Hello everyone,
My name is Dagoberto Cruz, and during the last three years, we have been working on
the use of social robots to support the care of older adults with dementia.
Thus, I will talk to you about how was used a conversational robot to support a cognitive
stimulation therapy and what was the impact on the daily behavior of a group of participants.
In recent years, socially assistive robots (SAR) have been used to simulate social contact
with people with dementia (PwD).
The studies have reported positive changes in behavior and mood of people with dementia
while they interact with the robot.
However, it is not clear if those changes prevail after the interaction, modifying the
daily behavior of the person with dementia (PwD), or improving her quality of life.
In this paper, we report on a naturalistic study conducted to assess the impact of a
intervention conducted by an autonomous social robot, called Eva.
In the scope of dementia, engagement is defined as the act of being occupied or involved with
an external stimulus. Thus, there is an implicit connection between engagement and the long-term
impact of a particular stimulus or therapeutic intervention.
We propose an adaptation of the Comprehensive Process Model of Engagement for dementia,
where the robot Eva is used as the external stimulus.
Thus, our prior work was focused on establishing the features of the robot and the PwD-robot
interaction to promote effective engagement.
The robot Eva is a conversational robot that includes features such as natural language
processing, essential synthesis of emotions, and speech.
The robot Eva was designed using conversational strategies to establish and improve verbal
communication in dementia proposed by organizations such as the Alzheimer's Association.
The interactive sessions were based on conversation and request music to singing or listening.
The main strategy during the interactions is the personalization.
To achieve this, the robot Eva uses relevant information such as musical preferences, favorite
topics of conversation, types of utterances successfully responded by the individuals,
and the average time that they take to make a response.
Results of our prior work provide strong evidence that participants were engaged in the sessions
guided by the robot Eva.
They talked to the robot, singed and showed clear cues of enjoyment.
Thus, we directed our effort to study the impact of the stimulus on the daily life of
participants.
For this study, we design an intervention based on a cognitive stimulation therapy compose
by 14 interactive group sessions guided by the robot Eva.
We evaluate the condition of the participants before and after to compare and establish
the effect of the intervention.
Using a mixed approach, we assess the frequency and intensity of dementia-related symptoms
using a quantitative instrument as the Neuropsychiatric Inventory (NPI ) for Dementia.
Besides, we conducted interviews, for each participant, with caregivers to obtain more
information to get an in-depth understanding of changes and their possible causes.
During the sessions, the robot Eva greets each participant, motivates them to sing their
favorite music.
Later, the robot Eva have a sustained conversation with each participant about their favorite
topics.
Afterward, the robot conducts a cognitive game based on completing well-known wisdom
sayings.
Finally, Eva guides breathing relaxation and gives a farewell.
This is a short video of conversation and music segments for one participant in a session.
A total of nine residents of the geriatric residence participated in
the study.
Besides, six caregivers participated as information proxies.
A total of 48 Neuropsychiatric Inventory instruments were administrated. Twenty four for each assessment,
before and after the intervention.
The figure shows the results for pre and post-intervention.
The statistical analysis shows a significant decrease in dementia-related behavioral symptoms.
The analysis per symptom shows a significant decrease in Delusion, Aggression, and Exaltation.
An analysis per subject shows a significant decrease in four participants.
P8 presents the most significant decrease in NPI total score. Caregivers reported 10 of 12 symptoms
in her pre-evaluation, while for her post-evaluation, they only report six.
A total of 48 interviews were analyzed using the inductive coding method, 24 for each evaluation.
Sixteen themes emerged from the analysis which was performed by two coders.
Four main categories were obtained: Behavior and mood, daily activities, socialization, and prevalence
of the impact.
Caregivers report a significant positive impact on participantsâ€™ moods. After the therapeutic
sessions conducted by the robot, caregivers perceived a cheerful mood by participants.
For example, participants were more cooperative in activities related to personal hygiene.
Also, the participants socialize with caregivers and other residents beyond the time of the
session. This socialization was based on activities performed during the meeting with the robot
Eva.
Caregivers coincided in reporting short-term effects for all participants. The intervention
is engaging and enjoyed by the participants and has a positive impact on them in the short-term.
For some participants, such as P5 and P7, this impact only is sustained during the same
day or hours after the session.
Caregivers coincide that the change of mood impacts on the participantsâ€™ behavior, even
in their performance of daily activity and socialization with other caregivers and residents.
These results show evidence of why quantitative results report a significant behavioral improvement
due to the decrease symptoms such as aggression and exaltation.
While not all participants show a significant decrease in the frequency and severity of
problematic behaviors, they enjoyed and engaged in sessions with the robot Eva.
The results are evidence of the feasibility that a cognitive stimulation therapy guided
by a conversational robot can have a positive impact on the daily behavior of people with
dementia.
If you have any questions please contact me via email.
Thank you and take care.