An Examination of Preferences and Effectiveness of Memory Wallets in the Management of Neuropsychiatric Symptoms of Dementia
Year: 2026
Type: other
Abstract: Project Description: The purpose of this project is to examine the use of memory wallets as a nonpharmacological intervention for long-term care residents with major neurocognitive disorder, commonly known as ‘dementia’. Memory wallets are personalized visual and written cues intended to foster stronger communication skills in those with dementia (Bourgeois, 1992). The current study seeks to compare the use of the traditional memory wallet style (i.e., a printed physical copy), against a virtual reality (VR) version with long-term care residents with depressive symptoms. The traditional memory wallets will consist of 10-20 photographs selected by family members or close friends of the resident which will be printed, placed in a binder sleeve, and put into a three-ring binder for each participant. The VR memory wallets will be intentionally constructed to mimic the same presentation of side-by-side pages in the binder and using the same order that the photos appear in the traditional binder. This study utilizes single-case design (i.e., a reversal design) where participants’ behaviors will be assessed at baseline (i.e., pre-intervention; “A” phase) and compared against their own behavior after each condition of the intervention (e.g., VR exposure; “B” phase). Behavior will be graphed and visual analysis used to ascertain the effects of the intervention on behavior across conditions. Baseline observations will continue until the observed behavior is seen at least three times to establish a trend and stability of each participant’s baseline. Each intervention phases (i.e., VR exposure and printed memory wallet exposure) will also continue for at least 3 days to align with design convention. After each intervention phase is completed, a return to baseline condition is complete (second “A” phase) to observe whether behavior returns to baseline without the presence of the intervention. Finally, the second “B” phase will be instituted to see whether behavior changes in response to the intervention again. Following this, the second intervention condition will be introduced (e.g., physical memory wallet; “C” phase) and behavior changes will be observed. Similar to earlier phases the “A” phase will be reinstated, followed by a second “C” phase. In this manner, the behavior is observed and graphed in each condition (ABABACAC) and if consistent responding is observed between the two intervention conditions, then a strong case can be made that the intervention was responsible for the behavior change. A crossover design will be implemented to control for order effects of the intervention type. Thus, participant 2 will receive a ACACABAB design. Depression assessment. Before the intervention (i.e., at baseline), in between the set of reversal conditions (i.e., in between “ABAB” and “ACAC”), and after the final intervention condition, the Cornell Scale for Depression in Dementia will be administered with a staff member who spends time with or knows the resident well. This allows us to evaluate the effects of the VR intervention on mood. For interobserver agreement (IOA), two members of the research team serve as independent observers and will be on site to record observations for a minimum of 25% of sessions across baseline and intervention phases. An observation data sheet will be used by the researchers for ease of tracking behavior. Following observations, the observers will compare data using the point-by-point method where the number of agreements will be divided by the number of agreements plus disagreements, and then multiplied by 100 to provide a percentage. Acceptable IOA is considered to be a minimum of 80% agreement across all trials. If IOA is found to be below 80%, the data point will be thrown out, observers would be re-trained to criterion, and the phase would be extended by an additional data point. Observations will occur during a time point identified collaboratively with staff so that we do not interrupt scheduled activities. Two members of the research team will be present to complete observations independently for 25% of sessions; one member will serve as primary and the other will serve as a secondary observer to calculate IOA. A data sheet will be utilized to prompt recording of time spent engaging with materials and on topic utterances. The purpose of this study is: 1) introduce a study implementing physical and virtual reality (VR) memory wallets personalized to each participant; 2) examine preference of memory wallet type (i.e., traditional printed version vs. VR) through total length of time spent engaging with the intervention; and 3) examine effectiveness of memory wallets in improving depressive symptoms. Hypotheses: Hypothesis 1: Participants will exhibit higher engagement with memory wallet conditions (regardless of modality) than in baseline conditions (without memory wallets), such that: - A. Participants will have a higher number of total utterances in the physical memory wallet conditions than in baseline conditions - B. Participants will have a higher number of on-topic utterances in the VR memory wallet conditions than in baseline conditions - Tested with Paired samples T test Hypothesis 2: Participants who exhibit greater engagement with the memory wallet conditions (duration, regardless of modality), will exhibit lower depression scores post-intervention on the Cornell Scale for Depression in Dementia - Tested with Pearson correlation Hypothesis 3 (exploratory): Explore whether the type of memory wallet (modality) impacts the level of engagement with the memory wallet (time spent engaging with stimulus). - It may be that the novelty of the VR headset and the immersive qualities of VR may lead to greater engagement with the VR condition (longer duration) - It may be that the similarity of the physical memory wallet condition to books/binders and the familiarity of this stimulus might lead to greater engagement with the traditional memory wallet condition (longer duration)
Source: Open Science Framework
Author: Annalee Smith
Subfield: Psychiatry and Mental health
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W7221441237
Cites:
Cited by:
Related to: