The effects of a digital memory book on the quality and quantity of conversations in adults with mild to moderate dementia

Abstract

Background: Research has demonstrated that adults with a moderate dementia can benefit from the introduction of a memory book to improve the quality of their conversational content. However, previous investigations in the area have focussed on low-tech alternative and augmentative communication aids. Few studies have investigated how digital media can be incorporated into therapy when working with people living with dementia. The present study addresses this gap in the literature by investigating the effects of a digital memory book on the quality and quantity of conversations in adults with mild to moderate dementia.

Method: A single-subject multiple baseline design across behaviours with replication across four participants was used in this investigation. Four English speaking adults with a mild to moderate dementia and four of their family members participated in the study. The researcher developed a digital memory book using the Pictello™ application on an Apple iPad with the help of the participant and their family/whānau. Photos and statements were chosen in relation to these three conversational topics: Daily Life, Family, and Myself. During baseline and treatment sessions, the researcher met with each participant to conduct and record a five-minute conversation based on the three conversational topics. During treatment sessions, the researcher used the digital memory book to establish the effect of the memory book on the participants’ conversational utterances. Each conversation was transcribed verbatim by the researcher and analysed and coded for Memory Book Statements, Novel On-Topic Statements, Ambiguous Utterances, Unintelligible Utterances, Perseverative Utterances, Error Statements, Other Utterances, Partner Prompts, Partner Statements, Partner Questions, and Partner Other statements. A research assistant independently transcribed 20% of the transcripts and coded 20% of the conversations to establish the inter-observer agreement for the transcription and coding.

Results: Visual analysis of the total-on-topic statements revealed a lack of evidence of a clear difference between the baseline and treatment phases across all the behaviours for each of the four participants. All four participants increased their total-on-topic statements with family members during an initial baseline session without the digital memory book to a follow-up session involving the digital memory book.

Conclusion: Although the use of a digital memory book did not improve the quality and quantity of conversations in adults with mild to moderate dementia during conversations with the researcher, further research in the area is warranted. Future studies could focus on individuals with moderate or more severe dementia and individuals who are familiar with using digital media in their daily lives. Research could also focus more on the use of digital memory books during conversations with family members.