designing auditory reminders that older people can remember

DESIGNING AUDITORY REMINDERS THAT OLDER PEOPLE CAN REMEMBER

MARIA WOLTERS UNIVERSITY OF EDINBURGH @MARIAWOLTERS (WITH COLLABORATORS FROM UNIVERSITIES OF EDINBURGH, GLASGOW, AND STRATHCLYDE AND QUEEN MARGARET UNIVERSITY)

THE PROBLEM: FORGETTING

▸ Our ability to remember to do things (prospective memory) declines with age

▸ Reminders help, but only if they can be understood

▸ However, perceptual abilities also decline due to

▸ age

▸ work history

▸ illness

▸ …

MARIA WOLTERS, BAA CONFERENCE 2015 @MARIAWOLTERS

WHY NOT JUST USE PICTURES?

▸ Alternative modalities (touch, vision) decline as well

▸ People have strong modality preferences that are independent of their actual ability (McGee-Lennon, Wolters, and Brewster, 2011)

▸ Visual reminders require people to be where they can see; tactile reminders require people to have something on them



WHAT IS THE SOLUTION?

▸ Empower people to support their own memory!

▸ We need to:

▸ Co-design with people

▸ Focus on ability

▸ Provide diverse options

CO-DESIGN

WHAT DOES CO-DESIGN MEAN?

▸ We develop the solution together with the people who will use it

▸ People know what works for them (metamemory: knowledge about one’s memory abilities)

▸ If they don’t like it, if it’s stigmatising, or if it threatens their identity, they won’t use it.


HABITS AND CONTEXT

▸ Routines and environments are powerful cues (McGee-Lennon, Wolters, and Brewster, 2011; Stawarz et al, 2014; Wolters 2014)

▸ Reminders work best when they build on habits and context cues

▸ In fact, when tested in real life, older people can remember to do things as well as younger people … (Rendell and Craik, 2000)


FOCUS ON ABILITY

ASPECTS OF ABILITY

▸ For a successful auditory reminder, people need to

▸ perceive (can hear all aspects of the signal required for identification)

▸ understand (what needs to be done)

▸ act (even after distraction)

▸ Parallel tasks (cooking, reading, walking) may be additional distractor


RELEVANT DIMENSIONS OF COGNITIVE ABILITY

▸ Information processing speedHow quickly can new information be analyzed and integrated?

▸ Working memoryshort term storage for information processing

▸ Metamemorywhat do I find difficult to remember?

▸ Fluid intelligence, e.g. reasoning, planning Making sense of a message, making plans

▸ Crystallised intelligence, e.g., semantic memory what do the words mean?


EXAMPLE: MEDICATION REMINDERS

▸ For medication reminders, it’s best to use actual names (too much difference in appearance for generics)

▸ Older people can’t recognise sequences of four medication names if they’ve been distracted after hearing them (Wolters et al, 2015), even if

▸ all they need to do is pick out their names from a list

▸ their function was explained (and function is given on list)

▸ Reminders for morning pills or afternoon pills would work much better


PROVIDE OPTIONS

MANY KINDS OF AUDITORY REMINDERS

▸ Speech

▸ Spearcons (speeded up speech)

▸ Earcons (abstract melodies)

▸ Auditory Icons (mimics relevant sounds)

▸ Musicons (short snippets of music)

▸ Beeps

▸ Ringtones


MANY KINDS OF (COMPUTER) SPEECH

▸ Look for an acceptable vocal personality

▸ People find an accent to which they are accustomed easier to understand - don’t trust popularity surveys!

▸ Clear articulation, maybe even Lombard speech, which is recorded while speaker hears noise

▸ Use pauses and emphasis to highlight information

▸ Let the person who will hear the reminders choose the voice, not their carer


THE POWER OF SYNTHETIC SPEECH

▸ Synthetic speech has become far more intelligible, even in noise

▸ Disadvantages:

▸ can sound like a computer

▸ Advantages:

▸ incredibly flexible - you can teach it any word

▸ easy to switch accents and speakers

▸ easy to personalize messages

▸ inexpensive


IN PRACTICE

WORKING WITH PATIENTS

▸ Likely to look at reminders when you have the luxury of a little aural rehabilitation work.

▸ People are experts on themselves - listen actively

▸ Questionnaires, worksheets, online & offline material help - ask how they prefer their information

▸ Ideal for working across services (if your work setting allows). Some solutions require additional support (e.g., pharmacist dispensing pills in box by time of day)


WORKING WITH TECHNOLOGY

▸ New „tech-savvy“ generations are a red herring - just imagine the innovations the current older people have seen in their lifetime!

▸ Stay with the familiar and non-stigmatising. Think

▸ cooker alarms

▸ simple mobile phones with reminder functions

▸ technology that does not look medical

▸ delivery through hearing aids (if worn reliably)



▸ Summary:Auditory reminders can work well, if they are designed to be clear and familiar. Computer-generated speech is an easy and inexpensive option, but be particularly careful with reminder design.

▸ Questions?

Maria Wolters, mariawolters.wordpress.com

@mariawolters, [email protected]

http://mariawolters.wordpress.com

mailto:[email protected]

REFERENCES

▸ Rendell, P. G., & Craik, F. I. M. (2000). Virtual week and actual week: Age-related differences in prospective memory. Applied Cognitive Psychology, 14, S43–S62.

▸ McGee-Lennon, M. R., Wolters, M. K., & Brewster, S. (2011). User-Centred Multimodal Reminders for Assistive Living. In CHI ’11: Proceedings of the 29th international conference on Human factors in computing systems.

▸ Stawarz, K., Cox, A. L., & Blandford, A. (2014). Don’t forget your pill! In Proceedings of the 32nd annual ACM conference on Human factors in computing systems - CHI ’14 (pp. 2269–2278). New York, New York, USA: ACM Press. http://doi.org/10.1145/2556288.2557079

▸ Wolters, M. K. (2014). The minimal effective dose of reminder technology. In Proceedings of the extended abstracts of the 32nd annual ACM conference on Human factors in computing systems - CHI EA ’14 (pp. 771–780). New York, New York, USA: ACM Press. http://doi.org/10.1145/2559206.2578878

▸ Wolters, M. K., Johnson, C., Campbell, P. E., DePlacido, C. G., & McKinstry, B. (2014). Can older people remember medication reminders presented using synthetic speech? Journal of the American Medical Informatics Association, 22(1), 35–42. http://doi.org/10.1136/amiajnl-2014-002820


http://doi.org/10.1145/2556288.2557079

http://doi.org/10.1136/amiajnl-2014-002820

TEXT

PICTURE REFERENCES

https://funnyoldlife.wordpress.com/tag/hearing-aid/http://38pitches.com/hearing-aids/http://www.kissmywonderwoman.com/2014/12/on-hearing-loss-hawkeye-and-superheroes.htmlhttps://www.pinterest.com/aaahearingaids/hearing-humor/https://en.wikipedia.org/wiki/Brad_Pitthttps://en.wikipedia.org/wiki/Austin_Powers_(character)

https://funnyoldlife.wordpress.com/tag/hearing-aid/

http://38pitches.com/hearing-aids/

http://www.kissmywonderwoman.com/2014/12/on-hearing-loss-hawkeye-and-superheroes.html

https://www.pinterest.com/aaahearingaids/hearing-humor/

https://en.wikipedia.org/wiki/Brad_Pitt

https://en.wikipedia.org/wiki/Austin_Powers_(character)

designing auditory reminders that older people can remember

Health & Medicine