to San Jose station where I boarded a double-decker Amtrak train bound for Van Nuys in Los Angeles. My return flight was out of LAX, so I had arranged to visit and stay with some friends who live in LA for a few days, before heading home.

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During the ten hour scenic journey, I decided to pay homage to historic British/Californian local, Eadweard Muybridge, and his pioneering work using sequential photographs to create a sense of movement; the earliest form of moving image produced from stop-motion animation. So here is the day-long train ride photographed and condensed into a very basic silent ‘movie’, lasting all of 54 seconds: San Jose to Van Nuys by Amtrak

What a vast and varied landscape! The epic sweep of California can only begin to be appreciated by opting for slower forms of transport. The journey also provided a great opportunity to assimilate the conference experience and step out of my full immersion into the encoded world of computer science.

Embracing my comfort zone once more, I relished a visit to the Los Angeles County Museum of Art to see a great range of sculptural work including Chris Burden’s Metropolis and Robert Irwin’s Miracle Mile, both particularly well situated against the backdrop of LA culture.

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A quiet but somehow moving exhibition of Agnes Martin’s work marked a new artistic discovery for me, and I was drawn to her concentrated abstract lines and muted coloured canvases.

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Martin believed that it was spiritual inspiration and not intellect that created great work. ‘Without awareness of beauty, innocence and happiness’ Martin wrote, ‘one cannot make works of art’.

I planned to keep this profoundly sensitive, uplifting and outward-looking artistic approach in mind, on my return to England, when I would be continuing to develop the nature sounds rocking chair for older people with dementia, with a focus on providing a sense of well-being through the beauty of nature.

As coincidence would have it, just around the corner from where I was staying with friends, in District La Brea, I happened upon the only known rocking chair store in Southern California.

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The manager was a very friendly local lady who invited me to browse and try out the different types of rocking chairs, despite my inability to purchase anything and ship it back to the UK. I told her about our project and she kindly allowed me to take some photos, including a shot of the back room, where some of the stock had to hang from the walls in order to fit in.

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A framed poster proudly suggested presidential endorsement of the humble rocking chair.

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As I enjoyed the soothing comfort of one of the many rockers in the shop, I noticed how serene JFK looks in this image, and thought about how difficult it seemed somehow, to feel stressed in a rocking chair. These are pieces of furniture designed for unhurried relaxation, for contemplation perhaps, provided by the rhythmic calming motion that was gently tilting me back and forth. As my mind started to wander, I began to look forward to developing new ideas around well-being for our nature sounds rocking chair back in the UK, and felt creatively fortified by the experience of this entire trip, that has provided me with an huge amount of inspiration for many months to come.