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[UPDATED Dec. 26: New Video, Refinement Questions, User Journey] BrightGuide: Relearn Your Daily Activities By Watching Videos of Yourself

BrightGuide is a web app that helps family caregivers prompt their loved ones and show customized instructions for daily living activities.

Photo of Krysta Traianovski
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Who is your idea designed for and how does it better support family caregivers as they care for a loved one with dementia?

Our idea is designed for caregivers with a loved one in the early/mid-stages of dementia, whose focus is independence. Adult child caregivers face career and parental responsibilities at the same time, and need tools for vital daily activities. We support family caregivers by teaching families new ways to interact with loved ones/increase quality of life at home. By creating wellness within families, persons with dementia achieve self-determination and families thrive when they are resilient.


Want to stay up to date after the IDEO Challenge? 

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Visit us: www.brightguide.ca


PART I: What is brightguide?

BrightGuide is a simple but powerful idea, born from years of neuroscience and human factors research. We help people living with dementia to relearn their memories by watching videos of themselves.

By watching a video of yourself in your own home, you can retain your identity, language and culture which is especially important for a multicultural society like our own.

Our app allows family caregivers to film their loved one completing daily tasks. These videos are scheduled to replay and show the loved one when, where and how to do the task on a challenging day. 

BrightGuide provides security and simplicity by recording videos instantly into the family’s private, online account. This means they never run out of storage space on the device or get frustrated transferring and organizing files. Loved ones never have to search for videos, they are prompted at the scheduled time.

BrightGuide better supports family caregivers by teaching families a new way to interact with loved ones and increase their quality of life at home for as long as possible. By creating wellness within families, persons living with dementia can achieve self-determination and communities can thrive when their members are resilient.


PART II: OUR STORY

In 2009, Sameer's father suffered a stroke and passed away in 2011. During those two years, Sameer and his mother struggled to provide care and help him maintain dignified living. In the final year, his father was completely paralyzed and bedridden, which was very hard for the family even with home care assistance. The stroke caused a slow neurological decline, with symptoms similar to dementia. Sameer began a PhD in neuroscience in 2012 to research solutions for neurological rehabilitation. He quit his program in 2015 to commercialize his findings. He joined the Master of Business, Entrepreneurship and Technology program at the University of Waterloo where he met Krysta.

Sameer's Father:

Sameer's Father


In 2010, Krysta's grandfather Sotir was diagnosed with Alzheimer's disease which both of his two older sisters had previously lived with. Sotir currently lives with his wife who is able to be a full-time caregiver, but as the symptoms of Alzheimer's have become more prominent and challenging, Krysta's parents visit more frequently. Krysta met Sameer in 2015 during her Master's program and immediately began working on the idea for BrightGuide after discussing their common personal experiences.

Krysta's Grandfather:

Krysta's Grandfather


PART III: The Science & HOW IT HELPS

The brain’s visual processing centre is called the occipital lobe, and it is functional even in late stages of dementia. Up until the late stages of dementia, we are able to both recognize ourselves as well as objects. This means we don't bump into things while wandering. This is true even when a person loses linguistic skills, procedural memory about how to do activities and episodic memory about places, people and events. 

Read more about the science of BrightGuide and see visuals of the brain here!


PART IV: USER JOURNEY

See a pdf version of our User Journey here!

Here are some more video ideas that caregivers can film!


PART V: How We Designed BrightGuide

We worked with Brady Clark to define the scope of our prototype for the IDEO and revisit some of our early design decisions and assumptions. Brady helped us narrow down from our original customer journey and use cases to focus on a single part of the interaction.

Original Customer Journey: specific to Ontario, Canada

Brady's Drawings: hand drawings and Moqups

Our biggest question for the refinement phase was "Do caregivers feel comfortable giving this as instruction to their loved ones?".

We took our original app plus our new prototype to 6 families who gave us their feedback. After that, we made a second prototype incorporating their suggestions and asked for more feedback.


Watch our video to see how we asked family caregivers for their opinion!


View our prototypes throughout the challenge:

Original Idea: sign in with a Google account from any Chrome browser

"The buttons and menu are too small. I'm having trouble navigating while holding the tablet." - Tom S., person living with dementia

First IDEO Prototype: made with InVision, best viewed from desktops

"I like this because it's more simple than the other one that had a bunch of things." - Frances D., family caregiver

Second IDEO Prototype: made with InVision, best viewed from desktops

"It's gotta be dead simple. It's gotta be all capitalized like road signs." - Nick T., family caregiver


PART VI: The business model

We asked 80 families what they would pay for a solution like BrightGuide and the median answer was $100 CAD ($80 USD) per month. Our plan is to charge a monthly subscription fee for access to the platform, unlimited video storage and premium features like "call a caregiver". At this price, we are able to cover the cost of customer acquisition, post-sales support, server costs and make a profit.

We project to have $250,000 of sales in 2018, which will help us to fuel growth beyond Canada into similar markets like the United States, the United Kingdom, Australia and beyond! 

Read more about our business model here!


PART VII: AWARDS

The BrightGuide team at DementiaHack 2017.


Our idea won "Best Solution for Helping Diagnosed Individuals" at DementiaHack 2017 in Toronto, Canada. Read more at BetaKit!



What early, lightweight experiment might you try out in your own community to find out if the idea will meet your expectations?

We have partnered with a local care facility Trinity Village (www.trinityvillage.com) to pilot our idea with members of their Adult Day Program and Assisted Living facility. This experiment will allow us to give 6 participants tablets for 3 months while we observe their performance with and without BrightGuide. This is a great way to find how much stress the BrightGuide tool relieves from their care partners and how much time or effort is saved, enhancing quality of life for family care partners

What skills, input, or guidance from the OpenIDEO community would be most helpful in building out or refining your idea?

We know that bring a digital health solution to market requires the collaboration of many groups: we need help with telecommunications partnerships (providing stable, affordable internet access), device hardware partnerships (ensuring families have accessible tablets), creating efficient marketing and distribution channels and providing advocacy and caregiver education for behavioural health. Please see our "How You Can Help" image to answer our questions to the community.

How long has your idea existed?

  • Over 1 year

This idea emerged from

  • A group brainstorm

Tell us about your work experience:

I have experience caregiving for my grandfather currently living with Alzheimer's. I have a BSc in Chemistry and a Masters in Business Entrepreneurship & Technology from the University of Waterloo. I have 3+ years experience health informatics innovation with Medella Health and Health Canada.

How would you describe this idea while in an elevator with someone?

BrightGuide helps persons living with early-stage dementias relearn their daily routine through videos of themselves. This gives autonomy and peace of mind to their family caregivers. Caregivers use the BrightGuide app on a tablet to film and schedule instructions for vital daily activities. This provides contextually-rich and culturally-appropriate cues for assisting the person, with dignity.

How does your idea demonstrate our Criteria of Accessibility?

Cognitive: Brain imaging studies show visual cues can be understood until the late stages of dementia. Our own voice/face is more trustworthy to show us “how-to” succeed in daily activities
Mobile: Our tablet case & UI design make it easy for elderly users to operate BrightGuide on the device they already own
Economic: 80 families said they can pay $100 CAD per month, saving them thousands of dollars in homecare costs
Global: Technique works in every culture & language, only needs WiFi

How does your idea demonstrate or plan to demonstrate scalability?

We are seeking partners like AARP, AT&T, Google, Amazon, etc. to integrate BrightGuide into private homes. We can distribute our React Native app globally through popular app stores after usability tests in March 2018. To support global users, our legal council at Gowling WLG have developed Terms of Service suited for users' local laws. We will work with local chapters of Alzheimer's associations to support and train caregivers on best practices for using BrightGuide.

How do you plan to measure the impact of your idea?

We plan to measure the impact of our idea inside the app through weekly self-reported “check-ins” and metrics related to videos watched and skipped (didn't need the video/didn't do the activity). Weekly surveys: Caregivers are asked about their stress, sense of control and frequency of repetition to measure their emotional stress, role empowerment, time saved. Their loved ones are asked about their confidence in performing daily activities and self-esteem to measure their autonomy and dignity.

What are your immediate next steps after the Challenge?

Our immediate next steps are:

- gathering user testimonies and evidence through existing partners like Trinity Village (January 2018)
- developing a refined native version of the app (March 2018)
- deploying in the app stores with a payment option (April 2018)
- nurturing partnerships through IDEO to understand local challenges worldwide (early 2018)
- developing a go-to-market strategy that addresses national and global challenges (late 2018)
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Team (2)

Krysta's profile
Sameer's profile
Sameer Khan

Role added on team:

"Sam is the co-founder of BrightGuide, and our innovation a tool that helps families do the technique he studied in his Master's and PhD research. Caregiver to his father who passed away in 2012. MSc in Industrial Engineering, Human Factors Engineering (University of Iowa). Masters in Business Entrepreneurship & Technology (University of Waterloo). 5+ years experience neuroscience research using fMRI and training high-performance pilots, soldiers, athletes and surgeons using video feedback."

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Attachments (7)

Scalable.jpg

BrightGuide is born global to help people around the world.

Seamless-Integration.jpg

BrightGuide seamlessly integrates with daily life and existing technology.

Affordable.jpg

BrightGuide is affordable and accessible.

People-Centric.jpg

BrightGuide puts caregivers and persons living with dementia at the centre.

How You Can Help.jpg

We would love to hear from caregivers, persons living with dementia and home care professionals in the community. We would also love to hear from challenge advisors Julia Belaya, Marguerite Manteau-Rao, Kerri Delaney-Horton, Leslie Kernisan, Nadia Morris, Sarah Lock, Rachel Main and Unity Stoakes.

BrightGuide Pitch.pdf

How we plan to bring BrightGuide to market.

BrightGuide_Brochure_Inside.pdf

Try BrightGuide now by logging into app.brightguide.ca from any Chrome browser.

38 comments

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Photo of Sameer Khan
Team

We greatly appreciate all the help and feedback from the Open Ideo Community in furthering our mission. We congratulate the winners of this challenge and look forward to improvements in the lives of carers and care recipients through all contributors.

Do follow us and check out news in the coming months about BrightGuide on twitter: https://twitter.com/brightguideinc and our website: https://www.brightguide.ca

Photo of Sameer Khan
Team

Hi All,

Today is a day for speaking about mental health in Canada supported by a campaign called "Bell Lets Talk". Honestly everyday should have a few minutes dedicated for speaking about mental health and emotional hygiene.

Over the past week I became quite exhausted and ill while taking care of my mom. I have now recovered and I'm happy that my mom has recovered very well from an ischemic seizure.

Part of the reason for my cold and cough I'd say was the travel from Canada to India and the particular flue season in northern hemisphere. The other part was trying to convince my mom to take appropriate steps to recover after her incident.

On the first day she was discharged form the hospital she was having difficulty completing sentences. She absolutely refused the idea of recording her speech and viewing herself recover. In the following days as her speech recovered she complained about severe dizziness. We went to the hospital and the doctor adjusted her medication. The dizziness could have been a side effect and now she seems better.

During the last month I made a gratitude video each night along with a message to myself about what to look forward to in the next day. I then watched the video the next morning at scheduled time to positively improve my mental hygiene and orient myself to the thing I was looking forward to. This is a personal adaption of the extinction method and positive psychology from my masters research.

1. https://en.wikipedia.org/wiki/Extinction_(psychology)
2. https://en.wikipedia.org/wiki/Positive_psychology

I boost my positivity and ability to reflect on daily achievements through the videos. Every morning, I recount the help I received from people and feel grateful for my situation by watching myself expressing genuine gratitude for factual events of the previous day. This high fidelity information helps me avoid illusory positive sentiments. I further boost genuine satisfaction in a day’s work by extinguishing sentiments of dissatisfaction by merely excluding them from my daily video logs. I can feel that this has helped me improve my relationships and to stay motivated. It has kept me going so that I can produce my best work in building a pioneering cognitive science company from scratch with Krysta.

But here is the hard truth: In none of the videos did I ever express that I was looking forward to dealing with my mom or going to the hospital with her. I hate hospitals. And I really reached my wit's end in trying to convince my mom to comply with her prescriptions. She is extremely well educated, a linguistics professor and one of the three living people in the world who can translate Sanskrit to Arabic. Yet, she is utterly stubborn about doing things the way she wants to do instead of following medical advice.

The cardiologist we met just didn't take the time to council her, the neurologist tried a bit but mostly nodded and mumbled. Finally, three days ago the pulmonologist took quite a bit of time to explain what each of her medicines was supposed to do and how her routine was supposed to help. He took a lot of time to deal with her questions and misgivings about medical prescriptions and reports. But towards the end he gave up with the sentence "Its my job to provide the prescription and the patient has a right to refusal of the treatment". I understand this ethical concern but her refusal of treatment was putting me into a mental crisis and ill health!

Two days ago my mom agreed to stick to her regime after seeing me unable to do my research work and out of concern for me she is taking better care of her self. I can only imagine how much harder it is for dementia carers who cannot reason with their loved one about simple things like eating or hygiene let alone complex medication or therapy routines.

Even though I have fair bit of experience and knowledge in this field I'm barely able to cope. And in the mean time, my neighbour who had a stroke three years ago is super enthusiastic in working with me and using BrightGuide. Her husband is a professor in physics and is extremely glad that I'm working to help his wife. They both are so gleeful to see evidence of the improvement through her rehabilitation regime in her videos. But in contrast, I can barely help my mom.

It seems attitudinal and personality traits of "openness to experience" and "agreeableness" are key to the success of a policy, program, product or service. If a person's belief system and attitude aren't conducive to accepting help, the task of helping the person becomes close to martyrdom.

Photo of Krysta Traianovski
Team

Today we visited the first family participating in our pilot through Trinity Village. Our first participant is a 92-year-old woman living in their assisted living facility. Today she was able to hold the tablet and watch a recorded video of herself. She was very excited to see her own face and in the video said "Looking good! Feeling good!". I was told she is a regular Facebook and video chat user to communicate with her 4 children who live in Canada, the U.S. and the U.K. I will be meeting with her each week for the next two months to try using the video to help with her chosen activity of daily living.

Photo of Joanna Spoth
Team

Hi Krysta Traianovski and Sameer! I saw your answer below to Tonia about using the iPad. We're also curious about the how BrightGuide would naturally integrate into current habits. Do you have a sense of how many people living with dementia are also comfortable using tablets? Have you done any testing with a tech-free version? Cards in the location where the activity takes place (e.g. bathroom sink, kitchen) could be a fun lightweight prototype. Maybe even used in tandem with the tablets at Trinity Village! Another super simple version could be with digital photo frames. They're cheaper than most tablets and while the alert functionality may go away, there could be an easy hack. Would love to hear your thinking on our "naturally integrates" evaluation criteria. Thanks!

Photo of Ngozi
Team

Dear Joanna Spoth, I also thought all these questions you asked above. I think they are very important and should be responded to so that we can also learn from it.

Photo of Sameer Khan
Team

Hi Joanna Spoth !

Thank you for your important questions about fidelity and natural integration. We’ve included the link at the end of short response here that includes more images and details showing what we learned about these topics.

Audio-video instructions afford appropriate help with aphasia and apraxia. Click our link to learn more about why this is critical!

Here is our earliest design thinking session from March 2017 with storyboards and static prototypes: http://www.srishaank.com/#/brightguide/

In March 2017 we tried the static images currently used by researchers. The binder with these images are promoted by the Alzheimer's Society here in Canada and is available for purchase for $150 CAD. We found that the images made end users angry because the drawings weren’t representative of their gender or ethnicity and depicted ageist stereotypes with confusing euphemisms. Click our link at bottom to see what these images look like and what happened when we tried them!

Static images in print or digital form don't aid procedural memory and are unhelpful for people with aphasia and apraxia. Prototype testing with static images didn't work very well because users weren't able to imagine the functionality due to their impairment. Professional caregiver did give us great feedback and collaborated to improve our UX and workflow. From a business perspective, it is uneconomic to fabricate such stock drawings or photos for the multitude of situations people need help with.

We aim to integrate with current global consumer behaviour. Digital health technology usage across generations is improving healthcare accessibility. Seniors use remote healthcare assistance more often than millennials in the US. The global trend in mobile technology adoption is stronger in countries with emerging economies than OECD countries. Click our link to learn more about how different age groups and different countries are adopting technology!

Each family in our target demographic already has multiple mobile devices at home. The diagnosed person is already comfortable using their personal mobile tablet for emails or games even through they struggle with it at times when dealing with system notifications. We all struggle with those annoying notifications, don't we? Click our link to learn more about how families said this could integrate into their daily life!

Some families who could use this solution have been caught on the wrong side of the digital divide due to poverty, disease, substance abuse, injury or other distress. These conditions are significant but not insurmountable. We must take special care to assist those in such circumstances to gain equal access to helpful technologies. Developing partnerships and flexible options for financing can help address these barriers in distribution.

We truly believe that encouraging families to develop new habits will ask them to stretch outside of their comfort zone, but in a way that will be worthwhile and fun when we provide the right guidance and training.

Link for detailed explanation: https://goo.gl/CSe3iE

Photo of Joanna Spoth
Team

Sameer Khan Thank you - we appreciate your thoughtful responses and the time you've put into this Challenge. We hope you've found participating helpful!

Photo of Ngozi
Team

Dear Joanna Spoth,
I see lots of reasoning in your comments and i agree with you in the sense that from our own experiences and project community most of the Dementia Patients do not even have the acknowledge of using some of the gadgets before they developed dementia and it is usually difficult process for them to use it at this period. But nevertheless, it takes patient from caregivers to put their love ones through on how to use these gadgets because it can serve as a healing process to some of them that may pick interest on such things. But in the community were we worked, some of them actually don't like getting involved with things they find difficult to understand so in such places do we also think it suitable for such persons?
Yes environments differ but these are some questions i asked myself when i went through Sameer's idea. But yet i still like it because i gives us more opportunity to brainstorm and reason together.

Photo of Krysta Traianovski
Team

Hi Ngozi,

Thank you for your thoughtful questions as well! The most important thing that we learned during this challenge was whether or not the person with dementia operates the the technology themselves, giving caregivers a tool to mediate communication improves life for everyone. We know that the number one reason a person transitions from home to long-term care in North America is caregiver burnout, so any tool that improves the ability of the caregiver to cope with changes and reduce stress will also improve the quality of life for a person with dementia.

Simply allowing caregivers to explain a task without repeating themselves and without having to fight to maintain a calm voice saves so many daily struggles and fights. The first time we showed this technique to a wife who was caring for her husband she said, "I feel like we are unstuck from a rut.". Sameer and I have dedicated our careers to show families this and other techniques to cope with caregiving because we know how great the challenge is and we believe that with better tools and training we will change lives.

Look forward to speaking with you more over email!

Krysta

Photo of Ngozi
Team

Dear Krysta Traianovski,
Thank you so much for your powerful responds. my email is snokere@yahoo.com.au
Its nice interacting and sharing thoughts with you.

Thank you

Photo of Mackenzie Jackson
Team

Hi Guys
I love the idea, I am curious though as to how you are dealing with the issue of losing the tablet or remembering to watch it. Or is the idea that the caregiver will be there to show them the video of themselves performing the task.

Photo of Krysta Traianovski
Team

Hi Mackenzie,

Our current way to deal with this issue is the "notification" video that plays automatically at the scheduled time for the video. This is recorded during set up to show the person with dementia saying "It's time to watch your next video. Come to the tablet and press play.". The tablet has loud enough audio for this to be heard. During the early to mid-stages of dementia, we have seen many people are indeed able to respond to this and operate the tablet. You also have the option of connecting your tablet to a TV using a device like Chromecast, so that the video is displayed larger and louder. We also ask families to create a dedicated place where they keep the tablet when they are not using it to charge. We ask them to film this as a reminder video that plays after every video they watch.

If a person has progressed later into the disease, the caregiver selecting and showing them the video is a great alternative method. We also found that family caregivers liked this because it gave them a tool to mediate the conversation they were having about daily activities. Rather than the conversation being about the caregiver "telling me what to do", it was the caregiver providing a hint about how the person likes to do things. Removing the feeling of subordination and replacing it with cooperation towards a shared goal. This allowed caregivers to feel calmer and speak less emotionally because they no longer had to repeat themselves for instructions, they could replay the video as many times as necessary.

Let us know if you have had this experience in your life with the challenges of caregiving and feelings of subordination amd frustration. Looking forward to the discussion!

Krysta

Photo of Krysta Traianovski
Team

Also forgot to mention - the future developments we would like to look into are especially to address the problem. With the popularity of home assistants like Amazon Alexa and Google Home, companies are now coming out with home assistants that will have a touchscreen similar to a tablet. These will be affordable enough for a family to place one in every room of the home.

We have been discussing locally woth Google Canada's head office here in Kitchener, Ontario to see if we can get early access to these new devices to build our application into the platform.

Have the audio and video visible throughout the house solves the issue of finding/remembering/hearing/charging the tablet and makes it most likely that a person will access the video without assistance.

Photo of Molly Oberholtzer
Team

Hi Krysta Traianovski  , this is a great idea with some excellent research. I'm happy to hear you are already in development talks with partners like Google. It reminds me of a semi-automated version of the new Amazon Echo Show, which I am very interested in using with my grandmother when our relationship becomes long-distance. I could see using this as an additional feature, maybe in the bathroom it could even be a motion detector thing. It would be nice if my grandmother could remind my grandmother to wash her hands after using the bathroom!! Best of luck, Molly

Photo of Krysta Traianovski
Team

Thanks Molly! I saw an article just yesterday that Facebook is also planning to release something similar. I think in the next few years we will have a lot more options for communications.

Sameer Khan brought a Nest cam and another webcam with him to India yesterday so we can keep track of his mom at home there. As more and more caregivers are living in different cities (and even different countries!) than their loved ones I think we will see people getting creative about how to help from afar. We were really thankful last week that we were able to live chat with the hospital in India and call an ambulance all the way from Canada! Sharing our solutions and ideas across borders will inspire new tools and techniques for caregiving.

Photo of Sameer Khan
Team

Hi,

I found out yesterday that my mom in India had a stroke and is now in a hospital. When I spoke to her she had difficulty understanding me and her speech was slurred. The doctors say that her MRI shows a small damage in the left part of her brain and that it isn't a haemorrhage.

I will be heading to Hyderabad, India on Jan 15th and will be working to help my mom recover using what I can.

Krysta will be working with families at Trinity Village in Canada and we hope that in the coming months we will be united again. We thank you all for your support and hope that you will support BrightGuide where ever we are in the globe.

Photo of Krysta Traianovski
Team

Hi everyone! We just noticed that the link to our Invision prototype had broken down. The links in our submission are now working again. In case you missed it, our final design is here: https://invis.io/NRF4I3VPG

Joanna Spoth 

Photo of John Gregory
Team

The application of video analysis feedback to improve elite sports performance has been well established since the 1990s. It has become increasingly sophisticated. The academic research of the BrightGuide founders builds on this neuropsychology understanding. It seems probable that video feedback can have a positive influence on delaying the loss of independence for those with dementia. This has many societal advantages of maintaining those affected in their own homes surrounded by family and friends. By engaging with health care service providers as well as arts, culture and library services, BrightGuide appears to be developing a role as a thought leader in driving this important conversation. Video platform hardware on handheld devices exists and can be expected to more ubiquitous, with lower costs to purchase and operate. Video will play our increasingly central role in all our lives over the next decades. The greatest challenge could be overcoming our short-term (generational) apprehension of technology. BrightGuide appears to be pioneering this field. The case studies from Trinity Village and others pilots should provide a good use case to back up the early positive results.

Photo of Sameer Khan
Team

Hi John Gregory 

Thank you for your comment about BrightGuide. I'm glad to see you tie connections from sports because my masters research at University of Iowa in 2008 was for training athletes and soldiers through videos of themselves. These days, watching "game day video" has become a ritual for many athletes. I'd like to bring the same uplifting technique for people needing cognitive assistance.

A picture is worth a thousand words. Now imagine how a video with a thousand images is worthy in providing guidance. There is no way I can explain how to wear a tie verbally. Now, if I were to show you how you typically wear one using a video, that would definitely work better than other modes of instruction.

From your writing style I can imagine that you are a serious analyst. Thank you for the analysis and summary of what you found in our writeup!

Photo of Sameer Khan
Team

While the BrightGuide technique and app can be applicable in helping children with cognitive challenges, persons with brain injury or stroke and even in training pilots, surgeons or soldiers we are focused on helping dementia caregivers. This is because of our personal experience as caregivers. We are making BrightGuide because we currently don't have any other viable tools and techniques for assisting our loved one do their activities of daily living.

While the technique of showing a person how to do an activity like toothbrushing or yoga using videos of themselves aids procedural memory it does not cure their memory problems. We can certainly pray and hope that our loved one doesn't suffer for long but we can do something lot more tangible with BrightGuide to support their daily quality of life.

Please join the conversation in making the world a more dignified place and let us know about how we may collaborate with you: https://goo.gl/yBcn6D

Photo of Joanna Spoth
Team

Hi Krysta Traianovski - great to see you in the Refinement Phase! When is your pilot at Trinity Village starting? Seems like a perfect opportunity to share some learnings in the OpenIDEO Challenge! Don't forget there are a few additional questions now that you're in the Refinement Phase - you can see them by clicking "Edit Contribution."

Photo of Sameer Khan
Team

Our pilot at Trinity Village is starting in the next few weeks, we are currently organizing with families since it involved members of the adult day program (who don't live in the facility) and members of assisted living. The families who volunteered to participate so far have given us great ideas about particular activities they would like to support their loved ones in doing.

Photo of Ngozi
Team

Dear Krysta Traianovski
The BRIGHTGUIDE video idea is great, I love it and its quite educative. But in a country like Nigeria where most rural communities do not have access to electricity to always power their devices, what could be their options if such an idea should be provided or created in such communities.

Photo of Sameer Khan
Team

Hi Ngozi,

We greatly appreciate your question. Reaching under-serviced and unserviced populations is an essential part of our global strategy.

We have been brainstorming and testing ideas along with founders of Hitch for the past one year to help indigenous and rural communities around the world gain self sufficiency and education through digital tools like BrightGuide. Our University of Waterloo classmates Uche and Steve founded Hitch (http://tryhitch.com/#learnmore).

Hitch provides solar powered long range wireless routers and solar panels for recharging mobile devices. The "mesh network" of devices can create the required internet infrastructure with only one node of the network connected to public internet. This works even with intermittent public internet connectivity.

Hitch also works offline by caching video content on high volume data storage attached to the routers. They are currently piloting dozens of their Hitch devices in Nigeria to help farmers gain education on best farming practices and in Uganda to help refugees in unelectrified camps gain education about health and vocational training. These kinds of educational content cannot be delivered effectively through print material because the subject matter requires ecologically appropriate and personalized demonstrations of "how to do a set of complex procedural steps" to succeed in a task.

Uche and Steve have developed a viable cost effective solution to help solve connectivity as well as infrastructure issues in remote areas. Such mesh networks are also provided by various companies around the world (https://en.wikipedia.org/wiki/Mesh_networking).

Uche and his wife Angela moved to Canada to support their three children, two of whom have special needs. They weren't able to get appropriate help in their native town near Abuja due to lack of research and funding for childhood developmental needs. They would like to help families like their own through empowering audio-video instructions. We are collaborating with them to figure out how vital information about ADD and ADHD can be transmitted to parents in Nigeria while allowing the child to become self actualized through videos of himself/herself. We are also looking into connecting volunteering physicians to provide counselling for mental health over video chat through BrightGuide to individuals in underserved communities.

We are testing ways of using Hitch mesh network to run BrightGuide in parts of India, Nigeria and rural parts of Canada and Australia. In these communities we will be using the BrightGuide technique of watching yourself in videos to support children with behavioural or learning challenges, cognitively able persons needing vocational training and to rehabilitate persons with cognitive impairments due to injury or disease.

Please let us know if you would like to collaborate with us to facilitate the use of BrightGuide on Hitch networks in your community.

Please do join us in addressing the economic and political impoverishment that accompanies technological and educational divide!

Photo of Sameer Khan
Team

Thanks Ngozi you can check out more details here. Let us know what you think!
https://goo.gl/CSe3iE

Photo of Wendy Carmical
Team

Hi Krysta: Thank you for sharing your project and process. It is so great to see people developing for this group and this is a really interesting idea. The video of themselves is a really unique idea. I think your use of chrome is very smart and I love the case.

As we are in feedback phase I'd like to add some thoughts. In my experience, it is difficult to get the dementia person to admit they have an issue. One suggestion would be to frame this as a friendly helper. Is your intent to layout the whole day? It might be interesting if you tied the available videos to the time of day or left it more open ended - Make Coffee rather than, now is the time to make coffee.

I agree that it might be hard to keep track of the device. To solve that issue, you could install devices throughout the home.

I think the sweet spot for this app would be when the user is still trying to maintain independence. Late Early Stage. As they get into mid-stage the user with dementia needs prompting. Maybe a sound component or integration with a home assistant like Alexa.

Photo of Krysta Traianovski
Team

Thanks Wendy! I found the case randomly on Amazon advertised as "kid-friendly".

I agree that it can be difficult for persons living with dementia (and even their family members) to come to terms with a diagnosis. In the early stages it wouldn't be necessary to lay out the entire day if the person only has occasional challenges or struggles with only one activity. I think this tool fits best as part of a proactive discussion about how the person wants to age gracefully. Our definition of aging gracefully is "staying active with the people, places and things that matter to you." Framed in this way, I think the person would feel both respected and like they have control and agency with regards to using the tool.

Currently there is the feature to schedule the videos so they appear on "Today's Guide", i.e. a video called "Toothbrushing" could be scheduled for Sun/Mon/Tues/Wed/Thurs/Fri/Sat at 8:00 AM. When it's time for the scheduled video, an audible alert plays so they only have to press once to watch that next video. They can also watch any of the videos by pressing the thumbnails in Today's Guide or clicking on of the categories ("Eating", "Dressing", "Hygiene" and "Other") which is great for early stages where they want to watch occasionally.

And yes, great suggestion about multiple devices - this is in our future plans to look at a home kit so the tablet acts as a screen in each room.

Home assistants can be very useful to help with sending audio throughout the house and also as an alternative input to start the video. So far we have seen that home assistants work well with early stages of dementia, but afterwards there can be difficulty since it is an "invisible interface" that doesn't necessarily remind you that it is there.

Let me know if you have more feedback!

Photo of Wendy Carmical
Team

Thank you for the dialogue, Krysta! Your idea is really compelling. I love the idea of helping the dementia user visualize themselves in tasks. Is there a stage you are targeting? I'm sorry if I missed that.

Photo of Krysta Traianovski
Team

Thanks Wendy. This works for all the stages between pre-diagnosis (may have concerns such as "memory challenges" and mild cognitive impairment) through mid-stage. Once a person is no longer able to recognize themself in photos, videos or the mirror (a common problem in the mid to late stages) this technique decreases in effectiveness. Usually around that time the person and their family are also less focused on independence and more focused on comfort and safety.

Photo of Wendy Carmical
Team

I know, my poor Mom once started crying when she saw her picture, she didn't know how old she was. However, in the early stages, this would be amazing. It reminds me of a short visualization technique. Lots of luck in the refinement round!

Photo of Krysta Traianovski
Team

Kate Rushton thank you for inviting us to participate! OpenIDEO is a really neat platform.

Photo of Kate Rushton
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Hi Krysta, I am glad you are here. What is the science underpinning BrightGuide? What additional studies do you have to do to link BrightGuide and improvements in behavior of the person with dementia?

Photo of Sameer Khan
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Hi Kate,

These links explain the general understanding within the neuroscience community:
alz dot org brain tour: https://www.alz.org/braintour/progression.asp (please click on links 14, 15 and 16 to learn more about the progression)
Understanding dementia video: https://youtu.be/Eq_Er-tqPsA

Above links explain how the neural degeneration typically starts at the mid brain and progresses to frontal and parietal lobes. My PhD research in 2014 at University of Trento, Italy with fMRI brain imaging data confirmed that the occipital lobe remains resilient up to the late stages of the disease.

Neuroscientists have mostly concentrated on what is deteriorating in the brain and ignored the stable parts even though such stable parts are evident in each fMRI investigation of a diagnosed person. Its a matter of perspective, you see.
(To see or not to see: https://en.wikipedia.org/wiki/Gestalt_psychology#Properties)

My expertise is in information theory (https://en.wikipedia.org/wiki/Information_theory). Its main tenant is that information needs to be presented to a cognizing system within high enough bandwidth and in an appropriate format so that the system can cognize i.e. process the incoming signal. Its a very simple and powerful idea. So we put the theorem and empirical findings together: the highest bandwidth medium that is still intact in a diagnosed person has to do with occipital lobe that is concerned with visual perception. So let's provide the required information for vital daily activities in high fidelity visual format.

Additional research in psychology indicates that our ability to recognize our voice, our name and our face within a "noisy" environment is very strong. So we decided on using videos of the diagnosed person instead of an avatar or stock footage. We also noted the failure of avatar and stock footage based solutions from research done at University of Waterloo and University of Toronto during the past 7 years for helping diagnosed individuals. This failure is expected - damage to mid brain prevents a diagnosed person from relating the context of an avatar's actions with that of their own. More over, trying to predict the artifacts, movement patterns and environmental conditions for activities performed by different individuals in different environments is impossible. There is "variation within the variation of the expected phenomenon". So we needed a better approach to dealing with such stochasticity than trying to film stock footage. The custom audio-video of the person overcomes issues of amnesia, aphasia and apraxia. Audio in user's language helps overcome cultural issues. Hurray!

Our solution is based on "ecological design principles" (https://en.wikipedia.org/wiki/Ecological_interface_design) which is a superset of design thinking. Ecological design and cognitive work analysis aren't as popular as design thinking even though they overcome issues of "breadth first search with cascade classification" which is essentially used in design thinking. Cognitive work analysis defines cultural, economic, political and physical boundaries of a problem space before exploring a matching solution space with gradient search methods. This helps reduce possibilities of misuse and abuse of a viable solution.

So what's next? We have tried our audio-video feedback technique with 6 diagnosed persons and have seen positive changes to mood and activity performance in each of them within minutes of watching their video. Such behavioural impact is seen among athletes who train using game-day videos of themselves. However, athletes are neurologically intact and are on a "cognitive incline" while people living with dementias suffer neural degeneration and are on a "cognitive decline". We don't yet know how long the effect lasts among diagnosed persons. We also don't know if video feedback triggers procedural memory or allows the person to "copy and do" without taxing memory stores. We are currently recruiting 20 more participants with early to mid stage dementia through community based research partners to answer questions about efficacy. The technique doesn't work in late stage dementia when the person can't recognize themselves.

Our early tests identified various legal and technical issues with storing the data on the local device and workflow issues in scheduling videos. Also, elderly users often have dexterity, audio and visual challenges. We are collaborating with our test users who currently live with dementia along with their care partners to create features for solving these issues. The end user completes the design loop so we strongly encourage the end user's inputs during the production process.

We estimate 4 month to go from our closed beta to commercially viable product available to clients across Canada. Then 6 more months to address legal hurdles in various global geographies regarding privacy and cyber security with the help of Google and Gowlings WLG.

Photo of Tonia Porras
Team

I do like this idea and congrats on your win! My only questions are, what happens if the person with dementia does not know how, or has forgotten how to use the iPad? And how accessible is on the iPad? Are there a lot of steps to get to the preferred video?

Photo of Krysta Traianovski
Team

Hi Tonia, great question! Our idea is to adapt the usage of the tablet as the person's condition changes. Initially people in early-stage dementia that we have consulted with happily use their tablets for multiple activities like games, browsing and communications. As they progress, they can use a cheap tablet as a dedicated device for BrightGuide in kiosk mode (similar to a sushi restaurant where you order with a tablet: https://media-cdn.tripadvisor.com/media/photo-s/0c/c1/23/b9/the-ordering-tablet.jpg). Finally, when they are no longer able to operate the tablet by themselves, family caregivers can manually replay the video for the person as a communication aid to reduce the frustrations associated with repeated verbal instructions.

If a person has never used tablets or technology like this before, I would recommend that they start in the early stages to become familiar with the device and make a habit of recording and reviewing videos regularly (could be used for psychologically beneficial activities like daily gratitudes). Persons living with dementia can still learn new things.

The first picture in the submission is a real image of the app on a tablet. When the scheduled time arrives for a video, a full screen notification pops up that says "It's time to watch your next video, press play!" and the person simply has to tap the screen. If they are looking to watch a video at other times, they can click on any of the videos listed in "Today's Guide" or click on of the categories to search: "Eating", "Dressing", "Hygiene", "Other". These categories were developed with advice from the local Alzheimer Society on how to categorize the most common activities of daily living.

I would love to get more of your feedback, it looks like you do great work in memory care :)

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Team

Congratulations on being today's Featured Contribution!

Photo of Krysta Traianovski
Team

Thank you, that's very exciting!

Photo of Krysta Traianovski
Team

Caregivers: How might we provide information in formats that are easy for you to access and understand quickly?

Persons Living With Dementia: How might we empower your independence at each stage of the journey?

Home Care Professionals: How might we enable your front-line workers to become familiar with clients quickly and easily?

Julia Belaya: How might we leverage corporate social responsibility to help connect families who would like to use our service with the internet and tablet they need?

Marguerite Manteau-Rao: How might we provide simple, easy to use devices to families who need them?

Kerri Delaney-Horton: How might we customize our advice and instructions to help the specific needs of each family?

Leslie Kernisan: How might we support practical education and training for family caregivers through our platform?

Nadia Morris: How might we develop telecommunications partnerships to connect families in all geographies to our digital health solution?

Sarah Lock: How might we enable families to feel greater security in their retirement and financial planning by aging gracefully at home for as long as possible?

Rachel Main: How might we help families understand, accept and cope with a diagnosis earlier in the disease progression?

Unity Stoakes: How might we enhance the brain health of >50 million people worldwide with a behavioural intervention rather than medication?