Dementia can turn even the simple task of getting dressed into a Herculean ordeal.
But an experimental automated system called “DRESS” might someday ease that challenge. Using available technology, the system might enable patients to dress themselves without a human assistant.
A just completed laboratory trial assessed the system’s ability to use video cameras, tablets, motion sensors, and barcodes to successfully pinpoint dressing problems among 11 dementia-free participants as they sorted through clothing by themselves.
The program correctly spotted clothing orientation and position, and was also able to distinguish between different types of clothing — for example, dresses versus shirts — with near perfect accuracy. DRESS also proved adept at tracking an individual’s evolving dressed-versus-undressed status.
However, it often failed to note when a user finished putting on a pair of pants or a shirt, so the research team say more work lies ahead.
“Dressing presents many challenges when you’re talking about dementia,” explained study author Winslow Burleson.
“First of all, for patients this is a task that they used to be able to do in five minutes, and that they typically did and want to do in private, in isolation. And for caregivers it’s often one of the most frustrating activities, and one that they often spend an hour or more a day helping out with,” he said.
“So what we’re doing now is just the beginning of a process — a process that will have many steps — towards determining the best way to try to help out with this,” Burleson added.
Burleson is an associate professor with New York University’s Rory Meyers College of Nursing, and founding director of the NYU-X Lab in New York City.
The preliminary DRESS system offers remote support, rather than fully automated assistance, the researchers explained.
Clothes are outfitted with barcodes by clothing type, location and orientation. A five-drawer dresser is equipped with lenses and sensors, with each drawer containing a single piece of clothing, sequenced to match a user’s dressing habits.
Out-of-sight, a caregiver launches an app to deliver an audio message alerting the patient to reach for the first drawer, which illuminates upon opening.
The caregiver and barcode reader track mistakes, and additional audio messages nudge the patient into corrective action, according to the report.
When the first item of clothing is correctly donned, the system encourages the person to move to the next item of clothing, while a bracelet sensor monitors their stress levels. If stress levels rise, a caregiver can step into the room and take over, the study authors pointed out.
The trial results were published in the April-June issue of the journal JMIR Medical Informatics.
Burleson emphasized that DRESS is very much a work in progress.
“Using visible barcodes is one big caveat,” he acknowledged. “Largely, we found that they offer robust detection of successful dressing and dressing that needs to be revised, like putting on the wrong sleeve, or putting something on backwards. But there is concern that barcodes could be stigmatizing. So, at some point we might try custom clothing iron-ons that are invisible or infra-red.”
Also, he added, “people have loved their furniture throughout their lives, so having a new dresser could be a problem as well.”
But, “the hope is that offering patients a remote and conflict-free way to be more independent could be worth some trade-offs,” Burleson said.
“First, we have to see if people can follow the remote process,” he said. “And then, if so, we think we try to automate it. But we don’t know yet. Our approach is very participatory, and we’re seeking advice and guidance from all sorts of people.”
Ruth Drew, director of information and support services with the Alzheimer’s Association, said the organization “supports the use of current and emerging technologies that can help people living with Alzheimer’s live more independently.”
Drew acknowledged that “the act of dressing for someone living with Alzheimer’s, particularly in the middle and late stages of the disease, can be a frustrating experience. Individuals may not remember how to dress or can be overwhelmed by having to make choices,” she noted.
“The DRESS prototype technology addresses these two common barriers,” Drew said. But she agreed that further study will be needed, “including specific examination of the technology with people living with Alzheimer’s.”
There’s more on Alzheimer’s and daily living at the Alzheimer’s Association.