The Tangible Memories team were delighted to hear that their extended abstract ‘Rekindling Imagination in Dementia Care with the Resonant Interface Rocking Chair’ has been accepted for CHI 2016 conference. This annual gathering of the world’s Computer-Human Interaction community will take place in San Jose, California, and focus on the theme of ‘technology for good’. Project team members Pete Bennett and Heidi Hinder are looking forward to presenting their research in May. Meanwhile, you can read more about CHI 2016 here: CHI conference 2016.
There are many things I’d do differently if I started the Tangible Memories project again tomorrow. Perhaps the most important thing I’d change however would be ensuring that we worked closely with care staff from the beginning. Our ‘gatekeepers’ were often senior managers who agreed to be involved, residents were asked if they wanted to be involved and were free to say no but care staff were never really approached at the beginning. In fact I think our focus on co-designing with residents obscured somewhat the need to work with care staff. Although contracts were signed with each home in which they agreed a member of care staff would be present in each of our sessions due to pressures of work, absent colleagues and issues related to what is considered to be ‘care work’ and what is not this very rarely happened.
In the last 6 months or so we’ve really stepped up our work with care home staff and I’ve met with managers frequently to make sure that the technologies we leave with them at the end of the project aren’t left on a shelf gathering dust. There are real challenges for managers in making time for care staff to do the one to one and group work with residents that we’re advocating for. This throws up all kinds of questions about what ‘care’ means and what the expectations are of someone who works as a carer in a residential home for older people.
In light of our realization of the importance of involving and working closely with care staff ‘on the ground’ we have been working with Alive! activities to design a process of working alongside care staff to introduce them to one of our prototypes – an app for storytelling. Last week up to 3 members of staff from each of our care homes came down to the university to be introduced to some of the techniques they might use.
Today Gill Roberts from Alive! activities and myself visited one of our settings to meet with care staff who had been given an ipad to help us test out our prototype storytelling app. Although the 3 members of staff had gone away from our session at the University fired up and ready to try the app with residents we found when we arrived that they’d not managed to find time to test the app with residents and they’d had various problems with using the ipad as well as with feeling confident enough to approach a resident to ask them to speak about their lives. Challenges were expressed and noted as, for instance: What questions can you ask? How do you invite residents to speak? How do you listen carefully to residents being comfortable with silence and allowing time for thought? How might you enable residents to use the technology themselves if they are able?
There is much work to be done here as we approach the end of the grant. Ensuring we do this collaboratively with care staff and residents will be the key to sustainability of the co-designed technologies in the care home settings.
A few weeks ago, we met with the Deputy Care Manager of the specialist dementia home that we are working with, in order to discuss the possibility of testing out our therapeutic rocking chair in situ, with some of the residents.
After some very useful conversations about health and safety, in perspective with positive risk-taking to ensure quality of life, we walked around the communal areas of the home, to choose a suitable location for the rocking chair to be situated on the initial test day.
There is a lovely ‘Garden Room’ in the care home which is not often used by the residents, partly due to the slightly foreboding approach of this long corridor:
Once there however, the space is sunny and peaceful, and as its name suggests, the Garden Room overlooks a wide lawn, edged by plants, bird tables, a water fountain and flowerbeds:
The natural place for the therapeutic rocking chair was in front of the French doors, so that residents could enjoy the view of the garden, while listening to music, poetry or sounds from nature, such as the dawn chorus, the wind in the treetops or crickets singing on a summer’s evening:
On the test day, the rocking chair was trialed by eight residents and four care staff. It was very touching to watch their reactions and witness some delightful responses, not only to the chair itself as a novel item of furniture in the home, but also to the varying sound content triggered by the rocking motion and movement.
One resident, a former pilot, spent some time to begin with, exploring the surface of the chair through touch, commenting that it was like being in the cockpit of an aeroplane. Then, listening carefully to the different sounds emitting from the speakers embedded in the rocking chair’s headrests, she identified a woodpecker and an owl’s call among the chorus of birdsong, and she even cooed back to the owl in reply. As she heard the rhythmic sound of someone walking on snow, she lifted her legs up and down in time, keeping apace with them, and describing a vivid story to us about what was happening in her imagination: ‘The farmer’s on his way…’
Later in the day, we decided to adjust the sensitivity of the app so that it would trigger the sound from much more subtle movements, in order to correspond to the level of strength and capability in some of the residents. Where their own physical co-ordination had deteriorated, residents were passively rocked by a member of staff who moved the chair on their behalf. One resident was only able to activate the sound content via the app when holding my iPhone in her hand, and making small gestures to keep it moving and playing.
As a result, alongside the interactive rocking chair, we are planning to develop a handheld object-based version of the app, by embedding an iPhone into a tactile object, such as a foam ball, that could be used for armchair exercises for older people in care homes. Continuous movement of the object would similarly trigger sounds, music or poems, combining light muscle activity with a spontaneous audio experience.
On the test day, not all the residents seemed to recognise that sound was triggered by movement through the rocking motion, or necessarily to register that sound was playing at all, but this did not seem to matter. At some level, all the residents appeared to benefit from, and engage with the therapeutic rocking chair experience, even if it was simply to snooze in the sunshine, or relax and enjoy the new position overlooking the garden.
We look forward to developing our prototype over the next few months!
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:
Read the findings online here: Rocking chair therapy
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….
…..and we’re ready to test it out!
As the augmented reality develops for the interactive books and app, Stand + Stare have been working with talented illustrator Hugh Cowling, to produce a series of beautiful shell drawings that trigger audio stories when they are scanned, functioning in a similar way to a QR code.
Here are some of Hugh’s wonderful illustrations, much more aesthetically appealing and poetic than a typical QR code:
Alongside the application of these drawings to the book/app prototypes, we are also exploring their potential for use on fabrics and textiles, while textured surfaces and soft objects such as cushions are considered to have some therapeutic uses for those living with dementia. Here are some examples of early tests using hand printed methods on cotton:
and a digitally printed version, on a tactile faux suede:
Evolving partly from the ButtonTuner musical cushion, we look forward to testing out the tech for these pillow cases and cushion covers, as well as developing the user experience.
The Tangible Memories team was delighted to hear news today that our work-in-progress paper ‘TopoTiles: Storytelling in Care Homes with Topographic Tangibles’ has been accepted into CHI 2015, the Human Computer Interaction conference, to be held in Seoul later this year.
Here’s more about this international HCI event, which is on the theme of ‘Crossings’, appropriate to our interdisciplinary project: http://chi2015.acm.org
Read more about the development of the TopoTiles in this previous blog post: http://tangible-memories.com/topotiles-and-other-tales-of-topographic-tangibles/
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.