ALZHEIMER

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ALZHEIMERS
PS30017 Controversies in Cognition

• Memory aids from a distributed cognition
  perspective
• By
• Olly Swanton
• Laura Misselbrook
• Susannah Redhead
• Peter Gomez-Luque

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Presentation Outline

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

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Dementia the Facts.

• Definition
• Briggs (1989)
• Occurrence
• Hagnell et al (1981)
• Cause
• Features

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Guide Me Project

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

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Aim

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

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Concept

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

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Guide Me Research

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

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Scenarios

• Scenario 1-
• due to a blackout.
• location of patient on map, with respect to where
  he/she is heading to.

• Scenario 2
• Emergency signal on the device.
• Provide reassurance to the caregiver and patient,
  in any case of emergency, that there is help at
  hand.

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Conclusions of Guide Me Project

• Harness GSM and GPS technologies
• Simple device
• Living situation for the partner and patient more
  bearable
• Alleviating stress
• Ultimately, prolonging the time that a patient
  can stay at home

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Controversy!

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

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Distributed Cognition

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

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Three Central Tenets

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

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Distributed Cognition cont.

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

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Memory Aids

• 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.
• Generic techniques such as paper and pen
  techniques
• Advanced electronic devices.

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Definition

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

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External Memory AidsChanges to your routine
which help jog memory

• Diary
• PDAs (Personal Digital Assistants)
• Alarm Clocks/Timers
• Pagers
• Lists on Memo Boards/Post it Notes

• Leaving physical items as reminders i.e. leave
  items you need to take with you by the front door.

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Wheres my house?

• Gloucester Smart-House
• Technology for maintaining independence
• The developmental stage

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Technology in the House

• Bath and Basin Monitor
• Night Light
• Cooker Monitor

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Rula
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Enable Project

• Evaluation of the Gloucester House
• Quality of life
• The carers and the sufferers

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Conclusion

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

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Conclusion cont.

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

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References

• Carmien, S., Gorman, A., DePaula, 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.
• Department of Health, (2004) Memory Aids and
  techniques, Online, Available HTTP
  www.mhra.gov.uk (Accessed May 2005)
• 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.
• Loh, J., Schietecat, T., Fai Kwok, T.,
  Lindeboom, L. (2004) Technology Applied to
  Address Difficulties of Alzheimer Patients and
  Their Partners. ACM Portal.

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References 2

• Briggs, R. S. J. Alzheimers Disease The
  clinical context in Davies, D.C. (Ed) (1989)
  Alzheimers Disease Towards an understanding,
  John Libby Company Ltd London.
• 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,
  pp443-470.
• 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.
• 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.

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References 3

• Clare, L., Roth, I., Wilson, B., Carter, G. and
  Hodges, J. (2002) Relearning face-name
  associations in early Alzheimers Disease.
• Neuropsychology, 2002, Vol 16, No.4, pp538-547.
• Adlam, T and Orpwood, R. (2002) The Gloucester
  Smart House, Online
• Available www.dementia-voice.org.uk/projects/proj
  ects_gloucesterproject.htm (Accessed May 2005)
• Preece, J. (2002) Interaction Design
• Wiley Press, U.K