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Applying Virtual Environments to Dementia Care – Mandy Salomon SUT



My doctoral research is to develop fun and entertaining iPad programs that will meaningfully engage people with dementia (PWD). Alzheimer’s Australia Victoria is this project’s industry partner. The principle is to offer failure-free, pleasurable activities by taking extant recreational activities that are offered to this community, such as memory books, arts and craft, gardening, discussion, cultural visits, music, dancing, pets, decorating and cooking, and interpreting them as immersive experiences within a 3D virtual environment. I call this program AVED, standing for ‘Applied Virtual Environment For Dementia Care’, and for my PhD, I am building a software prototype.
Two research questions shape the investigation: firstly, how might virtual environments be optimised for people with dementia? And secondly, does AVED engage people with dementia?
Delving into the first question, optimisation is a development issue. Development comes through understanding the cognitive and physical challenges of the user group, and the fact that both stressors may work in consort, adding greater complexity to the design. How should the interface be? What are the parameters of user inputs? What visual language works best; which colours and shapes are preferred? How should the information be structured? Is text useful? Such elements carry the content, so that the user experience of the content is an enabling one.
The second research question is: does AVED engage people with dementia? If the buzzword of 2012 was ‘innovation’, then surely 2013 is the year of ‘engagement’. Part of the word’s pervasiveness is its numerous contexts: industry, community, political, diplomatic, consumer and so on. It suggests an inclusive, active approach over a static, hierarchical one. With dementia, I propose that engagement occupies three domains: ‘proximity engagement’ is engagement with a person who has dementia; it is breaking through the fog and reaching the person; this is important for carers and family who attend to the loved one who is lost within it, and to them. Then, there is ‘experiential engagement’, engagement as the person themselves experiences it: it is to be enabled, to understand, to be motivated, to be stimulated, to try, to know, to choose, to react. Positive engagement is a laugh, a smile, a nod; to point, to feel…valued, safe, maybe even well.
In order to explore experiential engagement, we (a team of three) work one-on-one with residents from Emmy Monash, a residential aged care facility in Caulfield, Melbourne. The participants have moderate dementia, meaning they need support with many activities of daily living, and their working memory is limited to immediate experiences; though they do not recall of our previous visits, they are always happy to see us, to be involved, and they know that we value their time and insights. We have them shown them iPad apps to do with music, drawing, cooking, talking, and pictures of domestic scenes from which we have developed storyboards. They communicate their likes and dislikes, and we note the functional elements as we iteratively develop the prototype, a 3D immersive environment, using the Universe game engine that has been developed by Swinburne University PhD students. One feature to mention is a virtual companion in development, ‘Julie’, who chats to the person, seeks their assistance with her own virtual tasks and provides support as they undertake theirs.
And now to the third engagement domain: ‘existential engagement’. As dementia progresses, and it always does, people can become agitated, anxious, apathetic, insular, distressed, disorientated. Pharmaceuticals are commonly administered to treat behavioural disturbances, however if technology can assist with person-centred care, by customising content and addressing a person’s abilities rather than their deficits, it could be a doorway out of siloed existence. The existential engagement domain is outside the scope of my doctoral research, but it is a research area that neuroscientists may wish to take further.
I aim to complete the AVED field research and have the prototype software ready by the first quarter of 2014, with write-ups, presentations and journal publications to follow. Strategic planning to enable further research with Smart Services beyond June 14 is underway.

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