Designing for Dementia – The Power of Prompts

Written by Active Minds on Wednesday the 7th of May 2014.


Designing for Dementia – The Power of Prompts

From an article featured in Driven by Health magazine, Issue 1.2, April 2014

Three prototype examples of an Active Minds puzzle for dementia

Often some of the more interesting outputs of the research and testing involved in developing and designing products for people with dementia are the anecdotes that emerge during the process. The testing of product prototypes, that have up until that point been created with the end user in mind but not actually been tested by an end user in person, provides an interesting forum for observing whether assumptions that might have been made by a designer during the creation of a prototype are accurate or not.

Empathy is the keystone of a human-centered design process and although a designer may be hugely empathic to his or her design subject; until an end-user has had contact with a product prototype, until an end-user has been observed, engaged with, watched and listened to, it is impossible to predict the further insights that will take a basic design prototype to a well-designed and finished product.

It is not uncommon to hear stories from those who are caring for someone with dementia that tell of the missing links in various habitual routines of those they are caring for that inhibit the independence of that person. For example, someone may really take pleasure in still being able to do the washing-up but their carer observes that they are only able to participate in the activity and do all the tasks associated with washing-up if the sink is filled with water for them first. The missing link in this example is the first step in the task – the filling up of the sink with water – but it is unclear perhaps whether the cognitive stumbling block is finding the plug, turning on the tap, or both. Observing which prompt might result in increased independence for someone with dementia is something Ben Atkinson-Willes, founder of Active Minds, a company who design and develop activity products for those with cognitive impairment, is no stranger to.

“While spending time with my grandfather (who was diagnosed with Alzheimer’s when Ben was 10 years of age) I noticed that he often didn’t know how to start an activity but if I’d help him to start it, the remaining cognitive links in his memory chain would return and he’d be able to do the rest by himself. This was highlighted to me when it came to him cleaning his teeth. Initially he would look blankly at the toothbrush with no idea what to do, however, once I had put the toothpaste on it and put the brush in his mouth to initiate the first few brushes, you could see the light bulb come on and he’d finish cleaning his teeth himself.”

When Ben tested his very first activity product, a jigsaw puzzle for dementia, it was the observations made during his testing process with groups of end-users that further illuminated the idea of prompts and their use in supporting the independence and wellbeing of those with cognitive impairment.

A border on the puzzle’s backing-board that shows some detail of the first few outside centimetres of the puzzle’s image helps a user to place their first piece down and creates a frame that the puzzle pieces can be pushed up against. Each puzzle piece is an irregular shape i.e. each piece looks as if it is made up of two pieces that have got stuck together (as they often can) and this was shown during testing to be hugely helpful in prompting the correct placement of the piece. The backing board details the outline shape of each piece in the place that it belongs and each of these areas is shaded differently to the next, so that a decision of where a piece might sit can be made more fluidly.

“The design mantra”, Ben says “is ‘Empathise, Define, Ideate, Prototype, Test’.” That for me is the key to knowing which prompts will help to enhance a person’s wellbeing, independence and sense of achievement. And I think that applies both to a product’s design development and to figuring out which prompts work best in someone’s daily care routines.”