Minder Watch

Collaborators: 
Prof Aldo Faisal, Professor of AI & Neuroscience
Sarah Daniels, Clinical director
Bala Kadirvelu, Research associate
Matthew Harrison, Designer
Pip Batey, Designer
and Minder Champions / research participants.

What is the need?

The Computation team within the UK DRI Care Research & Technology Centre are interested in using wearable devices to monitor the movements of participants throughout the day. This serves two main purposes. Firstly the movement data itself would be an indicator of dementia related behaviours and could help identify risks of falls, patterns of agitation, and levels of activity over time. Secondly, the individual level of information from the watch helps understand other data from environmental sensors around the home in multiple occupancy dwellings. The Minder system needs to know which occupants are using the kitchen appliances, triggering movement sensors, and visiting the bathroom (part of the UTI detection algorithm). Mapping this data against movement data from the watch can help researchers make sense of all the data from the home.

The design challenge is to make sure that the experience of having a wearable device on your wrist is acceptable, and even desirable for the person with dementia and the carer, so that they are inclined to keep wearing it throughout the day, and get some reward from doing so.

Two of the people with dementia didn’t understand that they had to flick their wrist to see the time, or weren’t able to do so. So they didn’t really understand what the watch was for even if their carer told them, and eventually took it off. The new Apple Watch with an always on display may mean the difference between sucess and failure in this context.

What are the aims and objectives of the project?

The aims of this project are to understand what would encourage people with dementia (and carers) to wear a new digital wrist watch, that sends movement data back to the Minder platform over the Wi-Fi network in the home.

Part of this includes making sure the watch acts as an attractive and practical alternative to their own watch if it is being worn in place of an existing watch. Furthermore what additional value can the watch provide to the wearer, that could assist with the daily routine of life with dementia. Lastly, how can we help with practical steps like remembering to charge the watch each night, and put it on in the morning, and communicate if the watch is operating properly.

Project stage

How was the project approached?

The design input in this project resulted from unexpected negative outcomes from an initial study. Although the study involved the use of state of the art Apple Watches, which were eagerly anticipated by the users, compliance was very low. Users were unable to connect the watches to their Wi-Fi network, couldn’t make sense of the on-screen interface for the watch app, and furthermore found that the watch didn’t do all the things they expected it to.

Much of this was in part because the watches distributed were administered through centralised Apple accounts, and not through the participant’s own phones. This in turn meant that users were less able to configure them, and use their own apps and accounts on the watch. Furthermore, the App operates in the background, without user interaction and as such was being trialed without a meaningful user interface. This led to confusion on the part of the users.

What role does Patient and Public Involvement and Engagement (PPIE) play in this project?

We spoke to carers and people with dementia about their opinions of  wearing these Apple Watches all day. We discussed various points like the issue of replacing an existing and loved watch, the worry about misplacing such a valuable device, and possible options for useful features such as using ‘Find My Watch’ to help mitigate against ‘wandering’. However it wasn’t until the first few users received a watch and started wearing it that we realised some of the challenges in introducing a technology to replace an item that is usually of emotional value to a user.

What are the key insights to emerge? 

The engineers selected to work with Apple watches as they have good sensors and could be suitably configured for the research needs. For the users, it initially appeared to be an attractive technology, therefore increasing the desirability of the experience. However the lessons learned from the first usability trial have led to an ongoing design process to create an intervention that is far more considered for the end users.

First we need to think about adjustment to change. Wearing a watch for the first time (or swapping wrists if you are used to one wrist) is quite an unusual feeling. Someone with dementia may find it distracting, and so we are encouraging gradual adoption, starting with wearing the watch for an hour or two a day and then building up to the full day.

We need to make sure the device performs the basic role of a timepiece for the user, and has a simple, attractive display of the time that suits the cognitive needs of the individual, whether they prefer a digital or ‘analogue’ display. We need to remember that watches are not just for telling the time, they are embedded in culture, in fashion, in the dignity of the wearer. A watch is a tool of independence, whereas a wristband is a sign of being controlled.

Finally we need to build functionality that further enhances the daily lives of users. Minder Champions have indicated that reminders on the watch would help people with dementia remember important routines, including those for the Minder study. These prompts could be managed through the Minder App. Providing help in locating people and guiding them home may also be of value.

What are the next stages? 

We are at the early stage of designing the Minder Watch and there is a lot to experiment with in the coming years. We will be introducing the features slowly to users, providing support, and iterating based on their feedback.