PS 30017 Controversies in Cognition ALZHEIMERS Memory aids

PS 30017 Controversies in Cognition ALZHEIMER’S Memory aids from a distributed cognition perspective By Olly Swanton Laura Misselbrook Susannah Redhead Peter Gomez-Luque

Presentation Outline Two case studies reflecting both sides of the controversy. Ø Ø Ø Ø Dementia - Definition, Cause, Features Case Study 1 - Guide Me Project Controversy Distributed Cognition Memory aids Case Study 2 - Gloucester Smart House Conclusion and Discussion

Dementia: the Facts. Ø Definition Briggs (1989) Ø Occurrence Hagnell et al (1981) Ø Cause Ø Features

‘Guide Me’ Project Ø With the advancements of technology, its potential can be utilized in order to bring benefit to the lives of those suffering with Alzheimer’s. Ø Guide Me Project – undertaken by Dept. of Industrial Design, University of Eindhoven. Ø Integrates GPS & GSM technologies Ø Locator and communication product for Alzheimer’s patients.

Aim Ø In the early stages of the disease, patients will suffer from temporary memory loss, also known as ‘blackouts’. Ø These can occur at any time and often cause the patient to lose track of their own whereabouts. Ø Becomes a worry for caregivers of the patient.

Concept Ø Non-intrusive channel Ø Patient can go about his/her daily life without constant supervision from caregiver. Ø Prolong the period of care that can be administered by the caregiver Ø Delaying the admission into an Alzheimer's institute.

Guide Me Research Interviews conducted Ø Socially active people whom want to maintain their current lifestyles. Ø Maintain Self preservation Ø Accept that there are social limitations Ø

Scenarios Scenario 1: Ø due to a blackout. Ø location of patient on map, with respect to where he/she is heading to. Ø Scenario 2: Ø Emergency signal on the device. Ø Provide reassurance to the caregiver and patient, in any case of emergency, that there is help at hand. Ø

Conclusions of Guide Me Project Ø Harness GSM and GPS technologies Ø Simple device Ø Living situation for the partner and patient more bearable Ø Alleviating stress Ø Ultimately, prolonging the time that a patient can stay at home

Controversy! Ø A paradox - to become more independent, and thus assure better quality of life, cognition is distributed between both caregivers and technology. Ø Independence? Ethical concerns emphasised.

Distributed Cognition Ø Devised over last 12 years by Hutchins, Clark, Minsky, Lakoff. Ø Reconceptualises what is considered cognitive. Ø Hutchins (1995) – Cognitive ethnography on board US Navy ships.

Three Central Tenets Caroll (2002), Hutchins (1995) Ø Socially distributed – social organisation itself is a form of cognitive architecture Ø Embodied – Organisation of mind an emergent property of interactions among internal/ external resources Ø Culturally embedded – Study of cognition not separable from study of culture

Distributed Cognition cont. Ø New theoretical foundation for HCI Carmien 2003 - Increasing workplace independence for people with cognitive disabilities by leveraging distributed cognition among caregivers and clients. Ø Emphasises mediating tools and social processes by which patients cognition is spread. Ø Support groups (social configurations) Ø MAPS (Memory Aid Prompting System)

Memory Aids Ø A device or strategy which can be used by a patient suffering memory loss in order to store information or to alert a user to an event or an issue which might otherwise be forgotten. Ø Generic techniques such as paper and pen techniques Ø Advanced electronic devices.

Definition Ø These combinations of external representations and physical tools have greatly extended and supported people’s ability to carry out cognitive activities. (Norman, 1993) Main goals which have cognitive benefits: Ø 1. Externalizing to reduce memory load Ø 2. Computational Offloading Ø 3. Annotating and cognitive tracing Ø

External Memory Aids Changes to your routine which help jog memory Diary Ø PDA’s (Personal Digital Assistants) Ø Alarm Clocks/Timers Ø Pagers Ø Lists on Memo Boards/Post it Notes Ø Ø Leaving physical items as reminders i. e. leave items you need to take with you by the front door.

Where’s my house? Ø Gloucester Smart-House Ø Technology for maintaining independence Ø The developmental stage

Technology in the House Ø Bath and Basin Monitor Ø Night Light Ø Cooker Monitor

‘Rula’

‘Enable Project’ Ø Evaluation of the Gloucester House Ø Quality of life Ø The carers and the sufferers

Conclusion Guide Me Project – cognition distributed between caregivers and technology. Ø Smart Houses – more genuine independence. Ø However – from distributed cognition perspective, others are implicated in cognition regardless of whether cognitive deficit. Ø Iterative design process – ethical concerns can be taken into account. Ø

Conclusion cont. Ø Distributed cognition affords framework for design and evaluation of digital artefacts. Hutchins – Memory processes in airport cockpit. Ø However, does not address potential for learning. Carmien 2003

References Ø Carmien, S. , Gorman, A. , De. Paula, R. , & Kintsch, A. (2004) Increasing Workplace Independence for People with Cognitive Disabilities by Leveraging Distributed Cognition among Caregivers and Clients. ACM Portal, Vol. 13, Issue 5 -6. Ø Department of Health, (2004) Memory Aids and techniques, Online, Available HTTP: www. mhra. gov. uk (Accessed May 2005) Ø Hollan, J. , Hutchins, E. & Kirsch, D. (2000) Distributed Cognition: Toward a New Foundation for Human-Computer Interaction Research, ACM Transcations on Computer-Human Interaction, Vol. 7. No. 2. Ø Loh, J. , Schietecat, T. , Fai Kwok, T. , & Lindeboom, L. (2004) Technology Applied to Address Difficulties of Alzheimer Patients and Their Partners. ACM Portal.

References 2 Ø Briggs, R. S. J. Alzheimer’s Disease: The clinical context in: Davies, D. C. (Ed) (1989) Alzheimer’s Disease: Towards an understanding, John Libby & Company Ltd: London. Ø Carmien, S. , Depaula, R. , Gorman, A. and Kintsch, A. (2004) Increasing workplace independence for people with cognitive disabilities by leveraging distributed cognition among caregivers and clients. Computer Supported Cooperative Work, 13, pp 443 -470. Ø Loh, J. , Schietecat, T. , Kwok, T. F. and Lindeboom, L. (2004) Technology applied to address difficulties of Alzheimer patients and their partners. [online] ACM International Conference Proceeding Series, ACM Press: New York. Ø Giere, R. N. (1996) Models as parts of distributed cognitive systems. In: Magnani, L. and Nersessian, M. (2000) Model Based Reasoning: Science, Technology, Values. Kluwer University Press: New York.

References 3 Ø Clare, L. , Roth, I. , Wilson, B. , Carter, G. and Hodges, J. (2002) Relearning face-name associations in early Alzheimer’s Disease. Neuropsychology, 2002, Vol 16, No. 4, pp 538 -547. Ø Adlam, T and Orpwood, R. (2002) The Gloucester Smart House, Online Available www. dementiavoice. org. uk/projects_gloucesterproject. htm (Accessed May 2005) Ø Preece, J. (2002) Interaction Design Wiley Press, U. K