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)
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.
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!’
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.
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!
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:
It makes such a difference to be collaborating with such enthusiastic partners and we look forward to working towards a satisfying outcome for all.
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.
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?
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.
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:
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….