Purpose
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The WHO has estimated that the global prevalence of dementia will nearly double every 20 years, from 35.6 million, to 65.7 million by 2030 [1]. The first symptom of Alzheimer's disease, which is the most common type of dementia, is forgetfulness. During the middle stage, behavioral and psychological symptoms of dementia (BPSD) frequently surface, such as leaving the house, uttering verbal abuses, etc. Caregivers have to deal with the constant worry of watching patients. Although some medications are approved for the treatment of dementia, these medications have no effect on the fundamental pathophysiological cure. Therefore, various therapeutic interventions have been developed, such as music therapy, reminiscence therapy, and validation therapy [2].
Animal assisted therapy involves using animals as an intervention to improve an individual’s social or emotional functioning. Dogs are commonly used in this therapy [3]. Due to their attractive appearance, dogs have been shown to help relieve stress to those who like having dogs around. The therapeutic interactive effects of dogs can also be related to changes in physical health as well. For example, walking with dogs can provide owners’ exercise, fresh air, and social interaction [3]. Although individuals with dementia are continually losing their acquired memory, language, and executive abilities, their affection for dogs will be preserved until the last stage of their disease.
Traditionally, dogs also have been trained for various purposes that take advantage of their acute sense of smell, hearing, and mobility, such as police dogs, detection dogs, hunting dogs, rescue dogs, etc. Furthermore, dogs have also been used to successfully help individuals with disabilities, including visual, hearing, and physical impairments. Guide dogs, for example, assist blind people so they can avoid various physical obstacles. A hearing dog can alert their owner to important sounds, such as door bells, alarm clocks, ringing telephones, etc. They also work outside the home, alerting people to sounds, such as sirens, approaching cars, and to let them know if someone is calling their name. Service dogs are taught to pick up dropped items, open doors, turn on lights, and pull wheel chairs for physically handicapped owners. They can carry oxygen tanks for breath support. Some dogs also help individuals with mental disabilities, including depression and autism. Other dogs are even used to help with early detection of seizures and diabetes. These dogs are called assistance dogs [4 ].
However, except for animal assisted therapy, use of assistance dogs has not been reported for individuals with dementia. Although details are not known, several anecdotal episodes have been found on the Internet. For instance, for an individual with dementia, the utterance of the phrase "home" will help the dog navigate to the person’s home from wherever they are, even if they’ve lost their way. If individuals leave their home, the dog will let the caregiver know by giving a particular signal. A dog may teach individuals the parking spot of car. The dog can also be trained to convey that it is time to take medicine at a scheduled time.
Not limited to forgetting their way, parking spots, and taking medicine, individuals with dementia also show other forgetful behaviors, such as forgetting to execute daily tasks, forgetting where items are located, etc. Additionally, various BPSD often appear, such as eating few meals, getting angered easily, asking the same question repeatedly, etc. [2]. However, no comprehensive supporting ideas for these symptoms have been proposed utilizing assistance dogs. Because, conventionally trained assistance dogs cannot cope with these symptoms. In order to better deal with these disturbances, assistance dogs are urgently required to level up their abilities by incorporating other interventions.
As one of the interventions for assisting individuals with dementia, assistive technology or information communication technologies (ICT) have been utilized [5]. IC recorders were effective as an automatic output of messages for individuals with memory impairment and dementia [6]. The IC recorder also attempted to treat other BPSDs, such as eating few meals and getting angered easily by the sound of music [7]. Additionally, the reminiscence photo video was a slideshow video of individual’s photos with narration, background music, and pan/zoom visual effects as a form of reminiscence therapy [8]. Most of the individuals with dementia showed more attention to their photo video than to other TV shows. Kuwahara et al., (2009) have created remote reminiscence talking and scheduling prompter systems using video phones [9]. For two out of four individuals, these interventions were effective for their psychological stability and schedule performances. Yasuda et al., (2010) developed a wearable system to record one day’s behavior, using a small video recorder and IC recorders [10]. The recorded utterances were analyzed by speech recognition software on a personal computer (PC). This was possible because an elderly person with forgetfulness succeeded in recording his behavior for 11 hours in one day. Toileting- task support systems for individuals with dementia were tried out using 3-D human posture measurements [11]. Recently, Sakai et al., (2011) developed a free-talking system in which an anime agent on a PC monitor asked individuals questions; other questions followed after the agent recognized the finish of an individual’s reply to each question [12].
The research described above suggests that various ICT devices and content are effective in coping with various symptoms of individuals with dementia. The main impairment of dementia is forgetfulness, and the forgetfulness arises due to lack of appropriate recalled information. For example, they might wander and get lost if accurate topographical information is not recalled. Therefore, the best way to help individuals with dementia is to provide them with appropriate information via ICT devices [5]. As for psychological stability, appropriate content, such as an individual’s favorite photo, music, and videos should be provided.
However, individuals with dementia often forget to possess their ICT devices, so they cannot hear the messages from the devices outside of their home. Also, they often dislike or refuse to wear the devices. Furthermore, due to lack of motivation, or lack of the psychological interaction with the devices, some individuals do not perform the daily tasks instructed by the devices [5, 9]. As a result, caregivers often need to search for individuals with dementia, advise them repeatedly, or motivate them by pulling or pushing.
A lot of pet robots have also been created as images of pet animals [13]. Some individuals even treat these artificial machines as actual pets. Engineers are also developing various assistance robots, such as communication robots and care giving robot. Although a robot can move, they are slow in going up stairs or walking on rugged roads or fields. These robots also need complicated software and are too expensive to be used in a normal home. In addition, engineers are also studying smart homes, in which household activities are atomized through the integration of sensors, computer networks, and various devices. Thus, the smart home can provide security, improved convenience, and increased quality of life for the elderly who might otherwise require caregivers or institutional care. However, such smart homes are also too expensive to build, or these types of systems are too expensive to install. This system also does not work outside of the home, so its functionality is limited.
Consequently, we came up with an idea that if dogs were mounted with ICT devices, such as sensors, computers, other electronic appliances, then various tasks would become possible. This ICT- augmented- assistance dog can help individuals with dementia relax, initiate actions, and more easily execute daily tasks, which the traditional assistance dogs or ICT devices cannot realize, respectively. Related ideas have not been found, except one in the military literature, in which camera and radio transmitter systems were built in the armored vest of a scouting dog [14].
The functional abilities between dogs and ICT devices are compared in Table 1. Additionally, both have some ability to understand verbal commands. As for the demerit, dogs require extensive training, and daily care. ICT devices also need electricity, maintenance, and complicated programming. If the abilities of a dog and ICT devices were integrated, a more efficient and unprecedented assistance system can be created, while eliminating their demerits simultaneously.
In regard to using assistance dogs in this manner, we can hire professional trainers to breed and train dogs, and then adapt the trained dogs to individuals with dementia. Some amateurs, such as dog lovers or volunteers, have also expressed interest and have the capacity to train dogs. Also, we have requested that engineers develop more suitable, efficient devices and software for further realization of this idea. These dogs are also applied to elderly without dementia and to individuals with other higher brain function impairments by various etiologies. As an academic field of engineering, Human-Computer Interface (HCI) has been developed to create more human-friendly devices. What we are proposing now may be called the Human-Computer-Animal Interface (HCAI), incorporating various fields, such medical, welfare, engineering, and dog training. We would like to describe the details of this idea. Anticipated effects on the quality of living of individuals with dementia are also discussed.
Animal assisted therapy involves using animals as an intervention to improve an individual’s social or emotional functioning. Dogs are commonly used in this therapy [3]. Due to their attractive appearance, dogs have been shown to help relieve stress to those who like having dogs around. The therapeutic interactive effects of dogs can also be related to changes in physical health as well. For example, walking with dogs can provide owners’ exercise, fresh air, and social interaction [3]. Although individuals with dementia are continually losing their acquired memory, language, and executive abilities, their affection for dogs will be preserved until the last stage of their disease.
Traditionally, dogs also have been trained for various purposes that take advantage of their acute sense of smell, hearing, and mobility, such as police dogs, detection dogs, hunting dogs, rescue dogs, etc. Furthermore, dogs have also been used to successfully help individuals with disabilities, including visual, hearing, and physical impairments. Guide dogs, for example, assist blind people so they can avoid various physical obstacles. A hearing dog can alert their owner to important sounds, such as door bells, alarm clocks, ringing telephones, etc. They also work outside the home, alerting people to sounds, such as sirens, approaching cars, and to let them know if someone is calling their name. Service dogs are taught to pick up dropped items, open doors, turn on lights, and pull wheel chairs for physically handicapped owners. They can carry oxygen tanks for breath support. Some dogs also help individuals with mental disabilities, including depression and autism. Other dogs are even used to help with early detection of seizures and diabetes. These dogs are called assistance dogs [4 ].
However, except for animal assisted therapy, use of assistance dogs has not been reported for individuals with dementia. Although details are not known, several anecdotal episodes have been found on the Internet. For instance, for an individual with dementia, the utterance of the phrase "home" will help the dog navigate to the person’s home from wherever they are, even if they’ve lost their way. If individuals leave their home, the dog will let the caregiver know by giving a particular signal. A dog may teach individuals the parking spot of car. The dog can also be trained to convey that it is time to take medicine at a scheduled time.
Not limited to forgetting their way, parking spots, and taking medicine, individuals with dementia also show other forgetful behaviors, such as forgetting to execute daily tasks, forgetting where items are located, etc. Additionally, various BPSD often appear, such as eating few meals, getting angered easily, asking the same question repeatedly, etc. [2]. However, no comprehensive supporting ideas for these symptoms have been proposed utilizing assistance dogs. Because, conventionally trained assistance dogs cannot cope with these symptoms. In order to better deal with these disturbances, assistance dogs are urgently required to level up their abilities by incorporating other interventions.
As one of the interventions for assisting individuals with dementia, assistive technology or information communication technologies (ICT) have been utilized [5]. IC recorders were effective as an automatic output of messages for individuals with memory impairment and dementia [6]. The IC recorder also attempted to treat other BPSDs, such as eating few meals and getting angered easily by the sound of music [7]. Additionally, the reminiscence photo video was a slideshow video of individual’s photos with narration, background music, and pan/zoom visual effects as a form of reminiscence therapy [8]. Most of the individuals with dementia showed more attention to their photo video than to other TV shows. Kuwahara et al., (2009) have created remote reminiscence talking and scheduling prompter systems using video phones [9]. For two out of four individuals, these interventions were effective for their psychological stability and schedule performances. Yasuda et al., (2010) developed a wearable system to record one day’s behavior, using a small video recorder and IC recorders [10]. The recorded utterances were analyzed by speech recognition software on a personal computer (PC). This was possible because an elderly person with forgetfulness succeeded in recording his behavior for 11 hours in one day. Toileting- task support systems for individuals with dementia were tried out using 3-D human posture measurements [11]. Recently, Sakai et al., (2011) developed a free-talking system in which an anime agent on a PC monitor asked individuals questions; other questions followed after the agent recognized the finish of an individual’s reply to each question [12].
The research described above suggests that various ICT devices and content are effective in coping with various symptoms of individuals with dementia. The main impairment of dementia is forgetfulness, and the forgetfulness arises due to lack of appropriate recalled information. For example, they might wander and get lost if accurate topographical information is not recalled. Therefore, the best way to help individuals with dementia is to provide them with appropriate information via ICT devices [5]. As for psychological stability, appropriate content, such as an individual’s favorite photo, music, and videos should be provided.
However, individuals with dementia often forget to possess their ICT devices, so they cannot hear the messages from the devices outside of their home. Also, they often dislike or refuse to wear the devices. Furthermore, due to lack of motivation, or lack of the psychological interaction with the devices, some individuals do not perform the daily tasks instructed by the devices [5, 9]. As a result, caregivers often need to search for individuals with dementia, advise them repeatedly, or motivate them by pulling or pushing.
A lot of pet robots have also been created as images of pet animals [13]. Some individuals even treat these artificial machines as actual pets. Engineers are also developing various assistance robots, such as communication robots and care giving robot. Although a robot can move, they are slow in going up stairs or walking on rugged roads or fields. These robots also need complicated software and are too expensive to be used in a normal home. In addition, engineers are also studying smart homes, in which household activities are atomized through the integration of sensors, computer networks, and various devices. Thus, the smart home can provide security, improved convenience, and increased quality of life for the elderly who might otherwise require caregivers or institutional care. However, such smart homes are also too expensive to build, or these types of systems are too expensive to install. This system also does not work outside of the home, so its functionality is limited.
Consequently, we came up with an idea that if dogs were mounted with ICT devices, such as sensors, computers, other electronic appliances, then various tasks would become possible. This ICT- augmented- assistance dog can help individuals with dementia relax, initiate actions, and more easily execute daily tasks, which the traditional assistance dogs or ICT devices cannot realize, respectively. Related ideas have not been found, except one in the military literature, in which camera and radio transmitter systems were built in the armored vest of a scouting dog [14].
The functional abilities between dogs and ICT devices are compared in Table 1. Additionally, both have some ability to understand verbal commands. As for the demerit, dogs require extensive training, and daily care. ICT devices also need electricity, maintenance, and complicated programming. If the abilities of a dog and ICT devices were integrated, a more efficient and unprecedented assistance system can be created, while eliminating their demerits simultaneously.
In regard to using assistance dogs in this manner, we can hire professional trainers to breed and train dogs, and then adapt the trained dogs to individuals with dementia. Some amateurs, such as dog lovers or volunteers, have also expressed interest and have the capacity to train dogs. Also, we have requested that engineers develop more suitable, efficient devices and software for further realization of this idea. These dogs are also applied to elderly without dementia and to individuals with other higher brain function impairments by various etiologies. As an academic field of engineering, Human-Computer Interface (HCI) has been developed to create more human-friendly devices. What we are proposing now may be called the Human-Computer-Animal Interface (HCAI), incorporating various fields, such medical, welfare, engineering, and dog training. We would like to describe the details of this idea. Anticipated effects on the quality of living of individuals with dementia are also discussed.