This article is sponsored by Eugeria. This article is based on a Senior Housing News discussion with Dr. Quoc Dinh Nguyen, geriatrician and co-founder of Eugeria, Valerie Larochelle, CEO and co-founder of Eugeria, and Mathijs Konings, co-founder and chief product officer Tover. The discussion took place on July 20, 2023 during SHN BRAIN Memory Care Conference in Washington D.C.. The article below has been edited for length and clarity.
This article focuses on not only the what but the how and why Tover and Eugeria design for dementia.
Eugeria specializes in innovation for dementia care, with an expertise in how different products and approaches help individuals at different stages in the dementia journey.
Mathijs Konings is the co-founder and chief product officer of Tover, the company that created the Tovertafel, an interactive light projection game system designed specifically to engage, stimulate and improve the quality of life of people living with mid- to late-stage dementia.
Designing technology for individuals living with dementia
“At a high level, we believe there are many technologies out there where [the creators make] the technology and then say, ‘Oh, by the way it’s for seniors.’ We think it’s the opposite. You have to design for dementia and then say, ‘By the way, there’s technology in it.’ Technology is not usually the hard part; designing for someone living with cognitive impairment is the hard part,” says Valerie Larochelle, CEO and co-founder of Eugeria.
An added challenge relative to memory care is to think that dementia manifests the same in all individuals.
“Dementia at the early stage, mid-stage, and late stage are all extremely different. Depending on the symptoms that people have, their past history, and their care support, dementia is very heterogeneous and extremely challenging,” says Dr. Quoc Dinh Nguyen, geriatrician and co-founder of Eugeria.
Because of the different stages of dementia, it’s not possible for all developers or technologists to create a single solution in a given memory care setting.
“If you design for only one person, you have no business case, but if you design for the average person, it won’t work for many individuals,” says Nguyen. “One of the answers to that is flexibility and adaptability. Being able to create a product that is adaptable so that depending on how people are doing, it still has positive effects.”
One key part of the challenge in designing technology for dementia is adoption – will people learn to use this technology?
“When you design technology you tend to think about the end-user. In the case of dementia, you not only have the end-user who is the person with dementia, but you also have their family caregiver and the healthcare professional(s). That’s three people to design for. If what you develop doesn’t work for all three of them, each one of them is a hurdle, making adoption an issue,” says Nguyen.
Before starting Tover, Mathijs Konings was a game design developer. He and his team created an interactive experience for people with neurodivergent brains. He partnered with Hester Le Riche, who is now the CEO of Tover. Le Riche did her PhD studies on how to reduce apathy with people living with late stage dementia.
“I quickly realized I really had to unlearn everything I knew about game design and rebuild that whole body of knowledge but around people living with dementia. Not only that, [I had to consider] their caretakers, the care staff, and the whole context of the care facility. What we did was go work in a nursing home,” says Mathijs Konings, Tover’s co-founder and chief product officer.
After building the product and seeing how it performed in a real life environment with real people, Tover created a prototype with six games.
The organization soon received feedback from the care staff, indicating the results were ground breaking. Two residents who hadn’t spoken in months were suddenly laughing and showing limited speech once again.
Why technology should monitor less and assist more
“We’ve become increasingly good with data and sensors to predict [outcomes],” says Dr. Nguyen. “My key issue as a healthcare worker, as a geriatrician, is that there is a large difference between using technology to predict vs to intervene. There is a large difference in the impact I can have in the lives of my patients if instead of more monitoring, technology helps me assist them when they need it.”
Eugeria has found that technology that adapts is the key in dementia care. When older adults have a good day, technology shouldn’t intervene to help. When they have a bad day, technology could intervene in such a way that it improves their day.
“Our starting point is creating that intervention,” Konings says. “Creating something that actually has an impact. You can measure your heart rate, but measuring it won’t make you more healthy, because you need an intervention; you need to start running or doing cardio. With Tovertafel, we are creating that intervention, that cardio.”
Getting people with late-stage dementia out of an apathetic state is the objective number one for Tover, because apathy (lack of initiative) has a significant negative effects on social, emotional and physical health. As a result, the organization introduced ‘activating cues’ in their interactive projector games.
“By introducing very small cues, at the level of difficulty that is right for the players, we are having a really huge impact on their quality of life. And we’re not working on monitoring technology” says Konings.
Tover works with research institutes internationally to conduct research studies on the impact of their technology on quality of life of people living with dementia.
Person-centered care: bringing people together around the Tovertafel
By introducing the Tovertafel in memory care, Tover found that their technology was able to create social moments among the users. As a result, individuals who had lived very different lives and had experienced social isolation due to cognitive impairment had come out of their shells to become more social.
“After seeing that, we decided to introduce a new platform, Tover Lab, where you can upload your own content like photos, or personal pictures, right into the games” says Konings. “The puzzle game could have images of your youth. ”
The Tovertafel technology no longer only encourages social interactions but now also engages reminiscence in the residents, a significant step in enabling person-centered care.
“We also have some games with conversation starters, for example,” Konings says. “These can be used by care staff to have a conversation with somebody, a literal question, or maybe an image of something that everybody had in their past.”
The staff can use technology (such as the Tovertafel) to ensure residents have a good day. Agitated and problematic behaviors are often prevented because a resident has had fun or had an active morning. So the Tovertafel helps to prevent challenging behaviors.
With advancements in technology,the goal is for care staff to work with the technology in improving the experience for memory care residents.
“There are many things that do not require a human being and that humans do today as part of their work, things that robots can do” says Nguyen. “My answer to that is that maybe technology can do the stuff that does not require a human touch and then the time we have left for staff, which is always not enough, then the human can do the person-centered care, which is deeply humane.”
Eugeria offers innovative products that combine science and technology, and preserve the dignity of residents affected by dementia. To learn more, visit: https://eugeria.care/.