Feasibility of machine -based prompting for people with Alzheimer's disease
Alzheimer’s disease (AD) is the leading cause of dementia in persons over 65 in the United States (National Institute on Aging, 2004). As AD progresses, a person’s independent function may be affected. Cognitive impairments affect daily functional abilities of more than 10 percent of people over age 65, making caregiving challenging (Georges, Jansen, Jackson, Meyrieux, Sadowska, & Selmes, 2008; Hebert, Scherr, Bienias, Bennett, & Evans, 2003). Assistive devices have the potential to provide assistance with these activities to help the person with AD live more independently and reduce caregiver burden.
This study was completed in two steps. Step One was included to make sure that participants with AD would be able to operate the device. This step of the study included five participants and took place at an adult day program. Participants completed five separate trials with an electronic memory aid (EMA) completing the tasks of making a seasonal decoration, taking a drink of water, or making a list from an advertisement. Their responses were recorded to determine their success in responding to the prompts. Caregivers reported the behavioral symptoms of the person with Alzheimer’s using the Kingston Standard Behavioural Assessment (KSBA). Field notes and data taken from a modified Philadelphia Geriatric Center Affect Rating Scale (PGARS) were also recorded.
The goal of Step Two was to test this device over a four to six week period utilizing a single subject design. Three participants and their caregivers took part in this step of the study and were seen in their own homes. A specific activity of daily living (ADL) or instrumental activity of daily living (IADL) task was chosen by the principle investigator and the participant’s caregiver. The participants’ responses to prompts were recorded under two conditions: (1) in-person prompting and (2) machine-based prompting utilizing the EMA. The caregivers completed the Revised Memory and Behavior Problems Checklist (RMBPC) on the days the sessions took place.
In this study, participants with moderate cognitive impairment were able to consistently respond to machine-based prompting from the EMA. However, they frequently required reassurance that they were completing tasks correctly or needed additional in-person prompts for safety or to complete some step of the tasks thoroughly. Participants with severe cognitive impairment were either unable to respond to the EMA or needed a maximum number of additional in-person prompts or physical assistance to complete the tasks prompted by the EMA. Overall, prompting from the device used in this study was not successful in helping participants complete activities independently. However, valuable information regarding prompting needs of people with Alzheimer’s disease was collected and can be used in the development of more sophisticated prompting devices for this population.