People with dementia often experience loneliness and social isolation. This can result in increased cognitive decline which, in turn, has a negative impact on quality of life. This paper explores the use of the social robot, MARIO, with older people living with dementia as a way of addressing these issues. A descriptive qualitative study was conducted to explore the perceptions and experiences of the use and impact of MARIO. The research took place in the UK, Italy and Ireland. Semi-structured interviews were held in each location with people with dementia (n = 38), relatives/carers (n = 28), formal carers (n = 28) and managers (n = 13). The data was analyzed using qualitative content analysis. The findings revealed that despite challenges in relation to voice recognition and the practicalities of conducting research involving robots in real-life settings, most participants were positive about MARIO. Through the robot’s user-led design and personalized applications, MARIO provided a point of interest, social activities, and cognitive engagement increased. However, some formal carers and managers voiced concern that robots might replace care staff.
Background: In the EU funded MARIO project, specific technological tools are adopted for the people living with dementia (PLWD). In the final stage of the project, a validation of the MARIO companion robot was performed from August to October 2017. Objective:The aims of the present study are: 1) to illustrate the key results and evidence obtained in the final evaluation phase of the project across the three different pilot sites; 2) to assess the engagement dimensions of the PLWD who interacted with the MARIO robot; and 3) to assess the acceptability and efficacy of the MARIO companion robot on clinical, cognitive, neuropsychiatric, affective and social aspects, resilience, quality of life in PLWD, and burden level of the caregivers. Methods: 38 people (M = 14; F = 24) with Alzheimer's disease were screened for eligibility and all were included. The following tests were administered Pre and Post interactions with MARIO: Observational Measurement of Engagement (OME), Mini-Mental State Examination (MMSE), Clock Drawing Test (CDT), Frontal Assessment Battery (FAB), Neuropsychiatric Inventory (NPI), Cornell Scale for Depression in Dementia (CSDD), Multidimensional Scale of Perceived Social Support (MSPSS), 14-item Resilience Scale (RS-14), Quality of Life in Alzheimer's Disease (QOL-AD), Caregiver Burden Inventory (CBI), Tinetti Balance Assessment (TBA), and Comprehensive Geriatric Assessment (CGA) was carried out. Results: In Post-MARIO interactions, significant improvements were observed in RS-14 (p = 0.020).Considering the age of the people, PLWD with 68-76 years perceived that they had major social support (MSPSS Total: p = 0.016) and friends to support them (MSPSS Fri: p = 0.014). Indeed, the younger people (55-67 years) were less depressed (CSDD: p = 0.033), and more resilient (RS-14: p = 0.003). The people aged 77-85 years perceived they had major family support (MSPSS Fam: p = 0.018). The participants were gender and education matched without any statistically significant difference.
MARIO is a social robot developed with and for people living with dementia (PLWD) to promote social connectivity and reduce loneliness and isolation by providing access to a number of applications that PLWD can access, via speech and/or touchscreen commands. These applications include My Calendar, which reminds the PLWD about daily schedules and appointments; My Music which provides access to the PLWD's personalised music and My Memories which gives the PLWD the opportunity to reminiscence by showing them photographs of family, friends and/or significant life events. MARIO was developed tested and evaluated with PLWD in a long stay residential setting over a 13-month period from September 2016 to October 2017. During the first five months of MARIO's introduction to PLWD, researchers maintained a reflective practice diary. The aims of the study were twofold: (1) To capture the experiences of researchers of being involved in this process and (2) To help identify strategies to enhance PLWD's engagement with the robot. These reflections were analysed in NVIVO 11.4 using thematic analysis guided by a qualitative descriptive methodology. The following themes emerged from the research: (1) Level of interest in having MARIO present in long-term residential care (LTC), (2) MARIO's appearance and functionalities, (3) Engaging with MARIO, (4) Researchers' Recommendations for Introducing Robots in Dementia Care and (5) Impact on researchers. From the researcher's recommendations for introducing robots in dementia care, a number of key strategies were identified which may facilitate the engagement of PLWD with social robots. These include the use of verbal and/or physical prompting by the robot, lack of distraction, and actively engaging staff members or family members when introducing the robot to PLWD. This work highlights the important contribution of reflective practice to the introduction and development of social robots in dementia care.
Background: Resilience is a process of adapting to stress. For people with dementia, resilience is enhanced through having positive social relationships. Social robots, such as MARIO, can facilitate social engagement. However, the effect of social robots on resilience has not yet been determined. Objective: To investigate how MARIO, a social robot, affects the resilience of people with dementia. Method: Multiple case study methodology was used to explore the resilience of people with dementia during and after they used MARIO in 12 facilitated sessions. Data collection was conducted using: dementia care mapping; semi-structured interviews with people with dementia (n=10), caregivers (n=6), and relatives (n=7); and questionnaires including the Quality of Life in Alzheimer's disease and The Resilience Scale. During sessions, data was collected using the Observational Measure of Engagement. Data analysis was guided by framework analysis. Qualitative and quantitative data were analysed in NVIVO 12 and SPSS respectively. Then, all data was triangulated in a matrix, analysed for similarities and differences within and across cases, and themes were developed. Results: The cross-case analysis produced four themes: Resilience changes minute to minute; Initiating and maintaining readiness; Active co-creation of meaningful activity; Impact on resilience. The findings revealed that people with dementia required skilled facilitation to use MARIO. During interactions with MARIO, the resilience of eight out of ten people was supported. Sessions with MARIO increased the wellbeing of people with dementia by providing a meaningful activity that re-enforced their positive self-concept. Conclusion: Social robots need to have greater capability to interpret and respond to the emotional needs of users if they are to benefit the resilience of people with dementia without the presence of a supportive facilitator. Future research should explore how strengthbased strategies can empower people with dementia to create a meaningful activity using social robots.
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