Authors: Jeffrey Sebastian, Jun-Ming Lu, Yeh-Liang Hsu (2013-04-23); recommended: Yeh-Liang Hsu (2014-09-09).
Note: This paper was presented in 2013 International Conference on Advanced
Robotics and Intelligent Systems (ARIS), Tainan, 2013/05.
Robotic concept design for dementia care
Abstract—This paper reaches into the possibilities that robotic technology
can provide to be applied into dementia care, proposing a concept design on how
technology can meet the needs of caregivers and those affected with dementia.
Through the use of touch screen technology and telepresence robotics the needs
for memory aid, reminiscence therapy and communication can be fulfilled with through
the application of available technology into a robotic design. These are to be
applied into an alternative medicine therapy for caregiving and assisting the
independence of demented patients.
Keywords—dementia care technology; telepresence
robot; alternative medicine
Dementia is the term used
to describe the symptoms of a large group of illnesses that cause a progressive
decline in a person’s cognition and ability to function. It is a broad term to
describe a loss of memory, intellect, rationality, social skills and what would
be considered normal emotional reactions . All of these changes affect
the social life, physical ability, emotions and independence of the person
affected with dementia, also affecting family members, friends and those
It is estimated
that 35.6 million people is affected with dementia worldwide. There are 7.7
million new cases of dementia each year, 45% are extreme-severe, 35% moderate
and 19% mild dementia . Dementia is not a normal part of ageing,
however, 87% of demented patients are over 65 years old. 
usually divided into 8 classifications, depending on their origin and way of
Alzheimer Disease: The
neural connections between brain cells get tangled, preventing information to
travel to areas in the brain, causing memory loss and physical impediments.
Vascular Dementia: A
sequence of brain strokes causes brain damage due to poor blood flow to the
Lewy Bodies: Abnormal
structures inside the brain cells called Lewy bodies interfere with normal
functionality of brain communications and cause hallucinations to those
Fronto-Temporal Lobar Degeneration: Frontal and Temporal parts of the brain are affected, the patient
loses its ability to communicate verbally or with written words (Aphasia and
Semantic Dementia “loss of the meaning of the words”) and slow shrinking of the
brain (Pick’s disease)
Huntington’s Disease: Due
to brain cells being affected, patients display involuntary muscle movement of
the limbs or face, behavioral disorders, intellectual impairment, loss of
verbal fluency, bipolarity and more
Parkinson’s Disease: Brain
affections cause stiffness in the joints and limbs, difficulty on physical
action, speech impediments and involuntary rhythmical muscle movement on any
part of the body.
Through excessive alcohol ingest, the patient can develop irreversible brain
Disease: This is a
really rare (one in a million) cerebral affection, caused by a protein particle
called prion. Patients display memory loss, behavior changes, lack of
coordination, involuntary muscle movement, limb weakness and blindness. Brain
shrinkage also may be present.
Among the 8
classifications, Alzheimer disease is the most common kinds of dementia types,
affecting in between 50% to 70% of all demented patients .
depends directly on several factors like type of dementia, level of impairment,
past and present skills and abilities on the patient after being affected by
dementia, patient’s personality after being affected (some patients can turn
aggressive after being affected by dementia) and the skills and motivation of
the people around the patient. As a caregiver (not as a physician) it is really
important to provide activities for the demented patients to improve their life
quality, keeping their brain active.
medicine care, such as reminiscence environments, multisensory therapy rooms and
memory aids, has proven to be effective in dementia care, but have fewer side
effects than the traditional medical way for the dementia affected patients .
Dementia is not a curable disease. This kind of alternative medicine care will
only aid their daily living but won’t be able to reverse this degenerative
affection . Alternative medicine care is also where technology developers can
assist in dementia care, for the patient and the caregiver.
technology has been implemented to assist dementia-affected patients, having
positive and surprising results. For example, touch screen technology is used to
restore the bridge in between the relationships that were broken by the
irreversible affections caused by dementia . If properly focused,
technology can be used into assisting the daily living of demented patients and
their care givers, to constantly stimulate the patients’ brains, giving them a
feeling of accomplishment, with small tasks that will keep an open bridge of communication
and interactivity with the caregiver. 
reaches into the possibilities that robotic technology can provide to be
applied into dementia care, proposing a concept design on how robotic technology
can meet the needs of caregivers and those affected with dementia. Section 2 of
the paper briefly describes medical applications of robotics and the needs for
dementia care that robotics can cover; Section 3 and 4 presents our robotic
concept design for dementia care with telepresence robots. In particular, two
versions of telepresence robot, TRiCmini+ and Wobots are
presented. Finally, Section 5 concludes the paper.
Robotic Applications to Meet the Needs of Dementia Care
Over the past
few decades, robotics has been moving forward in aiding human daily tasks. Modern
medicine has been using robotic assistance for several tasks in homecare and
medical applications. Depending on their core functionality, robotic
applications for medical care can be classified into training, surgery, diagnosis,
consultation, monitoring, rehabilitation, therapy, assistance, communication, pharmacy
and prosthetics .
There are some
important needs for dementia care that robotics can cover, as numbered below:
therapy: Therapy based on recollecting past experiences or events through an
audio-visual experiences  
Through audio-visual reminders and assets to keep the oriented while doing
their daily tasks. 
Research has shown that demented patients have express they feel lonely ,
although this problem is not exclusive for demented patients but also between
the elderly population of the world.
Among the types
of robotic applications for medical care, communication robots have proven to
meet the needs for dementia care . Communication robots came through the
idea of robots with videoconference features embedded in them . For medical
purposes, these robots are used as a doctor-patient communication bridge or
caregiver-patient bridge. Considering the needs for dementia care, tele-presence robots came to the
picture. Through the aid of telepresence robots, demented patients can be
assisted to overcome their loneliness and open a bridge of communication
between them and the caregivers or family members .
The term telepresence
is used to describe a set of technologies, such as high definition audio,
video, and other interactive elements that enable people to feel or appear as
if they were present in a location which they are not physically in . This
allows caregivers and demented patients to communicate and interact in those
cases when family or caregivers cannot be present at the location were the
patient is at.
Robotics Concept Design for Dementia Care
Based on the
concept of a communication robot a
telepresence robot design for dementia care could be a game changer in the
care-giver/patient relationship, taking with it the touchscreen based concept 
for daily care of demented patients . We can take advantage of options that
tablets have brought to our daily living, being a really reliable tool when
Research Center of Yuan Ze University has been developing a Telepresence Robot
for Interpersonal Communication (TRIC). The purpose is to open a bridge of
communication between the caregiver and care receiver. As shown in Figure 1, “TRiCmini+”
is a small lightweight telepresence robot designed for the caregiver to be able
to deliver care and monitor their patients, taking advantage of the tablet
Figure 1. Prototype and basic specifications of TRiCmini+
allowed users to combine several care tools within the telepresence robot.
Instead of having a computer attached to a robot, the tablet is used as the
central controller of TRiCmini+. It is a detachable
feature of the robot to be used as a normal tablet as well. The tablet can
be used for vital sign monitoring of the patient and
share this information with the caregiver or doctor online. It also allows
local users to use the tablet as a memory aid, as keeping them updated with
date and time;
of the high-resolution graphics that a tablet provides, TRiCmini+
provides a set of emotions and facial expressions that combined with the mechanical
motion of the body of the robot to duplicate the three-dimensional face-to-face
communication experience. With such features in the robot, dementia affected
patients can find a character, personality and even a name for their “new
friend” keeping their brain active, and aiding to the reminiscence experience
that the robot can bring through the audio visual interaction. The telepresence
robot also keeps communication open between the caregiver and the patient.
Figure 2 shows
the information structure of TRiCmini+. The remote user
manipulates TRiCmini+ through the user interface on a
smart phone/tablet/PC to freely move it around and communicate with the local
user, who is staying with the robot in the home environment. By providing both
verbal and nonverbal elements of interpersonal communication, the robot can
better serve as the avatar of the family members or caregivers for expressing
their care to the older adults at home.
Figure 2. Information structure of TRiCmini+
has an innovative system structure which separates the “brain (a tablet)” and
the “body (the robotic vehicle)”. Tablet is used to receive commands from the
remote site via the Internet, perform audio/video conferencing, as well as the “face”
of TRiCmini+. The robot control software is an android App
on the tablet. The robotic vehicle is equipped with a power management module
and a robotic movement module to provide omnidirectional mobility. The robot
movement commands received by the tablet are relayed to the robotic vehicle via
concept on the TRiCmini+ is based on an important
anthropomorphic rule, in which the appearance of the robot will influence the
perception of the person interacting with it will have. This is achieved by
having proportional limbs and a face to interact with and look at. Following
these concepts, personality and physical characteristics should be given to it
through the usage or body movements and facial expressions. This design
principle on TRiCmini+ is a very important feature for
the reminiscence therapy, in which the patient affected with dementia can
interact with TRiCmini+ also helping to overcome
loneliness, offering a multisensory experience keeping the patient’s brain
stimulated and active.
An Alternative Robotics Concept Design for Dementia Care
In dementia care
institutions a mobile robot might not be suitable due to the spacing and
clearance needed. A different approach for telepresence robot should be
An extension on TRiCmini+
is being developed, which will be used in the Dementia Care, Research and
Education Park in Tainan, Taiwan. This extension is a stationary robot with a
more cartoony playful appeal to it called “Wobot”. As shown in Figure 3, Wobot’s
concept design, facial animations and personality features have been based on
the principles of character animation by  , and facial expressions have
been combined with specific colors to enhance the experience for the patience
through color psychology .
Wobot is a
really different approach into tele-presence robotics. Wobot differentiates
from TRiCmini+ in the fact that this is not a mobile
robot. Wobot is a semi-static robot that will still have all the features that
TRiCmini+ has, and will be placed on the patient’s room’s desk for
them to have an open window of communication, interactivity and alternative
medicine therapy near them.
Figure 3. Wobot project, by Gerontechnology
Research Center, at Yuan Ze University
needs for dementia care are feed by both, TRiCmini+ and
Wobot, through their various technologies integrated in them. Reminiscence
Therapy, through the audio-visual aiding experience given by the different
personalities integrated in both robots design; Memory aid, through the Apps
already installed in the tablet, also aiding their independence; Communication,
through the integration of the telepresence system, being this the core of both
robots connecting caregivers, physicians and elders affected with dementia. In
the Dementia Care, Research and Education Park in Tainan, Taiwan, Wobot is to
be used as a remote way of care giving between the families who live far away
from the institution, being the family members the remote users, allowing a
bridge of communication and care between them. Also through the telehealth
system integrated in our App, doctors can keep record of vital signs of each
patient through their user.
and Wobot present an integration of technologies that can aid and feed
the needs of dementia care. Through the audio-visual experience that can be deliver remotely families, physicians and patients are connected
through the communication system of our telepresence robot. This design is to
be evaluated in the near future in dementia care institutions, hoping to expand the horizons for dementia care through technology
concept for a robotic design to be used in dementia care, requires a simplistic
yet extremely creative process. The
challenge is to be able to deliver the proper tools to fulfill basic needs for
the proper care of demented patients. Each robotic design should be focused, and
depending on the problem to be solved that’s how the technology can be applied.
Dementia is a
growing problem. Each demented patient has its own characteristics and needs. The
understanding of the needs for dementia care allows technology developers to
create solutions to assist and improve the living quality for those affected
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