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Scheduling Accessory Assists Patients with Cognitive Disorders

Individuals with memory, attention, and cognitive impairment may struggle to remember that they have to perform certain tasks. Those with severe impairment to the point where independent living is a challenge are affected most, as they may not only forget to perform tasks, but forget how to perform them.

Whether individuals are mildly or severely impaired, PEAT makes it easier for them to get through their planned schedules by providing cues for task completion and adjusting for unplanned schedule conflicts. PEAT can automatically shift flexible tasks that do not require an exact start time in order to keep the prioritized, scheduled events on track. For example, an individual using PEAT wakes up to a preplanned day that consists of having breakfast with a family member from 9:30 to 10:30, followed by stopping at the bank, and then seeing a 12:00 matinee show with a friend (the individual receives cues from PEAT to inform him/her of all of these scheduled tasks). This agenda was preprogrammed in the user’s device (either programmed by the user or by a caregiver, depending on the degree of impairment), with breakfast and the movie being the top-priority scheduled tasks, and the bank trip being a secondary, unscheduled routine task.

Not everything goes as planned, however. It turns out that breakfast takes longer than the scheduled hour, so the user does not have time to stop at the bank before the movie. Since the bank trip did not require an exact start time, it is a task that PEAT can automatically shift to another available time. This way, the task, though delayed, is not ignored and will not be forgotten, and the individual’s priority tasks — breakfast and the movie — are not interrupted.

The automatic cues that PEAT delivers to its users to start and stop activities can be in the form of customized voice recordings, sounds, and pictures; extra large text and pictures help users with visual and motor problems. Cueing continues until the user responds. Additionally, users can program customized scripts (activity sequences) for breaking large tasks into multiple, small tasks. This feature is especially helpful for highly impaired users who may find difficulty completing tasks such as getting dressed in the morning or fixing themselves a meal.

PEAT’s Cue Card display provides a countdown timer until the next scheduled event and cues the user to start or stop at the scheduled time. Highly impaired users may be locked into this Cue Card section, which means they will only see reminders for one event at a time. This mode keeps the reminders simple and does not create unwarranted confusion for these users. The device keeps a log of all of these actions, so that the caregivers and family members can evaluate how well a user is adapting to the technology and accomplishing real-world tasks. For the user, the accomplishments boost independence and confidence, and diminish cost of care.

“PEAT can be simplified by hiding features so that highly impaired users will use a system with far less features than higher-functioning users,” stated Levinson. “We start off simple with each user and add options over time. In some cases, a caregiver or therapist sets up the schedule and the user must only respond to cues, while PEAT monitors their progress and automatically adjusts the schedule as necessary,” he added.

PEAT is sold as a complete system that includes software, hardware, documentation, and technical support. In addition to the flagship Pocket PEAT device, there is PEAT Phone: software that runs on cellular phones; PC PEAT: software that runs on desktop and laptop PCs, where the larger screen and keyboard may be used to configure the system, enter data, train users, and back up data; and PEAT Link: software that links the Pocket PEAT device to PC PEAT for software copying and data transfer.

Where it Stands

PEAT is currently providing planning and execution assistance to patients at Department of Rehabilitation facilities in 25 states, Santa Clara Valley Medical Center, the U.S.
Department of Veterans Affairs’ Palo Alto Health Care System, and to school districts and assistive technology centers.

At the Palo Alto hospital’s Polytrauma Rehabilitation Center, Dr. Harriet Zeiner, lead clinical neuropsychologist, has developed treatment protocols for troops returning from overseas with mild traumatic brain injuries from improvised explosive devices, as well as for soldiers with post-traumatic stress disorder. Zeiner’s treatments include using the PEAT device as a memory prosthesis.

Meanwhile, clinical studies of PEAT continue at Santa Clara Valley Medical Center. Levinson also foresees the technology he first developed for autonomous robotic planning to have “spin-in” application for NASA’s astronauts.

More Information

For more information on the PEAT system, visit http://info.hotims.com/28055-132.