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1. Suggestions for Improvement and for Amsterdam Belfast Lulea Future devices Nice N A EEE slople otnehilse N A GPS can be good provided it is easy What do you think about GPS location technique i to understand and operate F1 asa mean to help your finding the way in the N A future Would notwork It should mainly be used for me to Sceptical about usability be locate he PWD N A think it could be useful 86 Amsterdam Belfast Lulea Possibly useful in the future no need for it now N A Carer would feel safer if Pwd could N A It could facilitate a filing of safety for What do you think about GPS location call both of us F2 device as a means for your to feel safer when N A walking around on his her own outside No need for it now It could make him less dependent if N A he can learn how to use it Comforting thought N A Seems useful Nice N A i wey Convoning Nes It would be very nice to be able to What do you think about being able to locate your know that vou cai tirid him anv tim F3 position with GPS while he she is outside Very nice and a comforting thought N A y y s taking a walk Sie Not very good N A have no problem with it Nice thought N A 87 A 1 4 Observation scheme Observation checklist Halgeir Holthe Franka Meiland Rose Marie Dr es 26 April 2007 Instructions for researchers e Itis important to make the observations as open as po
2. Amsterdam Belfast Lulea Background characteristics informal carer Informal carer Personal details 1 Name XXXXXX XXXXXX XXXXXX 2 Sex Male 2 Male 3 Male 3 Female 3 Female 2 Female 3 3 Mean age range 59 2 49 78 GA RASE O Married cohabiting 5 Married cohabiting 5 Married cohabiting 4 4 What is your current civil status Divorced 0 Divorced K Divorced i j y i Widow Widower 0 Widow Widower 0 Widow Widower Single 0 Single 0 Single d 5 What is your educational background Primary school 0 Primary school 0 Primary school 0 Junior second vocational 1 Junior second vocational 2 Junior second vocational 1 Second vocational z1 Second vocational 2 Second vocational 0 Senior second school 0 Senior second school 0 Senior second school 12 Higher professional ae Higher professional 0 Higher professional 1 University z2 University 1 University 12 Other 0 Other 0 Other 6 Do you currently have any other activities No 12 No 2 No 3 Paid work 2 Paid work z2 Paid work 2 Caring for another person 1 Caring for another person 0 Caring for another person 0 Volunteer work sA Volunteer work 1 Volunteer work x Study training course 0 Study training course 0 Study training course Al Other 0 Other 0 Other 0 Mean hours per week total other activities 8 08 Mean hours per week total other activities 0 4 Mean hours per week total other activities T Partner 4 Partner 3 Partner 3 Daughter 1 Da
3. Amsterdam Belfast Lulea The pick up function was not working well The combination of text and pictures worked well i Very good 1 How do you judge the basic audio very goon very good g Appropriate 4 P2 Appropriate 2 Appropriate 5 call function Not good 0 Not good 2 Not good 0 ony No opinion 1 Too loud 1 Too loud 0 Too loud 0 P3 How do you find the audibility of the audio call Appropriate 3 Appropriate 5 Appropriate 6 Too soft 1 Too soft 0 Too soft 0 Very helpful 2 How do you judge the picture dialling yew Help A vey Wel Appropriate 2 P4 Appropriate 3 Appropriate 1 Function for your Not very helpful 0 Not very helpful 2 Not very helpful 1 nC No opinion 2 r Too small 1 Too small 0 Too small 0 How do you judge the size of the pictures on P5 P Appropriate 4 Appropriate 5 Appropriate 6 the stationary device Too large 0 Too large 0 Too large 0 How do you judge the size of the pictures on ee ide iA Tee large 2 Tee large P6 Appropriate 0 Appropriate 1 Appropriate the mobile device Too small 0 Too small 1 Too small How do you find that your uses the picture DIP NSR PIA Dee relate aie P7 y a p Appropriate 2 Appropriate 4 pprop address book on the stationary device Easy to use 1 Easy to use 0 Easy to use 0 No opinion 0 78 Amsterdam Belfast Lulea Easy touse 0 How do you
4. Amsterdam Belfast Lulea Too soft 1 Too soft 0 Too soft 0 No opinion 1 Very helpful 0 Very helpful 2 ee P4 How do you judge the picture dialling function Appropriate 2 Appropriate 2 pprop Not very helpful 3 Not very helpful 0 Aor vanne pis yA pur ia a No opinion 1 How do you judge the size of the pictures on the 100 small ae TS Smal n Teo small P5 st tionamidavice Appropriate 5 Appropriate 4 Appropriate 6 Y i Too large 0 Too large 0 Too large 0 Too large 0 How do you judge the size of the pictures on the Too large 0 qog large K Appropriate 4 P6 Appropriate 1 Appropriate 1 mobile device Too small 1 Too small 0 Too small 2 NE No opinion 1 How do you find using the picture address book Difficult to use 0 Difficult to use 1 Difficult to use 0 P7 o t estationary device Appropriate 3 Appropriate 3 Appropriate 4 y Easy touse 2 Easy to use 0 Easy to use 2 i Easy to use 0 How do you find using the picture address book patie aS es Easy le os a Appropriate 5 P8 P Appropriate 0 Appropriate 1 ae on the mobile device Difficult to use 0 Difficult to use 0 Difficult to use 1 ae No opinion 1 Difficult to use 0 Difficult to use 0 PIREU toee How do you find the emergency contact j Appropriate 2 P9 Appropriate 1 Appropriate 3 function Easy to use 2 Easy to use 2 Easy to use 1 ie No opinion 1 How do you judge the picture dialling function as Makes it easier to keep in touch
5. 20 The configurations of reminders were limited to a specific date and to content The limitation made it difficult to make individual adjustments and created many problems when trying to make the evaluation meaningful The main problem with the mobile device was unstable function and a tendency to lose the connection with the stationary device There were also problems with the limited range of the connection of the device and it could not be used outdoors There was a problem in operating the mobile device due to the many steps in the different functions For example First press button then type text message The same problem was involved when turning off functions such as the radio Another example was that at the start of a call a window was displayed asking whether the user wanted to proceed with the call or not This was difficult for the Pwd to manage due to the small text and too many steps When the phone function was used the ordinary window of the device was displayed and the device had problems in returning to COGNOW navigator mode The return functions when calling were difficult to use and to understand and seemed not to work properly They were often slow and subject to delay The reminding function and the safety warning did not work on the mobile device 4 2 Reminding functionality 4 2 1 Semi structured interviews and observations Amsterdam All participants with dementia reacted positively to the reminding function
6. Lulea Mobile Device Amsterdam Belfast Lulea Not applicable Not very user friendly Icons too small Could be useful for other people if It has to many functions as it is now It must be very stable and simple to Useful Unenown they could be taught how to use it use M1 Hew ae you Judge tne mobile device ery Not very user friendly Difficult to What do you operate the touch function usefulness user friendliness etc Looks nice A see screen when it is winter and you Seems nice the contrast on the have gloves __ Not user friendly screen is a problem Would be nice if he buttons word removed The mobile device should focus on Mobile device didn t function security and facilitate communication questions about mobile device N A Too large 0 Too large 0 Too large 0 M2 How do you judge the size of the mobile device Appropriate 4 Appropriate 5 Appropriate 6 Too small 1 Too small 0 Too small 0 How do you judge the screen size of the mobile Tee amas ie T99 amar Tog onal s M3 Appropriate 5 Appropriate 4 Appropriate 6 device Too large 0 Too large 0 Too large 0 How do you judge the size of the text on the Tee SS ae T99 large i Ms large A M4 eens Appropriate 3 Appropriate 0 Appropriate 5 3 Too small 1 Too small 4 Too small 1 Nice Not clear The icons are good and easy to see How do you judge the icons on the mobile Clear recognizable Ok The radi
7. to clothes body Difficult to attach Difficult to attach 2 Difficult to attach 0 No opinion 2 49 Amsterdam Belfast Lulea Ne Ne 2 hehe M9 Do you loose the mobile device easily Sometimes 1 Sometimes 0 Yes 0 Yes 0 Yes 0 a No opinion 3 vee 0 bas 3 A M10 Do you forget the mobile device easily Sometimes 3 Sometimes 0 No o No 4 No 0 ate 3 No opinion 3 Easy to charge 2 Easy to charge 0 Bay ae Parag Appropriate 21 Appropriate 0 Appropriate M11 How do you judge the chargeability of Difficult to charge 0 Difficult to charge 0 Difficult to charge 0 the mobile device My takes care My takes care My takes care of chargin 0 of chargin er enatging ging i ging No opinion 4 Too often What do you think of the frequency FOO CHEN a FOO onen 0 Acceptable frequency M12 F Acceptable frequency 0 Acceptable frequency 0 that you have to charge the battery with Very good frequency Very good frequency 0 Very good frequency 0 n No opinion 6 i Very good How do you judge the reminder to charge the very good 0 Very good 9 Appropriate M13 Appropriate 0 Appropriate 0 battery of the mobile device oe ie Insufficient Insufficient 0 Insufficient 0 No opinion 6 Amsterdam Belfast Lulea M14 How useful do you find the mobile device Not applicable Useful think have a use for it Useful but the icons should
8. Lulea Not applicable No suggestions Reminding Service Amsterdam Belfast How do you judge the reminding service R1 function interaction experiences usefulness user friendliness etc don t have a need for it yet maybe in the future Seems all right Don t need it can remember it myself Not bad at all The icon is clear Very good Would be very useful for appointments Unable to give opinion Very useful Very good useful This would be very useful It could be useful in the future but not now It must be adjusted to my needs It could be very useful How well do you find the reminder messages to Mol ungersannaple 0 NOt Me Srenderle me DEEE Fa i R2 y 9 Understandable with effort 1 Understandable with effort 3 i understand Easy to understand 3 Easy to understand 4 Easy to understand 1 ies No opinion 2 F Good to hear 4 Good to hear 4 oe Wy hear a Do you find the reminders good to hear when Sometimes good not 1 R3 ai are inthe same roe Sometimes good not 0 Sometimes good not 0 Difficult to hear 0 y i Difficult to hear 1 Difficult to hear 0 i No opinion 4 Do you find the reminders good to hear when melio ngar a pe ence d not R4 y 9 i Sometimes good not 2 sometimes good not 2 g you are in another room Good to hear 1 Good to hear 3 Good to hear Not tested 6 52 Amsterdam Belfa
9. Pwds and their close persons together We have however tried to avoid the term carer in this connection since the close person is not a carer in the professional meaning of the term As a synonym for the term close person we sometimes apply the term informal carer Actually professional carers are not included in the initial Human Factor Impact Analysis even if they certainly will be users of the COGKNOW prosthetic device Hence in this text the category user is restricted to mean Pwds and those persons close to them The professional helpers will be included in The Human Factor Impact Analysis from field test 2 and onwards The following definition of needs wants and demands is used in this report Kotler 1980 A need is a felt state of deprivation including basic needs social needs and individual needs for example when someone says he lacks companionship this implies a need for social contact Needs can be communicated as met e g enjoy the company of my children or unmet I miss the company of my children A want is the expression of a need as shaped by a person s culture and individual development for example need someone to talk to A demand is a preferred specific solution for a person to fulfil his or her need depending on the resources a person have Our term user friendliness refers to users observed ability to handle the equipment and its functionalities whereas the term usefulness relates to the perce
10. 105 The audio recording was received positively by two Pwds and their informal carers One of the Pwds immediately knew how to use it the other had some difficulties with it The buttons for making the audio recording were considered small Another limitation was that the audio message could not be played back and the visual confirmation of successful recording came rather late after the recording had stopped As for new functionalities One Pwd did not miss any function on the system She wondered what else could be necessary to have in everyday life One Pwd suggested an extra function to allow choosing pieces of music manually and an informal carer suggested an extra button with a picture of the artist or album to choose from One informal carer suggested guidance for using the remote control of the TV as the Pwd seemed to have difficulties with this the Pwd did not agree One informal carer suggested that the reminders could be accompanied by a recognisable melody or a verbal reminder recorded by the informal carer that stimulated the Pwd to act upon the reminder Another informal carer suggested recording the content of calls so that they could be played back to check whether appointments and the like had been made When asked about the usefulness of the GPS technique allowing the carer to see where the Pwd is the Pwd joked to the informal carer that she did not feel unsafe on the streets However the informal carer would feel more at ease
11. 2 Makes it easier to keep in touch 3 Makes it easier to keep in touch 1 P10 a means to facilitate social contact with family Doesn t make a difference i Doesn t make a difference 1 Doesn t make a difference 5 and friends Makes it more difficult a Makes it more difficult 0 Makes it more difficult 0 56 Amsterdam Belfast Lulea How useful do you find the picture dialling Not applicable Unknown Useful Unable to give opinion Two of the Pwds had no comments P11 function in relation to your needs Seems useful N A Does the system help you keep in contact with Three found the picture dialling people whom and how Emergency call function should be May be useful to others but Pwd is function useful or very useful more in the foreground able to make ordinary phone calls don t need it at the moment N A Hew dovouexperience the piste diallin Not at all inconvenient 4 Not at all inconvenient 4 Not at all inconvenient 6 P12 f y P P g A little bit more inconvenient 1 A little bit more inconvenient 0 A little bit more inconvenient 0 function F F A lot more inconvenient 0 A lot more inconvenient 0 A lot more inconvenient 0 ie ta A Very satisfied 0 Very satisfied 3 Very satisfied 2 P13 a are youwithi the plete dialling latched Satisfied 1 Satisfied 4 g i Dissatisfied 1 Dissatisfied 0 Dissatisfied 0 All in one The function sho
12. 2 Sometimes 0 No 0 No 2 No 0 REE No opinion 4 Easy to charge x3 Easy to charge 0 Pasy Crane io Appropriate 2 Appropriate 0 Appropriate oe M11 How do you judge the chargeability of the mobile Difficult to charge 0 Difficult to charge 0 Difficult to charge 0 device My takes care My takes care My takes care of chargin 0 of chargin 0 oreharging ging ging i no opinion 4 72 Amsterdam Belfast Lulea M12 What do you think of the frequency that you have to charge the battery with Too often 0 Acceptable frequency 0 Very good frequency 0 Too often 0 Acceptable frequency 0 Very good frequency 0 Too often 0 Acceptable frequency 2 Very good frequency 0 No opinion4 Very good How do you judge the reminder to charge the vay goad Very goga p Appropriate M13 f Appropriate 0 Appropriate 0 ee battery of the mobile device aoe Ve Insufficient Insufficient 0 Insufficient 0 Ne No opinion 6 M14 How useful do you find the mobile device think it could be useful GPS technology would be practical think the mobile device is the most essential part of the system Would make things easier than at the way we currently do things Would forget it easily The contact Big screen is better It could be useful for some people but not here unfortunately Would much prefer the stationary device Not as useful as big screen It co
13. 3 Communication functionality Results from Amsterdam Belfast and Lulea Amsterdam Four of the five Pwds did not find it easy to understand the picture dialling function and they used the Help button Sometimes after hesitation instead of the picture dialling address book One Pwd did this several times he seemed to know how to use the picture dialling book but he just used the easiest way to call his wife One Pwd recognised the functionality of storing phone numbers in a picture address book as the telephone she currently uses also has pictures of her relatives on the keyboard One Pwd was very much surprised that pictures of her children together with their phone numbers were already configured in the system When asked to use the picture dialling function three Pwds did not know immediately how to operate it One Pwd found it confusing that several steps had to be taken before the call was made Another Pwd explained that it was confusing to perform different steps by having to push the picture on the screen first and then use the phone to actually make the call On a second attempt this Pwd made the call without hesitation One Pwd picked up the phone too late after she had pressed the picture and it was not possible to make a connection Returning to the main screen was easy after instructions had been given With respect to the usefulness of this function one Pwd found worked very well for her Although it looked like her usual phon
14. Comments The mobile device didn t make a sound in any of the cases No comments were made on the pitch of the sound from the home screen by either Pwd or carer However comments were made on the content of the sound Mobile device too low Home screen too low Comments Mobile device too high Home screen too high Mobile device too high Mobile device too low Home screen too high Home screen too low Comments 91 Amsterdam Belfast Lulea 7 Forgot to charge the mobile device Yes NA Comments As the system was tested 1 day the mobile device did not need charging by Pwd or carer Yes Comments Yes 3 Comments 8 Other issues Sensitivity of the home screen was a topic of discussion when confirming reminders in all cases Touch screen had to be pushed relatively hard according to all Pwd s Active buttons underneath the reminder caused some confusion As confirming the reminder would activate another function e g radio 92 A 1 6 Test task COGKNOW Field Trial One 2007 Test tasks Field trial one aims to evaluate the user friendliness and usefulness of the COGKNOW home hub and mobile prototype devices The test starts with an introduction to and training with the home screen and the mobile device For each Pwd different reminders have been set in the devices based on their preferences as expressed during the pre trial inter
15. Helping people with mild dementia navigate their day COGKNOW CONSENT FORM hereby declare have been informed orally and in writing and understand the nature method and goal of the study My questions have been answered to my satisfaction have received the written information booklet which accompanies this consent form give my permission to obtain if necessary information from other caregivers voluntarily consent to participate in this study reserve the right to withdraw my consent at any time and am not obliged to give a reason signature participant signature legal representative informal carer name participant name legal representative informal carer date Lee date nae Being the informal carer of name asssssssessssssessrssesrnnnsrsnnnssennnnnrennnns consent to participate in the abovementioned study hereby declare have been informed orally and in writing and understand the nature method and goal of the study My questions have been answered to my satisfaction have received the written information which accompanies this consent form give my permission to obtain if necessary information from other caregivers voluntarily consent to participate in this study reserve the right to withdraw my consent at any time and am not obliged to give a reason SIQNALUIC oeii es eve EEE You have received oral and written information on the study will answer any additional quest
16. Hornb k 2000 Measuring usability are effectiveness efficiency and satisfaction really correlated In Proceeding of ACM Conference on Human Factors in Computer Systems ACM Press New York NY pp 309 316 Gilliard J ed 2004 Enabling Technologies for People with Dementia Cross national analysis report version 8 http Awww dementia voice org uk Projects EnableFinalProject pdf Checked December 10 2008 35 Galliard J and Hagen 2004 Enabling technologies for people with dementia Cross national analysis report version 8 pp1 69 http www dementia voice org uk Projects EnableFinalProject pdf Checked December 10 2008 Holte T Hagen l and S Bj rneby 1998 Evaluation of an electronic calendar as helping aid for persons suffering from memory problems or cognitive impairment Report of the TED group www forglemmegei no dokumenter rapport kalender pdf checked December 10 2008 Inglis E A Szymkowiak A Gregor P Newell A F Hine N Shah P Wilson B A and J Evans 2003 Issues surrounding the user centred development of a new interactive memory aid Univ Acces Inf Soc 2 226 234 Kort S 2005 Mobile Coaching A pilot study into the user friendliness and effects of Mobile Coaching on the wellbeing of people with dementia and their informal caregivers MSc thesis Faculty of Psychology Vrije Universiteit Amsterdam Kotler P 1980 Principles of Marketing Englewood Cliffs New
17. Jersey Lauriks S Reinersmann A Roest H van der Meiland F J M Davies R J Moelaert F Mulvenna M D Nugent C D and R M Droes 2007 Review of ICT based services for identified unmet needs in people with dementia Ageing Research Reviews 6 223 246 Lekeu F Wojtasik V Van der Linden M and E Salmon 2002 Training early Alzheimer patients to use a mobile phone Acta Neurol Belg 102 3 114 21 Monk A 2002 Noddy s guide to usability Interfaces 50 31 33 Nyberg M Bjork S Goldstein M and J Redstrom 2001 Handhelp application design merging information appliances without affecting Computer Interaction In Proceedings of IFIP TC 13 Conference on Human Computer Interaction IOS Press Amsterdam pp 391 398 Olsen R V Hutchings B L and E Ehrenkrantz 2000 Media memory lane Interventions in an Alzheimer s day care centre American Journal of Alzheimer s Disease 15 3 163 175 Oriani M Moniz Cook E Binetti G Zanieri G Frisoni G B Geroldi C Vreese L de and O Zanetti 2003 An electronic memory aid to support prospective memory in patients in the early stages of Alzheimer s disease a pilot study Aging amp Mental health 7 1 22 27 Raskin J 2000 The Human Interface New Directions for Designing Interactive Systems Adddison Wesley Reading MA Reisberg B 1983 The brief cognitive rating scale and global deterioration scale In Assesent in geriatric ps
18. Pwd and informal carer reacted with amusement to the sound and picture of the reminder Two Pwds thought it should be louder sharper and more alarming The sound of the reminders was not heard by one of the Pwds and was not loud enough for two Pwds when they were further away one Pwd did not hear it when she was outside in the garden but did hear it when she went upstairs another Pwd did not hear it upstairs Two Pwds 108 considered the sound itself annoying and irritating One Pwd said it reminded him of an emergency One Pwd could not place the sound or its meaning another Pwd and informal carer said they easily recognised what the alarm was for One informal carer said it would be good if the reminder was a recognisable melody or a piece of music that stimulated the Pwd to act upon the reminder Design issues of the Mobile device The buttons for making the audio recording were perceived as small by two Pwds One Pwd considered it confusing to have extra buttons on the CCA that were not used One Pwd had to put on reading glasses to see the text and icons The mobile phone clip was easily attached and carried around by one Pwd another had difficulties attaching it to her belt The System s characteristics The system allowed for the radio and music to play simultaneously The CHH fell into a stand by mode three times which had to be fixed by the technician A scheduled reminder was not shown on the CHH when the system was warning at th
19. Pwd remarked that she currently uses a list of carers next to her telephone in the living and bedroom which is very simple She would like a system where during the night she would not have to search for the light switch to read the telephone numbers Then it would be an improvement compared to the current routine The door sensors were easy to understand for one Pwd and the carer they recognized what the alarm is for and were able to connect the sound with the fact that the door is left open Another Pwd was interviewed and was slightly surprised when she hared the alarm When she looked on the CHH she remembered what the signal is for The door sensors were appreciated as useful one Pwd and carer were amused and found the sensors very effective Another Pwd was also positive about this function even more so when the interviewer explained about the compatibility with fridge and oven Belfast During the one of the tests the prompt to close the front door was displayed on the stationary device and the Pwd went to close the front door Upon carrying out this action the door sensor fell off its mounting position due to the small width of the corridor The patient noticed that something had happened but did not know what had happened When prompted with the alarm to close the front door a few of the Pwds were surprised to see that the door had been left open when they went to close it Lulea The function of the door sensor was well understoo
20. a g i SURP i y SUPP No opinion 5 ee ee Very supportive 3 How do you judge the reminder as a support in ery Supportive 9 very supportive Some supportive sometimes not 0 R10 Some supportive sometimes not 1 Some supportive sometimes not 0 remembering phone calls i Not supportive at all 0 Not supportive at all 13 Not supportive at all 0 Hi No opinion 3 Not supportive at all 3 Not supportive at all 0 Not supportive at all 0 How do you judge the reminder as a support in Some supportive sometimes not 0 Some supportive sometimes not 0 Some supportive sometimes not 1 R11 remembering to brush your teeth Very supportive 0 Very supportive 4 Very supportive 2 No opinion 3 53 Amsterdam Belfast Lulea How do you judge the reminder as a means to Very supportive 1 Very supportive 0 Very supportive 3 Some supportive sometimes not 0 R12 enhance the control over the activities you have Some supportive sometimes not 0 Some supportive sometimes not 0 i to remember in your everyday life Not supportive at all 13 Not supportive at all 0 Not supportive at all o i i i No opinion 3 vory goog me en ceed K PE EAA sometime ae i R13 How well do you think that the reminders work Works sometimes sometime not 2 Works sometimes sometime not 0 Not well s 0 Not well 0 Not well 0 ee j No opinion 4 Very useful Could be useful for
21. be clearer Not applicable What use do the buttons have Would be very useful if tried for longer It would be useful to be able to use it from the armchair not have to get up down with arthritis Unable to give opinion Might be useful particularly at night i e To use as a mobile phone Might prove useful Would probably be very helpful particularly at night It could be good if it is adjusted to my needs It is needed when being out doors If can handle it it would provide increased safety M15 How do you experience your mobile device Not at all inconvenient 23 A little bit more inconvenient 0 A lot more inconvenient 0 Not at all inconvenient 2 A little bit more inconvenient 1 A lot more inconvenient 0 Not at all inconvenient 0 A little bit more inconvenient 1 A lot more inconvenient 3 No opinion 2 M16 How Satisfied are you with the mobile device in general Very satisfied 0 Satisfied 13 Dissatisfied 0 Very satisfied 1 Satisfied 1 Dissatisfied 1 Very satisfied 0 Satisfied 4 Dissatisfied 0 No opinion 2 M17 Do you have suggestions to improve form and battery of the mobile device Not applicable None Smaller more stylish more compact Lighter and smaller None Unable to give opinion No suggestions No suggestions It should be easy to operate No opinion 51 Amsterdam Belfast
22. confusion about the help button that seemed to be related to the fact that it had the same design as the other buttons However after the first attempts it was easy to use Several Pwds in Lulea even used the help button as an easy way to call the primary carer instead of selecting her picture in the address book 4 3 2 Bottlenecks Amsterdam The Home screen crashed after using the picture dialling function and or help function in three cases There was no communication functionality on the CCA Belfast One problem particularly prevalent with the picture dialling service was that an accidental double press on the phone book icon would automatically select the contact that was in the same location on the following screen This had the undesired effect of prematurely dialling a contact usually the first one Lulea When a call was initiated the computer held the call for some time and it took a long time for the ordinary telephone function to take over Sometimes the computer held the call all the time This was confusing for some of the participants When the volume of the loudspeakers was tuned for reminders and safety indicators it became too loud for telephone calls and there was a problem with acoustic feedback Calls were not immediately disconnected by the home hub even if the person on the other side had disconnected 25 4 4 Activity functionality 4 4 1 Semi structured interviews Amsterdam Four persons with dementia fo
23. did not comprehend how to deactivate the screen saver The lack of contrast in the colours of icons and background also made it difficult to see and identify them When the screen saver was deactivated by a touch it often happened that an icon was pressed by accident and an unwanted action was initiated A 4 2 Reminding functionality Results from Amsterdam Belfast and Lulea Amsterdam Design issues regarding the COGKNOW Home screen One Pwd was dissatisfied with the design and size of the screen and the form of buttons on it This overall aesthetical disharmonic design she would not want to have in her living room She also found the overall screen slightly unclear even when she was wearing glasses She had difficulties in deciphering pictures and text on the screen Another Pwd and his informal carer also found the design insufficiently clear because of lack of contrast in the screen and the pictures making pictures more difficult to recognise One Pwd could read the text and buttons at a distance of about one meter and did not need glasses then She also found the text of the reminders was easy to read One Pwd thought the text should stand out more and another Pwd found the text underneath the pictures too small but the words to describe the functions were clear Two Pwd complained about the colours one perceived the overall colour of the screen and the different colours of the buttons as distracting the other found the col
24. difficulties attaching it to her belt The System s characteristics The system allowed for the radio and music to play simultaneously The CHH fell into a stand by mode three times which had to be fixed by the technician A scheduled 104 reminder was not shown on the CHH when the system was warning at the same time that the door had been left open The CCA had the time set to the Irish time zone as well as the format of the date The reminder to make a phone call showed the right picture but not the matching text underneath it The text of one reminder was in English Under the reminders the other buttons were active which made it difficult to confirm the reminder properly because the Pwd did not know where to touch the screen The researcher noticed that it might be confusing for the Pwd to have a picture of the informal carer on the help button as well as on the picture dialling address book Regarding the connections there were several problems with getting a good telephone connection The computer crashed several times after the picture dialling function was tested One Pwd received a telephone call during the test which caused some confusion She picked up the phone but did not get a connection Later the Pwd was not able to get a proper telephone connection she did not know what to do the system was making beeping noises and the telephone of the informal carer was ringing She then picked up the phone and seemed to be somewhat startl
25. dinner e Optional reminder to brush teeth b Maintaining social contact e Receive incoming telephone calls e Picture dialling call a contact by touching a picture on the screen c Performing activities of daily living e Music player e Radio function d Enhancing feelings of safety e Warning alert when front door is left open e Possibility to call for help at the touch of a button 2 5 2 5 Research questions in field test 1 In field test 1 the focus has been on user friendliness of the stationary and mobile devices and on investigating basic usefulness regarding the functionality of the COGKNOW device The general question on user friendliness was Are people with dementia able to use the device single handedly What are the obstacles to self sufficient use The general question on user friendliness was Do the users value the functionalities of the device as supportive in their daily living In appendix A 3 we provide a complete list of research questions and methods for field test 1 Within WP1 four groups were established with responsibility for elaborating the different research methods Group1 Pre test interviews led by CDH Group 2 Semi structured interviews led by VUMC Group 3 Observation scheme led by NST Group 4 bottleneck list led by TI In addition work packages 2 and 3 were asked to elaborate the in situ measurement methods Some of the research questions had already been formulated in D5 1 1 see the e
26. find that your uses the picture Easy te is S Fayo bans EA Appropriate 3 P8 Appropriate 0 Appropriate 1 vee address book on the mobile device Difficult to use 1 Difficult to use 0 Difficult to use 2 ma No opinion 2 3 Difficult to use 1 Difficult to use 1 Difficult to ugi How do you find the emergency contact function Appropriate 2 P9 Appropriate 2 Appropriate 3 for your Easy to use 1 Easy to use 1 Easy to use 1 ae No opinion 2 How do you judge the picture dialling Makes it easier to keep in touch 2 Makes it easier to keep in touch 2 Makes it easier to keep in touch 6 P10 function as a means to facilitate social contact Doesn t make a difference 2 Doesn t make a difference 2 Doesn t make a difference 0 of your with family and friends Makes it more difficult 1 Makes it more difficult 1 Makes it more difficult 0 Easier less chance to make a i Possibly mistake Difficult to use because of separate Alloo confusing t stressful How useful do you find the picture dialling devices Possibl function in relation to your needs y All carers found the function useful P11 F Does the system help you keep in contact with Not useful works fine without or very useful Pwd already phones several times a people whom and how da Not useful current routine works y iine Not useful at present as Pwd is still Useful able to make phone calls Howdowouexperience the picture didllin Not at all inconv
27. inconvenient T9 y P A little bit more inconvenient 0 A little bit more inconvenient 4 A little bit more inconvenient music player F F s A lot more inconvenient 0 A lot more inconvenient 0 A lot more inconvenient f Very satisfied 0 How satisfied are you with the Radio control and Very sallsticg 0 ely sateled Satisfied 4 T10 dsi olaver Satisfied 4 Satisfied 1 Dissatisfied prayer Dissatisfied 0 Dissatisfied 0 n No opinion 2 It should be adjusted to the kind of None No suggestions SICA TEI AO Nlo suggestons NA eener Bovodnavecuguesionsiowipevemaados oS We Nate eee en T11 Bee aae eraai naas aena control and music player No comment No suggestions indones media pageran dA NA si i E download function would be nice ceeeeeteetettnnattteteeeeeeessessntssttetesesssesnanaeas Nosugdesions Eee Amsterdam Belfast Lulea Safety Warnings 59 Amsterdam Belfast Lulea It must be adjusted to our needs Notappli abie Useful Better with warning for unlocked doors than open Nor Appiigable N A COOMS ss reerd E oE OEE EE EES How do you judge the safety warning services eee ee eg a ee Eee ted a a a W1 function interaction experiences usefulness Not applicable Wsetul Ne a SN RE a oy ok Soe user friendliness etc aaa e eaaa L aaa a hen E a E a Bcd Mice Cone ANG Migugni Useful o j Daae a inne Would be more useful in the kitchen e a e Remgerator and o
28. interviews were composed for the persons with dementia and their informal carers see Annex A1 2 A1 3 Part of the interview was conducted during the field test and part of it after the field test had been finished The questions in the interviews were focused on user friendliness and on expected usefulness of the different functionalities in the four COGKNOW areas memory communication daily activities and safety The interviews were conducted by specifically trained senior and junior researchers These researchers worked under direct supervision of the responsible test site clinical managers to ensure that proper practice was followed and that all identified ethical issues were addressed see Annex A3 DoW on Ethical Issues During the field tests the participants were interviewed in their own homes and observed while actually using the COGKNOW Day Navigator See http www minimental com 13 3 4 Observation scheme During the field test the user device interaction was also observed by the researchers A standard observation scheme was composed to make comparisons between the users at the three test sites possible see Annex A1 4 The observations were conducted by specifically trained senior and junior researchers The pre test and field test interviews mainly have a structured and semi structured form The field observations are open and allow for inspection of the users handling of the equipment as well as of specific inter
29. needs for applicability However the Pwds are divided in their opinions about the user friendliness of different components of the system and aspects of the design A significant number of informants found the COGKNOW Day Navigator easy to use But some of the Pwds felt that the touch screen represents a difficult way of communicating with the system This was most pronounced for the mobile device The report from the test site in Belfast stated The most common problem that was observed with regard to operation was in relation to the touch screen on both the stationary and the mobile device The touch screen on the mobile device did not function very well In general the informal carers seem to be even more positive about the present user friendliness of the device than the Pwds A majority of the Pwds were able to operate the device independently relatively quickly The Irish test leader writes In general all the Pwds were able to learn various functions of the system in a short period of time The informal carers all found the COGKNOW devices easy to use and learn how to operate Most of the informants found the screen size icons and texts of the user interface appropriate The pictures of the dialling system were regarded as clear However there are some differences in the evaluation of the home screen and the mobile device in this respect The display of the mobile device is considerably smaller than that of the stationary devic
30. one person found it to be a little more inconvenient Three participants were satisfied with the service in general If the picture dialling function was on a single device integration of the telephone with the stationary device the service would be much improved according to two persons with dementia One participant stated that the emergency contact function should be more in the foreground Three informal carers stated that the picture dialling function would not be useful for the Pwd either because making a phone call was not difficult for the person with dementia using the current method 23 two informal carers or because the service was too difficult due to the separate devices and steps needed to make a phone call with the service one informal carer The other two informal carers participating thought the function would be useful for the person with dementia In correspondence with these findings two informal carers experienced the picture dialling function as not at all inconvenient and three found it to be a little bit more inconvenient However all informal carers were satisfied with picture dialling in general Two informal carers suggested that the telephone should be integrated with the stationary device so that no confusion could arise with regard to separate devices and steps Two informal carers would like to see the option to add more contacts in the picture dialling address book Another informal carer suggested the help icon
31. sensitivity high and it bothered her that the system reacted so promptly She thought it would discomfort her if she accidentally touched the radio button and the radio started playing immediately Later during the test this actually happened and in a slight panic she was unable to switch off the music the informal carer had to help her Another Pwd accidentally pushed the music button twice and the music started playing again this time with another song This enabled the Pwd to choose between songs Usefulness of the system Because of environmental issues one Pwd disliked the idea that the system would be running all day and night Another Pwd said he had no need for the system yet but could see the usefulness of such a system in the future Another Pwd thought it could be very helpful and useful in his everyday life when the system functioned as intended The charger was tested in one case and there were some difficulties with it When placing the CCA in the charger the informal carer accidentally touched the bar at the top of the screen and opened a Windows menu When the Pwd placed the CCA in the charger the Pwd pushed reasonably hard on the devices With the second attempt the Pwd tried to put the CCA in the socket for the spare battery but eventually succeeded in placing the CCA on the charger The Pwd had also some difficulty in removing the CCA from the charger she moved the CCA back and forth on the pin a few times to get it off
32. severe cognitive decline early dementia stage GDS 5 assessed by using the standardized Brief Cognitive Rating Scale Reisberg 1983 People willing and able to participate actively in a research project confirmed by individual interviews or participation in a focus group in which an ICT device is being developed aiming at support of memory daily activities communication with family and friends and feelings of safety The close person informal carer is regularly in contact with cares for the person with dementia Table 2 Characteristics of participants in field test 1 Amsterdam n 5 Belfast n 5 Lulea n 6 Persons with dementia Age Mean 64 7 range 56 78 Mean 70 8 range 66 78 Mean 69 5 range 60 77 Gender 3 female 4 female 4 female 2 male 1 male 2 male Civil status 4 married 3 married 5 married 1 divorced 1 widowed 1 single 1 single Carers Age Mean 59 2 range 49 78 Mean 64 2 range 45 72 Mean 58 5 range 23 78 Gender 3 female 2 female 3 female 2 male 3 male 3 male Relation to 4 spouses 3 spouses 3 spouses person 1 daughter 1 children 1 daughter 1 cousin 2 son 3 1 3 Experiences of researchers and users The installation of the COGKNOW device in the Pwds homes may to some extent have altered our informants daily activities Our informants are persons partially dependent on the care provided by others and hence the interruption caused by installing a prototype not n
33. solved prior to the tests at the second and third test site Also the quality of the radio receptions was sometimes poor At one site the mobile device had no activity functionality 5 1 5 Safety functionality The safety functionality could not be tested properly in two of the sites of field test 1 due to technical difficulties In Lulea a door sensor was tested In the results from Lulea it was stated The door sensor was working and tested at three sites The function was well understood by the three Pwds but they had difficulties in relating it to their own situation at the moment Some of our informants judged the future usefulness of this service as high This also goes for more specific warning functionalities e g warnings for stoves and iron left on 5 2 Discussion Our conclusions from field test 1 are on line with findings described in the literature about the application of ICT devices by people with dementia Positive results on the usability of a reminding device were found in several other studies Holthe et al 1998 Zanetti et al 2000 Wilson et al 2001 Oriani et al 2003 Baruch et al 2004 Van den Broek et al 2004 Gilliard amp Hagen 2004 Szymkowiak et al 2004 In our field test some remarks were made about possible difficulties with the visual reminders on the stationary and mobile devices The reminders did not attract the attention of the users as expected Inglis 2003 and Szymkowiak 2004 propose remind
34. that they were satisfied with the device in general Two persons with dementia suggested that the mobile device could be lighter and smaller one person suggested removing the buttons beneath the screen as they had no apparent use Informal carers were divided on their experience with the COGKNOW Day Navigator Three informal carers stated that this is a good development for people with dementia On a more personal level the system could be useful in the future but with regard to the stage of dementia of their loved ones this would be a good time to learn how to use the devices In contrast one informal carer said this system would be too difficult to learn especially when the person with dementia did not have any previous experience with computers All informal carers were satisfied with the Day Navigator in general All informal carers expected to learn how to use the device quickly themselves but were divided on how much support and help the person with dementia would need in learning the functions and how to use the device Three informal carers expected that the person with dementia would need at least some help in remembering the functions and using the system Size button size text size as well as the number of buttons on the stationary device were judged appropriate by all informal carers All but one informal carer stated that the stationary device would be useful for the person with dementia and that the arrangement was sufficiently use
35. the loudspeakers There seemed to be too many steps and it was not confusing to speak directly with the screen The important step seemed to be to establish the connection with the person on the other side when that had been done they concentrated on the communication The picture directory system worked well All Pwds need repeated verbal instructions and practice before they could manage the directory on their own After some practice three of the Pwds succeeded in completing all steps in the calling procedure on their own A 4 4 Activity functionality Results from Amsterdam Belfast and Lulea Amsterdam Arrangement of the music player one Pwd accidentally touched the music button and turned on music when trying to confirm a reminder 113 The Music function was easy to understand for one Pwd it was easy for him to switch music on and off Three Pwds clearly knew how to operate it by switching it on and off and another Pwd did not have any problems in turning the music on but was very unsure about switching it off In the end he managed to do this and he was surprised that he had remembered correctly how to do it As for the usefulness one Pwd said she would not use it often because she preferred reading However if this were to become possible in the future such a function would probably facilitate listening to the music Another Pwd liked the function very much his facial expression showed a positive impression One Pwd won
36. to learn how to use the device on their own provided they got opportunity to practice Some of the Pwds recognizes that they have problems of remembering and that they need assistance Some were used to their carer reminding them on activities and it was difficult to perceive how the devices could replace that The devices can not help me in social activities but they can remind me to take part If the mobile unit was working well and easy to understand II could feel safer when walking in the neighbourhood Pictures are easier to understand than text 44 Amsterdam Belfast Lulea Which part of the COGKNOW day helps you the most in daily life No comment Pwd doesn t know At this stage none of the functions makes any difference with the way live now Perhaps in the future Help function and picture dialling service seem most useful Radio function Picture dialling service Reminders would be most useful N A Wouldn t use it N A not tested in daily life Reminders would be useful N A not tested in daily life The picture dialling is easiest to understand and could be very useful The possibility to listen to music and radio is a very nice function Help function is necessary for me as a safety function don t need the functions right now but think could learn how to use the devices Which part of the COGKNOW Day Navigator helps G3 you the least i
37. use the device Amsterdam Belfast Lulea How do you experience learning how to use the a devices and functions Easy to learn Easy enough to learn Surprised at how easy it was Difficult for carers It is possible to learn for the Pwds It needs repletion and practice 84 Amsterdam Belfast Lulea Easy to learn manual is clear Not difficult Fine Not difficult Fine No problem Totally agree 5 Totally agree 4 Totally agree 3 L2 I quickly learned how to use the device Dis agree somewhat 0 Dis agree somewhat 1 Dis agree somewhat 1 Totally Disagree 0 Totally Disagree 0 Totally Disagree 1 Totally agree 5 needed little support in learning how to use Totally ee 9 Teel on Dis agree somewhat 0 L3 Dis agree somewhat 2 Dis agree somewhat 4 the device Totally Disagree 0 Totally Disagree 0 Totally Disagree 0 fae No opinion 1 X Totally agree 3 find the device easy to use for my for the erally oo ee Totaly wae 9 Dis agree somewhat 2 L4 F Dis agree somewhat 2 Dis agree somewhat 5 f functions he she needs fF i Totally Disagree 0 Totally Disagree Pa Totally Disagree 0 Mg No opinion 1 My easily remembers the various functions of sea meee Toray aeS Totally oe oe 5 L5 fhe device Dis agree somewhat 1 Dis agree somewhat 3 Dis agree somewhat 2 Totally Disagree 1 Totally Disagree 2 Totally Disagree if Totally agree 2 Total
38. you judge the reminding service R1 function interaction experiences usefulness user friendliness etc Useful practical Nice it s clear what has to be done Not very useful maybe for keys or medication Useful Pwd needs to be reminded by telephone at present Open door reminder could be useful Could be very useful Could be very useful if it is adjusted to personal needs More important to be reminded on such things as medication Useful Pwd forgets to eat Useful It should be possible to easy adjust the reminders by the carers Not very useful Excellent How well do you think your understands the NOP Ende sredaple aD Nor uodetstaridable a P my R2 7 y SRAN Understandable with effort 0 Understandable with effort 2 reminder messages Easy to understand 1 Easy to understand 25 Easy to understand 2 No comments 3 gt F Good to hear 4 Good to hear 5 Sood to Heal 3 Do you find the reminders good to hear when A Sometimes good not 0 R3 o are in the same toom Sometimes good not 0 Sometimes good not 0 Difficult to hear 0 y i Difficult to hear 1 Difficult to hear 0 Wd f No opinion 3 74 Amsterdam Belfast Lulea Do you find the reminders good to hear when Difficult to hear 2 Difficult to hear 0 Difficult to hear 0 Sometimes good not 0 R4 you are in another room Sometimes good not 3 Sometimes good not o Good to
39. 1 Useful Useful the Pwd would possibly listen Not useful to music radio more often All too confusing stressful How useful do you find the Radio control Integrate windows media player and The music function is very useful if it and music player in relation to your needs the option to select albums songs Could be difficult to get used to Pwd can be loaded with the right music T7 Does the system help you in these kind of artists is able to use TV control manually daily activities what and how The radio might be very useful Music function is practical radio Not useful function is not Doesn t listen to radio much Not really a need for it Pwd doesn t listen to the radio music very often Howdovowetperience tha Racie conteland Not at all inconvenient 15 Not at all inconvenient 1 Not at all inconvenient T8 i y P A little bit more inconvenient 0 A little bit more inconvenient 3 A little bit more inconvenient music player A lot more inconvenient 0 A lot more inconvenient 0 A lot more inconvenient 81 Amsterdam Belfast Lulea Very satisfied 0 Very satisfied 1 Very satisfied 0 T9 cS E you with the Radio control and Satisfied 5 Satisfied 3 eae i Dissatisfied 0 Dissatisfied 0 Pe i No opinion 2 None No comment No suggestions No comment No suggestions Do you have suggestions to improve the Radio Option to choose radiostations and T10 artists
40. Bay COGKNOW Human Factors Impact Analysis lead Editors Br Polit Halgeir Holthe Ney Neneh Anna Lena Andersson CDH LTU Sweden WWW COQKNOW ECU The human factor analysis of the Cogknow project field test 1 By Halgeir Holthe and Anna Lena Andersson COGKNOW Report Context Work package wp1 Human Factor Analysis WP Leader Anna Lena Andersson CDH Lulea SWE Rose Marie Drdes VUMC Amsterdam NL COGKNOW Task 1 5 Work task Leader Halgeir Holthe dr polit NST Starting date 31 08 07 Release date 22 10 07 Author s Halgeir Holthe NST and Anna Lena Andersson CDH Coauthors Rose Marie Dr es VUMC Franka Meiland VUMC Richard Davies UU Stefan Savenstedt LTU Reviewers Johan Bengtsson CDH LTU Ferial Moelaert TI Report nr 02 2009 ISBN 978 82 8242 002 0 Contents 1 2 3 1 Summary The COGKNOW project aims at developing a functional user validated cognitive prosthetic device which addresses the needs of people with mild forms of dementia Our main target group is living in Europe all in all around 900 000 people The vision of the project is to assist these people in navigating through their day by providing technological support for cognitive reinforcement Work package 1 wp1 of the COGKNOW project is designed to deliver a Human Factor Analysis on data collected in three field tests of the COGKNOW device and services termed the COGKNOW Day Navigator for people with dementia Pwds
41. GKNOW device with respect to the four functionality areas A slight adjustment in the timing of field tests at different sites made minor bug fixes and adaptations of the COGKNOW device possible during the test period Hence the functionality of the device first subjected to testing was not exactly the same as on those tested at the end of the trial period In particular the test in the Netherlands used fairly early versions of the prototype while the tests in Northern Ireland and Sweden used identical versions of CS CHH CSH and CCA except for one user in Sweden who used a minor update to the CCA Even if these adaptations only represent minor differences within some of the functionality areas they might have influenced some of the users opinions on applicability and usefulness See http www medrounds org encyclopedia of aging 2006 01 reisburgs global deterioration scale html 11 3 1 2 Participants in Field test 1 Inclusion criteria for Pwds and close persons Pwd informal carer dyads are People with the diagnosis dementia of the Alzheimer type possible probable as described in the DSM IV TR Characteristics of Pwd participants and close persons in field test 1 are summarised in table 2 People suffering from mild dementia as described in the Global Deterioration Scale stages 3 4 and 5 mild cognitive decline early confusional stage GDS 3 moderate cognitive decline late confusional stage GDS 4 and moderately
42. LULEA TEKNISKA UNIVERSITET Wer har mailica ELETE Pad eel University Belfast acrosstiirmits Vechnol Duras MO D ME LANS LANDSTING Explanation of the purpose of the project Dementia frequently occurs in elderly people Most people prefer to stay in their own home as long as possible Often they need help to do so The European COGKNOW project aims to develop technological solutions to help people with mild dementia experience greater autonomy and feelings of empowerment and enjoy an enhanced quality of life COGKNOW focuses on electronic means of support that will help people remember maintain contact with family and friends perform daily activities and enhance feelings of safety Up to now little research has been done into technical solutions specifically from the point of view of people with dementia themselves For instance little is known about the person s individual needs and wishes We feel it is very important that technical means of support are developed alongside the sufferer so that solutions actually fit their needs We are seeking participants to collaborate in this project to develop adequate support solutions that are user friendly useful and effective The results of the project could help many people with dementia live at home in a safer and more enjoyable way and for a longer period of time 96 Participation in test 1 The first phase of assessing needs is now completed an
43. Notapplicapie reminding for e g pick up for day Useful centre Three of the Pwds have the opinion Berica to comment that they don t need reminders How useful do you find the reminder function in Reminder for taking medication 4 R14 relation to your needs would be useful Could be useful They have to be adjusted to my Does the system help you remember important needs 4 things what and how No need for it Could be useful for appointments l ate Reminders on phone calls could be No need for it at the moment maybe i good inthe tuture Would be very useful for Pwd carer to help remember appointments Not at all inconvenient 15 Not at all inconvenient 4 Nk 2 a R15 How do you experience the reminder function A little bit more inconvenient 0 A little bit more inconvenient 0 gt gt P A lot more inconvenient A lot more inconvenient 0 A lot more inconvenient 0 Aa No opinion 6 Very satisfied 0 How satisfied are you with the reminder in very atistied 0 vary Falisned Satisfied 1 R16 eneral Satisfied 14 Satisfied 1 Dissatisfied 0 9 i Dissatisfied 0 Dissatisfied 0 ae f No opinion 5 R17 Do you have suggestions to improve the Every day is different and for daily No suggestions None of the Pwds had any reminding service activities don t need it yet suggestion 54 Picture Dialling Amsterdam Belfast Lulea Refused to comment __ hee cecececececeeeeeeeeeee
44. S3 Stationar device Appropriate 4 Appropriate 2 Appropriate 5 y Too small 1 Too small 0 Too small 1 How do you judge the size of the text on the Tog large 199 large 0 TOR targe a S4 Sereen Appropriate 4 Appropriate 4 Appropriate 6 i Too small 1 Too small 0 Too small 0 How do you judge the number of buttons on the Too many buttons 0 Too many buttons 0 Too many buttons 0 S5 device Appropriate 5 Appropriate 1 Appropriate 4 Needs more buttons 0 Needs more buttons 0 Needs more buttons 2 Clear Easy to see recognise The Icon of help function is not clear Childish but recognizable How do you judge the icons on the device Dis Nice clear only the icon for finding Don t know lhe icon for finding the mobile the mobile device is not clear device is not clear S6 like them recognize them please add remarks to specific icons Should be rectangular buttons the icon for finding the mobile device is not clear Icon for finding the mobile device Easily recognisable Easy to see The icon for time of the day is difficult to understand The pictures in the telephone directory are easy to understand 46 Amsterdam Belfast Lulea and the icon for the picture dialling service are not clear All the icons are easy to recognise It is easier to understand a ordinary clock than just Too bright 1 Too bright 0 Too bright 0 S7 How do you judge the
45. W Project title COGKNOW Helping people with mild dementia navigate their day CS COGKNOW Server CSH COGKNOW Sensorised Home GDS Global Deterioration Scale LTU Lulea Technical University Lulea Sweden MMSE Mini Mental State Examination NST National Centre for Telemedicine Troms Norway Pwd Person with Dementia TI Telematica Institute Enschede the Netherlands VUMC Vrije Universiteit Medical Centre Amsterdam the Netherlands WP Work package 8 References Baruch J Downs M Baldwin C and E Bruce 2004 A case study in the use of technology to reassure and support a person with dementia In The International Journal of Social Research and Practice 3 3 327 377 Broek M D van Downes J Johnson Z Dayus B and N Hilton 2000 Evaluation of an electronic memory aid in the neuropsychological rehabilitation of prospective memory deficits Brain Injury 14 455 462 Deliverables of the COGKNOW project Deliverable 1 4 1 Hettinga M et al 2007 Functional Requirements Specification Deliverable 5 1 1 Moelaert F 2007 Evaluation Strategy Dillon A 2001 Beyond usability process outcome and effect in human computer interactions Canadian J Information Science 26 4 57 69 Folstein M F Folstein S E and P R McHugh 1975 Mini Mental State A practical method for grading the cognitive state of persons for the clinician J of Psychiatric Research 12 189 198 Frokjzer E Hertzum M and K
46. actions with different functionalities The observations were written down in a field log during observation of the users 3 5 Digital in situ measurement Some of the research questions are approached partly by in situ measurements which measure phenomena through technology The in situ measurements log traffic data and frequency and timing of specific use of different functionality areas In addition the in situ measurement software allowed for sound recordings of user comments For this aim research software was developed in WP2 and 3 for more details see COGKNOW deliverable 3 1 1 Technical Specification of Systems and Services The in situ measurement software was installed on the mobile device 3 6 Bottleneck list To investigate problems in the user device interaction during the field test a bottleneck list was established see Annex A1 5 The bottleneck list is a checklist established on the basis of the researchers estimations of difficulties prior to field test 1 The list was used at each test site and left at the Pwds homes if the test took more than one day It was filled in by the users or by the researcher who conducted the interview In field trial 1 where at some test sites the COGKNOW Day Navigator application was used only under supervision of the researcher for a short period half a day the researcher filled in the bottleneck list 3 7 Prescribed test tasks The first prototype of the COGKNOW device has restricted
47. ality Two participants stated that they had no use for it at the moment but could see themselves using it in the future Four persons with dementia found the reminder messages easy to understand one understood the messages with some effort Four persons with dementia found the reminders easy to hear when in the same room but only one participant judged the reminder easy to hear from another room Three persons with dementia judged the reminder difficult to acknowledge The participants were divided on which content of the reminder would be supportive Three persons with dementia found a reminder to make a phone call a reminder to brush your teeth or a reminder intended to enhance control over activities of daily living not supportive at all Three persons with dementia judged a reminder to eat at least sometimes supportive and two participants thought of other content for which the reminding functionality would be useful for them personally for instance a reminder to take medication or a reminder to bring one s keys when going out All the persons with dementia found the reminder function not at all inconvenient and were satisfied with the service in general One person suggested that the sound of the reminder could be the voice of the informal carer Another person said the acknowledgement of the reminder would need improvement as the screen for confirming receipt had to be pressed too hard Four informal carers judged the service to be useful in remi
48. and their informal carers Each field test covers increasingly complex levels of functionality of the prototype to be tested While in the first two field tests the focus will be on user friendliness and perceived usefulness the third field test will investigate the functionality usability and acceptance of the finished prototype and its impact on the Pwds autonomy and quality of life Each field test is performed at three test sites Northern Ireland The Netherlands and Sweden with a total of 15 18 user dyads Pwds and informal carers This report Deliverable 1 5 1 of the COGKNOW project presents the Human Factor Impact Analysis of field test 1 which was carried out in the homes of 16 people with dementia living in the regions of Amsterdam Belfast and Lulea The study was carried out in 2007 The methods and work plan for data collection before during and after the field test were described in detail in deliverable 4 1 1 0f the COGNOW project We have applied semi structured interviews field observations pre formulated bottleneck checklists and some in situ measurements to investigate the applicability and perceived usefulness of the COGKNOW device as implemented in its first prototype A majority of our informants evaluated the overall system design as user friendly and useful However some difficulties were reported in the use of the touch screen interface and in its present form the mobile device was evaluated as less applicable b
49. ansport 1 Public transport 0 Public transport 1 Other 0 Other 0 Other 13 Is there anyone that you share the informal care Share care with Share care with Share care with with If so with whom and with how many other 0 2 3 0 3 Ore people 1 3 1 T2 1 3 If not what is the reason you cannot share the care 2 1 2 0 2 2 with anyone else 3 0 3 0 3 0 More 0 More 0 More 14 Help occasionally Help occasionally Help occasionally Are there any other people who help occasionally If O 5 0 3 0 5 so who and how many others e g a neighbour 1 2 0 10 1 e that buys groceries every now and then not 2 0 2 1 2 0 structurally 3 0 2 0 3 0 More 0 More 0 More 15 Do you have any physical complaints illnesses that Physical complaints 0 number Physical complaints 1 number Physical complaints number you are being treated for What type of phys complaints NAG iil eer A Diabetes rnam ieee eae ease sect ee a ee EE E a 16 To what degree do these physical complaints not at all 25 not at all l not at all 6 illnesses hinder you in your care task to a small degree 0 to a small degree to a small degree 0 somewhat 0 somewhat somewhat 0 considerably 0 considerably considerably 0 very much 0 very much very much 0 ie a ere ae complaints illnesses Psychological complaints 1 number Psychological complaints number Psychological complaints number 40 Amsterdam Belfast Lul
50. ast Lulea How do you judge the stationary device design function usefulness user friendliness etc Recognizable clarifying Nice Nice size user friendly enough Good clear arrangement the buttons should be more spread out Excellent Well designed Icons easily recognisable N A Very satisfactory It could be very useful The whole thing looks to technical there are to many cords and things It should not be possible to put off the power to the equipment 68 Amsterdam Belfast Lulea No comment Very user friendly It seems easy to understand The concept with pictures combined with text is good How do you judge the size of the stationary Too large 0 Too large 0 Too large 1 S2 device Appropriate 5 Appropriate 4 Appropriate 5 Too small 0 Too small 0 Too small 0 How do you judge the size of the buttons of the Tee large As Tog large s To age g S3 stationary d vice Appropriate 5 Appropriate 0 Appropriate 6 y Too small 0 Too small 0 Too small 0 How do you judge the size of the text on the yee ide ie 199 largo 0 1o largo ie S4 aes Appropriate 5 Appropriate 4 Appropriate 6 i Too small 0 Too small 0 Too small 0 How do you judge the number of buttons on the Too many buttons 0 Too many buttons 0 Too many buttons 0 S5 device Appropriate 5 Appropriate 3 Appropriate 6 i Needs more buttons 0 Needs more buttons 0 N
51. atisfied 1 Very satisfied 0 R17 a are you with the reminder in Satisfied 4 Satisfied 3 nasa came g i Dissatisfied 1 Dissatisfied 0 e f No opinion 3 Link to audio speakers in other rooms No suggestions No suggestions No suggestions The reminders should be combined P with voice messages R18 Do you have suggestions to improve the Help function should be clearer on No suggestions reminding service the screen More alternatives for content reminder The option to set reminders daily No suggestions No suggestions It should be possible to use a variety of reminders Picture Dialling Amsterdam Belfast Lulea How do you judge the picture dialling service P1 function interaction experiences usefulness user friendliness etc Useful Nice proceedings are clear Useful practical Too complicated Looks nice but at the moment it s not easier than the current routine Very useful Too difficult for a confused person Very useful Very useful but Pwd is able to make ordinary phone calls at present Could be useful but Pwd is able to use ordinary phone at present Most of the carers found the picture dialling useful or very useful There were some problems with the ending of calls The text instruction of lifting the receiver was not working well The directory could be bigger in order to include more persons 77
52. bile screens two different types of presses had to be performed The stationary device seemed to require a short sharp nudge with the soft tip of the forefinger The mobile device required a press using the nail of the finger rather than the soft tip These solutions came about after a trial and error approach with some direction from the informal carers On one occasion the Pwd pressed the phone button on the home screen twice in quick succession which resulted in the first contact being called irrespective of whether this was the intended recipient Usefulness of the system The system was envisaged to be potentially useful by all the Pwds and their informal carers However they felt that in its current testing format it would not be that useful Some of the informal carers felt that the system would become more useful if placed in the Pwds home for a longer period of time Informal carers also felt that greater potential for remote control both of the types of reminders and of the way in which they were delivered would be valuable The charger was present during the trial to hold the mobile device but there was no interaction testing involving persons or informal carers The audio recording feature was not tested as the concept was too difficult for Pwds to grasp New functionalities When they saw the radio feature demonstrated some informal carers suggested that it would be useful to control other devices such as the television The same i
53. city 1 Town city 0 Town city 4 8 What is the educational background of your Primary school 11 Primary school 12 Primary school 0 Junior second vocational 0 Junior second vocational 3 Junior second vocational 3 Second vocational 2 Second vocational 0 Second vocational 2 Senior second school zA Senior second school 0 Senior second school 0 Higher professional 0 Higher professional 0 Higher professional 0 University 71 University 0 University 1 Other Other 0 Other 0 9 Which hobbies does your have Playing the piano gardening reading walking and listening to music Pottery and drawing in a group Cycling 1 travel 1 word searches 1 knitting 1 watching TV 2 reading 2 Gardening 1 listening to music 1 fishing 1 walking 2 Amsterdam Belfast Lulea Reading Tennis and golf Used to do professional dancing Care 19 a complaints ilinesses Physical complaints 1 number Physical complaints number 4 Physical complaints 3 number What type of phys complaints BP high cholesterol headaches arthritis J s ssssssssssssssessrssissrssersrrssrrsrrssrssrrstrnsrssrrntneseeent Diabetes Pace maker thyroid gland stomach ulcer diabetes arthritis in hip back pain and Parkinson s hypertension disease ii i 11 ee eee a Psychological complaints 5 number Psychological complaint
54. correct wrong 0 Sometimes correct wrong 0 Working for your i Very well Very well 2 Very well 0 Peat No opinion 6 83 Amsterdam Belfast Lulea How useful do you find the warning alarms in relation to your needs Does the system give you a feeling of safety when and how W10 Not applicable Not applicable Not applicable Has potential Not useful Would give a feeling of security All cares found the present warning not useful No comment Could be useful No comment Could be very useful How do you experience the safety warnin Norat all Inconvenient ne Not atallinconyenient Rae E SR f W11 y P y 9 A little bit more inconvenient 0 A little bit more inconvenient 0 f s alarms f A lot more inconvenient A lot more inconvenient 0 A lot more inconvenient 1 No opinion 6 How Satisfied are you with the warning alarms in W12 general Very satisfied 1 Satisfied 1 Dissatisfied 0 Very satisfied 3 Satisfied 1 Dissatisfied 1 Very satisfied 0 Satisfied 2 Dissatisfied 0 No opinion 4 Do you have any suggestions to improve the W13 warning alarms Not applicable Not applicable Not applicable Sensor to detect locked door would be useful open closed locked warning alarms No suggestions No suggestions No suggestions No suggestions No suggestions Sensors for locked doors could be Statements on Learning how to
55. d among the three Pwds where it was tested even though they could not understand the usefulness of the function The symbol for an open door was well recognized and it seemed easy to connect the warning with the fact that the door was open One of the Pwds immediately stood up and went to close the door when warning sound and the symbol of the open door was showing on the screen 115 COGKNOW Helping people with mild dementia navigate their day www cogKknow eu info cogknow eu ISBN 978 82 8242 002 0
56. d did not listen to music or radio very often Belfast When asked to comment on the radio and music features two Pwds said that it was not useful and two said that they did not listen to music although one Pwd mentioned that they did enjoy it The control button for the radio and music were judged to be appropriate by four Pwds Four Pwds reported that they enjoyed the music playback function One Pwd commented that they only watched the television now and did not listen to music or the radio The experience of using the music or radio features was reported by four Pwds to be not at all stressful Two Pwds thought that the music and radio service was unpractical while two thought it was practical When asked to comment on improvements four Pwds had no suggestions Three carers reported the music and radio service to be not useful and one carer thought the service to be useful Three carers thought the service was an enjoyable experience and one carer thought that it was boring Four carers were satisfied with the service and three thought the experience was a little inconvenient or stressful Lulea All of the Pwds appreciated the possibility to turn on music and the radio via the touch screen Two of the Pwds had a special interest in listening to music and they had for some time not been able to turn on their own CD player They thought that the function was easy to use even though it required some practice Three of the Pwds were regular rad
57. d on the stationary device Both the size of the mobile itself and the size of the screen and its text were reported by three persons to be appropriate One person was only able to comment on the size of the mobile because it was not functioning on the day of the test and one person was unable to give any opinion on the mobile device When asked to comment on the usefulness of the mobile device three persons said that it might be useful with one person commenting on how it could be used from an armchair to avoid having to move around with arthritis In general the informal carers responded in a positive way to the COGKNOW system mainly surprised at how easy the system was to use Two informal carers felt that such a short testing period was maybe not useful and both suggested that the system should be tested for a longer period and when the Pwd is alone All the informal carers felt that the reminding functionality of the system would be of most benefit to help the Pwd to structure and stimulate their day The size of the screen buttons and text were all reported to be satisfactory with icons being easily recognisable Three informal carers were satisfied with one being very satisfied with the stationary device When asked to comment on improvements for the stationary device two informal carers suggested that the screen could be wall mounted and one informal carer also suggested that reminders could be accompanied by flashing lights as well as an ala
58. d problems with the many steps involved in turning the function on and off None of the participants found the activity function in the mobile device useful 4 4 2 Bottlenecks Amsterdam On the CHH the music and radio could be played simultaneously There was no activity functionality on the CCA Belfast There were no observed bottlenecks with respect to either the radio or the music functions Lulea The function worked well on both the CHH and the CCA when the CCA was stable and had a good internet connection 4 5 Safety functionality 4 5 1 Semi structured interviews and observations Amsterdam Safety warnings functioned in only two of the five field tests Persons with dementia thought it would be useful especially in the kitchen on the refrigerator or oven door Both persons with dementia were satisfied with the safety warnings although both thought the warnings sometimes worked and sometimes did not Likewise the audibility of the safety warning on the stationary device was sometimes judged easy to hear by one person with dementia and difficult to hear by the other The visual safety warning on the stationary device was found to be appropriate by both persons with dementia One person with dementia said the safety warning was a little inconvenient and suggested the option of turning the safety warning on the door off when the person is at home The other person said it was not inconvenient at all and had no suggestions for improveme
59. d we are asking you to participate in the test of the first version of the assistive electronic devices The test will be held in June 2007 and is aimed at testing the user friendliness and usefulness of the devices Based on information from this first test the device will be adapted where necessary In total two of these preliminary tests and one final test will be conducted during the time period of June 2006 until October 2009 The final test focuses mainly on the effectiveness of the developed device in daily functioning You as a participant can join one or more test phases if you want We are asking you and your next of kin primary informal caregiver for explicit consent to participate in the project Participation includes an initial home visit to discuss your present situation and to check information that is needed by the technical staff in order to install devices Some weeks later the devices will be installed in your home and you and your next of kin will be trained in how to use them The testing of the devices will take place during one or several days Both during the test and after two researchers will ask you and your next of kin many questions related to the use of the devices The technical devices will be installed in your home only during the test period During this time you have access to a helpdesk that can answer all questions on the devices and assist you See phone numbers at the back of this brochure 3 COGKNOW
60. daily basis using traditional methods Additionally the Pwds don t listen to music while in the home environment and although the music service was considered enjoyable it was perceived to be not useful The mobile device in relation to Belfast s cohort of Pwds are considered unnecessary and as a further complication If GPS functionality should be retained and linked to the home hub then perhaps a key fob could carry out the same role as the current mobile device Personalised reminders whether it is in relation to taking medication doctors appointments or the front door left open is the way forward as seen from Belfast 5 3 Recommendations The bottlenecks encountered in field test 1 should be resolved prior to field test 2 The most significant of these bottlenecks are a The touch screen on both the stationary and the mobile devices did not detect the Pwds touches as expected This problem was most pronounced on the mobile device b A general unstable function of the Day Navigator s screen on the mobile device c Reminding and safety warnings not working properly on the mobile device d The connection between door sensors and CHH did not work properly See also Annex A1 5 Charging the battery of the mobile device of the COGKNOW Day Navigator needs to be further developed and tested as well as the SocioXensor and its voice recording system The external design of the stationary device should be adapted to blend better with furnit
61. dered how to choose her own preference of music and remarked about the necessity of preventing monotony in the music that the system offers Also the Radio function was easy to operate for four Pwds It was easy to find and touch the right button Turning it off was a bit more difficult for one Pwd he hesitated and was surprised when the radio was actually turned off He appreciated the fact that the COGKNOW radio function was easier to use than his own radio One carer thought the radio function was more difficult than the Pwd s own radio because its use was familiar that s the way it is in the head Three Pwds did not find this radio function useful One said she preferred reading but she might appreciate it in the future see above another Pwd said she could easily turn on the radio on her own stereo this is the only button on it she is able to use and one Pwd evaluated the radio function as annoying and impractical He found the picture for the radio unrealistic Another Pwd thought it was useful he liked the ease of use and the novelty of the function Belfast Four Pwds had no problems in using both the music and radio features and were able to operate in an efficient manner The four Pwds enjoyed these two services the most however they all said that they did not really listen to music that much while in the house and really only watched television Lulea This function was easy to understand and appreciated by most of t
62. device forgotten d What is the battery life of the mobile e In situ measurement WP3 device in practice log battery level regularly log when device goes on off SeniorXensor e When how often is the device charged How often do people forget to recharge e In situ measurement log when charging starts and stops WP3 SeniorXensor f What are the effects if charging is forgotten How can we help our users not to forget recharging the device e Semi structured interview post field trial people with dementia and carers WP1 group 2 98 Field trial 1 Aims Questions Methods WP Who 2 Evaluate a To what extent are messages e Observation during field WP1 group 3 assumptions reminders of the COGKNOW Day trial Gious4 about the Navigator heard attended to How oup user often amp when where not To what e Bottle necks list Group 2 friendliness extent does this depend on e Semi structured ve the device that offers the interview post field trial _ USEMINESS OF message reminder stationary or with people with dementia basic mobile and carers concepts i used in where the reminding device is or oe relative to the location of the user In situ measurement WP1 amp WP3 A TN the time of the message reminder sAudio dian SeniorXensor e g the volume of the message reminder for bottle necks list reminders where people are when the message
63. display of the screen Appropriate 4 Appropriate 4 Appropriate 6 Too dark 0 Too dark 0 Too dark 0 Could be useful Four Pwds find it useful or very useful Don t know Two feel that it has to be adjusted to their needs and routines in order to No comments pws doesn t know Could be very useful become Useable seems useful USetUle te A heb ee i Very useable Couldbe useful _ dianadcdhanteedayennedtaaaee eE da eerste 99 How Uusell do you Mna Mhe statonan device Doesn t make any difference with my tet tt ett t ete e ee ete eeeeeeeeeeaeeeaeeeaes current routine Would be very useful J eee eee cee ee ec ee eeeeeeeteeeeeeeeeeeeeeeeeeaes ldontreall know if Ng eee ee eatin ciate idee Gbtigdn dene How doiyou experience the presence of the Not at all inconvenient l 4 Not at all inconvenient l 2 Not at all inconvenient l 5 2 ee A little bit more inconvenient 0 A little bit more inconvenient 2 A little bit more inconvenient 1 stationary device in your home f F A lot more inconvenient 0 A lot more inconvenient 1 A lot more inconvenient 0 47 Amsterdam Belfast Lulea Very satisfied 0 Very satisfied 2 Very satisfied 2 10 Nes are you with the stationary device in Satisfied lt A Satisfied 2 Satisfied 4 g i Dissatisfied 0 Dissatisfied 1 Dissatisfied 0 If you could hang it from the wall No suggestions pa besi S S9 know would be better PP y l Notable to giye suggestion
64. e Dis agree somewhat 2 Dis agree somewhat 0 Dis agree somewhat 1 Totally Disagree 0 Totally Disagree 0 Totally Disagree 0 Totally agree 0 Totally agree 0 a lt a e L8 The technical support was sufficient Dis agree somewhat 0 Dis agree somewhat 4 g j Totally Disagree 1 Totally Disagree 0 Totally Disagree 0 fae No opinion 2 Very satisfied 0 Very satisfied 4 Very satisfied 2 L9 How satisfied are you with the device in general Satisfied 4 Satisfied 0 Satisfied 4 Dissatisfied 0 Dissatisfied 0 Dissatisfied 0 63 Amsterdam Belfast Lulea No comment No suggestions None of the Pwds had any None N A suggestions Do you have suggestions to make the device can understand this so think it s eo o d dC nee e BN A rng eS Oe L10 lt No suggestions easier to learn and use allright SR a S gt lIO A n esit No suggestions No suggestions E IC A None No suggestions Suggestions for Improvement and for Future Amsterdam Belfast Lulea devices Nocommenk Two of the Pwds new what GPS was N A and they thought it would be good to ip Saoud Be Yen ple fear have provided it was not to difficult to Neighbours work better than GPS N A is p What doyo think about GPS locationtechniaus i i SG aeaeaei ta F1 asa mean to help you finding the way in the don t need it at the moment but it NI RS RRS MEM RE A GR ag TOR TS AA future s
65. e and for some of the users the mobile device seemed to be difficult to operate Some of the users viewed the mobile device as not being user friendly with icons which are difficult to see Moreover it is the impression of the field observers that Pwds do not react to written messages and reminders as expected Another approach to messaging will be suggested for field test 2 The size of the home screen was in general judged as appropriate but some of the users stated that a wall mounted device would be preferable Charging of the COGKNOW Day Navigator was difficult for some of the users and needs to be tested further Also the SocioXensor and its voice recording system was difficult to use and should be subjected to further development prior to field test 2 Usefulness The usefulness of the COGKNOW Day Navigator was in general judged as satisfactory by our informants Due to a restricted implementation of functionalities in the prototype used in field test 1 some of the Pwds did not feel that the COGKNOW services were useful for their own situation In general usefulness seemed to be judged higher among informal carers than among Pwads 30 During this first field test several technical bottlenecks were encountered with respect to for example the stand by mode the sensitivity of the touch screen the door sensors and reception of radio programs The research questions for three of the four investigation areas were answered s
66. e she would prefer the COGKNOW picture dialling as it struck her as more modern One Pwd did not need this function now but thought it might be helpful when her illness 112 progresses The carer confronted her with the fact that she already sometimes forgot the names of her grandchildren One Pwd found the normal way of calling easier and thought it s a lot of hassle to call with this picture dialling service Belfast In general four Pwds were able to make a phone call using the picture dialling service One Pwd had some problems and would show signs of being hesitant after selecting a contact from the picture address book This resulted in verbal reminders from both the carer and researchers present to tell the Pwd to pick up the handset After a few attempts at phone calls the Pwd was able to learn this procedure with no problems Additionally on the first attempt the same Pwd upon selecting the phone book accidentally pressed the screen twice in quick succession This resulted in the first person in the phone book being dialled irrespective of the desired contact Two persons were competent enough with the phone in general that using the picture dialling service was simple for them to use However it should be noted that four Pwds all showed some signs of confusion at first when asked to dial a contact The four Pwds all immediately recognised the pictures of their family members and were surprised to see them there at least in the firs
67. e of using the COGKNOW day Navigator Good development This is a good time to start learning this kind of system No comment didn t really have an experience yet This is too difficult to learn when you don t have any previous computer experience We don t need it yet but it could be useful in the future You should start early to learn how to use it 67 Simpler to use than anticipated Although testing for such a short time is maybe not good Disappointed Pwd didn t test it Difficult to assess over 1 days use but think it has great potential Surprised that the Pwd didn t find it more difficult Easy enough to use All six carers thought the devices had potential to develop into a useful tool The day navigator may assist in helping the PWD to become more independent from me A day navigator would help me to feel safer when am outside of the home on my own does not need to many functions as long as they are adjusted to his needs It is difficult to start using an assistive device before it is fully needed it may take away the motivation There should not be so many options on the mobile device it should focus on communication The stationary screen is very useful and easy to learn It will be easier to learn if both of us are using the same device The appearance of the stationary screen can be developed with more contrast only the active buttons is clearly v
68. e pictures of the picture dialling and the picture of the help function Some suggested integrating the telephone into the stationary device 31 Bottlenecks during field test 1 were for example that the picture dialling functionality did not work on the mobile device and that the volume of the loudspeakers had to be changed when using the reminding functionality or the picture dialling 5 1 4 Activity functionality The activity functionality is evaluated as user friendly both by Pwds and informal carers In general our informants evaluated this service also as useful The report from the test site in Lulea stated All of the Pwds appreciated the possibility to turn on music and the radio via the touch screen Two of the Pwds had a special interest in listening to music and they had for some time not been able to turn on their own CD player The results from Belfast stated The icons for phone music and radio did not cause any confusion for most of the Pwds However one Pwd would hesitate when asked to turn on the music or radio This resulted in the Pwd hovering with her finger over the phone music and radio icons unsure which one to press This pausing before selecting the appropriate icon was particularly prevalent during the first couple of attempts however after a few tries the Pwd became much more competent Among the important bottlenecks we found that the music player and radio sometimes interfered with each other This was
69. e same time that the door had been left open The CCA had the time set to the Irish time zone as well as the format of the date The reminder to make a phone call showed the right picture but not the matching text underneath it The text of one reminder was in English Under the reminders the other buttons were active which made it difficult to confirm the reminder properly because the Pwd did not know where to touch the screen The researcher noticed that it might be confusing for the Pwd to have a picture of the informal carer on the help button as well as on the picture dialling address book Regarding the connections there were several problems with getting a good telephone connection The computer crashed several times after the picture dialling function was tested One Pwd received a telephone call during the test which caused some confusion She picked up the phone but did not get a connection Later the Pwd was not able to get a proper telephone connection she did not know what to do the system was making beeping noises and the telephone of the informal carer was ringing She then picked up the phone and seemed to be somewhat startled by the beeping noises in her ear Another time the phone seemed dysfunctional no connecting sound was heard by the Pwa the CHH and laptop crashed and the technician rebooted the system In two tests the emergency call function did not work while the dialling function worked During one of the two tests wi
70. ea What type of psych complaints Depression 18 To what degree do these psychological complaints not at all 15 not at all 5 not at all 6 illnesses hinder you in your care task to a small degree 0 to a small degree 0 to a small degree 0 somewhat 0 somewhat 0 somewhat 0 considerably 0 considerably 0 considerably 0 very much 0 very much 0 very much 0 Background characteristics of person with dementia Person with Dementia 1 Name XXXXXX XXXXXX XXXXXX 2 Sex Male 2 Male 1 Male 2 ox Female 3 Female 4 Female 4 3 Mean age range 64 7 56 78 70 8 66 78 0 fe Married cohabiting 4 Married cohabiting 3 Married cohabiting 5 Divorced 71 Divorced 0 Divorced 1 ey A Ar T AVRA nee TEU GNP OIYO UN fi WidowWidower 0 WidowWidower 1 Widow Widower 0 Single 0 Single 1 Single 0 Lives alone 71 Lives alone 1 Lives alone 1 3 Ti dee AS With partner 4 With partner 33 With partner 5 2 3 What is sherliving sialon of yout 4 3 With other relatives 0 With other relatives 1 With other relatives 0 With others 0 With others 0 With others 0 6 In what type of housing does your live Flat 2 Flat 1 Flat 2 House 13 House 4 House 4 Assisted living 0 Assisted living 0 Assisted living 0 Carehome 0 Care home 0 Carehome 0 Nursing home 0 Nursing home 0 Nursing home 0 Other 0 Other 0 Other 0 ve In what kind of area does your live Countryside 1 Countryside 0 Countryside 1 Village 13 Village 5 Village 1 Town
71. ecessarily functioning perfectly from start on may have caused some unintended stress at the trial site Even if explicit precautions were taken to prevent this it was sometimes observed that our informants became tired or stopped cooperating with the interviewers observers In the majority of cases however the researchers experienced informants as cooperative with a keen interest in the potential benefits from using the COGKNOW services The users generally seem to have an open minded approach to their encounters with new technology 12 3 2 Pre test interviews One month before the field trial all the people who had participated in the needs inventory workshops persons with dementia and informal carers were asked if they were still willing to participate in the field test If so their availability during the planned field test period was checked and an appointment was made for an individual pre test interview in their home about two weeks before the field test The procedure during the home visit was explained During the home visit possible changes in background and context variables of the person with dementia and the carer were checked see Annex A1 1 and when necessary the cognitive status of the person with dementia was checked as well This was tested with the Mini Mental State Examination 2 MMSE The person with dementia was not included in the field test if it appeared that because of cognitive deterioration the person with dement
72. ed This caused confusion and the feeling that the Pwd had done something wrong upon which they would gesture with the device to the closest person hoping that this person could fix it As the majority of the Pwds were female attaching the mobile device to the body was not really an issue all the female Pwds preferred to store or carry the device in their handbag The phone connection was problematic as a continuous beep would sound throughout the call and would continue even after the handset had been reset This caused some confusion and in some cases the Pwd thought that the beeping noise was to signal that the call was in progress In general the Pwds were able to make calls and connect to their intended recipient even with the technical problems that this feature presented Ease of learning The majority of the Pwds were able to learn the various features of the system with few problems and in some cases were operating features such as music and radio without any direction One Pwd in particular had some difficulties in learning how the functions operated and where they were located on the screen 106 The most common problem that was observed with regard to operation was in relation to the touch screen on both the stationary and mobile device The primary concern for the majority of the Pwds was the difference in tactile feedback given by both devices The Pwds reported that in order to get a correct press on both the stationary and mo
73. ed by the beeping noises in her ear Another time the phone seemed dysfunctional no connecting sound was heard by the Pwd the CHH and laptop crashed and the technician rebooted the system In two tests the emergency call function did not work while the dialling function worked During one of the two tests with the door sensor it showed limited functionality When the door was open an ongoing repetition of sound was given Then the screen automatically returned to the default screen The display disappeared shortly afterward and the technician touched the screen The alarm went off even though the door was closed Ease of learning One Pwd was very hesitant and insecure when having to use the system in the beginning She had comprehension problems and imagining scenarios which included the use of a given function being difficult to her She very often only understood what was meant after the interviewer demonstrated a given function Frequently she repeated in her own words what she understood the interviewer and the informal carer then corrected or added explanations Ease of operation The sensitivity of the touch screen of the CHH was not high enough for four of the five Pwds They touched the screen too gently and were not or only after several attempts able to confirm the reminder When the technician came in to confirm a reminder questions were raised on how hard one had to touch the screen At another time one of these Pwds considered the
74. ee ee a cs kek t acat a bnast eae oie Hew He vou exsenenca the Saleh warin Not at all inconvenient zal Not at all inconvenient 14 Not at all inconvenient W11 y p y 9 A little bit more inconvenient 1 A little bit more inconvenient 0 A little bit more inconvenient alarms A lot more inconvenient 0 A lot more inconvenient 0 A lot more inconvenient W12 How satisfied are you with the warning alarms in Very satisfied 0 Very satisfied 1 Very satisfied 1 general Satisfied 2 Satisfied 3 Satisfied 2 61 Amsterdam Belfast Lulea Dissatisfied 0 Dissatisfied 0 Dissatisfied 1 W13 Do you have any suggestions to improve the warning alarms Not applicable Not applicable Not applicable No suggestions You should be able to turn it off when you are at home No suggestions N A No suggestions No suggestions No suggestions Should be adjusted to individual needs Amsterdam Belfast Lulea Statements on Learning how to use the device It takes some training and practice to learn how to use it No comment s It will be easy to learn how to use it Need a little time to learn you need Net diiicul p f to araw ih it The mobile device may be a bit 9 i N A difficult to learn how to use L1 How do you a te learning Row To se the Fine clear clarifying Nobo much Not difficult ooo aac c cece eceeeaeeeeeaeeeeeeeeeeeeeseeeeeeeens devices and functions bu
75. eeds more buttons 0 Fine maybe the Help button Easily recognisable It is good with the combination of should be a different colour icons and text Contrast should be higher N A Plain text not good The icon tor finding the mobile The icon for time of the day is not device is unclear All the icons are easily recognisable working Well How do you judge the icons on the device dis Find mobile device is unclear 9 S6 like them recognize them please add remarks to maybe only the mobile device should Easily recognisable There should be morg contrast specific icons be shown leave out the magnifying both in colour and brightness glass Easy to recognise The find mobile device icon with the magnifying glass is not recognizable The radio icon should be with a different more modern radio Too bright 1 Too bright 0 Too bright 0 S7 How do you judge the display of the screen Appropriate 5 Appropriate 4 Appropriate 6 69 Amsterdam Belfast Lulea Too dark 0 Too dark 0 Too dark 0 How to operate and the functions will not be remembered the number of functions is too large Useful Has good potential N A All find the device useful or very useful Some feel it can be developed in different ways 5 ee S8 How useful do you find the stationary device It could not be simpler Would be very useful it wo ld be more useful with a Good to use the contrast should be Wo
76. eeeeeeeeeeaeeeeeeeees Nosuggestions tee e eect eee ee eee ee ee ee teeta eeeees No suggestions I ha eee ce eetteeteceeeeceneneeceeceeeneceeeeeennaeeeeeeeees Nosuggestions fae tte tee ee tect ce eect aaaeeeeeesenaeeeeeeeeeeeeaees No suggestioNS I seeasineesutcteaticnpes ctecasoeee caves ineeie idoiterna Maybe the reminder could be the fo ieee cette te te eeeeeeeecneaeeeeeeseeaeeaeeteeaeeeees voice of the spouse or carer No suggestions The screen has to be touched too hard to confirm the reminder Amsterdam Belfast Lulea How do you judge the picture dialling service P1 function interaction experiences usefulness user friendliness etc Easy enough Actions on two different devices are confusing Unclear too many steps too many devices Don t need it yet have my own address book on my telephone Very useful Easy to use Refused to comment Very useful Very useful but have no problem using ordinary phone daily Five of the Pwds found the picture dialling function useful or very useful One PWD had no opinion Seems functional Moly userul Very good 0 Very good 4 Acai P2 How do you judge the basic audio call function Appropriate 3 Appropriate 0 eee Not good 0 Not good 1 Not good 0 i No opinion 1 Too loud 1 Too loud 0 Tooloud 1 ot 9 P3 How do you find the audibility of the audio call Appropriate 2 Appropriate Appropriate 4 55
77. eems fun a tt eenen NA oeenn kdontreadiynons 0 aA aes Reece NAP sesssssessessasrasnsasnnnaanananseseststnsnseeeeeeeeetsnn Could help NE Comment ME Two of the Pwds thought they would Wouldn t make a difference N A Desatar What dyo think about GPS lecation devicstor oo IR ee eee erence te F2 feel safer when walking around on your own would feel safer when you ask for N A EEE outside diecionsyoutontawayeknow i o E ESSERE who you re talking to NAP seessssessesssseasnnnsnnnaananeasessnttstssteteeeeeenensne Possibly practical in the future NAP ssssssassssssnnnnnttttttttesststsesneeeeeceeeeeneenenennn 64 Amsterdam Belfast Lulea don t feel unsafe F3 What do you think about your partner being able to locate your position with GPS while you are outside taking a walk No comment think that would be practical No need this is such a small place When ask for it my carer can see where am Would be nice and useful N A N A N A N A N A No Pwd had an opinion about this but several of the carers would have liked it if it was easy to use 65 A 1 3 Results Semi structured interview carers Semi structured interview with Carer Field Test 1 Amsterdam Belfast Lulea General opinion Amsterdam Belfast Lulea 66 Amsterdam Belfast Lulea G1 Can you tell me about your experienc
78. enient a2 Not at all inconvenient 0 Not at all inconvenient 6 P12 y P P 9 A little bit more inconvenient 3 A little bit more inconvenient 2 A little bit more inconvenient 0 function y F A lot more inconvenient 0 A lot more inconvenient 3 A lot more inconvenient 0 i Very satisfied 2 How satisfied are you with the picture dialling in vey salisnicd 0 Ney Fansen Satisfied 3 P13 eneral Satisfied 5 Satisfied 4 Dissatisfied 0 9 i Dissatisfied 0 Dissatisfied 1 E i No opinion 1 79 Amsterdam Belfast Lulea P14 Do you have suggestions to improve the picture dialling function Everything should be in one device The help icon should be renamed The option to input more contacts friends neighbours More pages in the address book scroll through the pages Integrate phone and picture dialling one device No suggestions No suggestions No suggestions No suggestions No suggestions A possibility to include more persons in the directory The calling should be easier with less steps All calling through the screen and no receiver Amsterdam Belfast Lulea Radio control amp music player More useful than the current system should have the option to choose stations yveryuser fendly The function is easy to use and Nice practical N A unger stang How do you judge the Radio music player pe T1 services function interaction experiences Music functi
79. erdam Belfast Lulea Very useful 0 Very useful 0 Very useful No opinion 1 Good to hear How do you judge the audibility of the safety agon p naar oe ip hear 3 Sometimes good not W7 Sometimes good not 0 Sometimes good not 0 sE warning on the mobile device 3 Difficult to hear Difficult to hear 0 Difficult to hear 0 a No opinion 6 Very good visible 0 Very good visible 0 very goon visible How do you judge the visual safety warning on 7 Appropriate W8 the mobile device epee ae Appropriate a Difficult to decipher i Difficult to decipher 0 Difficult to decipher 0 ie pagr No opinion 6 s Not well 0 Not well 0 Not well How well do you think are the warning alarms i wg Sometimes correct wrong 2 Sometimes correct wrong 0 Sometimes correct wrong working Very well 0 Very well 4 Very well No opinions Not applicable Would be useful A A EEA Sat ann ee Not applicable NA fase eateeeesrnssnnrereeeteeeceeesnsnnnnnnenenreretsnen How useful do you find the warning alarms inf en cacntneeeeeesecaeeeseeeeeeeeaeeeeeeeee relation to your needs Not applicable taana o Ree recente creer reer A eree wao Does the system give you a feeling of safety Would be EIA SS SSN Ns ccemecetaaecanralicnade aaseawdeten when and how No comment could be made on Would be useful SC eeeereeeterrrieserrrseeeesrreeesrereeseessseesesssnien usefulness YE eae ee US Se Neo a een seer reed Seems useful Bae a
80. erruption of about 30 seconds The reminder to close the front door worked on the stationary device but failed to relay to the mobile device Lulea In most cases the reminding function worked well from a technical point of view At one test site the reminders did not work at all and we could not determine if this was a technical problem or a problem of configuration since the reminding function was linked to the date The reminding function of the CCA never worked 4 3 Communication functionality 4 3 1 Semi structured interviews and observations Amsterdam Two persons with dementia stated that the communication functionality would be useful Two participants found the separate devices and the order in which they had to be used confusing and unclear One person with dementia said he she would not have a use for it yet as the current telephone had its own address book Thus three persons with dementia judged the picture dialling service as not very helpful However the size of the pictures of contacts on the stationary device was judged appropriate by all participants and all found the picture address book at least appropriate to use Likewise the three persons with dementia who used the emergency contact function in two cases this function did not work during the field test found it to be appropriate one person or even easy to use two people Four persons with dementia stated that the picture dialling function was not at all inconvenient
81. ers accompanied by a form of vibration to more effectively serve people with visual and hearing impairments Voice messages are another possibility to attract users attention more efficiently The positive evaluation of the picture dialling functions confirms the general experience that Pictophones are valued as useful by elderly people and the finding that people with dementia can still learn to use simple equipment Lekeu et al 2000 Lauriks et al 2007 The experience in our field test which people with dementia have difficulties recognising pictures of family and friends on a mobile phone confirms the previous findings of S Kort Kort 2005 Positive evaluation of a picture 32 gramophone or other electronic music aids was also reported in studies by R Olsen and co workers Olsen et al 2000 and by J Gilliard and I Hagen Gilliard 2000 Gilliard and Hagen 2004 Though in practice alarm functions are generally not provided to people with dementia because of the expected frequent misuse little research has been done into the understanding of alarm systems by people with dementia Lauriks et al 2007 Our field test indicates that the function of the door sensor as well as the message on the home screen was understood by people with dementia The time allowed for field observations during field test 1 has been relatively short and more so in Belfast and Amsterdam as compared with Lulea Hence our conclusions must be viewed against
82. ext size to be too small When asked how useful they thought the stationary device would be two persons with dementia said it would be useful One person stated that it would not make any difference with the current routine but they could see its use for the future Two persons could not make any statements on the usefulness of the stationary device None of the persons with dementia found the stationary device to be inconvenient to have in their home and all were satisfied with the 15 stationary device in general One person with dementia stated that it would be even better if the stationary device could be hanged from the wall Another stated that the home hub could be smaller and less conspicuous in the room The size of the mobile device was judged too large by two of the persons with dementia participating three persons judged its size as appropriate The screen size however was judged appropriate by all but one person with dementia With regard to the weight of the mobile device three persons judged it as appropriate and two persons thought it was too heavy All persons with dementia said the mobile device was too bulky and heavy to carry around Two participants found the mobile device to be difficult to attach to clothes or body In contrast all persons with dementia who used the mobile device during this test in two test cases the mobile device did not have any functionality stated that the mobile device was not inconvenient at all and
83. f the usefulness of the warning for open door was divided Both Pwd and carers in Amsterdam and Belfast found the function useful while the participants in Lulea preferred unlocked door warnings instead of open door warnings 28 4 5 2 Bottlenecks Amsterdam Safety warning continued after closing the door in one test in three other tests the door sensor didn t work thus safety warnings couldn t be tested There was no safety functionality on the CCA Belfast The success of the installation in relation to the door sensor depended heavily upon the living environment of the Pwds home Corridor width and general hallway space proved to be the primary factor affecting the installation of the sensor given that a wire had to be run to the doorway To avoid future problems with the door sensor it is suggested that a wireless sensor be deployed in all situations wherever possible and for all sensor types Lulea The door sensor was not working as expected all the time and on three test sites the sensors were very unstable and worked sometimes but later failed In one case the door sensor fell down on the floor due to problems with the mountings The safety warning on the CCA did not work 29 5 Conclusions discussion and recommendations 5 1 Conclusions 5 1 1 COGKNOW Day Navigator system and design User friendliness The overall feedback from our informants suggested that the system and design of the COGKNOW Day Navigator met users
84. for her action was all the cords and connection devices that had lamps that indicated that power was on The home hub did not pick up its configuration automatically when power was switched on and had to be reconfigured by a technician in order for the different functions to start working properly The door sensor had many different problems One was not indicating all the time in the right way in another cases it fell down on the floor The search function for the mobile device had difficulties due to connection problems Even when the mobile device had a connection with the internet it was only possible to activate the search function a couple of times most times it failed In a couple of cases there were problems with the reception of programmes with the attached radio receiver There seemed to be too many devices in one place and the radio reception was disturbed by other devices When a call was initiated the computer held the call for some time and it took a long time for the ordinary telephone function to take over Sometimes the computer held the call all the time This was confusing for some of the participants In a couple of instances the call was not immediately disconnected by the home hub even if the person on the other side had disconnected When the volume of the loudspeakers was tuned for reminders and safety indicators it became too loud for telephone calls and there was a problem with acoustic feedback in some of the trials
85. functionality areas However certain key aspects of the prototype are essential for the overall functioning of the system see Annex A1 5 These key aspects e g charging internet connection communication between mobile and stationary device audibility of alarms and readability of the user interface were addressed by specifically formulated test tasks prior to testing To ensure that the different aspects of applicability and usefulness of the COGKNOW Day Navigator were tested and all questions of the semi structured interview could be answered in the first field test several prescribed tasks were composed by researchers of WP1 before the tests During the field test the persons with dementia were invited to perform these tasks 3 8 Data storage and analysis of data All data were made anonymous to ensure confidentiality Before any computer storage a personal key was applied and the key safely locked The quantitative data were coded according to a common scheme for all sites and stored in a format suitable for SPSS analysis Only anonymous data were exchanged between sites The qualitative data were coded according to a common scheme for all sites using the NVivo software Only data which had been made anonymous were exchanged All persons with access to data were bound by the same ethical standards and principles of confidentiality and privacy Special training on communication skills ethics and data protection was therefore provided to per
86. ger Task 18 PD moves away from home hub and mobile device as per retiring at night to bed 93 A 2 Information booklet for filed test 1 and consent form 94 Procedure and confidentiality You as a participant in this project are very important to us and you can be reassured that we will do our very best to take into account your wishes so that the project is as smooth and as enjoyable as possible Your participation is totally voluntary and you are free to withdraw from the project at any time All personal data that are collected during this project will be handled confidentially and destroyed at the project s termination Participants have the right to inspection All personal data will be security encoded preventing access by third parties Experienced doctors and researchers will manage all confidential data The results of the evaluation will be documented in scientific papers and reports If you have any questions regarding your participation in the test or the function of the devices please contact Stefan Savenstedt Kurt Blomgren Researcher Technical support Phone 0920 493919 0920 493218 An independent expert informant Dr 00 will be available during business hours at tel nr or email wo eee 95 COGKNOW Helping people with mild dementia navigate en day COGKNOW A study into the use of electronic supportive instruments Information for participants JURER UREN
87. ggested Pwds ranked the usefulness of the reminding functionality as high for events that did not take place every day Among informal carers this functionality was also ranked as useful for everyday events The results from Belfast suggest When asked to comment on the most useful function of the COGKNOW system two Pwds reported that they would benefit from reminders the most while two stated that they could not see how it would be useful in their daily life The results further suggest that reminders need to be individualised prior to field test 2 to increase their usefulness Bottlenecks were encountered in the combinations of reminders and pictures resetting after configuration of each reminder confirming the reminders and not functioning reminders on the mobile device 5 1 3 Communication functionality The applicability of the communication system i e the picture dialling facility is evaluated as good both by most of the Pwds and most of the informal carers Both parties seem to find this functionality easy to operate and easy to learn how to use Both Pwds and informal carers rank the usefulness of this service as high The user friendliness of the dialling functionality would however increase if individual adaptations of the address book could be made on the COGKNOW device Some comments were made on the different steps necessary for dialling too difficult for some persons with dementia and there was some confusion between th
88. he Pwds Four of them thought that the function was very useful while two Pwds already had a system for listening to radio and music that worked well for them The four Pwds who appreciated the function as useful had lost the ability or the initiative to switch on the radio or the music player even though they liked to listen to them These functions were used by other family members and their interest supported the Pwd in using the function It seemed that both the radio and the music functions were easy to operate after practicing a few times None of the Pwds found it easy to learn how to switch between the pre recorded music sections but when the music they liked was identified with the assistance of the carers they could easily switch the function off and on The icons for music and radio on the mobile device were difficult for three of the Pwds to identify and all had problems with the many steps involved in turning the function on and off None of the participants found the function in the mobile device useful A 4 5 Safety functionality Results from Amsterdam Belfast and Lulea Amsterdam CHH Arrangement One carer asked how the Help function works when two numbers a fixed and mobile are used by the primary carer 114 The Help function was not easy to understand for one Pwd because he mixed up this function with the picture address book One Pwd liked the function because it s easy to operate With respect to usefulness one
89. hear 0 How do you judge the audibility of the safety peed to near 2 Goon a near gt Sometimes good not good 1 W4 warnina on the stationary device Sometimes good not good 0 Sometimes good not good 0 Difficult to hear 2 i Difficult to hear 0 Difficult to hear 0 w i No opinion 3 How do you judge the visual safety warning on Very good visible 0 Very good visible 4 Very good visible W5 the statisnary davica Appropriate 2 Appropriate 1 Appropriate Y i Difficult to decipher 0 Difficult to decipher 0 Difficult to decipher Not useful 0 Not useful 1 Nog kaon 3 How do you judge the safety warning of an open eee eee Appropriate 0 W6 Appropriate 0 Appropriate 0 door on the mobile device Very useful 0 Very useful 0 Very useful 1 oa No opinion 3 Good to hear 0 How do you judge the audibility of the safety 2000 to naar T pend to near Sometimes good not 3 W7 Waminaon th mobile devica Sometimes good not 0 Sometimes good not 0 Difficult to hear 0 g i Difficult to hear 0 Difficult to hear 0 Sa No opinion 3 F Very good visible 0 Very good visible 1 very geod visible How do you judge the visual safety warning on Appropriate w8 Appropriate 0 Appropriate 0 ee the mobile device Difficult to decipher Difficult to decipher 0 Difficult to decipher 1 Not tested 6 l Not well 0 Not well 4 pee How well do you think are the warning alarms f Sometimes correct wrong wg Sometimes
90. hear 3 Good to hear 0 Good to hear 4 ae No opinion 3 oe Too often 0 Too often 0 Too often 0 How do you judge the frequency of repetition of i R5 the reminder Appropriate 1 Appropriate 0 Appropriate i Not often enough 0 Not often enough 0 Not often enough Difficult to acknowledge 4 Difficult to acknowledge 0 DIMOU IG aennowledge N How do you judge the acknowledgement of the F Appropriate 3 R6 Appropriate a Appropriate 4 reminder by your Easy to acknowledge 0 Easy to acknowledge 0 Easy to acknowledge 0 No opinion 3 Works very good How do you judge the working of the reminder Works very good 0 Works very good 0 i i f Works good R7 on your mobile device when your is outside of Works good 2 Works good 0 the house Works not good anymore 0 Works not good anymore 0 Work nordost anymore i Not tested 6 Seer Not timely enough 1 Not timely enough 0 net mAy enough 2 How do you judge the timeliness of reminder 4 ieee BEANE Point of time is appropriate 3 R8 Point of time is appropriate 1 Point of time is appropriate 0 messages Reminders are too early 0 Reminders are too early 0 Reminders are too early 0 ae No opinion 3 Not supportive at all 3 Not supportive at all 0 Not supportive stall 2 F Some supportive sometimes not 1 How do you judge the reminder as a support for Some supportive sometimes not 1 Some supportive sometimes not 0 ii our
91. hould stand out more and another Pwd found the text underneath the pictures too small but the words to describe the functions were clear Two Pwd complained about the colours one perceived the overall colour of the screen and the different colours of the buttons as distracting the other found the colours not aesthetic One Pwd would prefer a less conspicuous smaller size of the screen Another Pwd found the size of the screen and buttons appropriate As for the icons the Find icon was not clear for two Pwds one interpreted the magnifying glass as a tennis racket and did not recognise the mobile device She thought she would get used to the other icons easily One Pwd found the Help icon a bit scary because the picture of the informal carer and the text help implied that the informal carer needed help The informal carer reacted similarly I don t need help do A Pwd and his informal carer found it confusing that the emergency button had the same photo of the informal carer as in the picture dialling address book One informal carer found the radio picture was not clear and suggested adding an antenna A Pwd found the picture for radio unrealistic and also disliked the pictures for music and telephone as he found it difficult to decipher them at first glance However he liked the clarity of the photos of his relatives in the picture address book Another Pwd was positive about the clarity of the pho
92. ia no longer fulfilled the inclusion criteria person with mild dementia GDS stage 3 4 and 5 or MMSE gt 14 Reisberg 1993 and therefore almost certainly would have many problems in using the COGKNOW Day Navigator They were thanked for their voluntary participation in the project and were asked if they were interested in remaining informed about the project results If so the researchers promised to keep them informed If the person with dementia fulfilled the inclusion criteria the aim and procedure of the field test was explained in more detail In order to be able to configure the COGKNOW Day Navigator for each individual person with dementia several questions were asked during the pre test interview For example these concerned wishes with respect to the type and timing of reminders and information and photographs to be added to a picture dialling contact list The availability of equipment was also checked for instance a radio that could be switched on and off telephone and electrical outlets etc At the end of the pre test interview appointments were made specifying the date and time of the actual testing The persons with dementia and the close persons received an information flyer in which they could read all the information on the field test over again They were also asked to sign an informed consent form repeated informed consent procedure see Annex A2 3 3 Field test interviews For the first field test separate semi structured
93. iate 3 Appropriate 5 device Too large 0 Too large 0 Too large 1 How do you judge the size of the text on the Log large oe Tee large os TOR largs A M4 s r n Appropriate 3 Appropriate 2 Appropriate 4 Too small 1 Too small 0 Too small 2 Two Pwds have no comments Two find the design of icons good Not applicable nevemmment One PWD find the Icons difficult to Clear ne see and there is too little contrast Unable to give opinion i i with background How do you judge the icons on the mobile eee M5 device Dis like them recognize them please 9 gn A bit difficult to see sedis rae Three Pwds find the radio icon as add remarks to specific icons Recognizable difficult to see due to lack of contrast Not as clear as stationary device Icons are big enough contrast is N A One PWD can not understand the clear logic in which the icons are presented on the screen How do you judge the weight of the mobile T ligni 0 T light R To igni i M6 device Appropriate 3 Appropriate 4 Appropriate 5 i Too heavy 2 Too heavy 0 Too heavy 1 How do you find the mobile device Too bulky and heavy 5 Too bulky and heavy 0 Too bulky and heavy 0 M7 fo ean around Appropriate 0 Appropriate 3 Appropriate 6 y i Very good to carry 0 Very good to carry 0 Very good to carry 0 Good to attach 1 Good to attach 0 Good to attach 0 M8 How well do you find the mobile device to attach Appropriate sA Appropriate 0 Appropriate 4 i 2
94. ic or radio This resulted in the Pwd hovering with his finger over the phone music and radio icons unsure which one to press This pausing before selecting the appropriate icon was particularly prevalent during the first couple of attempts however after a few tries the Pwd became much more competent All the Pwds recognised their relatives right away and in most cases this was the first thing that was recognised particularly the picture in the help function There were no complaints about the colours or icons used in the interface design However one Pwd suggested that the word stop be used instead of back when exploring the phone menus The design issues of the mobile device made a much stronger impression on the Pwds and their informal carers The icons were reported to be less clear than those used on the stationary device and it was also more difficult to read the text on the mobile device The external buttons proved to get in the way and on some occasions features were activated by mistake such as the audio recording function In addition the mouse roller button was often activated resulting in the roller being illuminated This caused confusion and the feeling that the Pwd had done something wrong upon which they would gesture with the device to the closest person hoping that this person could fix it As the majority of the Pwds were female attaching the mobile device to the body was not really an issue all the female Pwd
95. ific question does the diary e In situ measurement WP3 method etc method work for people with dementia people may forget and or should we use experience sampling as well people may be surprised Diary method Pwd takes initiative by recording experiences in voice recorder this is used to create the bottle necks list Experience sampling is not used in field trial 1 SeniorXensor c Specific question To what extent can the day reconstruction method be applied N A in field trial 1 WP1 2 103 A 4 Results of field test 1 observations A 4 1 COGKNOW Day Navigator System and design Results from Amsterdam Belfast and Lulea Amsterdam Design issues regarding the COGKNOW Home screen One Pwd was dissatisfied with the design and size of the screen and the form of buttons on it This overall aesthetical disharmonic design she would not want to have in her living room She also found the overall screen slightly unclear even when she was wearing glasses She had difficulties in deciphering pictures and text on the screen Another Pwd and his informal carer also found the design insufficiently clear because of lack of contrast in the screen and the pictures making pictures more difficult to recognise One Pwd could read the text and buttons at a distance of about one meter and did not need glasses then She also found the text of the reminders was easy to read One Pwd thought the text s
96. in remembering to eat Very supportive 1 Very supportive 0 Very supportive 9 Pa g i 0 SUPR i y SUPP i No opinion 5 a ae Very supportive 2 How do you judge the reminder as a support for voy supportive ray SUPPONE i Some supportive sometimes not 1 R10 Some supportive sometimes not 2 Some supportive sometimes not 0 your in remembering phone calls f Not supportive at all 0 Not supportive at all 2 Not supportive at all 0 No opinion 3 15 Amsterdam Belfast Lulea Not supportive at all 4 Not supportive at all 0 me SOPPonNe el 2 p 3 Some supportive sometimes not 1 How do you judge the reminder as a support for Some supportive sometimes not 0 Some supportive sometimes not 1 RAN our in remembering to brush teeth Very supportive 1 Very supportive 3 very supportive 0 ues g n i a i AY SEPP No opinion 3 2 F Very supportive 3 How do you judge the reminder as a means to Very supportive 1 Very supportive 0 A F eee A F Some supportive sometimes not 0 R12 enhance the control over the activities your Some supportive sometimes not 3 Some supportive sometimes not 1 ee Not supportive at al 0 has to remember in his her everyday life Not supportive at all A Not supportive at all 0 he No opinion 3 Very good 2 How well do you think that the reminders for your very goed i ie daon 7 7 Works sometimes sometime not R13 W
97. ing the prototype functionalities self sufficiently In general our informants judged the system presented to them as useful or as potentially useful in future situations Several of the informants pointed to the need for individualized system functions and to a strengthening of the implemented functions conf users opinions on safety functioning and diary recording functions see Annex 4 The picture dialling system reminders and media control functionalities were in general judged as useful by the Pwds and their informal carers Because of environmental issues one Pwd in Belfast disliked the idea that the system would be running all day and night Another Pwd at the same location said he had no need for the system yet but could see the usefulness of such a system in the future 4 1 3 Bottlenecks Amsterdam The Home screen went into a stand by mode after which it did not switch on as recording and date time indication in all cases The door sensors did not function in three cases Belfast The stationary device had a problem in recognising a press on a few of the screens such as the reminder screens This bottleneck was only observed during the first day as it was quickly resolved The mobile device stopped working on the final day of testing and could not start the day navigator screen Lulea There were several problems after one of the Pwds had switched off the power when she wanted to save electricity using the CHH One reason
98. int planning sessions have ensured a common approach The descriptive and analytic results from each test site presented in this report have been put together by the local teams The users have contributed extensively to the design process of the COGKNOW prototype and in the Human Factor Impact Analysis they have been asked to make comments on the performance applicability and usefulness of the COGKNOW Day Navigator However it is a basic presumption for the COGKNOW project that the design builds on state of the art technology hardware as well as software Our informants needs and priorities have been investigated within this preset framework Chapters 3 through 5 of this report apply the standard approach to the field describing and analyzing methods results and recommendations respectively Chapter 2 provides the readers with necessary context information of the investigation We describe the aims of WP 1 as well as the design of the prototype In chapter 3 we detail the methods used prior to and during field testing Procedures during data collection and installation of equipment are described In chapter 4 the results of the investigation are presented concentrating on pre test and semi structured interviews and field test observations In chapter 5 we present our recommendations Throughout the text we have used the term person with dementia Pwd to denote our key informants In fact we have interviewed and observed dyads of users i e
99. interface of the mobile as well as of the stationary device would of course be to allow for auditory machine output as for example suggested in the Swedish results from field test 1 Several Pwds felt that some icons could be clearer with respect to indicating the functionality The usefulness of the present functionalities were sometimes confusing to our informants probably due to the present preset reminders and fixed dialling lists which were not easily connected to concrete situations of daily living of the Pwds We are nevertheless relatively sure that our informants Pwds and informal carers approved the overall user friendliness and usefulness of the functionalities provided for them The picture dialling system and the media control were ranked as useful by the 33 majority of the informants Additional functionalities were suggested such as TV control and a calendar with activities to remember The reminder and alarm facilities were in general approved both in terms of user friendliness and usefulness The test of the safety door sensor was not completed due to technical difficulties In Lulea it was suggested that a camera could be connected to the entrance door and linked to the home screen as well as the ward station allowing for assistance in the identification of visitors From the Belfast test it was observed that Pwds were relearning how to use the communication function when they were quite capable of making phone calls on a
100. io listeners and usually switched on the radio without assistance They thought that the new way of turning on the radio could still be useful provided that it was easy to tune in the right programmes For one of the Pwds the possibility of listening to the radio was a rediscovery of an appreciated activity that she had forgotten to use 26 For five of the six Pwds the design of the icons and the buttons on the stationary screen was easy to understand One of them expressed a problem in relating the icon for music and the icon for radio to the activity The carer thought that this phenomenon was related to initial problems in learning the concept One of the carers found the function interesting and thought that the usefulness of the function would increase if there was a simple way of changing radio stations and programmes directly on the touch screen Summery Observations The reported observations from all three sites confirm the findings in the semi structured interview that most of the Pwds appreciated the function and could easily learn how to operate both the radio and the music function The perception of usefulness was divided among both the Pwds and the carers In Amsterdam and Belfast several of the Pwds perceived the radio and the music function as not useful while four of the Pwds in Lulea found it very useful The icons for music and radio on the mobile device were difficult for three of the Pwds in Lulea to identify and they also ha
101. ions you may have about the study to the best of my ability FESE ANCHOR cicsice deilasdexiieduececboee LAE LE place of test Site ceceecsceeceeeeeeeeteeeneneeees telephone number date eiiean 97 A 3 Research questions Field trial 1 Preliminary integrated list of research questions and methods in field trial 1 from the perspective of WP1 2 3 5 Field trial 1 Aims Questions Methods WP Who 1 Evaluate a What do people with dementia think e Semi structured WP1 group 2 basic user about the device s in terms of user interview during and post friendliness of friendliness factors such as form field trial with people with mobile and factor basic interactions easy to learn dementia stationary wearability charging etc devices with a b What do informal caregivers think en about the device s in terms of user cia harpea aa WPT groupa friendliness factors such as form factor uring p related basic i field trial with informal factors such asic interactions easy to learn sarers as form wearability charging etc l factor basic Possibility for caregiver to configure ae the device will be evaluated in field trial interactions wearability 2 Dy WP1 and 2 charging etc c Where how often is the device taken e Semi structured WP1 group 2 along with the person both indoors interview post field trial and outdoors and how often is the with informal carers
102. isible Not good with a screen saver the symbols must be seen all the time The background could change accordina the time of the dav in Amsterdam Belfast Lulea Which part of the COGKNOW day helps your 62 the most in daily life None Music player as the CD and cassette player are to difficult to operate at the moment Help and picture dialling function Picture dialling function Picture dialling function Reminders e g clean your teeth other appointments etc in the future N A Reminders for stimulating Pwds day Reminders Reminders would be most useful particularly if the Pwd was alone for any length of time The music and radio functions seem easiest to get use to Picture dialling could be very useful Reminders could work well provided they were adjusted to needs Which part of the COGKNOW Day Navigator helps your the least in daily life None The find mobile device functions mainly due to the unclear icon Radio function Radio and music function Radio function Radio music N A Radio music Radio music Music Pwd doesn t listen to music Radio Pwd doesn t listen to radio only in car The mobile devise is to complicated as it is designed at the moment To put on music is not necessary We don t need warnings for open doors it could even be troublesome in summer time Stationary Device Amsterdam Belf
103. isualization of contacts picture dialling interface opinion on alternative more dynamic interface styles using mock ups How often does the need to recognize l a relevant other occur 3b k Semi structured et g interview post trial Which people amp how many need to be recognized spouse children other relatives neighbours familiar strangers total strangers etc 3c When do they need to be recognized 3d To what extent is cooperation from these relevant others desired or needed e g turning on Bluetooth on their phone 3e Which technology Bluetooth RFID In situ measurement WP3 audio speaker recognition video is accurate enough to establish the identity hint in field trial 2 3f e Log visible Bluetooth WP2 and WP3devices who s around SeniorXensor Activity functionality No questions for field trial 1 Safety functionality No questions for field trial 1 4 Evaluate in situ data collection methods and tools e g SeniorXensor a Do the data collected by pre test during test and post test interviews and by observation bottle neck list and in situ measurement offer the information that is relevant for evaluation of the COGKNOW Day Navigator Researchers opinion by comparing data collected by different methods WP1 2 3 4 5 7 102 Field trial 1 Aims Questions Methods WP Who di i pA me Hi ae A b Spec
104. its purpose until this was explained One of them thought that it would be easier to identify the help button if it had a stronger contrast with the background Four of the carers appreciated the function and thought it was important 24 Summary observations The reported observations from all three sites confirm the findings in the semi structured interviews that the picture address book was considered appropriate to use In Lulea the picture dialling function was even mentioned as the easiest to comprehend The reported observations also explain the recommendation made by the carers in the semi structured interviews to integrate the telephone and the stationary device Most of the Pwds at all sites did not immediately understand how to operate the picture phone The Pwds showed signs of confusion when using the picture dialling This varied from confusion during the first time of usage to repeated confusion during the first several attempts Several repeated verbal instructions and exercising were needed before the Pwd could manage the picture dialling Reported observations in Amsterdam and Belfast also showed that it was impossible to make a telephone connection when a Pwd picked up the phone too late after pressing the picture on the touch screen As mentioned in the semi structured interviews the opinion about the usage of the help button was different between the sites The reported observations at the Lulea site stated that there was some
105. ived ability of the equipment and its functionalities to meet the users needs We sometimes use the term applicability as a synonym for usability 2 2 Aim of work package 1 The COGKNOW project aims at developing a functional user validated cognitive prosthetic device which addresses the needs of people with mild forms of dementia Our main target group is living in Europe all in all around 900 000 people The vision of the project is to assist these people in navigating through their day by providing technological support for cognitive reinforcement Work package 1 of the COGKNOW project intends to ascertain the functionality and performance which the COGKNOW Day Navigator needs to fulfil in order for the service to be adequate for testing The concrete objectives of WP1 are a Obtain insight into the needs and priorities of users of the COGKNOW Day Navigator We focus on the key areas of reminding maintaining social contact performing activities of daily living and enhancing feelings of safety b Contribute to the user friendliness and usefulness of the COGKNOW Device Requirements will be specified within the context of the International Classification of Functioning Disability and Health ICF c Evaluate the impact of the developed system on users perceived autonomy and quality of life 2 3 Tasks roles and deliverables This report contributes to the Functional Requirement Specification of the COGKNOW Day Navigator but the resul
106. k The carers were divided in their opinion when it came to how the picture dialling function facilitated social contact with two carers claiming that it would make it easier to keep in touch and two stating that it would make no difference The emergency contact function was judged to be appropriate by three carers and thought to be easy to use by one carer When asked to comment on improvements none of the carers had any suggestions Lulea The communication function which made telephoning easy was appreciated by almost all participants One exception was a Pwd who thought that she had no need for it now All the Pwds found the function useful and easy to learn The concept of having a directory with pictures and written names was much appreciated Some of the Pwds could still remember phone numbers but the carers could foresee that they might have problems later on Two of the carers found the directory too small and wanted to have the possibility to include more persons Two of the carers found the system of calling confusing in the sense that the caller first spoke with the screen and was then requested to pick up the receiver They thought it was better to have fewer steps in the procedure and only talk directly to the screen Their thinking was that calling with the CHH was a new procedure that had to be learned anyway so why confuse it with the old way of calling Three of the Pwds found the help function confusing and did not understand
107. k and the visual confirmation of successful recording came rather late after the recording had stopped As for new functionalities One Pwd did not miss any function on the system She wondered what else could be necessary to have in everyday life One Pwd suggested an extra function to allow choosing pieces of music manually and an informal carer suggested an extra button with a picture of the artist or album to choose from One informal carer suggested guidance for using the remote control of the TV as the Pwd seemed to have difficulties with this the Pwd did not agree One informal carer suggested that the reminders could be accompanied by a recognisable melody or a verbal reminder recorded by the informal carer that stimulated the Pwd to act upon the reminder Another informal carer suggested recording the content of calls so that they could be played back to check whether appointments and the like had been made When asked about the usefulness of the GPS technique allowing the carer to see where the Pwd is the Pwd joked to the informal carer that she did not feel unsafe on the streets However the informal carer would feel more at ease when the Pwd went out if a locator function was available Belfast All the persons were able to read the text on the home screen with no problems The icons for the telephone music and radio did not cause any confusion for most of the Pwds However one Pwd would hesitate when asked to turn on the mus
108. ld make them more independent At the same time they had their doubts due to many practical problems needed to be solved Problems mentioned were the possibility that the Pwd would switch off the power forget to take it along or switch it off and put it away 4 1 2 Observations The overall system design was generally approved by the Pwds and their informal carers at all test sites The size of the stationary device was judged as appropriate but some of the Pwds remarked that the screen was not sufficiently clear and one Pwd in Lulea suggested that text messaging reminding functionality should be minimized One Pwd in Amsterdam had difficulties in deciphering pictures and text on the screen One Pwd in Amsterdam also thought the text should stand out more pronounced and another Pwd found the text underneath the pictures too small but the words to describe the functions were clear In general the touch screen design with pictures texts and icons was approved by our informants even if some of them had difficulties operating the touch screen on the stationary device The sensitivity of the touch screen of the CHH was not high enough for some of the Pwds Some of the Pwds suggested that a wall mounted version of the home hub would be preferable The handling of the mobile device by Pwds as well as informal carers turned out to be more difficult than the operation of the home hub screen CHH Since the screen size of the mobile device is 18 c
109. link to audio speakers in other rooms to improve audibility and would like to see more alternatives for reminder content Belfast Four out of five Pwds reacted positively to reminders and thought that reminders would be very useful Three Pwds found that they could understand the reminders with some effort and one Pwd stated that it was easy to understand the reminders In terms of hearing the reminder alarm four Pwds thought that reminders were easy to hear when in the same room One Pwd found it difficult to hear on some occasions when in another room Three persons with dementia found it difficult to acknowledge the reminders while one thought it to be appropriate Reminders to brush your teeth and make a phone call were considered to be very supportive by four Pwds who felt that the reminder function worked very well Two Pwds suggested that reminders would be useful for appointments One Pwd suggested that reminders would be useful for remembering about collection for day centre while one thought it would be useful but did not elaborate any further Three informal carers judged the reminding function to be useful with one carer referring to it as excellent Four informal carers were able to hear the reminder alarm when either in the same room or in another room Four informal carers thought that the reminder both to brush teeth and to make a phone call would be very supportive for the Pwd The reminders were thought not to be inconvenient or
110. ly agree 0 ean ease x Dis agree somewhat 2 L6 My easily remembers how to use the device Dis agree somewhat 2 Dis agree somewhat 3 i Totally Disagree 2 Totally Disagree aa Totally Disagree 2 ae No opinion 1 Totally agree 22 Totally agree 0 eee AEE L7 My needs little support when using the device Dis agree somewhat 2 Dis agree somewhat 2 g f i i Totally Disagree 0 Totally Disagree 74 Totally Disagree 3 No opinion 1 85 Amsterdam Belfast Lulea L8 The technical support was sufficient Totally agree 0 Dis agree somewhat 0 Totally Disagree 0 Totally agree 4 Dis agree somewhat 0 Totally Disagree 1 Totally agree 6 Dis agree somewhat 0 Totally Disagree 0 L9 How satisfied are you with the device in general Very satisfied 0 Satisfied 25 Dissatisfied 0 Very satisfied 3 Satisfied 1 Dissatisfied 1 Very satisfied 0 Satisfied 6 Dissatisfied 0 Do you have suggestions to make the device L10 more easy to learn and use No suggestions No suggestions No suggestions should use the system a little longer To remember the functions would be difficult for Pwd Picture dialling integrate the different devices No suggestions No suggestions No suggestions No suggestions No suggestions It should be designed so that all family members are encouraged to use it There should a minimum of text messages
111. mal carer had to help her Another Pwd accidentally pushed the music button twice and the music started playing again this time with another song This enabled the Pwd to choose between songs Usefulness of the system Because of environmental issues one Pwd disliked the idea that the system would be running all day and night Another Pwd said he had no need for the system yet but could 109 see the usefulness of such a system in the future Another Pwd thought it could be very helpful and useful in his everyday life when the system functioned as intended The charger was tested in one case and there were some difficulties with it When placing the CCA in the charger the informal carer accidentally touched the bar at the top of the screen and opened a Windows menu When the Pwd placed the CCA in the charger the Pwd pushed reasonably hard on the devices With the second attempt the Pwd tried to put the CCA in the socket for the spare battery but eventually succeeded in placing the CCA on the charger The Pwd had also some difficulty in removing the CCA from the charger she moved the CCA back and forth on the pin a few times to get it off The audio recording was received positively by two Pwds and their informal carers One of the Pwds immediately knew how to use it the other had some difficulties with it The buttons for making the audio recording were considered small Another limitation was that the audio message could not be played bac
112. n daily life No comment Pwd doesn t know Picture dialling service make phone calls all day it doesn t present me with any problems Radio function Radio and music function Picture dialling service Radio don t listen to the radio much N A not tested N A Music because I m not interested in music The mobile device is not useful for me now since it is too difficult to use My wife helps me with all the functions so don t need the device now N A Amsterdam Belfast Lulea Stationary Device Nice pleasant The colour appeals Satisfactory The stationary device could be very 3 2 to me useful S1 How de you judge the stationary device design The contrast is not clear enough N A not tested Easy to understand the icons function usefulness user friendliness etc Colour and icons look good Clever nice clear A good size easy to see The design looks good but is difficult to place in the home 45 Amsterdam Belfast Lulea Nice pretty fresh colours Satisfactory Very easy to see hopefully easy to use There are too many cords How do you judge the size of the stationary Too large 2 Too large 0 Too large 1 S2 device Appropriate 3 Appropriate 4 Appropriate 5 i Too small 0 Too small 0 Too small 0 How do you judge the size of the buttons of the i pide D T large 9 Too large uf
113. n new things but this often required a great deal of repetition and motivation from both the Pwds and the informal carers 17 The Pwds motivation to use new devices would increase if the COGKNOW Day Navigator became a family device instead of an assistive device only for the Pwd Another important motivating factor for the usefulness of the assistive devices pointed out by all the participants was the possibility to adjust the functions such as reminders according to personal needs All the Pwds except one applied a memory strategy where they used a large wall calendar to make notes about activities important to remember They thought that the stationary device should have a similar feature where it was easy for the informal carer to update the list of important activities Reminders of activities were needed by all the participating Pwds who often had problems in initiating them Both the possibility of being reminded to make calls and the easy way of making calls by pressing a button were appreciated by all Pwds except one who was still very independent Some informal carers thought it would be good to have a more expanded directory The design of the screen on the stationary device was appreciated by all participants The concept of using a combination of pictures icons and text worked well One of the Pwds who had perception problems thought that text messages could be taken away or at least be minimised Instead there should be voice prom
114. nalysis Task leader Deliverable T1 1 Detailed work plan CDH T1 2 Informational and needs inquiry VUMC workshops T1 3 Needs analysis and storyboards VUMC T1 4 Iteration between User Needs and Tl D1 4 1 Technical Providers T1 5 Human Factors Impact Analysis Test 1 NST D1 5 T1 6 Human Factors Impact Analysis Test 2 BCH D1 6 T1 7 Human Factors Impact Analysis Test 3 VUMC D1 7 2 4 The COGKNOW Day Navigator tested prototype in field test 1 The COGKNOW Day Navigator prototyped during field test 1 consists of two main hardware components The mobile device COGKNOW Cognitive Assistant mobile device is linked to the COGKNOW Server CS and other home infrastructure components namely the COGKNOW Home Hub and the COGKNOW Sensorised Home CSH The home screen is a stationary device placed in the users home which communicates with the rest of the system via broadband communication see the User Manual published as an annex to the Field Test Report D4 3 1 Figure 1 The pictures shows the COGKNOW prototype investigated during field test 1 Fig 1 The COGKNOW prosthetic device tested during field test 1 The COGKNOW prosthetic device aims at supporting Pwds in four main functional areas These are a Reminding e A day time indication e Optional reminder to make a phone call e Optional reminder to prepare have breakfast e Optional reminder to prepare have lunch e Optional reminder to prepare have
115. nctionality and found it to be very useful It also became clear that Pwds and carers were divided about the usefulness of the content of the provided standard reminders Except for the reminder to make a phone call which was valued as useful at all test sites Pwds and carers preferred reminders that were attuned to their own personal situation reminders for daily and special events and could be configured and adapted in an easy way by the carer In Lulea also a 22 calendar function was proposed Only some people found it difficult to understand reminders in Amsterdam or had difficulty with acknowledgement of the reminders on the touch screen Amsterdam Belfast or the procedure of acknowledgement Lulea Simple instruction however proved helpful in those cases 4 2 2 Bottlenecks Amsterdam On the CHH the reminding function displayed an incorrect picture and an incorrect message in two separate cases The sensitivity of the home screen was a topic of discussion regarding confirmation of reminders in all cases The touch screen had to be pushed relatively hard according to all the Pwds Active buttons underneath the reminder caused some confusion as confirming the reminder would activate another function e g radio There was no reminding functionality on the CCA Belfast One noticeable problem with reminders is the fact that the stationary device needs to be reset each time a new reminder is to be configured This caused a small int
116. nding Picture dialling Radio music player Safety warning Reminding Picture dialling Radio music player Safety warning One of the functions is not working properly on the mobile device function and or help function in 3 ommen Sommens cases Safety warning continued after closing door in 1 case in the other 3 cases the door sensor didn t work thus safety warnings couldn t be tested Reminding 5 Picture dialling 5 Radio music player 5 Reminding Reminding Safety warning 5 Comments Mobile device had no functionality in any of the cases However audio recording and date time indication worked in 3 cases Picture dialling Radio music player Safety warning Comments Picture dialling Radio music player Safety warning Comments 90 Amsterdam Belfast Lulea 4 The device is distracting Home screen 1 Mobile device 0 Comments 1 Pwd commented on the home screen being distracting due to icons and colours used Home screen Mobile device Comments Home screen Mobile device Comments 5 The mobile device is lost Yes NA Comments As the system was tested 1 day in the presence of the research team the mobile device was never lost Yes Comments Yes Comments The sound of the device is too high low Mobile device too high NA Mobile device too low NA Home screen too high 0 Home screen too low 0
117. nding them to bring the mobile device to eat or to take medication All informal carers thought their loved one would easily understand the reminder message Like the persons with dementia four informal carers judged the reminder easy to hear when in the same room but none of the informal carers found the reminders easy to hear from another room Four informal carers found that the reminder was difficult for the person with dementia to acknowledge Four informal carers thought a reminder to brush your teeth would not be supportive for the person with dementia Likewise three informal carers said a reminder to eat would not support the Pwd In contrast all informal carers participating thought the reminder would work very well for 21 persons with dementia Only one carer said he she would be unable to set reminders for the person with dementia Two informal carers thought they would have difficulties sometimes and two informal carers expected to have no difficulties in setting reminders for their loved ones Four informal carers felt that the reminder function was not inconvenient at all for the person with dementia one informal carer expected the service to be a little more inconvenient With one exception all informal carers were Satisfied with the reminder service in general one informal carer was dissatisfied because the informal carer expected the function to be too complicated for the person with dementia to learn Informal carers suggested a
118. nformal carer suggested that reminders could be accompanied by some form of visual flashing in addition to a sound to accommodate those with hearing difficulties Another feature that was suggested by an informal carer was to monitor whether the rubbish bin had been taken out and if not to remind the Pwd to do so Lulea All of the participants found the stationary device easy to handle understand and accept One observation made by several informal carers was that it was interesting for them to use some of the functions on the COGKNOW navigator themselves such as the radio and music player and they thought that it would be easier to learn and to integrate it in daily life if it was useful for all family members Informal carers also observed that the devices did not fit in well in their homes and one felt that it looked too technical They thought that it would have to be designed in such way that it would blend in with other furniture and home appliances Two of the participants were disturbed by the screen being on the whole night since they were used to switching off all appliances consuming electricity The concept of using text and pictures on buttons worked well but could be improved if there had also been a voice prompt supporting the activity This was obvious for one of the Pwds who had great problems with apraxia She could understand the icons and the picture could read the text messages but was still not able to initiate the reques
119. ng the user friendliness and usefulness as perceived by the users of the system Raskin 2000 Nyberg amp al 2001 Monk 2002 The results of this analysis form the point of departure for the further prototyping of the system A functional Requirement Specification is established on the basis of the Human Factor Analysis Designing the COGKNOW Day Navigator the Human Factor Analysis builds on personal interviews with selected informants and on workshops of informants gathered together in groups In addition context information has been collected Prior to this report deliverable D1 5 1 a Functional Requirement Specification has already been formulated deliverable 1 4 1 as a basis for the first prototype The Human Factor Impact Report presented here deals with the first field testing of this prototype as well as some additional pre test context data The analysis presented will be fed into work packages two and three of the COGKNOW project and serves as a basis for further development of the prototype subjected for testing in field test two during 2008 The Human Factor Impact Analysis concerns three test sites in the Netherlands Northern Ireland and Sweden Personal interviewing workshops and collection of context information have been conducted according to a common scheme for all test sites allowing for comparison of data between sites Each test site has been managed quite independently by local teams but several coordination meetings and jo
120. ns were conducted the researchers spending on average 4 5 hours together with the informants The Swedish approach probably allows for better acquaintance with the prototype prior to testing depending on the informants own initiative In their report from the test site the Swedish team writes At the time of the installation the participants received instructions on how to use the devices and they had the opportunity to use it on their own See the field test report deliverable 4 3 1 The field test interviews concentrate on the users interactions with the four main functionalities of the COGKNOW device A pre configured prototype fixed reminders fixed photographs for the calling system fixed music facilities and a standard warning sensor on doors was applied during testing General questions about the size shape and weight of the equipment were administered to the Pwds and those close to them along with questions about the charging of the system The screen size readability of text and icons audibility of the alarms and handling of buttons were checked in a structured manner a fixed approach was used at all the sites Open questions about the specific applicability of the functions installed and about the usefulness of these functionalities as seen from the users point of view were administered to all informants The field test observations were conducted at all sites These observations concern the users handling of the CO
121. nt 27 Informal carers thought the safety warning function was useful and practical for their loved ones They judged the safety warning easy to hear and the visual safety warning on the stationary device appropriate Both participating informal carers expected the safety warnings to work very well for the person with dementia and found the warning alarms not at all inconvenient The informal carers were satisfied with the warning alarms in general One informal carer suggested a distinction between an open closed and locked door in the audio warning alarm and or in the visual warning alarm Belfast Four Pwds thought that the door sensor was very effective in detecting an open or closed door and that it was very useful The audibility was judged easy to hear by four Pwds and the visibility of the warning message was said to be very good When asked to comment on how well the warning alarm was working four Pwds said that it worked very well Four Pwds stated that the experience with the safety alarms was not at all inconvenient or stressful In determining the effectiveness of the sensor in detecting an open closed door four informal carers reported that the sensor was very effective The safety warning was judged as very useful in three cases and appropriate in one other The audibility of the safety warning message was considered good by four informal carers Three informal carers reported that the visibility of the warning message was very go
122. o icon is particularly difficult M5 device dis like them recognize them please to see add remarks to specific icons Recognizable no further comments on icons Difficult to see in general Difficult to see The help icon is difficult to understand 71 Amsterdam Belfast Lulea Relative to the size of the device it s ok The contrast should be higher N A It is a problem with the screen saver that makes the screen dark The radio icon is less clear than on the stationary device How do you judge the weight of the mobile Tee lant a0 Tee light 9 TOR light X M6 device Appropriate 4 Appropriate 5 Appropriate 5 i Too heavy 1 Too heavy 0 Too heavy 1 How do you find the mobile device to carry Too bulky and heavy 4 Too bulky and heavy 0 Too bulky and heavy M7 around torvour gt Appropriate tA Appropriate 5 Appropriate y Gr Very good to carry 0 Very good to carry 0 Very good to carry Good to attach 2 Good to attach 0 ROT z M83 How well do you find the mobile device for your Appropriate 2 Appropriate 0 ei to attach 0 i to attach to clothes body Difficult to attach 1 Difficult to attach 3 a f No opinion 1 No gt Ne oe ae rane M9 Does your loose the mobile device easily Sometimes 2 Sometimes 0 Yes i 4 Yes 0 Yes 0 Fee No opinion 4 Yes 1 Yes 0 TOS eee Sometimes 2 M10 Do you find the mobile device is easy to forget Sometimes
123. od and one reported it as appropriate When asked to comment on the usefulness of the warning alarm two informal carers said it could be useful one commented that it had potential and one said it gave a feeling of security Three informal carers were very satisfied with the warning alarm and four reported no inconvenience or stress related to it Lulea All participants appreciated the usefulness of a safety function but had problems with the safety warning that was used in the test For their own security several of the Pwds wanted to check that the front door was locked in the evenings and preferred such a warning to a warning of an open door Two of the informal carers had concerns about what to do if the weather was warm and they wanted to keep the door open They were also concerned about the preset time for the warning function to turn on and felt that it was important that it could easily be altered or that the function could be switched off The safety warning was functional and tested in all test sites and the Pwds did not express any opinion about this function Three of the informal carers felt that there were many other security aspects where a warning function would be appropriate They mentioned warnings for the stove when the iron is left on and other common security issues in the home Summary observations In all three sites most of the Pwds that tested the warning function understood and reacted at the warnings The perception o
124. of the participants felt the lack of a function to customise the reminders and safety warnings according to their personal needs This made the evaluation of the reminders less meaningful The Pwds observed the reminders but seemed to think they had nothing to do with them On the other hand all carers expressed a need for reminders The mobile device was difficult to handle for all of the participants Two of the Pwds were using cell phones every day and were used to pressing buttons Since the mobile device had both a touch screen and buttons this became confusing There were too many functions displayed on the mobile unit and none of the Pwds or carers found the functions of music and radio useful on the mobile device When these functions were used all participants preferred to use the stationary device Most of the Pwds had problems in managing the touch screen function on the mobile device It seemed both difficult to see the icons and to activate them by pressing with their fingers They had great difficulties with the many steps of each command The screen saver made it difficult to see icons when they were activated and some of the Pwds did not comprehend how to deactivate the screen saver The lack of contrast in the colours of icons and background also made it difficult to see and identify them When the screen saver was deactivated by a touch it often happened that an icon was pressed by accident and an unwanted action was initiated A 4
125. ome screen and the mobile device did not work as expected and need to be further developed for testing prior to field test 2 The safety functionality of the COGKNOW Day Navigator did not work as expected and was tested only with a few informants During one of the two tests with the door sensor in Amsterdam it showed limited functionality When the door was open an ongoing repetition of sound was given The charger was only tested with some of our Pwd informal carer dyades Some problems in the application of the charging system were detected The observer from Amsterdam writes The charger was tested in one case and there were some difficulties with it When placing the CCA in the charger the informal carer accidentally touched the bar at the top of the screen and opened a Windows menu When the Pwd placed the CCA in the charger the Pwd pushed reasonably hard on the device With the second attempt the Pwd tried to put the CCA in the socket for the spare battery but eventually succeeded in placing the CCA on the charger The majority of the Pwds were able to learn the various features of the system with few problems and in some cases were operating features such as music and radio without any guidance or instruction The most common problem that was observed with regard to operation was in relation to the touch 19 screen on both the stationary and mobile device as mentioned earlier A few of the informants though had problems operat
126. on in combination with Not useful pea Delp toifacilitateto listen to usefulness user friendliness etc other functions is not very practical Could be difficult if Pwd was alone The function should be used by all Good useful i members in the family Easy to use Would be difficult if there were different radio stations i Very useful 3 How do you judge the Radio control function for very usetul 9 very usatu 0 Useful 2 T2 SURI Useful 4 Useful 1 Not useful 1 seas Not useful 1 Not useful 3 eho No opinion 1 80 Amsterdam Belfast Lulea How do you judge the size of the Too large 0 Too large 0 Too large 0 T3 Appropriate 4 Appropriate 1 Appropriate 6 control button Too small 1 Too small 0 Too small 0 Not well 0 How well do you find that your uses the Radio Not wel oo Not well 9 Sometimes well not well 2 T4 Sometimes well not well 1 Sometimes well not well 3 control Very well 4 Very well 4 Very well 3 Y i Y No opinion 1 Very practical 0 Very practical 0 Very practical 0 T5 api TE ae you find the musie Practical 4 Practical 3 Practical 3 prey i Unpractical 1 Unpractical 1 Unpractical 2 Boring 0 Boring 0 Boring a T6 How do you appreciate the music player for your Enjoyable 4 Enjoyable 3 Enjoyable 4 to listen to music Vanreniovablas 4 Very enjoyable 0 Very enjoyable 1 ry enjoy i ry enjoy No opinion
127. onsiderably smaller than that on the home hub the information presented on this smaller screen was harder to understand and the functions were less easy to operate for our informants Even so some of our informants suggested that a lighter and smaller version of the mobile device would be preferable The buttons for the audio recording were perceived as small by two Pwds One Pwd had to put on reading glasses to see the text and icons The mobile phone clip was easily attached by one Pwd another had difficulties attaching it to her belt The reminders used during field test 1 were preset not adjusted to individual preferences and hence not considered as useful by all of our informants Most Pwds and their informal carers were able to receive and understand text messages on the home screen although some of our informants suggested that text reminders should be accompanied by sound signals and or a flashing screen One of the Pwds suggested that text messages should be kept to a minimum due to reading difficulties The observers in Amsterdam notes Under the reminders the other buttons were active which made it difficult to confirm the reminder properly because the Pwd did not know where to touch the screen The report from Lulea states Many of the participants felt the lack of a function to customise the reminders and safety warnings according to their personal needs This made the evaluation of the reminders less meaningful The Pwds obser
128. ontrol button Appropriate 5 Appropriate 4 Appropriate 6 Too small 0 Too small 0 Too small 0 Borel Q Norwell 9 ie aa well not ae T4 How well do you find the Radio control to use Sometimes well not well 2 Sometimes well not well 0 Very well 0 Very well 13 Very well 4 No opinion 1 sona Li Very practical 10 How practical do you find the music player to vey Pincicel i zay PASIR Practical 4 T5 Practical 13 Practical 2 f listen to music A Unpractical 0 Unpractical 1 Unpractical 2 ne No opinion 1 7 Boring 1 Boring 0 Boring 1 17 e te appreciate the music player to listen Enjoyable 4 Enjoyable 4 Enjoyable 4 i Very enjoyable 0 Very enjoyable 0 Very enjoyable 0 58 Amsterdam Belfast Lulea Useful Don t listen to radio N A Four of the Pwds found the function Useful practical very useful How useful do you find the Radio control and T8 music player in relation to your needs Useful would listen to the radio or Not useful One had forgotten to use the radio Does the system help you in these kinds of daily music more often and rediscovered the possibility activities what and how Don t listen to radio No comment One had already a system for using Not useful carer usually listens to the radio would use this service music only watches TV Hdw do vouexperience the Radio contelend Not at all inconvenient 4 Not at all inconvenient 0 Not at all
129. orks sometimes sometime not 0 Works sometimes sometime not 0 afes work Not well 0 Not well 0 Not well 0 a No opinion 3 Able 0 l Able 2 Able 0 bop R14 How do you find yourself able to set reminders Sometimes difficulties 2 Sometimes difficulties 0 Sometimes difficulties 0 for your Unable 51 Unable a Unable 0 ne No opinion 5 Useful Could be very useful Once in possession and functions Won t work at all STEP aie learned IE CONE DUSEN Several of the carers thought that How useful do you find the reminder function in Could be very useful F reminders could be very useful if R15 relation to your needs No need for it at the moment maybe thev were ineanindtil for the PWD Does the system help you remember important a reminder to bring the mobile Could be useful if Pwd was on their y 9 things what and how device own useful for reminding of appointments Too complicated to learn Could be useful if Pwd was on their Useful for remembering medication own to remind about appointments R16 How do you experience the reminder function for Not at all inconvenient 4 Not at all inconvenient 4 Not at all inconvenient 1 A little bit more inconvenient 1 A little bit more inconvenient 0 A little bit more inconvenient 2 76 Amsterdam Belfast Lulea A lot more inconvenient 0 A lot more inconvenient 1 A lot more inconvenient 0 No opinion 3 Very satisfied 0 Very s
130. orm the design of b Specific questions in field trial 1 context aware from WP2 and 3 the bold numbers features of correspond with numbers used in the 2 1 1 and 3 1 1 COGKNOW Day Reminding functionality e Post test interview WP1 Navigator e g location How often does it happen that the detection D Puan pays not to ivi orget the mobile device 3a Seah 3a e In situ measurement WP2 amp WP3 SeniorXensor anomaly Log a basic usefulness detection report for each don t forget your mobile reminder integrated with the confirmation of the reminder e g Thanks this reminder was not useful or log timeout Location of mobile device indoors outdoors GPS coordinates Communication functionality How often did the Pwd communicate using the phone with whom and where 3i Under which circumstances situations does the Pwd wants to communicate 3j e In situ measurement Log phone communication patterns via COGKNOW Stationary amp Mobile Device time of day person dialled duration of call Log location of PD when call is made or received at home or inside WP2 and WP3 101 Field trial 1 Aims Questions Methods WP Who Can should the picture dialling e Interview about what WP 1 interface be improved in field test 2 people would like to know 3k about the status of the person to be called e Post trial interview about v
131. ours not aesthetic One Pwd would prefer a less conspicuous smaller size of the screen Another Pwd found the size of the screen and buttons appropriate As for the icons the Find icon was not clear for two Pwds one interpreted the magnifying glass as a tennis racket and did not recognise the mobile device She thought she would get used to the other icons easily One Pwd found the Help icon a bit scary because the picture of the informal carer and the text help implied that the informal carer needed help The informal carer reacted similarly I don t need help do A Pwd and his informal carer found it confusing that the emergency button had the same photo of the informal carer as in the picture dialling address book One informal carer found the radio picture was not clear and suggested adding an antenna A Pwd found the picture for radio unrealistic and also disliked the pictures for music and telephone as he found it difficult to decipher them at first glance However he liked the clarity of the photos of his relatives in the picture address book Another Pwd was positive about the clarity of the photos and thought the pictures were appropriate The pictures for the reminders were easily recognised by two Pwds One Pwd found the pictures childish The sound of the alarm was loud enough for one Pwd and his informal carer and they appreciated the repetition of sounds until the door was closed Another
132. pts reinforcing the messages He also thought that there should be stronger contrasts between the icons or buttons and the background One of the informal carers found the appearance of the stationary device with all the cords that went along with it too technical It would be easier for the Pwd to accept it if it had blended in more harmoniously with other household equipment and furniture The mobile device was more questioned and discussed by the participants than the stationary device Four out of six Pwds had been using cell phones prior to field test 1 but had quitted due to insecurity in using them Only two Pwds were still using mobile phones on an everyday basis The tested COGKNOW device was unstable in its functions and it was therefore difficult to have an opinion on its usability They all agreed that the mobile device had to be very easy to operate in order for the Pwd to feel secure in using it The most important function was the ability to call a family member or a friend if they felt insecure when outdoors Some of the informal carers thought that it could be good if the mobile unit was intelligent and in various ways could assist the Pwd to communicate or direct them selves but it should not contain too many buttons One of the Pwds thought that the touch screen was too sensitive and difficult to handle with his fingers All informal carers were hoping to find a solution where a mobile unit could be used by the Pwds since this wou
133. r friendly for the person with dementia to operate One informal carer expected the number of functions on the stationary device to be too large for the person with dementia to remember them all None of the informal carers found it stressful or inconvenient to have the stationary device in their home All informal carers were satisfied with the stationary device of which two were very satisfied Two informal carers suggested that the stationary device should be wall mounted One informal carer would like a separate help button next to the bed this could be the mobile device but as it had no functionality at the time the concept remained abstract One informal carer stated that the text could be removed from the screen as it had no use and would be confusing for the person with dementia Two informal carers expected their loved ones to lose the mobile device sometimes Three informal carers expected Pwds to forget the mobile device at least sometimes One informal carer stated that it would be useful to put contact information of the owner on the mobile device All informal carers were satisfied with the mobile device One carer suggested removing or covering up the hardware buttons as they have no function Another stated that the mobile device should be lighter and smaller Belfast The results from the Belfast test were largely positive with four out of the five persons tested reacting in a positive manner to one or more of the devices that we
134. re introduced into their home However one Pwd reacted in such a negative way to the technology that they refused to use any of the equipment In general all the Pwds were able to learn the various functions of the system in a short period of time The general reaction to the system was that they enjoyed using it and were surprised at how easy it was to use With regards to the stationary and mobile devices all the persons preferred the stationary device primarily due to its larger size and ease of use To begin with the majority of persons found 16 the concept of interacting and touching a screen easy to grasp When asked to comment on the most useful function of the COGKNOW system two persons reported that they would benefit from reminders the most while two stated that they could not see how it would be useful in their daily life The size of the stationary device screen the buttons and the text were all reported to be of appropriate size by four of the persons All the icons were perceived as easy to see or recognize and the brightness of the display was reported to be appropriate by four of the Pwds The presence of the stationary device in the home was of no inconvenience for two persons a little inconvenient or stressful for two persons and very stressful for one person With respect to the mobile device the general opinion was that it might prove useful if used for a longer period of time and the icons used were not as clear as those use
135. reminder is raised e g In the living vs other places in the house vs outdoors In situ measurement Log which device s notified time of notification start modality of notification volume vibrate screen location of mobile device indoors outdoors GPS coordinates time of confirmation by person with dementia timeout WP2 amp WP3 b What do people with dementia think about the messages reminders in terms of user friendliness and usefulness in their daily life e Semi structured interview during and post field trial with people with dementia WP1 group 2 e In situ measurement log reminder contents AND a basic usefulness report to each reminder integrated with the confirmation of the reminder e g two ways to stop notification Thanks This reminder was not needed WP2 amp WP3 c What do informal caregivers think about messages reminders in terms of user friendliness and usefulness in the daily life of the person with dementia e Semi structured interview post field trial with carers WP1 group 2 99 Field trial 1 Aims Questions Methods WP Who d Do people with dementia find the e Semi structured WP1 group 2 COGKNOW Day Navigator useful interview during and post How do they value the different field trial with person with functionalities within the four dementia COGKNOW areas support for memory social contact dail
136. rm sound to help people with hearing difficulties The mobile device was not viewed as user friendly with icons that were difficult to see The general opinion among all the informal carers was that the mobile device would not be as useful as the stationary device Lulea Both participating Pwds and informal carers thought that the stationary device could be useful and it would be even more useful if it was more closely adjusted to their personal needs Some of the Pwds who lived with a partner had problems understanding why it was needed since most of the functions in the COGKNOW Day Navigator were already taken care of by their partner However several of the informal carers could see the possibility of the Pwd becoming more independent if they had access to a COGKNOW device One of the Pwds who was living alone had some problems in understanding the usefulness of the device since she was currently able to perform most activities on her own However she could see that there was a point in learning to use the assistive devices while she still had a good ability to learn All informal carers and some of the Pwds thought that they would be able to learn how to use the stationary device on their own provided they got opportunity to practise Two of the informal carers thought that the process of learning would be facilitated if the devices were designed in such a way that they were useful for all family members It was possible for the Pwds to lear
137. s 0 number Psychological complaints 6 number What type of psych complaints Alzheimer s 4x Alzheimer s 5x Alzheimer s and Lewy body dementia 1x Alzheimer s and Lewy body dementia 1x 12 What aids does your use to get around no aids 13 no aids 5 no aids 6 cane zq cane 0 cane 0 walker 0 walker 0 walker 0 rollator 0 rollator 0 rollator 0 wheelchair 0 wheelchair 0 wheelchair 0 scootmobile 0 scootmobile 0 scootmobile 0 other ra other 0 other 0 Communication 13 Does your have a mobile phone at his her Yes 5 Yes 1 Yes 6 disposal No 0 No 4 No 0 Several times a week 0 Several times a week 0 Several times a week 2 14 If so how often does your use it Several times a month 21 Several times a month 0 Several times a month 0 Several times a year never 4 Several times a year never 1 Several times a year never 4 15 ee No 0 No 3 No ed Does your have a computer with internet and e A a F mail facilities at his her disposal Yes internet and e mail 3 Yes internet and e mail 2 Yes internet and e mail 5 Yes only internet 2 Yes only internet 0 Yes only internet 0 Several times a week 1 Several times a week 0 Several times a week 0 16 If so how often does your use it Several times a month 0 Several times a month 0 Several times a month 0 Several times a year never 3 Several times a year never 2 Several times a year never 6 7 Yes 0 Yes 0 Yes 0 17 Does yo
138. s It should fit with the other furniture of Do you have any suggestions to improve the form No suggestions the house S11 y y Sugg P No suggestions of the stationary device None Could be smaller less present in the home No suggestions No suggestions The touch screen is too sensitive easy to make mistakes No suggestions Mobile Device Amsterdam Belfast Lulea How do you judge the mobile device design function usefulness user friendliness etc Nice needs a little getting used to Big enough but to may icons on the screen Not applicable Not applicable Nice could be a little smaller and the buttons could be removed as you don t need them Very good but icons are not as clear as on stationary device Don t know Quite difficult to use Very good easy to use but more difficult to see icons Unable to assess as mobile device didn t function Two Pwds have no opinion There are too many functions on it It should be simple to use so dare use it It is difficult to use M2 How do you judge the size of the mobile device Too large 2 Appropriate 3 Too small 0 Too large 0 Appropriate 4 Too small 0 Too large 0 Appropriate 6 Too small 0 48 Amsterdam Belfast Lulea How do you judge the screen size of the mobile Too small 0 Too small 0 Too small 0 M3 2 Appropriate 4 Appropr
139. s preferred to store or carry the device in their handbag 110 The phone connection was problematic as a continuous beep would sound throughout the call and would continue even after the handset had been reset This caused some confusion and in some cases the Pwd thought that the beeping noise was to signal that the call was in progress In general the Pwds were able to make calls and connect to their intended recipient even with the technical problems that this feature presented Ease of learning The majority of the Pwds were able to learn the various features of the system with few problems and in some cases were operating features such as music and radio without any direction One Pwd in particular had some difficulties in learning how the functions operated and where they were located on the screen The most common problem that was observed with regard to operation was in relation to the touch screen on both the stationary and mobile device The primary concern for the majority of the Pwds was the difference in tactile feedback given by both devices The Pwds reported that in order to get a correct press on both the stationary and mobile screens two different types of presses had to be performed The stationary device seemed to require a short sharp nudge with the soft tip of the forefinger The mobile device required a press using the nail of the finger rather than the soft tip These solutions came about after a trial and error approach
140. should be renamed as the function would not be recognisable from the button name Belfast Four Pwds thought that the picture dialling feature was very useful however one Pwd stated that although it was useful they had no problem using the normal telephone Two Pwds said that the picture dialling function was very helpful and two said it was appropriate The size of the pictures used on the stationary screen was judged by four Pwds to be appropriate In contrast two Pwds thought that the size of pictures on the mobile device was too small The emergency contact function was considered appropriate by three Pwds with one finding it easy to use Four persons commented that using the picture dialling feature was not all inconvenient or stressful Three Pwds were very satisfied with the picture dialling service in general with one being just satisfied There were no suggestions from the Pwds about ways to improve the picture dialling function on either the stationary or mobile devices Two carers considered the picture dialling function to be very helpful and two thought it to be appropriate Four carers found the pictures displayed on the stationary device to be of an appropriate size while two carers thought the pictures on the mobile device were too small Three carers felt that the Pwds use of the address book on the stationary device was appropriate however two carers reported that it was difficult for the Pwd to use the mobile s address boo
141. so Lulea All of the participants found the stationary device easy to handle understand and accept One observation made by several informal carers was that it was interesting for them to use some of the functions on the COGKNOW navigator themselves such as the radio and music player and they thought that it would be easier to learn and to integrate it in daily life if it was useful for all family members Informal carers also observed that the devices did not fit in well in their homes and one felt that it looked too technical They thought that it would have to be designed in such way that it would blend in with other furniture and home appliances Two of the participants were disturbed by the screen being on the whole night since they were used to switching off all appliances consuming electricity 111 The concept of using text and pictures on buttons worked well but could be improved if there had also been a voice prompt supporting the activity This was obvious for one of the Pwds who had great problems with apraxia She could understand the icons and the picture could read the text messages but was still not able to initiate the requested action When prompted with a verbal instruction by the informal carer she was able to perform the action On some level all participants had similar problems but in different degrees One of the Pwds was distracted by the small icons buttons beside the day navigator functions on the screen Many
142. songs albums No suggestions There should be options where you control and music player Picture of the artist and an instruction on the screen No suggestions No suggestions No suggestions easy choose radio stations Safety Warnings Amsterdam Belfast Lulea How do you judge the safety warning services W1 function interaction experiences usefulness user friendliness etc Not applicable Not applicable Not applicable Useful practical Practical in the kitchen fridge and Useful Could be useful if installed before person gets too confused Potentially useful Could be useful We have no use of safety warning of open doors but a warning for unlocked doors would be very useful over door User friendly Ineffective 1 Ineffective 0 Ineffective 0 i ao How do you judge the sensors effectiveness in iD gt te gt Sometimes effective ineffective 0 w2 Sometimes effective ineffective 1 Sometimes effective ineffective 0 detecting an open closed door gt Very effective 1 Very effective 1 Very effective 5 Sy No opinion 4 82 Amsterdam Belfast Lulea How do you judge the safety warning of an Very useful 1 Very useful 2 Very useful 2 Appropriate we open door on the stationary device Appropriate 1 Appropriate Not useful 1 Not useful 0 Not useful 2 a No opinion 2 Good to
143. sonnel at the three test sites 14 The data analysis focused on answering questions about user friendliness and perceived usefulness of the device Descriptive analysis was conducted on the quantitative data of each test site by means of SPSS The analysis of the qualitative data collected by the field test observations were analyzed using NVivo The qualitative data collected by means of the bottleneck lists and in situ measurements were summarized in written reports from each test site The reason for analyzing the data of the three test sites separately was two fold a Small differences between the stability of the prototype tested at the different sites b The researchers interest into possible differences and variations between users Opinions on user friendliness and usefulness of the COGKNOW Day Navigator between the sites in the three countries At each test site approval from the respective national ethical committees was obtained before any data collection took place In field test 1 the data analysis focused on answering questions about user applicability and perceived usefulness of the device The analysis of field observations bottleneck lists in situ measurements and prescribed test tasks focused on user interactions with the COGKNOW device 4 Results of the Human Factor Analysis in field test 1 4 1 COGKNOW Day navigator system and design The report on the results below was written by the research teams at each tes
144. ssible and to use the following as a check list e The four function areas of the COGKNOW device should be covered and for reminders and alarms both the stationary and the mobile unit should be observed e It is important to distinguish between hardware and software functionality during observations General and procedural information 1 Informant s name 2 Address 3 Date dd mm yyyy 4 Date of receiving the device 5 Who is are present 6 Where is device stationed in the house 7 Interruptions during testing of devices 8 Characteristics of test environment 9 Sequence of activities functionality area during test 10 Duration of activities functionality area 11 Context What kind of home technologies do the Pwd use on a daily basis Product observations Instructions write down users remarks behaviours and problems Please report on which specific function or specific reminder alarm etc the observation applies to 12 System for example speed 13 Hardware Can the Pwd use the hardware as expected If any problems note the Pwd s or carer s remarks Functions of the device s 14 Reminding recognizing understanding handling problems etc 15 Picture dialling recognizing handling bottlenecks etc 16 TV radio control media playback recognizing handling bottlenecks etc 17 Safety warnings recognizing understanding handling problems etc 18 Content of the device s linguis
145. st Lulea ae Too often 0 Too often 0 ie ones 9 How do you judge the frequency of repetition of Appropriate 3 R5 Appropriate 0 Appropriate 1 the reminder Not often enough 0 Not often enough 0 Not often enough 0 a No opinion 3 r Difficult to acknowledge 3 Difficult to acknowledge 3 me 5 eokrowloede How do you judge the acknowledgement of the i Appropriate 3 R6 Appropriate 2 Appropriate 1 reminder Easy to acknowledge 0 Easy to acknowledge 0 Easy to acknowledge 0 a No opinion 3 Works very good How do you judge the working of the reminder Works very good rae Works very good 0 S Works good R7 on your mobile device when you are outside of Works good 0 Works good 0 the house Works not good anymore 0 Works not good anymore 0 Works n t good anymore i Not tested 6 e Not timely enough 2 Not timely enough 0 no Umay donne How do you judge the timeliness of reminder are 3 rarer Point of time is appropriate 3 R8 Point of time is appropriate 3 Point of time is appropriate 0 messages i Reminders are too early 0 Reminders are too early 0 Reminders are too early 0 tag No opinion 3 Not supportive at all 2 Not supportive at all 0 ne Supportive AEAN Some supportive sometimes not 0 How do you judge the reminder as a support in Some supportive sometimes not 1 Some supportive sometimes not 0 Re remembering to eat Very supportive 2 Very supportive 0 Very supportive
146. stressful for four informal carers and they were all satisfied with the reminding feature with one informal carer being very satisfied In relation to suggested improvements for the reminding feature four informal carers had no suggestions Lulea All participants accepted the function of reminders as something that was needed and useful However they felt that it was important that the reminders were adjusted to their personal needs The reminder to make phone calls was well accepted by several of the participants According to the carers four out of six of the Pwds had problems in initiating phone calls even though they appreciated them and the calls were important for their social contacts with family members and friends All Pwds thought it would be useful to be reminded of events and activities that did not happen every day such as birthdays of family members or scheduled visits to a hairdresser or the doctor Most of the carers thought that it would also be good to have reminders of daily events such as taking medication remembering to call and remembering what food to make An important aspect for some of the carers was the possibility of adding and adjusting reminders in an easy way Summery Observations The observation reports of the three test sites with respect to the reminding functionality see Annex A 4 confirm the results of the semi structured interviews Almost all Pwds and informal carers reacted positively to the reminding fu
147. t instance On several occasions usually on the first call some Pwds found that by the time the picture dialling was being explained to them during the first attempt that the handset was not being lifted quickly enough and the software would hang up before they even had a chance to lift the receiver Lulea The help button on both the stationary and the mobile device was not well understood by any of the participants The problem seemed related to the fact that it had the same design and colour as the other buttons One Pwd commented does he need help Referring to the person in the picture It was easy to use after instructions had been provided and for several of the Pwds this became the easy way to make calls instead of using the directory All carers and many of the Pwds thought that this function was very useful Four of the Pwds already had an established system for whom to call when they faced problems in daily life The picture dialling was the function that was easiest for the Pwds to comprehend and all found it useful The system with a combination of text and pictures seems to work well Two of the carers had the experience that written instructions did not work well The return function was difficult to understand for some of the participants Three of the participants who had more pronounced problems with apraxia felt confused by the written instruction to pick up the phone at the same time that the person was speaking through
148. t site In the text we have referred to Annex A1 in which the results of the questionnaires have been presented in detail and Annex A4 in which the results from observations have been presented for the three test sites The number of Pwds tested at each test site Amsterdam n 5 Lulea n 6 Belfast n 5 for more information see Table 2 4 1 1 Semi structured interviews Amsterdam In Amsterdam the overall first impression of the COGKNOW Day Navigator from persons with dementia was positive Some participants stated that although development is still in its early stages they could see the use for such a system All but one participant stated that the device was easy to learn for the functions they would need They expected to use a little time to remember the functions of the device but when interacting with the system they would learn how to use it When asked four persons with dementia said they were satisfied with the device in general None of the participants had any suggestions on how to make the device easier to learn and use With regard to the size of the stationary device two persons with dementia stated that it was too large the other three persons with dementia judged the size as appropriate However all participants stated that the number of buttons on the screen was appropriate and all but one person with dementia judged the button size and text size as appropriate One person with dementia found the button size as well as the t
149. ted action When prompted with a verbal instruction by the informal carer she was able to perform the action On some level all participants had similar problems but in different degrees One of the Pwds was distracted by the small icons buttons beside the day navigator functions on the screen Many of the participants felt the lack of a function to customise the reminders and safety warnings according to their personal needs This made the evaluation of the reminders less meaningful The Pwds observed the reminders but seemed to think they had nothing to do with them On the other hand all carers expressed a need for reminders 107 The mobile device was difficult to handle for all of the participants Two of the Pwds were using cell phones every day and were used to pressing buttons Since the mobile device had both a touch screen and buttons this became confusing There were too many functions displayed on the mobile unit and none of the Pwds or carers found the functions of music and radio useful on the mobile device When these functions were used all participants preferred to use the stationary device Most of the Pwds had problems in managing the touch screen function on the mobile device It seemed both difficult to see the icons and to activate them by pressing with their fingers They had great difficulties with the many steps of each command The screen saver made it difficult to see icons when they were activated and some of the Pwds
150. th the door sensor it showed limited functionality When the door was open an ongoing repetition of sound was given Then the screen automatically returned to the default screen The display disappeared shortly afterward and the technician touched the screen The alarm went off even though the door was closed Ease of learning One Pwd was very hesitant and insecure when having to use the system in the beginning She had comprehension problems and imagining scenarios which included the use of a given function being difficult to her She very often only understood what was meant after the interviewer demonstrated a given function Frequently she repeated in her own words what she understood the interviewer and the informal carer then corrected or added explanations Ease of operation The sensitivity of the touch screen of the CHH was not high enough for four of the five Pwds They touched the screen too gently and were not or only after several attempts able to confirm the reminder When the technician came in to confirm a reminder questions were raised on how hard one had to touch the screen At another time one of these Pwds considered the sensitivity high and it bothered her that the system reacted so promptly She thought it would discomfort her if she accidentally touched the radio button and the radio started playing immediately Later during the test this actually happened and in a slight panic she was unable to switch off the music the infor
151. the background of fairly restricted observation of the users actual interactions with the COGKNOW system For example the report from Belfast states With respect to the mobile device the general opinion was that it might prove useful if used for a longer period of time and the icons used were not as clear as those used on the stationary device However we have collected extensive interview material from all test sites and our conclusions regarding the overall system functioning and design seem decisive Even so as complexity increases future testing regarding functionality may yield slightly different results from those presented here Also the number of informants in the Human Factors Analysis in field test 1 was relatively small 16 Pwds and 16 carers Some of the research questions like how easy it is to learn how to operate the COGKNOW device may require a larger sample of interviewees than some statements about the feasibility of the overall system design We have however applied strict inclusion criteria for both Pwds and their informal carers and hence we believe our results exemplify Pwds interactions with the COGKNOW device fairly well Still our conclusions here are suggestive in character and are meant to indicate improvements for the COGKNOW system prior to field test 2 Though we are aware that some bugs were fixed on the system after the first tests in Amsterdam and hence that the COGKNOW Day Navigator functionalities
152. tic usage pictures 19 Reactions to the device as expressed in behaviour for example mood nervousness restless taking initiative or not dependent behaviour satisfaction 20 Other observations Application of audio diary for collecting bottle necks 21 Can we apply the diary method for persons with dementia a Do persons with dementia remember to use the audio tool b Do person with dementia know how to use it 88 A 1 5 Results Bottleneck list Which bottleneck appeared today while using the devices and services mark the applicable points Amsterdam Belfast Lulea Bottle necks Home screen 4 Home screen Home screen Mobile device 5 Mobile device Mobile device Door sensor 3 Door sensor Door sensor Comments The Home screen Comments Comments The device does not work properly 1 underline your choice home screen mobile device door sensor turned in a stand by mode after which it didn t switch on easily in 4 cases The Mobile device had no functionality except for audio recording and date time indication in all cases 89 Amsterdam Belfast Lulea One of the functions is not working properly on the home screen Reminding 2 Picture dialling 3 Radio music player 0 Safety warning 4 Comments The reminding function displayed a wrong picture and a wrong message in two separate cases The Home screen crashed after using the picture dialling Remi
153. tos and thought the pictures were appropriate The pictures for the reminders were easily recognised by two Pwds One Pwd found the pictures childish The sound of the alarm was loud enough for one Pwd and his informal carer and they appreciated the repetition of sounds until the door was closed Another Pwd and informal carer reacted with amusement to the sound and picture of the reminder Two Pwds thought it should be louder sharper and more alarming The sound of the reminders was not heard by one of the Pwds and was not loud enough for two Pwds when they were further away one Pwd did not hear it when she was outside in the garden but did hear it when she went upstairs another Pwd did not hear it upstairs Two Pwds considered the sound itself annoying and irritating One Pwd said it reminded him of an emergency One Pwd could not place the sound or its meaning another Pwd and informal carer said they easily recognised what the alarm was for One informal carer said it would be good if the reminder was a recognisable melody or a piece of music that stimulated the Pwd to act upon the reminder Design issues of the Mobile device The buttons for making the audio recording were perceived as small by two Pwds One Pwd considered it confusing to have extra buttons on the CCA that were not used One Pwd had to put on reading glasses to see the text and icons The mobile phone clip was easily attached and carried around by one Pwd another had
154. ts of the workshops with our informants have already been published in deliverable D1 4 1 The Functional Requirements will be updated based on the Human Factors Analysis with new users in the second and third phase of the developmental process Here is how the project description documents distinguish between deliverable D1 4 1 and D1 5 1 An initial Functional Requirement Specification will be established on the basis of interviews and workshops with the users D1 4 1 in project month six During the first year a first field test on the prototype will be carried out On the basis of this test field test 1 and the collected data a second Human Factors and Needs Analysis will be conducted completed in project month twelve in order to feed back information to the technical developers These results constitute a second deliverable D1 5 1 and an updated Functional Requirement Specification Task 1 4 Human Factor Analysis At the end of the project month 6 a clear specification of users functional requirements delivered to technical and service developers Task 1 5 Project month12 Analysis and list of fulfilled and unfulfilled requirements returned to technical and service developers on the basis of test results of field test 1 Table 1 describes work tasks task leaders and deliverables of work package 1 Table 1 Tasks responsible institutions and deliverables in Work package 1 WP 1 Human Factor A
155. ttons to remember Easy 0 Hida Sete nthe ate eee ed Meade eT ers oes The more you work with it the easier it gets It seems ease enough to learn Fairly easy 62 Amsterdam Belfast Lulea Totally agree 2 Totally agree 4 Totally agree 3 L2 I quickly learned how to use the device Dis agree somewhat 2 Dis agree somewhat 0 Dis agree somewhat 3 Totally Disagree 0 Totally Disagree 0 Totally Disagree 0 needed little support in learning how to use Totally agree A Totaly agree F Tey PIRS gt L3 th device Dis agree somewhat 1 Dis agree somewhat 1 Dis agree somewhat 0 Totally Disagree 0 Totally Disagree 0 Totally Disagree 0 find the device easy to use for the functions Totaly ae A Totaly agree i Totally agrs 4 L4 need it Dis agree somewhat 0 Dis agree somewhat 1 Dis agree somewhat 2 Totally Disagree 0 Totally Disagree 0 Totally Disagree 0 easily remember the various functions of Ty ons s Totaly Pyes 2 Totaly D i L5 ihadeuice Dis agree somewhat 3 Dis agree somewhat 2 Dis agree somewhat 2 Totally Disagree 0 Totally Disagree 0 Totally Disagree 1 Totally agree 23 Totally agree 0 Totally agree 1 L6 I easily remember how to use the device Dis agree somewhat 0 Dis agree somewhat 0 Dis agree somewhat 4 Totally Disagree ra Totally Disagree 4 Totally Disagree if Totally agree 2 Totally agree 14 Totally agree 5 L7 need little support when using the devic
156. uccessfully The evaluation of in situ data collection methods and tools was postponed to field test 2 due to technical problems In general our informants responded positively to the research questions related to the evaluation of basic hardware applicability and usefulness The informal carers were even more positive than the Pwds themselves However the user friendliness of the mobile device was ranked as poorer than that of the stationary component both by Pwds and by the informal carers Research questions concerning basic functionality of the COGKNOW Day Navigator received a positive response from our informants especially regarding picture dialling and media control The reminding functionality was evaluated as useful by both Pwds and their informal carers But difficulties with the human machine interface restricted applicability in particular for the mobile device The safety functionality needs further development in order to be tested properly 5 1 2 Reminding functionality The reminding system seems to have an appropriate audibility Some of the users commented that the text reminders should be accompanied by flashing screens and or a sound signal to attract the attention of the Pwd The user friendliness of the text reminders seems to be appropriate on the home screen but readability decreases on the mobile device In the report from the Lulea test site synthetic or digitalised voice machine output in connection with reminders is su
157. ughter 0 Daughter 1 What is your relationship to the person with Son 0 Son 1 Son 2 dementia Friend 0 Friend 0 Friend 0 Acquaintance 0 Acquaintance 0 Acquaintance 0 Other 0 Other 1 Other 0 39 Amsterdam Belfast Lulea 8 How far do you live from your Shared household 4 Shared household 3 Shared household 3 Walking distance EA Walking distance 0 Walking distance 0 In same municipality O In same municipality 2 In same municipality 2 In different municipality 0 In different municipality 0 In different municipality 1 9 How many days per week do you look after your less1 day 1 less 1 day 0 less1 day 2 Seat 1 day 0 1 day 0 1 day 0 2days 0 2days 0 2days 0 3days 0 3days 1 3days 0 4days 0 4days 1 4days 0 5days 0 5days 0 5days 0 6days 0 6days 0 6days 0 7 days 4 7 days 3 7 days 4 10 How many hours per week do you spend on Mean 26 2 Mean 15 Mean 23 5 average on the care and support of your Range 3 56 Range 5 30 Range 5 52 11 Since when are you taking care of your in Mean no of months 12 6 Mean no of months 34 8 Mean no of months connection with his her memory problems Range 9 18 Range 18 36 Range 12 Which means of transportation do you have at your Bicycle 4 Bicycle 0 Bicycle 4 disposal Car 15 Car 5 Car 6 Moped scooter 0 Moped scooter 0 Moped scooter 0 Motorcycle 0 Motorcycle 0 Motorcycle 0 Public tr
158. uld be on one Two Pwds wants a larger No suggestions device GireCtOry ccceceeeeeeeeeeeeeees l l l l abistooresnniown OA en P14 Do you have suggestions to improve the picture No suggestions cate eae caaeeeetteeeetaeeeeeaeeeeneeeeeneeeneaas dialling function No suggestions 0 peeeeemneteretensteninrnnennene tt None IIRS i eagan A a En The screen is rectangular the No suggestions Nh eas buttons are rounded and this looks strange Amsterdam Belfast Lulea Radio control amp music player 57 Amsterdam Belfast Lulea How do you judge the Radio music player The picture of radio and music player could be clearer A function to change the station would be useful Don t listen much to radio Unable to give opinion Not useful One Pwd thinks it is not needed The function is easy to use and T1 services function interaction experiences Useful using the buttons is eas useful usefulness user friendliness etc i 9 y Don t listen to radio Nice Two of the Pwds express that thy i Enjoyed being able to control music like music very much Would make listening to the radio r put really oniyWatehes TN easier Very useful 0 Very useful 0 Very useful 3 T2 How do you judge the Radio control function Useful 4 Useful 2 Useful 3 Not useful 1 Not useful 2 Not useful 0 Too large 0 Too large 0 Too large 0 T3 How do you judge the size of the c
159. uld be useful calendar function higher Not so bad think it s useable Very useful Not at all inconvenient 15 Not at all inconvenient 3 No at all inconvenient p How do you experience the presence of the A 7 A little bit more inconvenient 1 S9 hie A little bit more inconvenient 0 A little bit more inconvenient 1 i stationary device in your home P A lot more inconvenient 0 A lot more inconvenient 0 A lot more inconvenient 0 No opinion 1 S10 How satisfied are you with the stationary device in general Very satisfied 2 Satisfied n3 Dissatisfied 0 Very satisfied 1 Satisfied 3 Dissatisfied 0 Very satisfied 0 Satisfied 6 Dissatisfied 0 11 Do you have any suggestions to improve the form of the stationary device If you could hang it from the wall would be nice Hang it from the wall No suggestions Logical shape a separate help button next to the bed would be useful The word electronic assistant should be removed has no use No suggestions N A No suggestions No suggestions Yes reminders could be accompanied with flashing lights as well as a warning sound for people with hearing difficulties There should be voice prompts for all activities and buttons The dialling function should be simplified you can talk directly to the screen The help button must stand out much more 70 Amsterdam Belfast
160. uld be very useful if it is further developed It may help the PWD to be more independent out doors could feel safer if he could learn how to use it information of the owner should be in N A or on the mobile device Not at all inconvenient 13 Not at all inconvenient 2 Not a all ingonvenieni 4 How do you experience the presence of the i wt Po ay A little bit more inconvenient 1 M15 j A little bit more inconvenient 2 A little bit more inconvenient 1 mobile device for your A lot more inconvenient 1 A lot more inconvenient 0 A lot more inconvenient 1 a No opinion 3 M16 How satisfied are you with the mobile device in general Very satisfied 0 Satisfied 4 Dissatisfied 0 Very satisfied 0 Satisfied 2 Dissatisfied 1 Very satisfied 0 Satisfied 1 Dissatisfied 3 No opinion 2 M17 Do you have suggestions to improve form and battery of the mobile device If the buttons don t have any function than remove them or cover them up No suggestions There should be very few functions and buttons to pouch on 73 Amsterdam Belfast Lulea No suggestions No suggestions A little smaller and lighter The charger is fine think it s fine No suggestions No suggestions No suggestions No Comment There should not be so many steps in each command Reminding Service Amsterdam Belfast Lulea How do
161. und the radio control and music player function to be useful enjoyable and not at all inconvenient they were satisfied with the service in general All participants stated that the size of the control buttons was appropriate and found the radio control sometimes easy to use two persons or very easy to use three persons One person did not appreciate the music player or the radio function As this person did not like to listen to music at all the music and radio service seemed not useful impractical and boring Suggestions for improving this function included an option to change the radio station and integration of Windows media player and music downloads from the internet All but one informal carer judged the radio control function to be useful and the music player function to be practical for their loved ones All informal carers stated that the music player would be enjoyable for the person with dementia and all found the person with dementia to use the radio control sometimes well one informal carer or very well four informal carers One informal carer suggested adding an option to select radio stations and artists songs or aloums Another informal carer would like to see a picture of the artist playing and instructions on how to use the function on the screen As their loved one suggested one informal carer would like integration with Windows media player and one informal carer thought the function could be removed altogether as the Pw
162. ur have a PDA at his her disposal No 5 No 5 No 6 Several times a week 0 Several times a week 0 Several times a week 0 18 If so how often does your use it Several times a month 0 Several times a month 0 Several times a month 0 Several times a year never 0 Several times a year never 0 Several times a year never 6 42 A 1 2 Results Semi structured interview people with dementia Semi structured interview with person with dementia Field Test 1 Note Please pay attention to the response options the order can be different for different questions Amsterdam Belfast Lulea Amsterdam Belfast Lulea General opinion 43 Amsterdam Belfast Lulea G1 Can you tell me about your experience of using the COGKNOW day Navigator Nice seems useful Fine initiative still in it s early stages but it turned out better than expected Interesting it s a good thing that it is possible think the system could be of some use to me don t need it at the moment but should start using it early to learn the system Great no problem enjoyed using it don t want to touch it It was a good experience Very good interesting think it would be very useful Favourable experience overall enjoyable All think that the stationary device will be useful in the future when it is further developed All think that they will be able
163. ure in a living room environment A decision should be made whether the mobile device should include all the functionalities of the CDN or only restricted functionality e g to locate a person outdoors It should be easy to configure the reminding functionality with personally selected reminders to suit the Pwd s individual needs As it is the impression of the field observers that Pwds do not react to written messages and reminders as expected another approach to messaging needs to be investigated for field test 2 The picture dialling functionality should include a possibility to expand the address book Simplification of the necessary steps to make a phone call should be investigated The help function should be clearly distinguishable from the picture dialling address book It should be easy to configure the activity or media control functionality with personally selected music It would be preferable if different radio programmes could be selected and if a TV control functionality can be added The safety functionality should be further developed so as to meet individual choices e g door kitchen and bathroom 34 6 List of Tables Table 1 Tasks responsible institutions and deliverables in Work package 1 Table 2 Characteristics of participants in field test 1 7 Abbreviations CCA COGKNOW Cognitive Assistant CDH Centre for Distance spanning Healthcare Lulea Sweden CDN COGKNOW Day Navigator CHH COGKNOW Home Hub COGKNO
164. valuation strategy part 4 1 Some of them had been suggested by VUMC TI and NST and agreed upon by the other WP1 partners 10 3 Methods 3 1 Procedures participants and setting 3 1 1 Procedures All Pwds were screened according to the Global Deterioration Scale and the close persons were checked against the inclusion criteria for informants during the spring of 2007 After being informed about the aim and state of the project and the first field test all test participants signed a consent form A pre test interview with Pwds and those close to them was conducted prior to the installation of the COGKNOW device in the Pwds homes The pre test interviews focused on context data The COGKNOW Day Navigator was installed in the Pwds home during the summer of 2007 the installation work demanding a visit of between 30 and 120 minutes to the Pwds home In Northern Ireland and The Netherlands the installation test interviewing and un installation of the equipment was conducted on the same day approximately 4 5 hours in total In Sweden the equipment was installed one day in advance of testing but in two cases the installation was done 6 days prior to testing in one of these cases only the home screen was operational In The Netherlands and Northern Ireland the field test interviewing was completed within approximately two hours one hour with the Pwd and one hour with the informal carer whereas in Sweden prolonged interviewing sessio
165. ved the reminders but seemed to think they had nothing to do with them On the other hand all carers expressed a need for reminders The picture dialling system communication functionality of the COGKNOW prototype was in general judged as user friendly and useful by our informants In Amsterdam Belfast and Lulea both Pwds and their close persons found this functionality to be easy to apply and to learn how to use The interaction between the home screen and the Pwds telephone needs to be adjusted The observer in Belfast writes The phone connection was problematic as a continuous beep would sound throughout the call and would continue even after the handset had been reset This caused some confusion and in some cases the Pwd thought that the beeping noise was to signal that the call was in progress In general the Pwds were able to make calls and connect to their intended recipient even with the technical problems that this feature presented The media control system activity functionalities of the COGKNOW Day Navigator was judged as user friendly and useful by both Pwds and their informal carers The functionalities were found to be easy to operate self sufficiently by the Pwds and easy to learn how to use From Amsterdam it is noted though The system allowed for the radio and music to play simultaneously The CHH fell into a stand by mode three times which had to be fixed by the technician The communication between the h
166. ven door ryuseful 2 faaan aaraa ei e a aE f Ineffective 0 Ineffective 0 inetigetve eo F A How do you judge the sensors effectiveness in Pay gt ha Sometimes effective ineffective 0 W2 fi Sometimes effective ineffective 2 Sometimes effective ineffective 0 detecting an open closed door i Very effective 1 Very effective 0 Very effective 24 a No opinion 2 Very useful 0 How do you judge the safety warning of an open vay userul 9 yoy ae ai Appropriate 3 W3 f Appropriate 2 Appropriate 0 door on the stationary device Not useful 2 Not useful 0 Not useful 0 wed No opinion 1 ee Good to hear 0 Good to hear 4 eed p higar oe How do you judge the audibility of the safety i i i Sometimes good not good 1 W4 Sometimes good not good 1 Sometimes good not good 0 ae warning on the stationary device Difficult to hear 0 Difficult to hear zd Difficult to hear 0 ea No opinion 2 Very good visible 0 Very good visible 4 Very good vi ibI J How do you judge the visual safety warning on Appropriate 3 we the stationary device Appropriate a Npproprais 0 Difficult to decipher 0 Y i Difficult to decipher 0 Difficult to decipher 0 en PS No opinion 1 W6 How do you judge the safety warning of an open Not useful 0 Not useful 0 Not useful 5 door on the mobile device Appropriate 2 Appropriate 0 Appropriate 60 Amst
167. view If Pwd receive a reminder for a specific task during the test the Pwd has to follow the accompanying instructions Besides reacting on reminders and performing tasks prescribed tasks have been compiled to assist with testing the functionalities of the devices see below These tasks have to be administered only when they are not performed in reaction to reminders that were configured Task 1 Identify the home screen Task 2 Identify the mobile device Task 3 Remove the mobile device from the charger Task 4 Move away from the home hub with the mobile device Task 5 Place the mobile device in a preferred location on the person i e in a trouser pocket or a handbag Task 6 Home screen PD moves to home screen to turn on music selection Task 7 Pwd goes to front door leaves the door open and goes back inside Task 8 Home screen Pwd turns music off Task 9 Home hub PD initiates and completes a call to a carer Task 10 Mobile device Pwd initiates and completes a call to a carer Task 11 Home screen PD turns on the radio Task 12 Home screen Pwd asks home screen to find the mobile device Task 13 Home screen Pwd turns the radio off Task 14 Home screen Pwd performs an emergency call Task 15 Mobile device Pwd audio records a fake bottle neck Task 16 Mobile device carer audio records a fake bottle neck Task 17 Mobile device Return the mobile device to the char
168. were not exactly the same during the field tests in Amsterdam Belfast and Lulea we do not think this state of affairs has influenced our conclusions about the overall system functionality and design We have taken particular care to compare the results from Lulea and Belfast concerning the user friendliness and usefulness of the COGKNOW device with the first results from Amsterdam We have given the feedback from Pwds and informal carers the same weight when it comes to overall judgement of the user friendliness of the system design and its usefulness However we have given more weight to the Pwds own judgments when it comes to user friendliness of the user interface and the specific functionalities tested The prototype used during field test 1 had restricted functionality but we think that the reminders and alarms the dialling and the media control systems as well as the safety sensors involved are sufficient to realistically test basic user interactions and overall system functioning During field test 1 a significant number of interviewees have noted that the interface on the mobile device may be somewhat difficult to handle texts icons and pictures but this has been less of a problem with the stationary device with a considerably larger screen size The overall user evaluation of the home screen seems to be that the user interface is approved by Pwds as well as by their informal carers One way of trying to improve the accessibility to the
169. when the Pwd went out if a locator function was available Belfast All the persons were able to read the text on the home screen with no problems The icons for the telephone music and radio did not cause any confusion for most of the Pwds However one Pwd would hesitate when asked to turn on the music or radio This resulted in the Pwd hovering with his finger over the phone music and radio icons unsure which one to press This pausing before selecting the appropriate icon was particularly prevalent during the first couple of attempts however after a few tries the Pwd became much more competent All the Pwds recognised their relatives right away and in most cases this was the first thing that was recognised particularly the picture in the help function There were no complaints about the colours or icons used in the interface design However one Pwd suggested that the word stop be used instead of back when exploring the phone menus The design issues of the mobile device made a much stronger impression on the Pwds and their informal carers The icons were reported to be less clear than those used on the stationary device and it was also more difficult to read the text on the mobile device The external buttons proved to get in the way and on some occasions features were activated by mistake such as the audio recording function In addition the mouse roller button was often activated resulting in the roller being illuminat
170. with some direction from the informal carers On one occasion the Pwd pressed the phone button on the home screen twice in quick succession which resulted in the first contact being called irrespective of whether this was the intended recipient Usefulness of the system The system was envisaged to be potentially useful by all the Pwds and their informal carers However they felt that in its current testing format it would not be that useful Some of the informal carers felt that the system would become more useful if placed in the Pwds home for a longer period of time Informal carers also felt that greater potential for remote control both of the types of reminders and of the way in which they were delivered would be valuable The charger was present during the trial to hold the mobile device but there was no interaction testing involving persons or informal carers The audio recording feature was not tested as the concept was too difficult for Pwds to grasp New functionalities When they saw the radio feature demonstrated some informal carers suggested that it would be useful to control other devices such as the television The same informal carer suggested that reminders could be accompanied by some form of visual flashing in addition to a sound to accommodate those with hearing difficulties Another feature that was suggested by an informal carer was to monitor whether the rubbish bin had been taken out and if not to remind the Pwd to do
171. y activities and perceived safety Are they expected to improve their feelings of autonomy and quality of life e Do carers find the COGKNOW Day e Semi structured WP1 group 2 Navigator useful How do they value interview during and post the different functionalities within the field trial with informal four COGKNOW areas support for carers and professional memory social contact daily activities carers clinical and perceived safety researchers Are they expected to improve their feelings of autonomy and quality of life f How effective do the different e Observation during field WP1 group 3 components of the COGKNOW Day trial Navigator interact To be judged by people with dementia carers and e Bottle neck list group 4 researchers Semi structured l group 2 Aim to estimate the user friendliness interview post field trial _ for users with people with dementia and carers e In situ measurement WP1 amp WP3 Audio diary study for bottle neck list SeniorXensor 100 Field trial 1 Aims Questions Methods WP Who 3 Collect a General question which device e Pre trial interview WP1 basic data sensors provide sufficiently informative Questionnaire on about information for the context aware activities and context to activities and algorithms foreseen in the COGKNOW be administered from context in Day Navigator application people with dementia and order to carers inf
172. y the users than the stationary component of the COGKNOW system The first prototype of the COGKNOW device has limited functionalities The reminding and alarm systems are judged as useful by a majority of informants and this also goes for the picture dialling and media control facilities The media control and picture dialling systems are also judged as user friendly by the users Some technical difficulties have been reported on the communication system Based on the outcomes of field test 1 with users at the three test sites we have made the following overall recommendations for further development of the COGKNOW prototype prior to field test 2 The bottlenecks encountered during field test 1 should be resolved in advance of the next field test The most significant bottlenecks encountered in field test 1 are a The touch screen on both the stationary and the mobile device did not detect the Pwds touches as expected This problem was most pronounced on the mobile device b A general unstable function of the Day Navigator s screen on the mobile device c Reminding and safety warnings did not work properly on the mobile device d The connection between door sensors and the COGNOW Home Hubb CHH did not work properly 2 Introduction 2 1 The Human Factor Impact Analysis The Human Factor Impact Analysis of the COGKNOW project investigates user needs and priorities at an early project stage The human factor analysis aims at determini
173. ychopharmacology T Crook S Ferris amp C Bartus eds New Canaan Conn Mark Powley Ass Inc 19 35 Reisberg B 1993 Clinical Dementias Staging Methodologies The International Psychogeriatric Association Newsletter 10 2 16 17 Szymkowiak A Morrison K Shah P Gregor P Evans J Newell A Wilson B and S Shofield 2004 Memojog An interactive memory aid with remote communication Proceedings of 2nd Cambridge Workshop on Universal Access and Assistive Technology CWUAAT Designing a more inclusive world Fitzwilliam College University of Cambridge 15 24 36 Wilson B A Emslie H C Quirk K and J J Evans 2001 Reducing everyday memory and planning problems by means of a paging system a randomised control crossover study J Neurol Neurosurg Psychiatry Apr 70 4 477 82 h ttp www medrounds org encyclopedia of aging 2006 01 reisburgs global deterioration scale htm Checked December st 2008 http www minimental com Checked December 1 2008 Zanetti O Zanieri G Vreese L P de Frisoni G B Binetti G and M Trabucchi 2000 Utilizing an electronic memory aid with Alzheimer s disease patients A study of feasibility In Paper presented at the Sixth International Stockholm Springfield Symposium on Advances in Alzheimer Therapy 37 9 Annexes 38 A 1 Results of field test 1 A 1 1 Pre test interview results

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