We’ve all seen the news coverage about the increasing emergence of artificial intelligence, or AI. It’s a phenomenon that is being widely scrutinised, with projections about how it might affect jobs, and how we live our lives in general. But how might it specifically benefit healthcare systems of the future? Does recent press coverage overstate the possibilities, or does this herald the beginning of a new era in healthcare provision?
With AI-focused research generating plenty of pause for thought, the Scottish Dementia Working Group (SDWG) met up to discuss how AI approaches are increasingly being used in dementia research, and whether it could support the NHS more broadly. To kick-off the conversation, SDWG members were given in advance articles documenting two technological advances in particular:
- Agent-based Memory Prosthesis to Encourage Reminiscence (the AMPER project); and
- Digital avatars
For context, the AMPER project focuses on the development of a ‘digital companion’, accessed through a computer or tablet, capable of personalised storytelling to help an individual living with dementia recall personal, possibly forgotten, memories. These digital companions would be pre-programmed with details of the individual’s unique life experiences, their age, the social context, and be able to respond to the person’s changing needs.
Digital avatars take things a step further. These are computer-generated images that represent a real person – in other words, they are virtual humans. Such technology enables the creation of avatars that resemble the physical appearance, and mirror the expressions of, a real person – either living or deceased. Major advancements mean that users could potentially enter a dialogue with this ‘digital human’, holding real-time conversations and interactions with an avatar that represent a loved one who is not able to be with them.
The long-term vision for these developments is to integrate them into domestic, educational, health and assistive-needs settings – and various scholarly articles describe AI-enabled systems increasingly being used in dementia research. But how do people who are currently living with dementia feel about this prospect? Here’s some of the key points from the SDWG member discussion:
- On whether any members already use technology to support their daily life: Overwhelmingly, the answer to this question was yes – but at a more rudimentary, everyday level, such as using devices like Alexa for reminders and to listen to music, a smartphone to manage emails, calendars, and messages, or GPS tracking services. Members remarked that Alexa is helpful and informative, and is a valuable tool to remind of appointments, the time, day, and date etc. One member felt that although used for ‘trivial stuff’, it was nevertheless useful to help them stay in the ‘here and now’.
- On whether AMPER would be something they would consider using if there were proven benefits: Again, the consensus was yes – because there is power in reminiscence therapy and the idea that storytelling can improve self-esteem. One member explained that while some days it can feel like they’re running down a steep hill, reminiscence therapy can help to redress the balance, sparking happy memories that bring a smile. It was suggested that in group settings, perhaps day care centres, this type of approach would be particularly useful – though dependent upon the stage of dementia individuals are experiencing.
However, a need for caution was noted by all contributors. And one member felt that in many ways, the development of these technologies represents a misunderstanding of the needs of people living with dementia. They felt that rather than needing a machine to hold a catalogue of their past life, it would be far more beneficial to use technology to help with more day-to-day domestic tasks, grocery shopping for example.
Questions were posed about the ethics of holding so much very personal data on machines – along with how and where this would be stored. Who would be responsible for it, who would own it, how and when would it be deleted? How easy would it be to anonymise data and who would administer it? These are all areas that members of the group would be keen to learn more about.
- On the use of digital avatars and their use in dementia care:
As AI-based technology develops and is put into practice, there is scope for it to form a bigger part of social care, as well as in clinical settings. In theory, it could help dementia diagnoses occur more quickly, or even be used to offer specific treatments to individuals. So, could it be used to improve the quality of care received by people living with dementia?
Feedback from members suggests they are in favour of AI taking on more laborious, administrative tasks that can take up a lot of time for medics and carers. That is considered a potentially beneficial impact. However, while there is a general acceptance of AI and the ever-increasing likelihood that this scenario may transpire, the overwhelming feeling among the group is that AI should never, and could never, replace human to human interactions.
And while there may be uses for avatar technology which should be embraced, there was also concern that in some instances, it might cause more harm than good. For example, members expressed deep distrust of AI-inspired avatars ever being able to reliably administer medication. But more than that, there was a strong feeling that the warmth and compassion conveyed by a human being could never be replicated by an inanimate object. As one member noted, ‘you can’t look a robot in the eye’.
There was also concern that avatars could symbolise a degree of deception – because they give the impression of a real person being present, complete with a representation of their face, voice, expression, and pre-programmed knowledge. And it may not always be possible for people with dementia to distinguish reality from perception. So, is the concept of digital immortality a step too far?
You can hear Stuart, SDWG member, discussing this topic on BBC Sounds Digital Human here.
What do you think? If you have any thoughts, opinions or experiences you’d like to share, we’d love to hear from you. Please get in touch with us at [email protected]