Designing Auditory Reminders that Older People can Remember
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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
- 5. CO-DESIGN
- 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
- 12. PROVIDE OPTIONS
- 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
- 16. IN PRACTICE
- 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