PRE2024 3 Group19

Group members

Name	Student Number	Study
Marysia Huige	1896431	PT
Mare Hulshof	1754440	PT
Agnes Kiekebeld	1882511	PT
Lisa van den Berg		PT
Stijn Schroijen	1840150	CS

Subject Ideas (Brainstorm)

Subject

• Speech recognition systems.
• Make students aware of how much they use their screen (/ limit their screentime)
  • Using eyetracking (?)
• Pill dispenser for elderly
• Help robots for elderly
• Music and dementia → Robot that measures when someone with dementia gets stressed (with a wristband e.g.) and puts on music from their youth when this is the case

Problem Statement

In 2020, 55 million people were diagnosed with dementia worldwide. This number is expected to grow to 139 million people in 2050. (ADI - Dementia Statistics, n.d.) Two thirds of people living in care homes have dementia. (Sharp, 2007) Dementia is a general term for a syndrome that affects memory, thinking and the ability to perform daily tasks. A common symptom of dementia is agitation. When someone is agitated, they feel irritable and restless. People are uncooperative and have difficulties focusing when feeling agitated. They can also show violent or disruptive behavior and have a lack of impulse control. This negative and dangerous behavior could cause dangerous and unpleasant situations for both people with dementia but also for their family, friends, and staff of care homes.

This project aims to create an aid that uses music to help calm down patients with dementia when they are feeling agitated.

Objectives

The main objective of this research is to find a way to calm dementia patients down when they are feeling stressed. It is quite common for people with dementia to be distressed, which can be caused by feeling disoriented, having unmet needs, as well as many other factors (Coping with distress - Dementia UK). It has been found that music interventions lower anxiety levels and generally make patients (and even caregivers) feel more relaxed (Impacts of Music Intervention on Dementia: A Review Using Meta-Narrative Method and Agenda for Future Research). That is why music will be implemented in the design not alleviate stress In order to further assess what we want our design to achieve we will be using the MoSCoW method.

Must have

• A calming effect on the patient
• A stress sensor of some kind to determine when the music should be turned on

Should have

• Music from the patients youth
• Comfortability (if the stress sensor is wearable)

Could have

• A calming effect on the caregiver
• Slowly increase volume to limit the shock
• A wearable stress sensor, e.g. using HRV in the same way that a watch measures stress [1]
• A stress sensor based on sound

Will not have

• Scaring the patient by sudden loud music

Users (and their requirements)

The target users of this design are people with dementia, particularly those in the mid-to-late stages of the condition. Dementia affects cognitive functions such as reasoning, memory, and emotional regulation, making patients more prone to stress, anxiety, and agitation. This has detrimental effects on their well-being.

Given the cognitive impairments associated with dementia, the design of the aid to measure stress and play music must function autonomously with minimal user input. Furthermore, as most individuals with dementia belong to an older demographic, potential physical limitations should be taken into account. It is essential that the stress sensor is easy to use and imposes minimal physical constraints to ensure comfort and practicality. Potential perceptual limitations are also important to consider. The device for playing music must be able to adjust its volume settings to an appropriate level. The music should be loud enough for the patient to actually perceive the music, but it should not be too loud, since this could only contribute to the distress.

Another crucial user requirement is the personalization of the aid. Both in the measurement of stress and for the intervention in the form of playing music personalization is needed. Personalization allows the aid to calibrate to a user's unique stress patterns, ensuring more accurate responses. Furthermore, since music preferences vary from person to person, the system must be capable of playing the specific music that elicits positive emotions for each individual. This personalization is essential for effectively reducing stress levels and providing a soothing experience.

Since the caregivers of people with dementia are often also affected by distress of these individuals, they can be considered secondary users. They play a vital role in setting up and managing the device, selecting appropriate music and monitoring its effectiveness. To avoid adding to their workload, the system must be as simple to use as possible.

Approach, milestones and deliverables

Approach

Overall plan, steps, etc.

Start by doing a literature study. We want to make/ build a prototype and then interview healthcare workers on their opinions on our idea.

Week 1	Week 2	Week 3	Week 4	Week 5	Week 6	Week 7
13/02 Mail with topic and group	Make sketch for prototype	Start on prototype*	Work on prototype	Finalise and test the prototype (make adjustments if necessary)	Prepare presentation	Presentation
Set up project	Work on the design of the prototype	Set up the interview schedule	Make informed consent form	Interview healthcare workers on prototype*	Interpret results from interviews
Search and summarize 25 research papers	Order all necessary components	Start looking for interviewees
Work on Problem statement, Objectives, Users, approach, Milestones, Deliverables, and Planning

*rough estimate in planning

Milestones

What are the big checkpoints, so how long will we be working on each section e.g.

Week 1:

• Finish Problem statement, Objectives, Users, approach, Milestones, Deliverables, and Planning sections

• Finish State of the art section

Week 2:

• Finish making sketches
• Finalise the prototype design

Week 4:

• Finalise Informed consent form
• Finalise interview schedule

Week 5:

• Finalise the prototype and receive feedback

Week 6:

• Receive all data from the interviews

Week 7:

• Give final presentation

Deliverables

What we will be handing in (so are we making a prototype, literature study, etc.)

- Fuctional prototype

- Result of the interviews

- Report about the project in this Wiki

Planning

Taakverdeling (is this needed when we have a log book?)

State of the art

Literature study with at least 25 relevant papers

Marysia:

Effects of Music on Agitation in Dementia: A Meta-Analysis

https://www.frontiersin.org/journals/psychology/articles/10.3389/fpsyg.2017.00742/full

Pedersen et al. performed a meta-analysis to (1) investigate whether music therapy has a positive effect on reducing agitation for patients with dementia. Furthermore, they (2) compare personalized and group music intervention. Besides that, Pedersen (3) evaluates the effect of preferences in music by comparing music based on patient preference without prior consultation with patients or caregivers. Lastly, the study (4) focusses on comparing the benefits of active versus passive music intervention. In active music intervention, participants actively engage by singing, dancing, or playing an instrument. In passive music intervention, participants listen to live or recorded music without actively engaging.

The results of this meta-analysis indicate that (1) music intervention does significantly decrease agitation in patients with dementia. Furthermore, the analysis (2) shows that personalized music therapy may have a larger effect in certain cases, however the effect is less consistent across the different studies used in this research. Both individual and prescribed music preferences (3) show a medium effect size. Finally, both active and passive music interventions have similar effects. Passive interventions may work better in different settings.

The study performed by Pedersen et al. indicated that music intervention has a reducing effect on agitation of patients with dementia.

The Impact of Music on the Self in Dementia

https://www.researchgate.net/publication/322358822_The_Impact_of_Music_on_the_Self_in_Dementia

This study proposes a theoretical framework which enhances the sense self in patients with dementia. To explain this framework, numerous features of music have been mentioned: Engaging, Persuasive, Social, Synchronization, Physical, Emotional, and Personal.

This framework explains how music engages the five aspects of one’s self, namely ecological, interpersonal, private, extended, and conceptual self.

The ecological self is the self has it is perceived through sensory information and the environment. Numerous features of music, such as physical, synchronous, engaging, and emotional, are important for this self. The interpersonal self can be explained as the self that socially interacts with others. Here the persuasive and engaging aspects of music play a key role. The extended self shows how the self was in the past and how it might be in the future. The different way of engaging with music, and the personal and emotional features of music contributed to engaging the extended self for people with dementia. The private self exists of experiences that others do not have access to, such as thoughts, beliefs, and experiences. Music can help this self as a new way to express themselves. Finally, the conceptual self is indicated the concept that the individual has of themselves, for example self-identity, roles, and social identity.

The researchers of this paper identify the music features and the aspects of the self using two case studies and conclude that music has a unique ability to engage with multiple aspects of the self.

Music and dementia: Observing effects and searching for underlying theories

https://pubmed.ncbi.nlm.nih.gov/21069595/

This research paper studies whether the effect of music on dementia is beneficial and if so, why that is the case. The article focusses on three key areas, namely “music and memory”, “music and depression”, and “Agitation and aggressive behaviors”.

The article states that some people with dementia remember music longer than they remember and respond to other types of information.

Reminiscence music therapy, music therapy that uses familiar songs to trigger memories of the individual with dementia, has reduced working on symptoms of depression.  This could be explained by the fact that music induced physical and emotional changes. Furthermore, music could help reduce stress, sooth pain and energize the body. Therefore, music could be used as an aid for mood regulations.

Moreover, music has a beneficial influence on reducing agitated and aggressive behaviors of individuals with dementia during various activities and various times. Playing music that is preferred by the participant has the biggest outcome. Music makes sounds more familiar and predictable. This could lead to creating a positive emotional state as people retrieve positive memories.

Music and the wellbeing of people with dementia

https://www.researchgate.net/publication/231844344_Music_and_the_wellbeing_of_people_with_dementia

In this study, Sixsmith and Gibson perform qualitative research on the influence that music has on the everyday life of participants with dementia. In-depth interviews were conducted with a sample size consisting of 26 patients with dementia living in either their own homes or in residential care. This paper highlights the benefits of music but also the problems that could arise while listening or actively participating in musical activities.

The data from the interviews shows that the beneficial effect of having music in the lives of people with dementia could enhance the feelings of wellbeing. Music could make people with dementia ready to express their happiness both physically and emotionally.

Furthermore, music supports valued activities. Playing music in the background while working on a task could make the task more enjoyable for people with dementia.

Moreover, music encourages social interaction. During musical activities, most of the participants were accompanied by their family, carers or by other people with dementia. Music therefore is a way for people with dementia to communicate with other sand have meaningful social interactions.

Lastly, music gives people with dementia a higher degree of empowerment and control over their own lives.

Sixsmith and Gibson state multiple challenges that arise when people with dementia engage with music, such as difficulties expressing their preferences, hearing difficulties, the loss of confidence, and social barriers in care homes.

The importance of music for people with dementia: the perspectives of people with dementia, family carers, staff and music therapists

https://pubmed.ncbi.nlm.nih.gov/24410398/

This research paper focused on the meaning and value of musical intervention for not only people with dementia, but also their families, care home staff and music therapists. McDermott et al. are aiming to explore the meaning and value of music from the people with dementia point of view. The paper also analyses how families, care home staff and music therapists view the effects of music. Furthermore, the paper aims to find a link between psychosocial factors and the results of the study to be able to develop a theoretical musical framework of music in dementia.

The qualitative data was ‘gotten’ from conducting focus groups and interviews with care home residents with dementia and their families, care home staff, music therapies, and day hospital clients with dementia.

From the data received, it can be concluded that meaningful musical experience could result in people with dementia feeling emotionally connected with other people. Moreover, musical activities lead to social interaction between residents and staff in care homes. That has resulted in a more positive impact on the environment of the care home.

The researchers also state that music is linked to personal identity and life history of people with dementia.

Agnes

Impacts of Music Intervention on Dementia: A Review Using Meta-Narrative Method and Agenda for Future Research

https://www.mdpi.com/2035-8377/13/1/1

Lisa

Effects of Music Therapy on Patients with Dementia—A Systematic Review

https://www.mdpi.com/2308-3417/5/4/62

Music and Other Strategies to Improve the Care of Agitated Patients with Dementia

https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1471-6712.1997.tb00451.x?casa_token=NnZzIXUhdQUAAAAA%3AL6fS0EIVtkv8IdVNXRESCkM4dqy4GqrHrZhSASwlk26HXXDEnZm3whgnqyBoRzQgfXPa1vobJBxcD2I

Individualized music played for agitated patients with dementia: Analysis of video-recorded sessions

https://onlinelibrary.wiley.com/doi/full/10.1046/j.1440-172X.2001.00254.x?casa_token=1utOksc2pOoAAAAA%3AzPRT6zDTi8aX-g8styz3OcN1KMNGN_MBF3IsZ05oMD2iGYERAZ836hleMNW3U-h8AduawmQKPe1UGnc

Continuous stress detection using the sensors of commercial smartwatch

https://dl.acm.org/doi/abs/10.1145/3341162.3344831?casa_token=EFOoBlgQH-YAAAAA:p-7trEGvcQvtN6qPKkwJhL5dJFvpFdixELZjFKLRNOlQNgc4kfkHBDTcLz7k5YseBX459CjjNmEG

https://www.mdpi.com/1424-8220/22/1/151

Mare

https://karger.com/dem/article/47/3/131/103431

This article summarizes several key areas of technological development in dementia care. The main domains in which there is a lot of technological advancement include: 1) diagnosis assessment and monitoring, 2) maintenance of functioning, 3) leisure and activity, and 4) caregiving and management.

Examples of technological advances in the domain of leisure and activity also include systems that use music to soothe patients. In the paper a one-button radio is mentioned, but also a simple interface for making music and systems for collaborative music making.

The article ends with the conclusion that, despite numerous technological initiatives in dementia care, adoption rates remain low. Contributing factors include a lack of awareness, challenges in accessibility and insufficient support. The paper emphasizes the need for policies, funding, and practices that go beyond a purely medical approach, advocating for a holistic perspective that includes prevention strategies and ways to support a meaningful life with dementia.

JMIR Formative Research - Adapting Mobile and Wearable Technology to Provide Support and Monitoring in Rehabilitation for Dementia: Feasibility Case Series

https://www.mdpi.com/1424-8220/16/12/1989

This paper describes a study in which the effectiveness of measuring the stress levels in people with dementia using a single wristband sensor is explored. Stress is a common issue for individuals with dementia, and it is traditionally assessed through questionnaires completed by a caregiver. This is a time-consuming and subjective process. In this research, a wearable sensor that tracks galvanic skin response (GSR) and movement is assessed in its effectiveness of detecting stress episodes.

During the study, the sensor continuously recorded physiological data, which was processed using an online platform to classify the stress levels on a scale from 0 to 5. The goal was to find out if the identified stress episodes by the sensor correlated with those observed by the caregiver.

The results showed that there was a strong correlation between the data from the sensor and the caregiver observations. There were, however, strong variations in stress levels among individuals, which highlights the need for personalized stress thresholds. This can improve accuracy in detection.

The conclusion of the researchers is that a wristband sensor is a promising tool for monitoring stress. It provides objective, real-time data, which can help caregivers in for example recognizing stress patterns and intervening more effectively.

Stijn

The promise of music therapy for Alzheimer's disease: A review

https://pmc.ncbi.nlm.nih.gov/articles/PMC9796133/

The Effects of Music Therapy on Cognition, Psychiatric Symptoms, and Activities of Daily Living in Patients with Alzheimer’s Disease

https://content.iospress.com/articles/journal-of-alzheimers-disease/jad180183

The effect of music therapy on cognitive functions in patients with dementia: a systematic review and meta-analysis

https://www.tandfonline.com/doi/full/10.1080/13607863.2017.1348474#abstract

Dementia and the Power of Music Therapy

https://onlinelibrary.wiley.com/doi/full/10.1111/bioe.12148

Influence of Music Therapy and Music-Based Interventions on Dementia: A Pilot Study

https://academic.oup.com/jmt/article/58/3/e12/6265007?login=true

Log Book

Add the hours of work you spent in a week, what tasks you worked on and how long those subtasks took inside of your own table. Per week we should be able to see the total and there will also be a grand total at the end of the project.

Marysia Huige

Week	Task	Hours
1	Brainstorm	1
	Search literature studies	2
	Summarize literature studies	5
	Problem statement	1
	Approach, Milestones, and Deliverables	2
	Total	11
2

Mare Hulshof

Week	Task	Hours
1	Brainstorm	1
	Total	1
2

Agnes Kiekebeld

Week	Task	Hours
1	Brainstorm	1
	Setting up the wiki page	1
	Total	2
2

Lisa van den Berg

Week	Task	Hours
1	Brainstorm	1
	Search literature	1
	Total	2
2

Stijn Schroijen

Week	Task	Hours
1	Brainstorm	1
	Search literature	1.5
	Total	2.5
2

References

1. ADI - Dementia Statistics. (n.d.). ADI - Dementia Statistics. https://www.alzint.org/about/dementia-facts-figures/dementia-statistics/
2. 2. Sharp, S. (2007). Home From Home : A report highlighting opportunities for improving standards of dementia care in care homes. Alzheimer’s Society. https://europepmc.org/abstract/CTX/c3064