While medicine looks for both the cause and cure of dementia, millions of elderly around the world begin feeling the symptoms every year. New technologies, some existing now and some maturing towards consumer products, offer not only real-time information, they also include ways to inject this information into human interaction with their surroundings. Visual overlays in Google Glass, context aware assistive services such as Google Now, and our ever-present GPS location awareness can combine to provide supportive interactions with our world.

While these advancements are being developed for mass consumer adoption, they can also provide support for individuals who live with limitations such as dementia. I've been working on some ideas on how our elderly might use these devices, struggling to get traction beyond what is easily described and would be used by individuals, whether healthy or dealing with dementia. Then I recently heard about VocalID, a group collecting a range of human voices for the use of those without a voice of their own. In the past, individuals unable to speak were limited to a very small set of digital voices - most of them identical to the voice used by Stephen Hawking. To provide semi-unique voices, Dr Rupal Patel founded the Communication Analysis and Design Laboratory (CadLab) and the VocalID organization - the latter which collects 2-3 hours of donor voices to provide options for individuals suffering from severe speech impairment.

Slowly putting them together, I started to wonder if someone with dementia might feel more individual control over their actions if the voice for the technology helping them maintain their awareness was their own - just controlled by the support system. To identify realistic situations, I researched symptoms and focused on these issues (links from Alzheimer Europe, Alzheimers.org, WebMD, Helpguide.org):

• Trouble recalling people and faces
• Trouble finding the right words
• Trouble carrying out tasks
• Keeping up personal care and grooming
• Separating fact from fiction

There are four:

• Familiar voice commands
• Just in time directions
• Remote assistance
• Networked and automated surroundings

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Familiar Voice Commands (5-15 years)

Rose exited the store and stood squinting in the sunlight. "Where am I going?" She wondered out loud, as she had learned in the assistive service training. Always ask the tough questions out loud, it will help you find your way, was the primary message in a class she couldn't remember much any more, though the training had set.

A voice in her head - her voice - replied, "Turn left and follow the sidewalk." Rose tilted her head, wondering who said it and why it seemed so familiar. It made sense, so she turned left and started following the directions of the voice inside her head - but at least it was her voice.

Idea: Voice recognition is growing more accurate with every upgrade. I've experimented with them for nearly 20 years and used Dragon Dictate to transcribe most of a novel from my written copy. It still has a ways to go, especially for someone who might struggle to verbalize their problem. I believe the solute might be techniques to read words in the brain as they are formed. I doubt this technology will be 100% for everyone decades from now, but a combination of voice recognition and thought pattern recognition could provide more accurate and helpful services - especially for those who struggle to recall or say the word they want to use.

The technologies required:
- GPS location plus user focus awareness: This already exists. Google Maps reflecting which direction the phone is facing is an example. This could be built into someone's glasses or even a chip they wear in a brooch, jewelry or a watch.
- Voice recognition: Already available, though, as I point out above, the ability needs to mature further.
- Audio is sent to either inner ear or brain: The ability to send information directly to the user is in development by scientists already able to send signals to control other brains. Wireless audio can be sent directly to cochlear implants today. Being able to transmit audio directly to the ear, via seeded speakers, is in development and requires more advanced current generation and efficiency to work.
- A voice you trust: Part of my premise is the ability to hear your own voice, or maybe one identical to your internal voice, to completely trust the information/directions you are receiving. I'm assuming the voice has some psychological benefit, enhancing both responsiveness and also a sense of independence. This may not be true, though I still believe an internalized voice might be more trustworthy over time than something piped in via phone or some other external device.

__________

Just in Time Directions with voice commands and visual target marking (10-20 years)

Bob shuffled out of the water closet, settling his left hand on the bathroom door handle for stability. As he crossed the threshold, he heard a voice, "Go back and take the pill in the orange box."  

Ah, he thought, I forgot my pill. He turned back towards the sink, the pillbox to the right glowing orange. Popping the top, he placed the pill in his left palm. The orange glow faded and shifted to his cup. Take some water to help swallow the pill.

He picked up the cup and the tap glowed orange, but Bob had already stuck the cup under, going through familiar motions, and the faucet dispensed three ounces of water into the cup. Put the pill in your mouth and swallow.

Oh, he thought, I'd forgot the pill. He found he was holding it and placed it in his mouth and washed it down with the water. Turning back to the door, he walked to the bedroom and the light turned out behind him.

Idea: Individuals with dementia benefit from routine. A technology capable of identifying the routine and correcting would be beneficial. Mapping the required steps and objects would clarify as well.

The technologies required (in addition to that above):
- Flexible learning software: Software would need to learn both the context (home), steps, and identify a range of objects (though these could be marked via RFID or even visually).

__________

Remote Assistance (most technologies available today, but a simple and easily integrated system could be 10-20 years out)

Jenny opened her front door and peered out through the one way glass of her storm door. There was a man standing there, waiting at the door. "Yes?" she asked and the man's face smiled.

"Yes, ma'am. You have a broken tree limb and I was wondering if I could have the job of cutting it out for you."

Jenny hesitated, uncertain what to do. The house system, triggered by the sound of an unknown voice, pinged several people at once. All three of her children were busy at work, so her grandson answered from his dorm room. His game paused and his TV overlaid a view of the man on the porch, fed from the camera mounted above the door. "Can I help you?"

Jason's voice caught the man off guard. He took a step back, "Yes, um, I was driving by and noticed the limb on this sycamore is down. I handle tree removal and trimming and wanted to know if I could handle this for you today."

"Grandma," Jason asked, "did you know the limb broke?"

"Why, yes. Paul called me yesterday to tell me he could see it from his house. Is it in the way?"

"No, ma'am. It's not on the sidewalk or street, but it is up against your fence. If you'll let me, I could cut take it off and remove it. All you'll have is some sawdust on your yard."

"Well, I don't know. Jason, what do you think?"

"How much would it cost?" Jason muted the feed and told his system to search for limb removal in his grandmother's zip code.

The man rubbed at the back of his head. "I could do it for, say, a hundred bucks?"

The search results said that was a bit high unless it was a large limb or high off the ground. "Where did the limb break? Is it still on the tree?"

"Yeah," the man stepped back, "it's still hooked on a bit up top, say about 15 feet up. I can hit it with a pruning saw to get it down and then cut it up and toss it in the truck."

"Give us a minute." Jason told the system to localize on his grandmother and the feed went to her hearing implants. "If he's telling the truth, the price is fair. Do you want to have him do it?"

"Well, he's here now. I guess so."

Jason changed the connection to the entry speakers, "Sounds good. How can we pay?"

"Well, cash is always great, but you can send it to my Paypal account as well." He held up his phone, showing an icon on the screen. Jason's system grabbed the pattern and turned it into an account registered to a Carl Burke of Burke and Son Tree Solutions. It had 3.9 stars out of 5 and registered as insured.

Jason pinged the account with his contact info. "That's a fair price. Send me a picture when you're done and we'll transfer the payment. Thanks for the help."

Idea: I don't recall my grandmother being identified as having dementia, but I do recall some scammers came through and told her they could paint her roof (it was an old house with a tin roof) to reseal it. Uncertain and sold on their warnings of leaks, she paid up. They painted and it all came off at the next rain while they were long gone. Providing support for individuals who wish to remain in their homes, but can use help isn't always limited to physical needs. Fear of dealing with individuals combined with a struggle to identify truth from dishonesty can put a person in a bad spot. A system where families can be notified of possible situations without constant snooping provides both privacy and timely intervention when needed.

The technologies required (in addition to those above):
- Home security system capable of tracking conversations and other sounds to identify signs of distress.
- Flexible communication system: An inexpensive system providing video input and audio (and/or video) interaction. I considered having the grandson's Skype view appear in the storm door glass, but it seems a bit overkill.

__________

Networked and Automated Surroundings (requires near-complete context awareness, probably 30-50 years out)

Terrell stepped out of the autotaxi, pausing to get his bearings while the door slid shut behind him. He looked around, taking in the street and shops around him. I should take some wine, he thought to himself. Something to go with dinner.

His integrated assistant followed the thought, blinking a light on the left side of his vision. From his training to use the service, he turned his head that way and could see arrows marking a path to and around the corner. Terrell followed, his exoskeleton swinging his legs fairly gracefully as he strode the sidewalk without a walker for the first time in nearly a decade.

People walked by, Terrell watching them pass as his legs moved themselves. Turning the corner, the arrows continued about twenty steps and ended at an overlay of a flashing arrow pointing to the store entrance. Terrell walked to the shop, pausing in front to check the bottles arranged in the window.

His assistant overlaid ratings and prices pulled from the shop's online service over each bottle. A nice red was outlined, a Shiraz the service identified he'd had before and rated highly. He entered the shop, the system slowing to safely move him around the display cases.

The shopkeeper, a woman in her twenties, approached. "May I help you find something?"

Terrell paused, searching his memory for the vintage. "Yes, I saw an Arrenbell Shiraz in the window. I would like one in a gift bag to go, please."

The lady, Amanda by her name plate, which had sent an identifier signal to his assistant when he entered, smiled and led him to the next row. Picking up a bottle, she held it up for him. His assistant registered it was the same, so he nodded a smile and followed her to the counter where she slid it into a shoulder bag and helped loop it over his shoulder. The strap stuck to his shirt so he didn't have to worry about it sliding off. His assistant registered the payment and Terrell returned to the sidewalk.

The arrows had changed, sending him back around the corner to the main entrance. Reaching the entrance, the doors opened for him and the arrows lead on to the elevators, which matched his arrival. Stepping onto the lift, the doors shut and the system slowed the lift acceleration to ease the pressure on a recently repaired disk in Terrel's troubled back. The elevator slid up to the eighth floor and opened, the arrows now showing the path to Becky's apartment.

His system announced his arrival and the door opened as he arrived, letting him into the foyer. Becky's cousin Sammy met him, taking the wine and his coat. The welcome mat scrubbed his shoes as he entered - it wasn't easy for the him to remove his shoes, especially wearing an exoskeleton.

Most everyone was already here, chatting before the games started. Becky worked her way across the room, "Terrell. Good you could come." She kissed him on a cheek, thanking him for the wine. "How are the grandkids?"

"Fine, fine. They're doing well. How is your son, was his surgery a success?"

"Oh, yes. It's all outpatient nowadays. He was home that evening to rest and the incision in his arm had mostly healed by morning. Come, have a seat." She led him to the third table before excusing herself to answer the door.

In his visual overlay, names followed faces around the room. Terrell knew everyone here and the details he knew from conversations or rumor was in there as well. One face was familiar, though he couldn't recall much about a Bert Gorman. He looked at Bert for just a moment and the overlay exploded in his view, remaining there while Terrell kept his finger and thumb pinched. The few lines told him Bert had worked for IBM, had three children, was divorced, and enjoyed cigars.

Releasing the view, Terrell smiled at greetings as everyone moved towards their seats. As the room shuffled, a new person ended up in the seat next to his. He turned towards an attractive woman with the familiar look of someone with a century of experience, but the skin tone and health of someone forty years younger. "Hi, I'm Terrell." He smiled at her, suspecting he'd been set up and catching Becky's smirk as proof.

The pretty woman smiled back, "Hello (she paused, blinking a few times) Terrel. My name is Nia. Are you a (pause) friend of (pause) Becky's?"

By the end of the night, Terrell had lost some money towards charity, but his database now knew Nia took a moment to assisted recall, liked Thai food, had attended Cornell, lived in London for business for seven years, and, most importantly, her contact information.

Idea: In a perfect world, just in time information can be seamlessly added to any of our interactions with the world around us. This would help provide fairly complete support, especially by removing unknowns from the equation. It's certainly nice to not know all the restaurants, so you can discover a new gem on your own, but being able to map them to match need with service/product would make the world of retail easier for everyone.

Social interactions are listed as a major issue on nearly every dementia symptom list I read. Issues with social interactions cause withdrawal from social scenes leading to depression - a psychological issue often connected with memory loss, even among much younger individuals. Systems designed to help with names and other types of information would allow the ability to interact with greater depth and to also store important information to help with future conversations and connections.

The technologies required (in addition to those above):
- The Internet of Everything could create a sub web capable of sharing every piece of data on nearly every item. This would provide a smoother interaction with the surrounding world by eradicating unknown variables and helping focus on important tasks by presenting the closest solution.
- Facebook claims to have extremely accurate facial recognition software. Google has pushed back on allowing apps with facial recognition features, but it's probably a matter of time before we accept this feature as part of  our world. Perhaps the feature is only enabled in private locations or when filming an event, but I suspect it will be a widely used feature within the near future.