This month the Community Makers forum heard from a fascinating project led by Alive, and in partnership with teleconferencing company Meetupcall.

Emma from Alive was given funding by the Lottery’s catalyst programme fund to spend a few dedicated weeks talking to people affected by dementia about their needs and aspirations for connecting digitally to community groups, especially in the context of what has happened through the COVID lockdown.

Video conferring technologies; Zoom, Teams and others; have been a godsend during the lockdown, and we should consider ourselves fortunate that if there was going to be a pandemic like this, then it should happen at a time when we have these mature internet services available to so many in the population. Just 10 years ago, the pandemic would have been a very different experience without us being so easily able to meet, talk, educate and socialise through video calls. However, the availability of these platforms have perhaps meant that we have rushed into using them in many situations without taking the proper time to work out if it was the best available medium for people we are serving, including those affected by dementia.

Emma had the opportunity to do just that. To pause, and ask older people, and those affected by Dementia what they needed and what they wanted.

For many people with dementia, new technologies and new ways of communicating are alien to them. They may find it difficult to learn and retain new digital skills. Participating in a conversation on a video conferencing platform can be overwhelming with a riot of faces and disembodied voices. There are brand new social protocols to learn for interacting on video; muting, unmuting, raising hands, text chatting all complicate an already overwhelming experience.

Of course the phone is a familiar device in everyone’s life, and we all have a ‘muscle memory’ going back decades, relatively resistant to the effects of dementia. In fact many of us have probably had the very same landline handset for decades, and so using it is easy and familiar, drawing on the long term memory.. even if, for the first time, you have more than one voice at the other end. At least you only have to track the voices, and not the faces.

Through testing teleconferencing with dementia support groups, Emma points out that it’s harder to interrupt on voice only, and talking over each other becomes unintelligible very quickly, so people are more likely to be patient and follow the lead of a facilitator. Alive have found that groups of between 6 and 12 participants can have a great event on the phone, and describes how people share poetry, sing and share stories more freely than on video platforms or even in person.

Gavin, a product manager at Meetupcall, who works with Emma on this project explained how Meetupcall had noticed that during the pandemic there was an uptake in consumer use of their products, especially within the older demographic. Gavin turned some of his attention away from their usual clients – serving board meetings and corporate clients, to explore the needs of older people in the community, and approached Alive to collaborate.

The partnership allowed Emma and Gavin to dedicate some time, and follow a user-centred design process to develop a solution aimed at maximising accessibility for older people and those affected by dementia.

The user-centred design process starts with establishing the needs of intended users, and letting their insights and feedback determine the development of the product through regular testing.

This process, which many people did not have the luxury to follow when reacting to COVID, provided the insight that telephone use was found to be highly accessible and attractive to end users. One key advantage that Emma and Gavin uncovered was that telephone offered the only medium that allows you to ‘push communications’ (to use an internet era term) to the end user: you can call them to remind them about events, and you can call them into meetings – no need for passwords, reminders, codes, secure links and all the other hurdles to people with dementia.

Despite some hesitation about voice only events, Emma tells us that it has been surprising how effective teleconferencing has been once you get rid of some of the obstacles, like having to use the keypad mid call. Gavin has been working hard to eliminate these obstacles and create a platform for the organiser to manage participants, protect individual data and provide a calling out service rather than a calling in model.

The presentation was warmly received by the Community Makers, and there were many questions around the practicalities of running telephone based activities. Emma described that teleconferencing does need thoughtful and significant facilitation to make sure that all participants are able to participate to a satisfactory level.

In the group discussion we briefly debated the merits of adding video as an optional extra to the teleconferencing call. From a technical perspective you could easily dial people in on the phone, and complement this with visuals delivered on a tablet computer. (Providing passwords etc over the phone in real-time). On the one hand this could provide extra stimulus for engagement, and help include people with poor hearing or speech. On the other hand it may create a two tier participation, and disrupt the natural voice only rapport that seems to work well for this demographic. Something to be experimented with on a group by group basis.

None of this is to say that there isn’t a place for video calling. Video has been saving grace during the pandemic, helping us to have meaningful contact with familiar faces while shielding or isolating. When conversation is difficult, seeing a face can mean everything. Some people with dementia are comfortable with video and their carers can find value in it too. But the big lesson from Alive this month has been that there are advantages to using familiar devices and technologies, and that there may even be cases where less is more.. where radio kills the video star!

Emma is keen to hear from people who would like to help test and develop this approach, and Alive run training sessions on how to deliver teleconference based community support. Get in touch to find out more – Emma@aliveactivities.org

Photo by Annie Spratt on Unsplash