Caremate: Your Companion in Caring For Those With Dementia

ABOUT THIS PILOT PROJECT

Working in partnership with Alzheimer’s Disease Association (ADA) Singapore, the Caremate team — Siân Ng, rshong and JT Studioz has developed an everyday-tools package that consists of a mobile app and toolkit to help Singapore family caregivers to engage and orientate their loved ones at home.

Yes, Caremate empowers the caregivers with knowledge and guidance on handling dementia patients. The Caremate toolkit consists of 8 fun card games for increasing user’s cognitive abilities and a visual planner to better manage their daily routine.

“CareMate is your companion — Always ready to lend a helping hand and assist you in handling your loved ones. Giving family members & carers a greater piece of mind.”

OUR APP FEATURES

Symptoms & Diagnosis: The Caremate app gives access to all the latest research about dementia, learn about problems and symptoms in each stage of Alzheimer’s.
Mind Games: Provides fun and interactive games to maintain user’s cognitive abilities & slow the rate of decline in dementia.
Dealing with Dementia: Provides physical exercises and nutrition advice to let the person living with dementia also stay physically fit and promote a healthier life-style.
Reminiscence Therapy: Helps them to treasure their most important memories through reminiscence games.
Call Us: Get in touch with the various hotlines for immediate assistance.

THE STORY OF CAREMATE

Urban Myths of Dementia
We drew upon our personal experiences of the elderly with dementia will go missing or get lost on the way to find old haunts. After conducting in-depth interviews with a subject matter expert — Yong-En Care Centre manager and 3 home caregivers, we realised that wandering wasn’t the biggest problem we thought it was.

In trying to discover insights into dementia and its existing problems, we visited Yong-En Care Centre, a dementia day care centre. We observed that dementia patients were generally the recipients of care and unable to interact with technology well.

The interview with Jerald, the manager of the Care Centre yielded much useful insights.

  • Clients were already diagnosed
  • Structured therapy and routine was present in therapy
  • Activities were planned and repeated daily
  • Much physical therapy was present
  • Clients were not receptive to ipad games and 1 caregiver was required for the administration of the ipad game
  • Clients’ belongings were placed in set places and labelled
  • Professional caregivers in Singapore tend to be of a ratio of 20:1 but Yong-En was fortunate to have a 4:1 ratio of caregivers to clients
  • Once clients returned home, caregivers faced problems at home and were unable to handle the patients who could only interact positively during day care.
Caretakers at home are unable to provide good dementia care. If the patients were not diagnosed, there was no professional dementia care.

ON THE GROUNDS

Contextual inquiry
Visiting the places where dementia patients frequented helped us understand what it was like for caregivers when interacting with patients. A walkabout of Yong En reflected the importance of safety features in caring for elderly dementia patients, fun and engaging activities that resembled daily activities the patients would conduct at home and a recreation of the home environment to provide a sense of familiarity that will not displace or confuse the patients.

Observations
Way-finding is an important concept present at Yishun Polyclinic where coloured signages signposted the various locations for the patients for easier understanding. Screens were similarly colour-marked and information was presented in large readable fonts. This colour labelling method was later used as our primary guide for navigation.

User Interviews

The Caregivers — 3 interviews were conducted with caregivers. All interviewees did not get a medical diagnosis for their senior who has dementia. They also came up with their homemade solutions to cope with dementia. Many shared the frustrations and pains of taking care of their seniors. Two of the interviewees’ seniors were still being cared for at home, in their early or moderate stages of dementia, while the third interviewee’s senior is now in a hospice, being unable to respond or move around now.

The Service Professionals — Interviews were conducted with the manager of a dementia day care centre, a nurse at the Institute of Mental Health and a police patrol team leader. They shared that caregivers had to provide routine, structure and labelling of items were important. The manager was quick to offer activities to occupy the dementia patients, the nurse informed that reminiscence therapy and a dementia friendly garden were installed to treat dementia patients while the police officer shared that caregivers were often frustrated and the advice he had to give to them in dealing with dementia.

Affinity Mapping

Affinity mapping was conducted based on interviewees’ pain, pleasure, behaviour and context. We discovered that the main issue is that caregivers did not know how to care for their seniors who had dementia. We decided to narrow down on 2 main affinities in terms of solving their problems and beneficiary degree respectively.

Primary Focus — Managing Dementia Patient’s Behaviour
Secondary Focus — Solving Caregiver Pains & Challenges

OUR PERSONA & JOURNEY MAP

The results of the affinity mapping led us in a persona creation based on a housewife, Serene Ang whom is a home caregiver for her mother. Her mother’s behaviours and actions were soon affected when her mental health declines. Through the journey map graph, we followed Serene’s encounters and emotions through the early and moderate dementia stages of her mother.

The problem statement is how can we help Serene Ang to manage her mother’s (dementia patient) behaviour?

FEATURE PRIORITISATION

How to Avoid Featuritis
We plotted the key essences from the affinity mapping previously on a x-y graph with values based on the importance of the features were to Serene, corresponding to the degree of effort it would take to implement the solutions. 2 Key features — Information and tips on Dementia were picked.

Discovery of Caremate kit
As the ideas under information and tips were diverse, we conducted a further analysis into the pre-diagnosis of dementia patient. From there, we broke down into 3 main categories — mental stimulation, tips and helpline. We concluded that the design solution should include both physical and digital platforms for Serene due to her savviness with technology and the patient she needs to interact with.

Competitive/ Comparative Analysis

Competitive and comparative analyses were conducted with 3 popular iOS dementia apps in the market — MindMate, TalkingPoint and CareZone.

MINDMATE
Digital app providing mental stimulation for dementia patients and to be used by caregivers on an iPad or iPhone 6+.

User Interactions
1)
Upon launching app — a welcome screen with “Today is Monday 4 April 2016” — gives reminder to patient of current day.
2) Large buttons — senior-friendly

Observations
1) Fixed navigation bar at the top, not thumb-friendly

Heuristic: Aesthetic and Minimal Design
1) Soothing colour palette — more towards blue tones
2) Plenty of colour

Features
1
) Focuses on games
2) Based on research
3) Separate reminders and to-do list — could be combined
4) My Life — Getting to know me
5) My Wellbeing — Music — features a top hits from the 50s music list

ALZHEMIMER’S SOCIETY’S TALKINGPOINT FORUM
Talking Point is Alzheimer’s Society’s online support and discussion forum, for anyone affected by dementia. It’s a place to:
- read others’ experiences 
- ask for advice
- share information
- join in discussions
- feel supported.

User Interactions
1)
Display of information via forward scrolls

CareZone | Organize health information for you and your family
CareZone makes it simpler to take care of yourself, an aging parent, and other family members that need your help.

Observations
1) Simple layout
2) Clear navigation
3) Consistent icons
4) Soothing transitions
5) Consistent use of fonts enhances readability
6) Easy to understand
7) Sufficient whitespace

USABILITY TESTING

Usability testing lets the design and development teams identify problems before they are coded. Typically, during a test, the recruited participants will try to complete typical tasks while observers watch, listen and takes notes. The goal is to identify any usability problems, collect qualitative and quantitative data and determine the participant’s satisfaction with the product.

Test plan
In order to meet the short project completion, we planned for 3 rounds of testings to be performed on paper and digital platforms in the next 3 days. We first started with rough user flows and testing before we progressed into further iterations and higher fidelity.

Recruitment and Testing
We recruited 6 participants that fits closely to our persona and 2 of them had personal experiences of being a home caregiver. In the test, each participant is given 3 specified tasks:

“Find out information on their senior who had difficulties with mental math lately.’
‘Learn how to help their senior cope with dementia.’
‘Find out how to play ‘Colour Bingo’.’

Analyzing
At the end of every usability testing, we measure the results based on how long it takes to complete specified tasks, how satisfied participants are with our app and kit, identifying changes required to improve user performance and satisfaction and see if it meets our usability objectives.

ROUND 1: PAPER PROTOTYPE

3 participants were tested in the 1st stage of the low-fidelity prototype on POP. They were all able to access the information, learn how to deal with dementia patients, and learn how to play ‘Colour Bingo’ with their patient.

Key Takeaways

  • Colin had problems with reading the information on dementia.
  • Cassandra had trouble learning how to play Colour Bingo.
  • Only Jaden managed to order the Caremate kit.

Iterations Based on Recommendations

  • Bottom navigation bar was removed
  • Splash screen updated to project more emotional connection
  • “Order” Home Care Kit button made more prominent.
  • Errors within the screen on Stages of Dementia were refined

ROUND 2: DIGITAL & PHYSICAL PROTOTYPE

3 more participants were tested in the 2nd stage of high-fidelity prototype on InVision. They were able to complete at least 2 tasks and navigate around to look for content.

Key Takeaways

  • Doreen found the home screen hard to read as all buttons were of the same colour throughout.
  • Chrse is not unsure about scrolling for more information on the ‘dealing with dementia’ screen and thought that she had to pay for Caremate kit.
  • Stephanie is found that the description for each sympton was not elaborated.

Iterations Based on Recommendations

  • Added the word ‘free’ for the ordering of Caremate kit
  • Introduced specific colour labelling for each category
  • Reorganised and consolidated all information in the symptoms page

HEURISTIC ANALYSIS OF FINAL PROTOTYPE

1. Visibility of system status
Users are aware of what each screen was by reading the title on the top navigation bar.

2. Match between system and the real world
Users tend to find out about the Symptoms of dementia and wish to understand how to cope with the problem after. A ‘Next button’ and scrolling down will lead users to a button that gives advice on ‘Dealing with Dementia.

3. User Control and Freedom
Users could still navigate from one section to another easily, should they accidentally clicked on the wrong screen.

4. Consistency and standards
Each section is colour-coded and when users click on the screen, the colour scheme remains consistent to signal to users that they are on the same page they initially clicked on.

5. Error Prevention
Information on the free caremate kit is provided before users are directed to the “order now” button.

6. Recognition rather than recall
Appropriate icons to guide users. No hidden menus, linear navigation.

7. Flexibility and efficiency of use
Informational app. No flexibility and user input lead to the efficiency of use.

8. Aesthetic and minimalist design
Minimal, clean design with appropriate use of colours to differentiate different modules. Use of icons and text to direct the user.

9. Help users recognize, diagnose, and recover from errors
No error messages input because there are no user inputs.

10. Help and documentation
None created.

TECHNICAL BACKGROUND RESEARCH

3 in-depth consultations were conducted with developers based on the technical execution and duration required for our app.

Time
The developers estimated it would take a few weeks to create the app without games embedded in the app.

Input of Video
The developers informed that the input of a video was technically feasible. It could be placed on Amazon web services but another developer suggested simply embedding the video instead of creating one to save time and costs.

Input of Map
The developers informed that they could incorporate a map, customized from Google API such that nearby dementia centres can be visible from the user’s location.

Developing Games
The developers informed that a game would be easy to create, about a week if the game was simple.

Limitations
As the app is more information-based, the developer gauged that there is not much limitation to creating the app.

Competitive Analysis of MindMate app
The developer informed that it was a much more complex app due to the video capacity, interactive games and photo repository compared to our Caremate app.

NEXT STEPS

We started with a single goal of designing a technologically feasible and acceptable solution for the local caregivers who had a preference for low-tech and physical tools and empowering them with ‘Information on dementia’ on learning and coping with their loved ones. Through our Caremate mobile app and kit, we aim to meet ADA’s goal in enhancing the provision of quality care and support. This solution increases the families’ ability to cope with and continue caring for the elderly with dementia.

In our next phase, we are considering these:

  • Actual testing with primary home caregivers with pre-diagnosis dementia patients and further iterations from there
  • Consider language options including Malay and dialects 
     — older caregivers may not understand English well
  • Expanding into other platforms like iPad and OS like Android and Windows
  • Contact Dementia Care Institutes in Singapore and propose our solution
  • Start a Kickstarter campaign to develop a full scale Caremate toolkit
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