In this talk, I summarise work on helping older people remember what they need to do next. I focus on a particular modality, hearing, because auditory reminders can be heard even if you can't see or feel or be near their source. I close with suggestions for practicing audiologists.
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Designing Auditory Reminders that Older People can Remember
1. 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)
2. 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
3. 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
MARIA WOLTERS, BAA CONFERENCE 2015 @MARIAWOLTERS
4. MARIA WOLTERS, BAA CONFERENCE 2015 @MARIAWOLTERS
WHAT IS THE SOLUTION?
▸ Empower people to support their own memory!
▸ We need to:
▸ Co-design with people
▸ Focus on ability
▸ Provide diverse options
6. 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.
MARIA WOLTERS, BAA CONFERENCE 2015 @MARIAWOLTERS
7. 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)
MARIA WOLTERS, BAA CONFERENCE 2015 @MARIAWOLTERS
9. 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
MARIA WOLTERS, BAA CONFERENCE 2015 @MARIAWOLTERS
10. RELEVANT DIMENSIONS OF COGNITIVE ABILITY
▸ Information processing speed
How quickly can new information be analyzed and integrated?
▸ Working memory
short term storage for information processing
▸ Metamemory
what 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?
MARIA WOLTERS, BAA CONFERENCE 2015 @MARIAWOLTERS
11. 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
MARIA WOLTERS, BAA CONFERENCE 2015 @MARIAWOLTERS
13. 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
MARIA WOLTERS, BAA CONFERENCE 2015 @MARIAWOLTERS
14. 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
MARIA WOLTERS, BAA CONFERENCE 2015 @MARIAWOLTERS
15. 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
MARIA WOLTERS, BAA CONFERENCE 2015 @MARIAWOLTERS
17. 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)
MARIA WOLTERS, BAA CONFERENCE 2015 @MARIAWOLTERS
18. 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)
MARIA WOLTERS, BAA CONFERENCE 2015 @MARIAWOLTERS
19. MARIA WOLTERS, BAA CONFERENCE 2015 @MARIAWOLTERS
▸ 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, maria.wolters@ed.ac.uk
20. 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
MARIA WOLTERS, BAA CONFERENCE 2015 @MARIAWOLTERS