1. No category

Petra Černe Oven, Barbara Predan
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FOCUS:
SERVICE AND
INFORMATION
DESIGN
FOKUS:
STORITVENO IN
INFORMACIJSKO
OBLIKOVANJE
1. FIELD
2. TITLE
3. AUTHORS
HEALTH CARE
A Set of Social Games for Senior
Citizens with Dementia
Breda Klančič, Brina Fekonja, Katarina Kranjc,
1. PODROČJE
2. NASLOV
3. AVTORJI
Gregor Makovec, Urška Preis
4. STARTING POINT
We chose to explore design solutions for the so-called
ZDRAVSTVO
Komplet družabnih iger za starejše
osebe, obolele za demenco
Breda Klančič, Brina Fekonja, Katarina Kranjc,
Gregor Makovec, Urška Preis
4. IZHODIŠČA
Izbrali smo si oblikovanje za tretje življenjsko obdobje
third phase of life, and especially for senior citizens
in v okviru tega bolnike z demenco. Zanimalo nas je,
who show signs of dementia. We were interested in
kako je mogoče lajšati in upočasnjevati razvoj bolezni,
measures that might alleviate and slow the develop-
pa tudi to, kako bi lahko zagotavljali pomoč svojcem
ment of the disease and also in providing help to fam-
oziroma negovalcem. Za izhodiščni cilj smo si zadali
ily members and other caregivers. Our goal was to find
najti rešitev, ki bo dementnim pomagala zaposliti in
solutions that would help to keep people with dementia
urediti miselne procese ter bo primerna za bolnike v
engaged (both those living in nursing homes and those
domovih in/ali v domačem okolju.
still residing in the home environment) and to provide
tools to help them organize their thought processes.
5. ANALIZE
Raziskali smo kakovost življenja ljudi z demenco v
domačem okolju in v domovih za ostarele. Primer-
5. ANALYSIS
We researched the quality of life of people with de-
jali in analizirali smo zavode in domove za ostarele
mentia residing in both the home environment and in
doma in v tujini. Preučili smo simptome bolezni in
nursing homes. We compared and analyzed institu-
njen potek. Poiskali smo primere rešitev za lajšanje
tions and nursing and retirement homes in Slovenia
bolezni, med drugim tudi primere različnih družabnih
and other countries. We studied the symptoms of the
dejavnosti (igre, glasba, ples, ustvarjalne delavnice,
disease and their progress. We looked for examples of
skrb za živali), ki pomagajo pri vzdrževanju ali
solutions that alleviated the symptoms of the disease,
izboljšanju stanja. Po izčrpni analizi sekundarnega
including various social activities (games, music,
gradiva smo odšli na teren. Med vsakim obiskom smo
dance, creative workshops, caring for animals) that
svoja opazovanja zapisovali ter beležili (v avdio in
served to maintain or even improve the condition.
video obliki).
After an exhaustive analysis of secondary material,
we went out into the field. After each of our visits, we
Obiskali smo Zavod Papilot, v okviru katerega deluje
noted and recorded our observations (in audio and
Rozin vrt. V Rozinem vrtu izvajajo dnevne dejavnosti za
video format.)
starejše in obolele za demenco. Sodelovali smo pri telovadbi in vajah za spomin ter se pogovarjali z delovnimi
226
We visited the Papilot Institute, which operates Roza’s
terapevtkami in osebami, obolelimi za demenco. Miselne
Garden. Roza’s Garden offers daily activities for seniors
igre so temeljile na verbalni ravni: smiselno nadalje-
and patients with dementia. We participated in physi-
vanje povedi, iskanje asociacij, spodbujanje pripove227
cal exercises and memory exercises, and held discus-
dovanja. Med opazovanjem igre smo zaznali, da so bili
sions both with therapists and people with symptoms
udeleženci težko dalj časa osredotočeni. (sliki 1 in 2)
of dementia. Mental activity games take place on the
verbal level: continuing and completing sentences,
looking for associations, encouraging people to tell
stories. During our observation of these games, we
noticed that participants had difficulty focusing for
extended periods of time. (figs. 1 and 2)
We also observed the closed ward for people with
dementia in the Bokalce nursing home. During our
Slika 1/Fig. 1
Slika 2/Fig. 2
visits, we became acquainted with the way of life
there, the environment in which the patients live, the
Ogledali smo si tudi zaprti oddelek za dementne v
activities in which they engage, and the difficulties
Domu starejših občanov Bokalce. Med obiskom smo
encountered by both patients and caregivers. Caregiv-
spoznali njihov način življenja, okolje, v katerem se
ers at the home told us that people with dementia like
gibljejo, dejavnosti in težave, s katerimi se srečujejo
to work with their hands, which gives them a sense of
bolniki in njihovi negovalci. Negovalci v domu so nam
satisfaction and usefulness. To this end, workshops
povedali, da osebe z demenco rade ustvarjajo z rokami,
are organized, for example, to make little birds out of
saj to v njih zbudi občutek zadovoljstva in koristnosti.
paper or do simple tasks like sorting beans, shucking
Zato organizirajo ustvarjalne delavnice, na primer
corn, folding rags, and simple routine household work
izdelovanje ptičkov iz papirja, ali pa preproste naloge,
that reminds them of their past lives. Communication
kot so prebiranje fižola, luščenje koruze, zlaganje krp
through colours also proved to be extremely effective,
in podobna rutinska gospodinjska dela, ki jih spomin-
as was illustrated by the green bathroom door. Words
jajo na njihovo preteklo življenje. Za izredno učinkovito
and illustrations did not have the same communicative
se je izkazalo tudi komuniciranje z barvo. Slednje
effect. The green door solved the problem of people
so zgovorno ilustrirala zelena vrata stranišča. Napis
constantly asking and searching for the toilet. This
in ilustracija nista delovala. Zelena barva vrat pa je
made us think that colours could be an important fac-
nenehno spraševanje in iskanje stranišča v celoti rešila.
tor in design solutions for people with dementia.
To nam je dalo misliti, da je lahko barva zelo pomemben dejavnik pri oblikovanju za osebe z demenco.
6. STAKEHOLDERS
- The Papilot Institute
Nina Živković, the director of the day care centre for senior
citizens, and a group of ten visitors to Roza’s Garden.
- Nursing Home, Ljubljana Vič-Rudnik, Bokalce branch
228
6. DELEŽNIKI
Zavod Papilot
- Nina Živković, vodja dnevnega centra za oskrbo
starejših, in skupina desetih obiskovalcev
Mirjam Režek, an occupational therapist
Rozinega vrta
Sergeja Krivic, an administrator
Dom starejših občanov Ljubljana Vič - Rudnik,
Branka Drobnič, a social worker
enota Bokalce
229
- Spominčica (“Forgot-me-nots”)
Mirjam Režek, delovna terapevtka
Danica Simšič, the director of the Spominčica Asso-
Sergeja Krivic, poslovna sekretarka
ciation
Branka Drobnič, socialna delavka
Tina Ucin, a third-year student at the Faculty for Social
- Spominčica
Work
Danica Simšič, direktorica društva Spominčica
- Jožefa Fekonja, a person who has had dementia for
Tina Ucin, študentka 3. letnika Fakultete za socialno delo
five years
- Jožefa Fekonja, oseba, ki se z demenco spopada
- Gordana Makovec, a caregiver at the Dutovlje Institute
že 5 let
for Social Care
- Gordana Makovec, negovalka v Socialno-varstvenem
zavodu Dutovlje
7. SYNTHESIS OF
On the basis of our analysis, we concluded that the fol-
RESEARCH
lowing activities are effective when dealing with people
7. SINTEZA
Na podlagi analiziranih aktivnosti smo ugotovili, da
with dementia: word games, creative workshops, and
RAZISKANEGA
dobro učinkujejo besedne igre, ustvarjalne delavnice
communication through colours. As a logical exten-
in komunikacija z barvo. Kot smiselna nadgradnja se
sion, we started thinking about including sensual
je ponudilo razmišljanje v smeri vključevanja čutnih
perceptions (touch, vision, sound) with the aim of in-
zaznav (tip, vid, zvok) s ciljem povečanega zanimanja
creasing interest in participation, preserving attention,
za sodelovanje, ohranjanja pozornosti in spodbujanja
and stimulating associations.
asociacij.
8. PROPOSED
We created a set of social games using colours,
8. PREDLAGANE
Na temelju barve, oblike in teksture smo zasnovali
SOLUTIONS
shapes, and textures for elderly people with symp-
REŠITVE
komplet družabnih iger za starejše osebe, obolele za
toms of dementia. The purpose of the games was to
demenco. Namen kompleta iger je v krepitvi spomina
strengthen memory, to stimulate mental connections
ter spodbujanju miselnih povezav prek asociacij in
through associations and narrative, and to foster so-
pripovedovanja, s ciljem večje socialne povezanosti
cial links between the players. The set of games could
med igralci. Komplet iger bi lahko uporabljali v domo-
be used both in retirement homes and in the home
vih za ostarele ali v domačem okolju. Število igralcev je
environment. The number of players is flexible, from
mogoče prilagajati od ene osebe do poljubnega števila.
one person to any number of people. All of the games
Vse igre pa zahtevajo pomoč delovnega terapevta oz.
require the assistance of an occupational therapist or
skrbnika, ki usmerja potek igre, saj je ta najuspešnejša,
caregiver who directs the flow. The games will be most
če se jo da prilagajati glede na osebne lastnosti igralca
successful if they are adapted to the specific qualities
(njegovo zgodovino, njegove sposobnosti, stopnjo
of individual players (their history, abilities, the stage
bolezni itd.). Oblikovali smo naslednje igre:
of the disease, etc). We designed the following games:
1. Dementni, spomni se
230
1. Memory Parcheesi
Dementni, spomni se izhaja iz igre Človek, ne jezi
Memory Parcheesi derives from the game Parcheesi. It
se. Sestavljajo jo igralno polje, figurice in škatla
consists of a playing board, playing pieces, and boxes
z različnimi predmeti (čevelj, podkev, jabolko ... –
231
with different objects inside (shoe, horseshoe, apple –
poljubne stvari, ki jih imamo doma).
ordinary objects people have at home).
Način igranja: igralci iz škatle izvlečejo predmet in
How to play: players take an object from the box and
s pomočjo asociacij naštevajo besede v povezavi z
list words that they associate with the chosen object.
izbranim predmetom. Kolikor besed naštejejo, za toliko
The player is allowed to move their playing piece ahead
polj se na igralnem polju pomaknejo naprej (če ne
the same number of spaces as the words they have
naštejejo nič, se naprej pomaknejo le za eno polje).
listed. (If the player is unable to come up with any
Primer: igralec izvleče podkev in pove: konj, žebelj,
words, they are allowed to move their piece ahead one
kovač. Na igralnem polju se pomakne za tri polja
space.)
naprej. (sliki 3 in 4)
Example: the player pulls out the horseshoe and says:
horse, nail, blacksmith. The player is allowed to move
their piece forward three spaces. (figs. 3 and 4)
2. Flash card game
A set of cards with pictures of different themes. For
example: crafts/professions (photographs of a cobbler,
fruit grower, baker, glassmaker, seamstress, etc.), traditions and rituals (wedding, harvest, Mardi Gras, etc.),
hobbies (dancing, lawn bowling, knitting, etc.).
Slika 3/Fig. 3
Slika 4/Fig. 4
How to play: players choose pictures with the same
theme and try to remember things related to this
2. Igra s sličicami
theme.
Set kartic s sličicami različnih tematik. Na primer:
Example: Tanya selects a picture of an apple. Her task
obrti/poklici (fotografija čevljarja, sadjarja, peka,
is to list the number of dishes that can be made from
steklarja, šivilje ...), običaji in navade (poroka, pust,
apples. If she selects the picture of apple strudel,
trgatev, martinovanje …), hobiji (ples, balinanje,
she should list the ingredients, or pick out from other
pletenje …).
flashcards the ingredients and items she needs to
Način igranja: igralci zbirajo sličice z isto tematiko in
prepare this dish.
na izbrano temo obujajo spomine.
Primer: Tanja ima sličico, na kateri je jabolko. Njena
232
3. Searching for pairs – touch
naloga je, da našteje jedi iz jabolk. Ob sličici jabolčnega
We created a set of geometric figures: a circle, a
zavitka mora našteti sestavine ali pa med danimi
square, and a triangle. We made the figures from
sličicami izbere tiste, ki jih potrebujemo za pripravo
various materials with an emphasis on interesting
zavitka.
textures: fabric, wood, leather, cardboard, etc.
3. Iskanje parov – tipanje
How to play: players select tiles of either the same
Imamo nabor geometrijskih likov: krog, kvadrat in
material or the same shape. For example, they could
trikotnik. Liki so narejeni iz različnih materialov, s
be asked to find a leather triangle or a cork circle.
poudarkom na teksturi: tekstil, les, usnje, karton itd.
233
Other variations of the game might include selecting
Način igranja: igralci zbirajo ploščice istih materialov
all the tiles of the same material, for example all the
in oblik. Iskali bi na primer usnjena trikotnika ali plu-
cardboard tiles, or all the tiles of the same shape – for
tovinasta kroga. V drugi varianti zbirajo ploščice iz istih
example, all the squares.
materialov, na primer vse ploščice iz kartona, ali enake
Example: there are many figures in different shapes.
oblike, na primer vse kvadrate.
Players reach into the box and search for pairs without
Primer: v škatli so ploščice različnih oblik. Igralci se-
looking.
gajo v škatlo in iščejo pare, ne da bi gledali v škatlo.
9. TESTING IN
We made prototypes of the described games and test-
9. PREIZKUŠANJE
Izdelali smo prototipe opisanih iger in jih v praksi pre-
PRACTICE
ed them at the Papilot Institute and the nursing home
V PRAKSI (ALI
izkusili v Zavodu Papilot in v Domu starejših občanov
(OR SIMULATED
in Bokalce. The results of the tests were extremely
SIMULIRANA
Bokalce. Rezultati testiranja iger so bili izredno
TESTING) AND
positive and participants were very enthusiastic. The
PREIZKUŠNJA) IN
pozitivni, sodelujoče so igre zelo pritegnile. Nam pa je
POTENTIAL
testing period allowed us to see certain flaws that
POTENCIALNO
testiranje omogočilo prepoznanje določenih pomanj-
MEASUREMENT
resulted in the games not progressing as anticipated.
MERJENJE
kljivosti, zaradi katerih igra ni potekala tako, kot smo
OF EFFECT
This guided us in making improvements to the games:
UČINKA
si jo v izhodišču zamislili. Slednje nas je vodilo do
izboljšav in nadgradnje iger:
1. The board game (formerly “Memory Parcheesi”)
- The colours on the playing board turned out to be too
similar to one another (for example, light and dark
green).
- To make it easier to move the pieces over the board,
we made bigger spaces. We put velcro on the bottom
of the pieces (fig. 5) and painted one side in a single
colour, and the other side different colours. This made
it possible to play dominoes or ordering games. The
spaces could be combined however people wanted and
adapted to the number of players and the difficulty of
the game.
- Because the participating players often wondered
Slika 5/Fig. 5
where the dice were (probably from habit), we decided
to include a set of dice in the game set. A throw of
the dice dictated the number of associations on the
selected theme.
1. Igra z igralnim poljem (prej dementni, spomni se)
- Barve na igralnem polju so se izkazale za preveč podobne med seboj (npr. svetlo in temno zelena).
- Za lažje pomikanje figuric po ploskvi smo polja ode-
2. Flash card game
234
belili. Oblepili smo jih z ježki (slika 5) in na eni strani
- In some cases, the pictures proved to be unclear and
obarvali enobarvno, na drugi pa v različne barve; tako
consequently difficult to understand. We decided to
smo omogočili igranje domin ali igro zlaganja. Polja bi
235
find and create very clear pictures and thus increase
recognition. It also was troubling to the players to have
pictures of different dimensions, so we made them
lahko poljubno sestavljali in tako prilagajali glede na
število sodelujočih in zahtevnost igre.
- Ker so sodelujoči med igranjem pogrešali igralno
uniform. Finally, we chose matte lamination because
kocko (najverjetneje iz navade), smo se odločili, da jo
reflective surfaces were not suitable.
vključimo. Met kocke lahko diktira število asociacij na
- Because the flash cards proved to be useful in various
izbrano temo.
games, the themes began to get repetitive (the first
player got the horseshoe, the second the blacksmith,
2. Igra s sličicami
the third the hammer). We decided that before the
- Izbrane sličice so se v nekaterih primerih izkazale za
games started, it made sense to arrange the cards
nejasne in posledično težko razumljive. Odločili smo
by theme, and that we should also add more themes
se, da poiščemo in pripravimo izčiščene sličice in tako
(sports, food, historical events, etc). Also, the game
povečamo stopnjo prepoznavnosti. Za moteče so se
should allow therapists to add their own themes,
izkazale tudi različne dimenzije sličic, zato smo jih
which would make it even more personalized. Finally,
poenotili. Spremenili smo tudi tip plastifikacije (sijajna
we should coordinate the cards with the pair-finding
game and so make it possible to combine materials
and pictures.
zaradi odseva ni bila primerna).
- Ker so se sličice izkazale za zelo uporabne pri različnih igrah, so se teme začele ponavljati (prvi je dobil
podkev, drugi kovača, tretji kladivo). Odločili smo se,
3. Searching for pairs – touch
- It turned out that searching for pairs with closed eyes
da jih pred začetkom igre smiselno razvrstimo po
temah, hkrati pa dodamo več tem (od športa do hrane,
was too difficult. Rummaging through the box also
zgodovinskih dogodkov itd.). Hkrati smo omogočili,
proved to be too difficult. Through the testing process,
da sličice dodaja tudi terapevt, s čimer se lahko igra
we discovered that the game progressed better if all of
še bolj personalizira. Sličice smo uskladili tudi z igro
the tiles were arranged on the table.
iskanja parov in tako omogočili kombiniranje materiala
- While playing the game, the participants would turn
s sličico.
over the tiles. Because the tiles were all white on the
underside, the game became unstimulating and the
participants stopped looking for pairs. We decided
to make new tiles with both sides covered with the
prezahtevno. Tudi brskanje po škatli je bilo pretežko.
material.
Prek preizkušanja se je izkazalo, da je za začetek
- Because we had glued fabric onto a hard surface, it was
not recognized as textile by the participants, but rather
igranja najbolje, če so ploščice razporejene po mizi.
- Med igranjem so sodelujoči ploščice tudi obračali. Ker
was seen as only colour and pattern. We matched the
so bile na zadnji strani vse ploščice bele, so vajo pre-
backgrounds surfaces to the materials, for example,
hitro poenostavili in nehali iskati pare. Posledično smo
gluing paper onto wood, or fabric onto felt.
- We also noticed that one player began to make her
own puzzle out of the shapes (she developed her own
236
3. Iskanje parov – tipanje
- Izkazalo se je, da je iskanje parov z zaprtimi očmi
v novi različici like z obeh strani oblekli v material.
- Ker smo v izhodišču blago nalepili na trdo podlago,
ga niso prepoznali kot tekstil, temveč so v njem videli
237
game). We noticed that when putting the tiles back
le barvo in vzorec. Materiale smo glede na njihove
into the box, participants tended to sort the figures
značilnosti nalepili na leseno podlago (npr. papir) ali
by geometric shape. It was interesting that they didn’t
filc (npr. blago).
know what denim was, and that wool was also too
- Opazili smo še: da je ena igralka iz likov začela zlagati
difficult to recognize (we will switch it with a knitted
sestavljanko (razvila je svojo igro); med pospravljan-
fabric in the future).
jem v škatlo so ploščice pospravljali glede na geometrijski lik; zanimivo je bilo, da jeansa niso poznali,
pri prepoznavanju je bila prezahtevna tudi volna
Additional observations:
(zamenjali jo bomo s pletenino).
- Music, singing, and recitals seemed to play an important role in the lives of people with dementia. These
preferences should be considered as we continue to
Dodatna opažanja
reflect on possible games.
- Pomembno vlogo v njihovem življenju imajo glasba,
- The players need a lot of direction and stimulation
from occupational therapists. They are unable to play
petje in recitali. Smiselno bi bilo razmisliti tudi v tej
smeri.
on their own.
- Potrebujejo veliko usmerjanja in animiranja delovne
terapevtke. Samostojno ne morejo igrati.
10. FUTURE PLANS
In order to achieve the best possible results, we are
going to design new versions of the games and test
10. NAČRTI ZA
V želji, da bi dosegli čim boljše rezultate, bomo pre-
them again in practice.
NAPREJ
oblikovane verzije ponovno preverili v praksi.
Komplet družabnih iger bomo v nadaljevanju opremili
We are going to continue working on materials and
z gradivi in navodili, kako igre razvijati in še dodatno
instructions for our set of games, focusing on how
personalizirati, prilagajati uporabnikom/igralcem. Per-
to develop the games, personalize them more, and
sonalizacijo bi lahko opravili tako domači, ki skrbijo za
adapt them further to the users/players. The process
osebo z demenco, kot tudi terapevti v domovih. Tako
of personalization can also be undertaken by family
bi s kompletom iger dosegli tako tiste v domači oskrbi
members and caregivers involved in the care of people
kot vse v domovih za starejše.
with dementia, as well as by occupational therapists in
retirement homes. In such a way, the games could be
Med študijo in delom smo tudi ugotovili, da imajo
suitable for both people in home care and those living
otroci in starejše dementne osebe podobne misel-
in retirement homes.
ne sposobnosti in tudi nekatere vzorce obnašanja.
Opažanje je porodilo idejo o medgeneracijskem centru.
238
During our research and fieldwork, we discovered that
Program bi temeljil na povezovanju otrok (3–7 let)
children and elderly people with dementia had similar
in starejših, obolelih za demenco (začetne stopnje).
mental capabilities and patterns of behaviour. This ob-
Center bi otrokom in starejšim omogočal druženje ob
servation gave rise to the idea of an intergenerational
različnih aktivnostih v skupnih prostorih. Aktivnosti bi
centre. The program would bring together children
bile namenoma strukturirane tako, da bi bile primerne
(from three to seven years old) with elderly patients
za obe skupini in skupno druženje. Zamislili smo si
239
suffering from dementia (early phase). The centre
would offer children and elderly people the opportunity to socialize and engage in activities in a common
space. Activities would be specifically structured for
both groups and for social interaction between them.
A number of activities come to mind: visual art and
music, housework, social games, handicrafts, the
narration and reading of stories. Expert staff – occupational therapists and childcare specialists – would
coordinate all activities. Various volunteers – students,
other retired people, the unemployed – could assist
them. They would all go through a short training course
before beginning work there. The volunteers would find
an active use for their free time, and at the same time
Slika 6/Fig. 6
be performing socially useful work. They would also be
symbolically rewarded for their work, for example, with
različne aktivnosti: likovne in glasbene dejavnosti, gos-
a free lunch, lower expenses for living in the home (for
podinjstvo, družabne igre, ročna dela, pripovedovanje
retirees and students), tickets to the movies, thea-
in branje zgodb. Celotno dogajanje bi koordiniralo
tre, and other cultural events. The intergenerational
strokovno osebje – delovni terapevti in vzgojitelji. Hkrati
centre would encourage socializing (fig. 6), socially
bi jim pomagali različni prostovoljci: študenti, ostali
useful work, learning, the transfer of knowledge and
upokojenci, brezposelni. Vsi bi morali pred začetkom
experience, and feelings of importance, and also fun.
dela opraviti kratek uvajalni tečaj. Prostovoljcem bi delo
The results and the life in the community would be
omogočalo aktivno preživljanje prostega časa (slika
connected to the local environment. The results of the
6), hkrati pa bi na ta način opravljali tudi družbeno
activities would be presented at (sales) exhibitions,
koristno delo. Za delo bi bili tudi simbolično nagrajeni.
concerts, and social events such as storytelling.
Na primer: brezplačno kosilo; nižji stroški za bivanje
v domu (za upokojence, študente); vstopnice za kino,
gledališče in druge kulturne dogodke. Medgeneracijski
center bi torej spodbujal druženje, družbeno koristno
delo, učenje, prenos znanja in izkušenj, občutek
pomembnosti in tudi zabavo. Rezultate in življenje v
skupnosti bi povezali tudi z lokalnim okoljem. Rezultate
aktivnosti bi predstavljali na (prodajnih) razstavah,
koncertih in družabnih dogodkih – pripovedovanje
zgodb.
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