{"id":50103,"date":"2021-08-04T19:30:53","date_gmt":"2021-08-04T19:30:53","guid":{"rendered":"https:\/\/www.moraeslab.com\/biapt\/?p=50103"},"modified":"2021-09-30T19:39:53","modified_gmt":"2021-09-30T19:39:53","slug":"moving-with-and-tuning-in","status":"publish","type":"post","link":"https:\/\/www.moraeslab.com\/biapt\/moving-with-and-tuning-in\/","title":{"rendered":"Moving With and Tuning In"},"content":{"rendered":"

[et_pb_section fb_built=”1″ admin_label=”section” _builder_version=”4.10.5″ global_colors_info=”{}”][et_pb_row admin_label=”row” _builder_version=”3.25″ background_size=”initial” background_position=”top_left” background_repeat=”repeat” global_colors_info=”{}”][et_pb_column type=”4_4″ _builder_version=”3.25″ custom_padding=”|||” global_colors_info=”{}” custom_padding__hover=”|||”][et_pb_text admin_label=”Text” _builder_version=”3.27.4″ background_size=”initial” background_position=”top_left” background_repeat=”repeat” global_colors_info=”{}”]This project was conceived and developed in response to a call from the <\/span>Canadian Institutes of Health Research<\/span><\/a> for proposals to develop interventions that improve the social inclusion of individuals with dementia and their caregivers. \u00a0 The overarching aim of this participatory mixed-methods research program was to address the loss of personhood associated with dementia through two distinct relationship-centered interventions – <\/span>Moving-With<\/span><\/i> and <\/span>Tuning-In<\/span><\/i>.\u00a0 Personhood, as our holistic unit of analysis, brought explicit focus on the first-person subjective and inter-subjective experiences of social exclusion of individuals with dementia and their primary carers.\u00a0 The overarching methodology was participatory research, which is an approach to research that integrates the voices of stakeholders into the research process itself, as co-researchers.\u00a0 Theoretically, this approach is a transformative research process, and was designed to empower marginalized individuals and communities.\u00a0 This project was conducted in partnership with <\/span>Alzheimer\u2019s Group Inc.<\/span><\/a> (AGI) — a non-profit group serving individuals with dementia and their caregivers in the Montreal community — who were involved from study conception as co-applicants on the grant, to study completion as co-authors on the final published papers.\u00a0\u00a0<\/span><\/p>\n

This research program was designed to address three objectives:<\/span><\/p>\n

 <\/p>\n

Objective 1: Identify social situations and and places where\/when individuals with dementia and their primary carers experience exclusion in relationship to perceptions of personhood.<\/b><\/p>\n

 <\/p>\n

Dr. Rossio Motta Ochoa conducted nine-months of ethnographic fieldwork at AGI and at the homes of AGI\u2019s clients to explore the points of view of 1) persons with dementia; 2) primary caregivers; and 3) staff members about situations, moments and places of social inclusion and exclusion.\u00a0 Forty-nine individuals were recruited for participant observation and ethnographic interviews, enabling spontaneous conversations to emerge in real-time, rather than relying on the memory of individuals with dementia.\u00a0 Dr. Motta Ochoa also conducted semi-structured interviews with a sub-group for triangulation.\u00a0 All data were analyzed thematically, with the input of partners from AGI for discussions about the interpretation and meaning of the findings.\u00a0\u00a0<\/span><\/p>\n

 <\/p>\n

Our first major finding was that the participant\u2019s culture was inextricably linked to their experiences of social inclusion and exclusion.\u00a0 Participants reported how their culture affected the transformation of the person with dementia and the caregiver, the ways in which they participated in social networks and meaningful relations, and the styles of care provisions in health and social services.\u00a0 Cultural mandates prescribing practices of intergenerational care, and culturally specific notions associated with dementia shaped experiences of inclusion and exclusion.\u00a0 Our work also showed how engaging with the cultural elements of individuals with dementia was an effective and underexplored tool for fostering inclusion.\u00a0 These results are fully detailed in an article published in <\/span>Transcultural Psychiatry<\/span><\/i>: <\/span>\u201c\u2018When I hear my language, I travel back in time and I feel at home\u201d: Intersections of culture with social inclusion and exclusion of persons with dementia and their caregivers\u201d<\/span><\/a>.\u00a0\u00a0<\/span><\/p>\n

 <\/p>\n

Our second major result was a description of the in-action practices of social inclusion of individuals with dementia, extending the research lens to capture the various ways in which social inclusion is pragmatically enacted.\u00a0 We focused on actions, which are imbued by the meaningfulness to and intended purpose of the agent, and acknowledges the knowledge that is tacit in action.\u00a0 We identified seven in-actions practices of effective inclusion: ensuring time for individual relationships, building schedules centered around flexibility, empowering decision-making, normalizing dementia-related behaviours, involving family members, soliciting and integrating persons with dementia\u2019s feedback, and supporting persons with dementia to practice social inclusion.\u00a0 While many of our findings reflected principles that have been well-established in person-centered care, they highlighted two practices that have received little attention to-date: the contact solicitation of feedback from individuals with dementia; and the practices of social inclusion enacted by individuals with dementia with their peers and with staff.\u00a0 We also provide descriptions of all practices, aiming to facilitate their partial translation to other community-based organizations and multiple inclusive environments for persons with dementia.\u00a0 The full results are published in <\/span>Clinical Gerontology:<\/span><\/i> \u201c\u2018You\u2019re part of us and we\u2019re happy to have you here\u201d: Practices of social inclusion for persons with dementia\u201d<\/span><\/a>.\u00a0\u00a0<\/span><\/p>\n

 <\/p>\n

Objective 2: Tailor and implement <\/b>Moving-With<\/i><\/b> – a movement-based intervention for individuals with dementia and their carers.<\/b><\/p>\n

 <\/p>\n

To accomplish this objective, we partnered with <\/span>Ariane Boulet<\/span><\/a> and <\/span>Je Suis Julio<\/span><\/a>, who delivered movement-based programs called <\/span>Mouvement de passage <\/span><\/i>at AGI designed to foster moments of interpersonal connection between individuals with dementia and their carers.\u00a0 Dr. Rossio Motta Ochoa and Natalia Incio Serra used ethnographic methods — including participant observations and informal interviewers — to understand the relational effects of this program, conducted by two dancers and a musician.\u00a0 Eight sessions were delivered over the course of 4 months; sessions were videotaped, and the participants\u2019 physiological signals were monitored using wearable technology.\u00a0\u00a0<\/span><\/p>\n

 <\/p>\n

Our analysis revealed that participants in <\/span>Mouvement de passage<\/span><\/i> experienced increasing numbers of connections over the course of the program, despite most participants not remembering the previous movement sessions.\u00a0 In particular, participants had increasing numbers of reciprocal interpersonal connections throughout the program.\u00a0 Participants explored new forms of moving and creatively transformed the movement structures proposed by the dancers.\u00a0 Our results demonstrated the effectiveness of this program in augmenting connections and fostering exploration and creativity in individuals with dementia, providing a template for other interventions targeting the relational dimensions of dementia.\u00a0 The full results are published in <\/span>Dementia<\/span><\/i>: <\/span>\u201cMouvement de passage: Creating connections through movement among persons with dementia\u201d<\/span><\/a>.<\/span><\/p>\n

 <\/p>\n

During <\/span>Mouvement de passage<\/span><\/i>, we noticed how the movement program fostered expressions of agency in participants with dementia.\u00a0 We used the social science theories of interaction between structure and agency to examine how this arts-based movement program achieved this effect.\u00a0 Our results demonstrated that participants with dementia expressed their agency in three ways: 1) transforming the exercise\u2019s structure according to their individual interests and desires; 2) resisting the exercise\u2019s structure; and 3) improvising movements collectively.\u00a0 We also showed how the design of <\/span>Mouvement de passage<\/span><\/i> was effective in fostering agency, providing a template for developing future intervention to achieve similar effects.\u00a0 The full results are published in <\/span>Arts and Health<\/span><\/i>: <\/span>\u201cEnacting agency: movement, dementia and interaction\u201d<\/span><\/a>.<\/span><\/p>\n

 <\/p>\n

Objective 3: Tailor and implement <\/b>Tuning-In <\/i><\/b>– an emotion-recognition technology customized to particular individuals with dementia to increase perceptions of their personhood.<\/b><\/p>\n

 <\/p>\n

The BIAPT lab has invented <\/span>Biomusic<\/span><\/i> – a wearable technology that detects emotion-related changes in physiological signals and converts them to sonic output.\u00a0 In this objective, we wanted to determine if biomusic could be used by individuals with dementia and their caregivers to increase feelings of connection and personhood.\u00a0<\/span><\/p>\n

First, we determined that salient moments of connection could be detected from individuals with dementia using wearable technology.\u00a0 Using a finger sensor, we recorded three physiological signals — electrodermal activity, skin temperature, blood volume pulse — from individuals with dementia as they engaged in a movement program.\u00a0 We synchronized the physiological data with video data, and used salient physiological features (e.g. electrodermal reactions) to mark moments in the video which appeared physiologically significant to the participant.\u00a0 Immediately after the session, we showed a 30 second video clip containing the putative significant moment to the individual with dementia and their caregiver.\u00a0 Their verbal feedback confirmed that the physiological reactions corresponded with significant moments, validating the reliability of this method.\u00a0 The full results are published in <\/span>Biomedical Engineering Online:<\/span><\/i> \u201cWearable Technology for Detecting Significant Moments in Individuals with Dementia\u201d<\/span><\/a>.\u00a0<\/span><\/p>\n

We then tested biomusic in a series of participatory case studies with an individual with dementia and their caregiver.\u00a0 We involved the caregivers as co-designers, and iteratively tailored biomusic to meet their specific needs and contexts.\u00a0 Biomusic was used as a detector for negative emotions, which supported caregiver interpretations of the non-verbal behavior of the individual they were caring for.\u00a0 Most interestingly, biomusic was used in a \u201cremote monitoring\u201d setting, where a spouse was able to monitor the real-time physiological signals of her husband living in a long-term care home.\u00a0 These results were presented at the 2020 <\/span>4S annual meeting<\/span><\/a>: \u201cRethinking personhood and inclusive technologies: Biomusic as relational effect\u201d, and is the subject of a forthcoming article.\u00a0\u00a0<\/span><\/p>\n

As a result of this project, the biomusic Android app has evolved from a laboratory prototype to robust, stable software, with the ability to be customized to the individual needs of each user.\u00a0 We expect to release biomusic through our newly incorporated company, Expressiva, in the near future.<\/span>[\/et_pb_text][\/et_pb_column][\/et_pb_row][\/et_pb_section]<\/p>\n","protected":false},"excerpt":{"rendered":"

This project was conceived and developed in response to a call from the Canadian Institutes of Health Research for proposals to develop interventions that improve the social inclusion of individuals with dementia and their caregivers. \u00a0 The overarching aim of this participatory mixed-methods research program was to address the loss of personhood associated with dementia […]<\/p>\n","protected":false},"author":12,"featured_media":50104,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_et_pb_use_builder":"on","_et_pb_old_content":"This project was conceived and developed in response to a call from the <\/span>Canadian Institutes of Health Research<\/span><\/a> for proposals to develop interventions that improve the social inclusion of individuals with dementia and their caregivers. \u00a0 The overarching aim of this participatory mixed-methods research program was to address the loss of personhood associated with dementia through two distinct relationship-centered interventions - <\/span>Moving-With<\/span><\/i> and <\/span>Tuning-In<\/span><\/i>.\u00a0 Personhood, as our holistic unit of analysis, brought explicit focus on the first-person subjective and inter-subjective experiences of social exclusion of individuals with dementia and their primary carers.\u00a0 The overarching methodology was participatory research, which is an approach to research that integrates the voices of stakeholders into the research process itself, as co-researchers.\u00a0 Theoretically, this approach is a transformative research process, and was designed to empower marginalized individuals and communities.\u00a0 This project was conducted in partnership with <\/span>Alzheimer\u2019s Group Inc.<\/span><\/a> (AGI) -- a non-profit group serving individuals with dementia and their caregivers in the Montreal community -- who were involved from study conception as co-applicants on the grant, to study completion as co-authors on the final published papers.\u00a0\u00a0<\/span>\r\n\r\nThis research program was designed to address three objectives:<\/span>\r\n\r\n\u00a0\r\n\r\nObjective 1: Identify social situations and and places where\/when individuals with dementia and their primary carers experience exclusion in relationship to perceptions of personhood.<\/b>\r\n\r\n\u00a0\r\n\r\nDr. Rossio Motta Ochoa conducted nine-months of ethnographic fieldwork at AGI and at the homes of AGI\u2019s clients to explore the points of view of 1) persons with dementia; 2) primary caregivers; and 3) staff members about situations, moments and places of social inclusion and exclusion.\u00a0 Forty-nine individuals were recruited for participant observation and ethnographic interviews, enabling spontaneous conversations to emerge in real-time, rather than relying on the memory of individuals with dementia.\u00a0 Dr. Motta Ochoa also conducted semi-structured interviews with a sub-group for triangulation.\u00a0 All data were analyzed thematically, with the input of partners from AGI for discussions about the interpretation and meaning of the findings.\u00a0\u00a0<\/span>\r\n\r\n\u00a0\r\n\r\nOur first major finding was that the participant\u2019s culture was inextricably linked to their experiences of social inclusion and exclusion.\u00a0 Participants reported how their culture affected the transformation of the person with dementia and the caregiver, the ways in which they participated in social networks and meaningful relations, and the styles of care provisions in health and social services.\u00a0 Cultural mandates prescribing practices of intergenerational care, and culturally specific notions associated with dementia shaped experiences of inclusion and exclusion.\u00a0 Our work also showed how engaging with the cultural elements of individuals with dementia was an effective and underexplored tool for fostering inclusion.\u00a0 These results are fully detailed in an article published in <\/span>Transcultural Psychiatry<\/span><\/i>: <\/span>\u201c\u2018When I hear my language, I travel back in time and I feel at home\u201d: Intersections of culture with social inclusion and exclusion of persons with dementia and their caregivers\u201d<\/span><\/a>.\u00a0\u00a0<\/span>\r\n\r\n\u00a0\r\n\r\nOur second major result was a description of the in-action practices of social inclusion of individuals with dementia, extending the research lens to capture the various ways in which social inclusion is pragmatically enacted.\u00a0 We focused on actions, which are imbued by the meaningfulness to and intended purpose of the agent, and acknowledges the knowledge that is tacit in action.\u00a0 We identified seven in-actions practices of effective inclusion: ensuring time for individual relationships, building schedules centered around flexibility, empowering decision-making, normalizing dementia-related behaviours, involving family members, soliciting and integrating persons with dementia\u2019s feedback, and supporting persons with dementia to practice social inclusion.\u00a0 While many of our findings reflected principles that have been well-established in person-centered care, they highlighted two practices that have received little attention to-date: the contact solicitation of feedback from individuals with dementia; and the practices of social inclusion enacted by individuals with dementia with their peers and with staff.\u00a0 We also provide descriptions of all practices, aiming to facilitate their partial translation to other community-based organizations and multiple inclusive environments for persons with dementia.\u00a0 The full results are published in <\/span>Clinical Gerontology:<\/span><\/i> \u201c\u2018You\u2019re part of us and we\u2019re happy to have you here\u201d: Practices of social inclusion for persons with dementia\u201d<\/span><\/a>.\u00a0\u00a0<\/span>\r\n\r\n\u00a0\r\n\r\nObjective 2: Tailor and implement <\/b>Moving-With<\/i><\/b> - a movement-based intervention for individuals with dementia and their carers.<\/b>\r\n\r\n\u00a0\r\n\r\nTo accomplish this objective, we partnered with <\/span>Ariane Boulet<\/span><\/a> and <\/span>Je Suis Julio<\/span><\/a>, who delivered movement-based programs called <\/span>Mouvement de passage <\/span><\/i>at AGI designed to foster moments of interpersonal connection between individuals with dementia and their carers.\u00a0 Dr. Rossio Motta Ochoa and Natalia Incio Serra used ethnographic methods -- including participant observations and informal interviewers -- to understand the relational effects of this program, conducted by two dancers and a musician.\u00a0 Eight sessions were delivered over the course of 4 months; sessions were videotaped, and the participants\u2019 physiological signals were monitored using wearable technology.\u00a0\u00a0<\/span>\r\n\r\n\u00a0\r\n\r\nOur analysis revealed that participants in <\/span>Mouvement de passage<\/span><\/i> experienced increasing numbers of connections over the course of the program, despite most participants not remembering the previous movement sessions.\u00a0 In particular, participants had increasing numbers of reciprocal interpersonal connections throughout the program.\u00a0 Participants explored new forms of moving and creatively transformed the movement structures proposed by the dancers.\u00a0 Our results demonstrated the effectiveness of this program in augmenting connections and fostering exploration and creativity in individuals with dementia, providing a template for other interventions targeting the relational dimensions of dementia.\u00a0 The full results are published in <\/span>Dementia<\/span><\/i>: <\/span>\u201cMouvement de passage: Creating connections through movement among persons with dementia\u201d<\/span><\/a>.<\/span>\r\n\r\n\u00a0\r\n\r\nDuring <\/span>Mouvement de passage<\/span><\/i>, we noticed how the movement program fostered expressions of agency in participants with dementia.\u00a0 We used the social science theories of interaction between structure and agency to examine how this arts-based movement program achieved this effect.\u00a0 Our results demonstrated that participants with dementia expressed their agency in three ways: 1) transforming the exercise\u2019s structure according to their individual interests and desires; 2) resisting the exercise\u2019s structure; and 3) improvising movements collectively.\u00a0 We also showed how the design of <\/span>Mouvement de passage<\/span><\/i> was effective in fostering agency, providing a template for developing future intervention to achieve similar effects.\u00a0 The full results are published in <\/span>Arts and Health<\/span><\/i>: <\/span>\u201cEnacting agency: movement, dementia and interaction\u201d<\/span><\/a>.<\/span>\r\n\r\n\u00a0\r\n\r\nObjective 3: Tailor and implement <\/b>Tuning-In <\/i><\/b>- an emotion-recognition technology customized to particular individuals with dementia to increase perceptions of their personhood.<\/b>\r\n\r\n\u00a0\r\n\r\nThe BIAPT lab has invented <\/span>Biomusic<\/span><\/i> - a wearable technology that detects emotion-related changes in physiological signals and converts them to sonic output.\u00a0 In this objective, we wanted to determine if biomusic could be used by individuals with dementia and their caregivers to increase feelings of connection and personhood.\u00a0<\/span>\r\n\r\nFirst, we determined that salient moments of connection could be detected from individuals with dementia using wearable technology.\u00a0 Using a finger sensor, we recorded three physiological signals -- electrodermal activity, skin temperature, blood volume pulse -- from individuals with dementia as they engaged in a movement program.\u00a0 We synchronized the physiological data with video data, and used salient physiological features (e.g. electrodermal reactions) to mark moments in the video which appeared physiologically significant to the participant.\u00a0 Immediately after the session, we showed a 30 second video clip containing the putative significant moment to the individual with dementia and their caregiver.\u00a0 Their verbal feedback confirmed that the physiological reactions corresponded with significant moments, validating the reliability of this method.\u00a0 The full results are published in <\/span>Biomedical Engineering Online:<\/span><\/i> \u201cWearable Technology for Detecting Significant Moments in Individuals with Dementia\u201d<\/span><\/a>.\u00a0<\/span>\r\n\r\nWe then tested biomusic in a series of participatory case studies with an individual with dementia and their caregiver.\u00a0 We involved the caregivers as co-designers, and iteratively tailored biomusic to meet their specific needs and contexts.\u00a0 Biomusic was used as a detector for negative emotions, which supported caregiver interpretations of the non-verbal behavior of the individual they were caring for.\u00a0 Most interestingly, biomusic was used in a \u201cremote monitoring\u201d setting, where a spouse was able to monitor the real-time physiological signals of her husband living in a long-term care home.\u00a0 These results were presented at the 2020 <\/span>4S annual meeting<\/span><\/a>: \u201cRethinking personhood and inclusive technologies: Biomusic as relational effect\u201d, and is the subject of a forthcoming article.\u00a0\u00a0<\/span>\r\n\r\nAs a result of this project, the biomusic Android app has evolved from a laboratory prototype to robust, stable software, with the ability to be customized to the individual needs of each user.\u00a0 We expect to release biomusic through our newly incorporated company, Expressiva, in the near future.<\/span>","_et_gb_content_width":"","footnotes":""},"categories":[57,50],"tags":[],"class_list":["post-50103","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-moving_with_tuning_in","category-past-projects"],"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/www.moraeslab.com\/biapt\/wp-json\/wp\/v2\/posts\/50103","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.moraeslab.com\/biapt\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.moraeslab.com\/biapt\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.moraeslab.com\/biapt\/wp-json\/wp\/v2\/users\/12"}],"replies":[{"embeddable":true,"href":"https:\/\/www.moraeslab.com\/biapt\/wp-json\/wp\/v2\/comments?post=50103"}],"version-history":[{"count":7,"href":"https:\/\/www.moraeslab.com\/biapt\/wp-json\/wp\/v2\/posts\/50103\/revisions"}],"predecessor-version":[{"id":50268,"href":"https:\/\/www.moraeslab.com\/biapt\/wp-json\/wp\/v2\/posts\/50103\/revisions\/50268"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.moraeslab.com\/biapt\/wp-json\/wp\/v2\/media\/50104"}],"wp:attachment":[{"href":"https:\/\/www.moraeslab.com\/biapt\/wp-json\/wp\/v2\/media?parent=50103"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.moraeslab.com\/biapt\/wp-json\/wp\/v2\/categories?post=50103"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.moraeslab.com\/biapt\/wp-json\/wp\/v2\/tags?post=50103"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}