An easy-to-use touch screen multimedia system has helped people with dementia be more interactive with carers.

The Computer Interactive Reminiscence and Conversation Aid (Circa) packages clips of old films, music and photos which can be played via a touch screen.

Reminiscence therapy is important for people with dementia but they are often led and controlled by the carer.

Circa instead lets the individual take control by choosing clips that may trigger some memory and conversation.

"It has long been accepted that memories from longer ago are well established," explained project leader, Dr Arlene Astell, from St Andrews University.

"We were trying to find way to tap into those reminiscences and use them as basis for conversation with carers, while minimising load on working memory."

The team which developed and tested the system over three years is now looking at creating a similar one which individuals could use alone.

They hope the Engineering and Physical Sciences Research Council (EPSRC) funded research could be built on to help people with learning problems and head injuries in the future.

Easy and accessible

"The people it is aimed at, people with dementia, have very severe working memory problems," explained Dr Arlene Astell.

"So if you are trying to have a conversation, they forget what they were talking about. It is difficult to retrieve information based on direct questions. So we're trying to use technology to find a way around those problems."

The frustration in trying to have a conversation would not only be felt by the person with dementia, but also by their carer - family members and professionals.

The Circa system is based on something called hypermedia. This is linked content that works like internet hyperlinks. It uses the carefully chosen media as memory aids and prompts instead.

The clips of sound - Elvis tracks for example - photos of local areas, or film clips - from Casablanca and other films - all date from between the 1930s and 1960s.

The aim was to make something that was very accessible to people with no computer skills, and something that looked inviting and easy to use.

The system, tested by 40 dementia sufferers and their carers, proved to be a hit when it came to music clips, said Dr Astell.

In some cases, carers reported the testers seemed like "their old selves".

Elvis rock

"The purpose is to try to address an area that is neglected in dementia care. So much is focused on everyday needs. Having conversation and interaction is often overlooked," said Dr Astell.

There may not always be time for carers to prepare rich media material for similar one-to-one reminiscing sessions, without such a system.

The feedback from carers has been positive so far.

One 56-year-old woman, cared for at home by her husband, watched a clip of Elvis Presley. She took her husband's hand and started swinging it in time to the music.

At one point, her husband Richard said, she moved in closer to him and rubbed noses with him.

Richard told the researchers he thought it was her attempt to show him that "she remembered".

Another headstrong 80-year-old, John, tried the system after his nursing home carers found it a struggle to get him to join in group or planned reminiscing sessions.

Giving control over to him meant he could choose the clips of images, audio and movies that he wanted, prompting him to talk about what he saw.

"We did a bit of investigation as to what sort of stimuli would be good for encouraging people to reminisce," Dr Astell said.

"We found that pretty much anything is good if you give people the opportunity to talk about it."

She added, though, including photos or video clips that were too personal to the person with dementia was too upsetting for them and family carers.

The frustration they felt not being able to recognise people clouded their enjoyment.

"Our philosophy has been that the computer is a vehicle for having a positive shared activity. It is not a memory test," said Dr Astell.