The following is a guest article by Hester Le Riche, CEO and Founder at Tover.
When I speak with caregivers of people with dementia at nursing homes or memory care communities, they say a smile is worth 1,000 words. Many days, caregivers and family of residents who have advanced dementia are looking to elicit a smile, a set of interactions, or a few moments of simple joy. For those who are quiet, withdrawn, anxious, or depressed, engaging them in their surroundings can be quite challenging. They also face common myths about their condition and its associated behaviors, which can further impact the quality of their lives.
In healthcare technology, it seems vendors remain focused on medical devices and services that address specific clinical challenges, but not quality of life or patient well-being. Warm technologies offer so many opportunities to touch the human side of aging in people with cognitive challenges. Clinicians ask, “How can we prolong this patient’s life?” and manufacturers respond innovatively. But no one asks, “How can I help give this person a beautiful day?”
Dementia is a major health crisis. There are over 55 million people worldwide living with it, and it’s projected this number will almost double every 20 years to reach 78 million by 2030 and 139 million in 2050. In the technology world, we mustn’t forget about these marginalized groups. Similarly, adults with intellectual disabilities struggle with cognitive, attention, and memory difficulties which can make social engagement challenging. About 200 million people worldwide have a neurodevelopmental disorder, and would benefit from technology that improves the quality of their interactions.
American psychologist Theresa A. Kestly, PhD, said, “Our brains are built to benefit from play no matter what our age.” By helping marginalized groups interact through play, we have the opportunity to reduce fear, anger, and sadness with an increase in physical activity, social interaction, and, ultimately, happiness. To elicit this type of transformative experience, we must better understand some of the common misconceptions about people with dementia. In doing so, we can enhance their wellness.
Myth 1: Many people with impairments want to be left alone. There are various reasons why people with dementia become disconnected from social interaction. Verbal communication can become a struggle; isolation can serve as a coping mechanism for negative emotions; or there can be a loss of confidence in carrying on everyday conversations. In nursing homes, I’ve witnessed a perceived lack of initiative regarding communication and interaction. But we are social creatures. I’ve found that if residents—even the quietest, most withdrawn—are enticed into engagement, they will participate with others and take interest in what’s happening in their environment again. By stimulating interaction with technology, apathy can be conquered, generating a personal sense of belonging and meaning.
Myth 2: In people with dementia, memories entirely disappear. When people with dementia withdraw or become hyperfocused on a present distressing situation, caregivers can assume they’ve forgotten their past. Similarly for those with intellectual disabilities, they assume they’re not able to recall the impactful stories that comprise the fabric of their beings. But what we’ve found in research through the use of play and technology is that engagement sparks brain activity that can unlock memories and the language to share them. Memory recall can be a powerful experience for patients with dementia, and it’s not clear what exactly will trigger it.
For example, one of our games, Silverware, encourages the familiar task of rubbing cutlery clean, which creates a sense of homeliness. After engaging in this activity, one of the nursing home residents reminisced about polishing her mother’s silver as a child. The staff used the opportunity to ask other residents about their experience with the task, and the group had a lively discussion about their memories from long ago. By increasing alertness and focus, residents were able to revisit experiences.
Myth #3: You can’t teach an old dog new tricks. Unfortunately, it’s a common misconception that people with dementia—and other cognitive challenges—can’t learn new things. Older adults and those with intellectual disabilities are certainly capable of growing their knowledge regarding new skills, hobbies, and concepts. With the introduction of play technologies, we’ve seen residents show great curiosity. Our interactive light animations spark inquisitiveness, unlocking the imagination of participants to enable a rediscovery of their sense of self. They are drawn in by very basic concepts of compelling games and intuit how their movements enable the games to unfold. Motivation and self-confidence reappear as they experience, through technology, that learning has not been lost.
Myth 4: Movement doesn’t matter. Particularly when cognitive difficulties are experienced by older adults, general apathy can yield patterns of inactivity. But it’s important not to become resigned to a life without movement. Physical exercise prevents muscle weakness and mobility problems, and promotes routines, improves mood, and increases social participation. The social part of movement—even if it’s only slight movements in a chair or wheelchair—is one of the goals we targeted with our technology. As we witness residents in care homes using hand motions to engage in games, we see the reduction of anxiety, sadness, and apathy, which motivated even more movement. It’s true what they say: “Move a muscle, change a thought.”
Using interactive technology for awakening
It’s time to rethink how we’ll manage in the influx of older adults in the U.S. and worldwide in coming years. Regardless of one’s cognitive challenges, the prospect of maintaining quality of life is essential, requiring our attention and guidance to include modern technologies that can assist in their care. With strategies that go beyond traditional communication methods to increase physical activity and improve social interaction, we can reach others through their senses—with touch, music, laughter, and fun.
As we approach the two-year anniversary of COVID-19 lockdowns, it’s vital to acknowledge how quarantines have isolated our older populations. Nursing homes and memory care communities must bring together the most vulnerable residents for willing engagement in physical, cognitive, and social activities. Technologies are starting to play an important role in facilitating the human side of aging, promoting social wellness and enabling joyful moments. It’s time to see the light.
About Hester Le Riche
Hester Le Riche is the CEO and founder of Tover, the healthcare technology company creating a more caring and inclusive world for people living with cognitive challenges, including dementia. Combining industrial design engineering with clinical psychology during her PhD at the Delft University of Technology in the Netherlands, Hester explored and developed how games and “purposeful play” could help people living with dementia. Her discoveries began the journey to her creation of the pioneering cognitive stimulation system the Tovertafel (or “Magic Table’” in Dutch), which uses interactive light animation to stimulate physical and cognitive activity and social interaction.
