Using the Kinect to Engage People with Dementia - Ontario Shores ...
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Using the Kinect to Engage People
with Dementia
Erica Dove1, BHSc (Hons), Andrea Reyes1,2, BHSc (Hons) Candidate, and Arlene J. Astell1,3,4, PhD, C. Psych
1Ontario Shores Centre for Mental Health Sciences, Whitby, Canada
2University of Ontario Institute of Technology, Oshawa, Canada
3University of Toronto, Toronto, Canada
4University of Reading, Reading, UK
1
Engagement
- Engagement means “to occupy, attract or involve someone’s interest
or attention”
- Engaging in meaningful activities increases positive emotions and
improves quality of life (Cohen-Mansfield et al., 2009)
- Engaging activities are important to well-being, but people with
dementia have reduced opportunities
2
Motion-Based Technology
- Motion-based technologies can provide cognitive, physical and leisure
activities to people with dementia (Dove & Astell, 2017a)
- People with dementia can learn to use motion-based technologies with
training and support (Dove & Astell, 2017b)
- Implementing motion-based technologies in adult day programs is
feasible (Dove & Astell, 2018)
3
Engagement and its Measurement
Engagement in people with dementia is often measured through:
1. Direct observations
2. Behavioral observation scales
3. Focus groups
4. Interviews
5. Satisfaction surveys
6. Self-report (e.g. asking directly)
4
Challenges of Measuring Engagement
1. Impairments in cognitive function can impact ability to provide
descriptive feedback in focus groups or interviews
2. Impairments in speech can impact ability to express opinions towards
activities
3. Direct observations and observation scales are time-intensive
4. Measures can be subjective, with questionable accuracy (e.g. rating
positive engagement on a 5-point scale)
5
Study Objectives
1. To examine the use of motion-based technology as an engaging
group activity for people with dementia
2. To explore ways in which engagement can be measured in group
motion-based activities for people with dementia
6
Methods
- Participants (n=38) were recruited from three adult day programs in
Durham Region
Table 1. Demographic Summary
Age (years) Mean=75.4 Range=58-93
Sex Male=18 (47.4%) Female=20 (52.6%)
MoCA score (out of 30) Mean=12.43 Range=0-25
Use of a Mobility Device Total=16 (42.1%) No device=22 (57.9%)
• Cane=4
• Walker=10
• Wheelchair=2
7
Methods
- Participants played a digital bowling game on Xbox Kinect in a group
setting
- One-hour sessions were held at each site, twice per week for 10-12 weeks
- A member of the research team supported participants during the sessions
8
Methods
- Sessions were video-recorded to thoroughly capture the participants,
the facilitator, the group dynamic and the activity
9
Methods
- A framework adapted from two existing engagement measures for
dementia (Cohen-Mansfield et al., 2017; Judge et al., 2000) was trialed with the video-
recorded data
- Both measures are tally-based, featuring discrete categories that
behaviors (e.g. smiling) fall into
- Group engagement was examined at session 1 and 20
10The group dynamic in action:
11Engagement Framework
- This includes examining the different types of engagement and how
these change over time
Table 2. Overview of Engagement Framework
Type of Engagement Examples
Active Engagement - Reminiscing, laughter/enjoyment, conversing,
celebrating
Passive Engagement - Responding, eye contact, nodding/agreement,
listening to others
Non-Engagement - Looking away, sleeping/dozing, walking away/
leaving, negative comments, indifference/apathy
12Results: Active Engagement
Active Engagement: Session 1 Active Engagement: Session 20
8% 8%
33% 35%
59% 57%
13Example: Active Engagement
14Results: Passive Engagement
Passive Engagement: Session 1 Passive Engagement: Session 20
8% 8%
33% 35%
59% 57%
15Example: Passive Engagement
16Results: Non-Engagement
Non-Engagement: Session 1 Non-Engagement: Session 20
8% 8%
33% 35%
59% 57%
17Example: Non-Engagement
18Framework Findings
- Motion-based technology can provide engaging group activities to
people with dementia
- Framework captured 92% engagement at both pre- and post
- Frequent conversing, smiling, laughter and celebrating/cheering
- Frequent looking/eye contact, responding and listening to others
19Group Motion-Based Engagement
20Limitations of the Framework
1. Does not illustrate different behaviors within the three categories, and
how these behaviors interact with one another
2. Does not truly illustrate how engagement changes over time
3. Does not illustrate how participants interact individually or as a group
4. Captures frequency, but not duration or context
21Future Directions
- Video-recorded data will be analyzed using behavioral coding software
(Observer® XT 12; Noldus Information Technology, 2018)
- Captures a rich and detailed understanding of the group dynamic, and
how it changes over time
- Captures frequency, duration and context
- Captures individual and group interactions
22Behavioral Coding Example
23Conclusions
- Motion-based technologies can be used to provide engaging group
activities to people with dementia
- For technologies to be successfully integrated in dementia care
settings requires a simple way for staff to measure engagement
- Development of an efficient and reliable measure of engagement for
people with dementia is required
24Our Funders:
25Our Partners:
26For more information:
Erica Dove
Research Assistant, Ontario Shores
Email: dovee@ontarioshores.ca
Phone: (905) 430-4055 ext. 6313
Dr. Arlene Astell
Research Chair, Ontario Shores
Email: astella@ontarioshores.ca
Phone: (905) 430-4055 ext. 6750
27References
1. Dove, E., Astell, A. J. (2017a). The Use of Motion-Based Technology for People Living With Dementia or Mild Cognitive
Impairment: A Literature Review. Journal of Medical Internet Research, 19(1), e3. doi: 10.2196/jmir.6518
2. Dove, E., Astell, A. J. (2017b). The Kinect Project: Group motion-based gaming for people living with dementia. Dementia,
(online first). doi: 10.1177/1471301217743575
3. Dove, E., Astell, A. (2018). Dementia: Kinecting Through Group Digital Games. Journal of Dementia Care, 20(1), 18-19.
4. Cohen-Mansfield, J., Dakheel-Ali, M., Marx, M. S. (2009). Engagement in persons with dementia: the concept and its
measurement. American Journal of Geriatric Psychiatry, 17(4), 299-307.
5. Cohen-Mansfield, J., Hai, T., Comishen, M. (2017). Group engagement in persons with dementia: The concept and its
measurement. Psychiatry Research, 251, 237-243.
6. Judge, K. S., Camp, C. J., Orsulic-Jeras, S. (2000). Use of Montessori-based activities for clients with dementia in adult day
care: Effects on engagement. American Journal of Alzheimer’s Disease, 15(1), 42-46.
7. Noldus Information Technology. (2018). The Observer® XT. Retrieved Feb 1, 2018 from http://www.noldus.com/human-
behavior-research/products/the-observer-xt
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