The loss of memory can have a profound and disabling effect on individuals. People who acquire memory impairments are often unable to live independent lives because they cannot remember what they need to do. In many cases, they rely on family members who live with them. When I carried out ethnographic fieldwork to explore this domain, I observed that individuals with amnesia were surrounded by family members who provided extensive memory support (e.g. reminders). I found that such families very worked closely together to accomplish everyday activities, such as coordinating a family outing or planning a doctor’s appointment. However, these activities were often undermined by family members forgetting. This led me to view memory aids as collaboration technology, rather than as tools that only support an individual’s memory. My dissertation explores this idea and how it can lead to more appropriate designs of assistive technology. To design collaborative assistive technology, I involved persons with amnesia and their family members in a process of participatory design. The design team included six individuals with amnesia, two neuropsychologists, and myself. Five family members were also involved in later stages. This team envisioned the design of a shared calendar application, called Family-Link, that I implemented for Palm mobile devices. I evaluated Family-Link by comparing it to the commercially available Palm Calendar in a six-month study with four families. I found that participants had significantly more shared events when using Family-Link than when using Palm Calendar. Qualitative evidence suggests that Family-Link increased all participants’ awareness of other family members’ schedules, provided caregivers with a greater a sense of security by enabling them to track their family member with amnesia, and reduced the amount of effort that caregivers needed to coordinate. Family-Link also fulfilled the individual needs of persons with amnesia by providing an information storage and retrieval mechanism. However, persons with amnesia and caregivers differed in their opinions about which features were useful. Family-Link can be a particularly important tool for families where members are not co-located throughout the day.

The loss of memory can have a profound and disabling effect on individuals. People who acquire memory impairments are often unable to live independent lives because they cannot remember what they need to do. In many cases, they rely on family members who live with them. When I carried out ethnographic fieldwork to explore this domain, I observed that individuals with amnesia were surrounded by family members who provided extensive memory support (e.g. reminders). I found that such families very worked closely together to accomplish everyday activities, such as coordinating a family outing or planning a doctor’s appointment. However, these activities were often undermined by family members forgetting. This led me to view memory aids as collaboration technology, rather than as tools that only support an individual’s memory. My dissertation explores this idea and how it can lead to more appropriate designs of assistive technology. To design collaborative assistive technology, I involved persons with amnesia and their family members in a process of participatory design. The design team included six individuals with amnesia, two neuropsychologists, and myself. Five family members were also involved in later stages. This team envisioned the design of a shared calendar application, called Family-Link, that I implemented for Palm mobile devices. I evaluated Family-Link by comparing it to the commercially available Palm Calendar in a six-month study with four families. I found that participants had significantly more shared events when using Family-Link than when using Palm Calendar. Qualitative evidence suggests that Family-Link increased all participants’ awareness of other family members’ schedules, provided caregivers with a greater a sense of security by enabling them to track their family member with amnesia, and reduced the amount of effort that caregivers needed to coordinate. Family-Link also fulfilled the individual needs of persons with amnesia by providing an information storage and retrieval mechanism. However, persons with amnesia and caregivers differed in their opinions about which features were useful. Family-Link can be a particularly important tool for families where members are not co-located throughout the day.

As the management of dementia is a significant public health concern, efforts to increase access to effective treatments to a greater number of residents with dementia in skilled nursing facilities (SNFs) are warranted. The treatment addressed in this study, non-electronic external memory aids, is an evidence-based practice that has been found to increase positive communicative interactions and decrease negative behavioral problems of residents with dementia in SNFs. Although use of memory aids is recommended, there are significant barriers such as lack of time and resources that inhibit the use of effective treatments in typical clinical settings. To address such barriers to evidence-based practice (EBP) implementation, the Promoting Action on Research in Health Services (PARIHS) framework is available. The PARIHS framework accounts for elements outside of the clinician knowledge base that may impact EBP delivery such as perceptions of the specific EBP and the specific context in which the EBP will be delivered. Organizational variables such as culture, leadership priorities, and resource availability are considered. Although the PARIHS framework has been used to successfully study and support EBP uptake in other areas of health care such as nursing, this framework has not to date been used in the field of Speech-Language Pathology, the clinician group of interest in this study. This study utilized a transformative, mixed-methods design within the PARIHS framework to investigate potential impacts of Speech-Language Pathologists' (SLPs) and Facility Rehabilitation Directors' (FRDs) perceptions of the evidence and organizational context on the use of non-electronic external memory aids in SNFs. The project explored differences between FRDs' and SLPs' perceptions of such variables, as well as the relationship between those variables and the SLPs' reported percentage of use of non-electronic external memory aids. Qualitative methods through semi-structured interviewing of SLPs further provided contextualized and detailed data regarding facilitators and barriers to the use of memory aids in SNFs. Results of the study indicated that there were statistically significant differences between SLP and FRD groups in terms of perceptions of the organizational context in the SNF, with the FRDs viewing the organizational context more favorably. There were no significant quantitative differences between SLPs and FRDs in terms of perception of the evidence for the practice of non-electronic external memory aids. Both groups demonstrated relatively favorable perceptions of the practice (3.8 on a 5-point scale with 5 being strongly favorable). Each additional point regarding favorable perceptions of SLPs in terms of the evidence for non-electronic external memory aids were associated with a 24% increase in percentage of use of the practice. Perceptions of the organizational context in the SNF were not significantly associated with higher percentages of SLP use of the practice; however, issues of organizational context were heavily present in the qualitative data. Analysis of the interview data yielded a total of 318 codes and 191/318 (60%) of those codes addressed issues of organizational context. Qualitatively, the most common codes related to issues of lack of necessary staff to both implement and sustain the use of non-electronic external memory aids. Further, lack of physical materials and time to create memory aids was also a frequently reported barrier in the interview data. There was not mention of local performance data or systems for which to evaluate performance in relationship to non-electronic external memory aid usage in the interview data. Results of this study may contribute to the acceleration of a successful, systematic uptake of non-electronic external memory aids for residents with dementia in SNFs by considering SLPs' perceptions of evidence and by engaging the end organizational context. This project may also serve as a model to contribute to the successful implementation of other EBP for patients with cognitive-communicative impairments.

This thesis aimed to study the everyday use of ICT-enabled memory aids in order to understand and to describe the technological mediations that are brought by them (i.e. how they shape/mediate experiences and actions of their users). To do this, a post-phenomenological approach was appropriated. Postphenomenology is a modified, hybrid phenomenology that tries to overcome the limitations of phenomenology. As for theoretical framework, ‘Technological Mediation’ was adopted to conduct the study. Technological Mediation as a theory provides concepts suitable for explorations of the phenomenon of human-technology relation. It was believed that this specific choice of approach and theoretical framework would provide a new way of exploring the use of concrete technologies in everyday life of human beings and the implications that this use might have on humans’ lives. The study was conducted in the city of Växjö, Sweden. Data was collected by conducting twelve face-to-face semi-structured interviews. Collected data was, then, analyzed by applying the concepts within the theoretical framework – Technological Mediation - to them. The results of this study provided a list of ICT-enabled devices and services that participants were using in their everyday life in order to support their memory such as: calendars, alarms, notes, bookmarks, etc. Furthermore, this study resulted in a detailed description of how these devices and services shaped/mediated the experiences and the actions of their users.

No description available.

Location-based reminder systems (LBRs) are typically used to remind people to complete a to-do task at a particular location. People use their prospective memory to remember future to-do tasks. However, the current design of LBRs fails to take advantage of human prospective memory theory. In this dissertation, I propose a framework connecting human prospective memory theory with LBRs. My work applies human prospective memory into the technical design of LBRs. The goal of my work is to make the reminder work more consistently with how human memory works. Prospective memory research suggests that encoding of the location and familiarity with the location have an impact on prospective remembering. I conducted two empirical studies to test how this theoretical knowledge applies to LBRs. In one experiment, I hypothesized that if the encoding stage provides a closer match to the retrieval stage in LBRs, then location recognition and task recall should improve at retrieval time. The results indicate that providing a first-person view (street view of the desired location) at the encoding stage benefits prospective remembering the most. Prospective memory theory also suggests that the familiarity with the external cue has a significant influence on prospective remembering. In the second experiment, I hypothesized that familiarity with a location has an impact on the location recognition at the retrieval. The results show that the encoding interface is used differently for familiar and unfamiliar cities and businesses to support recognizing a target location. The findings have implications for the design of future LBRs. I designed an LBR prototype by applying these empirical research findings and conducted a usability evaluation. Future designers of LBR should consider 1) providing more support in matching the encoding stage to the eventual cue in retrieval stage and 2) involving user’s familiarity level with the places at the encoding stage to provide a better user experience. My work showed the importance of using prospective memory theory in the design of LBR systems. / Ph. D.

The topic of this thesis is how the decline of cognitive abilities and memory functioning in elder people can be assisted by external memory aids. This issue was approached through a combination of methods. The starting point was a literature review of two approaches to the study of memory – the traditional where memory functions are located in the brain and the situated where remembering transcends over external resources, and by a literature review on declining memory abilities in elderly people. An ethnographic study of everyday remembering in an older population, aged from 72 to 91, found many instances of the spontaneous use of the environment to support a declining memory ability, which in turn suggest that the traditional approach to memory research is of limited value when studying everyday memory abilities in older people. A study on existing memory aids, as well as memory aids currently under development in research laboratories showed that these technologies are primarily based on an explicit or implicit traditional view of memory that disregard several aspects of remembering in the natural world. It is therefore suggested that future development of memory aids could fruitfully benefit from a distributed and situated approach, where the individuals‘ current use of external memory aids are used as the starting point, with the goal of extending and amplifying methods and artefacts already spontaneously in use.