Instinctively

2023 - now | BIMA Award winner | Alzheimer’s Society Partner

Assistive technology designed to guide people living with dementia through daily tasks of living using sensory stimulation.

What is Instinctively?

Instinctively aims to tackle the loss of autonomy experienced by people living with dementia due to cognitive decline, which can be hard to navigate both pre-and post-diagnosis.

Instinctively helps users identify tasks that they struggle to perform independently and uses habit formation techniques to provide guidance via their smartphone.

The solution consists of two apps. The primary app on the PLWD’s device provides bespoke cues for tasks they wish to complete independently. The secondary app on the Carer’s device can be used to add and modify tasks as well as track task completion, allowing them to provide care from afar and only intervene when necessary.

Screenshots from the Instinctively Main and Supporter apps.

A bit of background

From conceptual to into the hands of users

During dedicated R&D sessions, my colleague and I created a digital product concept based on our own personal experiences with dementia.

Our idea, Instinctively, won a 12-month partnership and £80k in funding from the Alzheimer’s Society via their Innovation Hub Accelerator Programme in 2023, which gave us the opportunity to conduct further research as well as develop a POC app which underwent two rounds of testing in the homes of our target audience.

Our vision is for this to become a commercially available product that older adults are recommended for maintaining cognitive resilience.

Discovery

Our knowledge of the problem space originated from our personal experiences with loved ones living with dementia, however discovery practices enabled us to understand the diversity and complexity of issues experienced by PLWD and their families. Some discovery methods included:

1. Desk research on dementia and habit formation 

Procedural memory, the memory that allows us to act out of instinct, is the last to leave you as dementia advances. This paired with our research into habit formation caused us to foucs on creating ways for PLWD to create and retain habits to slow the progression of dementia.

2. Discovery workshops with professionals and carers

Speaking to many professionals in the space, it was encouraging to learn that older adults are becoming more competent with and accepting of technological solutions.

3. Co-design workshops with a panel of PLWD

Monthly interaction with the panel enabled them to directly influence the visual look and feel and functionality of the app. The app was significantly simplified based on feedback.

Recruitment

I was responsible for recruiting and onboarding participants for two 6-week rounds of app testing. As this was a new experience for me, it came with many learnings:

1. Face-to-face interaction

It is important when engaging with older adults and PLWD to win their trust. We only had a privilege of meeting a handful of participants in person prior to testing but noticed a significant difference in engagement by doing so. It gave the participants time to get to know the people behind the product and allowed us to support them through the app onboarding process.

2. Onboarding and setup

We had many drop-outs between the stages of initial interest and participation in usability testing. The main issues causing these drop-outs was long lead times and too many steps (screener survey, intro video/webinar, data upload, and finally app download via testflight). The convoluted process made for a frustrating experience for some individuals. Recruiting in person could alleviate some of this friction.

3. Androids are popular with older adults

Due to assumption, limited data and developer limitations, our first iteration of the app was designed solely for iOS. However, our recruitment process revealed that expanding to Android would significantly boost participation among older adults.

Usability testing

During our partnership with the Alzheimer’s Society, we managed to conduct two rounds of 6-week usability testing on participants. After each round we collected valuable insight which directly fed into a new and improved iteration of the app.

Round 1 testing

Refining our addressable audience

Participants in our first round of testing ranged in ages, capability to use technology, and stage of dementia. One participant was completely resistant to acknowledging his need for support and pulled out of the testing entirely. Another, in the early stages of cognitive decline, resisted using Instinctively without encouragement from her husband, highlighting the stigma surrounding dementia. This prompted us to re-evaluate who this product is suitable for (people in early-stage dementia who are proactively looking for assistive tools) and adapt the language and functionality of the app to feel less patronising to PLWD.

Catering to the stages of cognitive decline

To provide utility for people in early stage dementia, we introduced ‘suggestions’, which are mini nudges for day-to-day activities such as drinking water, standing up or even playing Wordle. This feature encourages light-touch engagement with the app, familiarising users with its functionality so they can transition to more guided features as their dementia progresses.

Round 2 testing

Positive feedback

The general feedback from round 2 showed that Instinctively had significantly improved in terms of usability since the first version. This was confirmed by participants who trialled the app in both rounds. Positive feedback was also given to our simplistic app design, which had been designed to reduce cognitive load and was developed alongside our co-creation panel consisting of PLWD.

Catering to our audience

However, we noticed there was more we could do to cater to our audience of PLWD in their early stages. It was clear through recruitment and from user feedback that PLWD would benefit from having the autonomy to build and modify their tasks through their device and not have to go through their carer. Providing this extra autonomy would also support PLWD who live alone or doesn’t have regular access to their carers.

The effectiveness of audio cues

Our bespoke task creation process enabled users to upload prompts that they would respond well to. This included imagery, videos, voice recordings and text. We noticed that users tended to opt for imagery and voice recordings. When probing why this was, we learned that participants found voice recordings, either of themselves or their carers, more familiar and easy to follow. Almost all participants expressed interest in integrating voice assistants to provide more conversational and ‘in-the-moment’ guidance.

What have I enjoyed from this experience?

Instinctively has given me the unique opportunity to work on building a business idea of my own from scratch, while still being in full employment and supported by my employer. I like to think of it as ‘start up on training wheels’. Therefore, I have been able to take risks, focus on a topic that I am personally invested in, and develop skills such as product management and data handling which I wouldn’t typically get from my day job. As with most of my job highlights, it’s the emotional aspect of talking to and interacting with people affected by dementia that I feel most fulfilled by.

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