The Tovertafel began with research, during Hester Le Riche’s PhD, and research remains central to what we do at Active Cues. We believe it is important that the Tovertafel matches not only the needs of the users, but those of care staff and families too.
Dementia & the Tovertafel
PhD Research: Playful design for activation Learn more about this research
Care institutions as stimulating environments Learn more about this research
Environment makes an active contribution Learn more about this research
Game design and dementia Learn more about this research
Co-designing the Tovertafel Original Learn more about this research
PhD Research: Playful design for activation
Tovertafel creator Hester successfully defended her PhD at the TU Delft with her research on the Tovertafel. In care institutes, 90 per cent of residents with dementia suffer from apathy. The goal of Hester's PhD research was to reduce passivity among elderly with dementia by developing a product that stimulates physical activity and social interaction.
During her research, she performed multiple studies to learn more about the target group and the context they live in. In multiple design steps, always combined with scientific research, the so-called 'research by design', she developed the resulting concept of the Active Cues Tovertafel.
Care institutions as stimulating environments
Various studies have been done on the effect of the physical environment in care institutions on the movements of residents on the dementia journey. We carried out a systematic literature review to chart what is known about the effect of these physical elements. This article was published in the Journal of Applied Ergonomics.
- Positive results were found with: music, functional adaptations in the interior (for example memory aids or pointers) and decorating communal rooms so they look like a home.
- Generally positive results were found with small-scale living arrangements.
- Mixed results were found with: multi-sensory environments (snoezelen), (extra) bright light, and changes in the layout of the care institution.
Environment makes an active contribution
With qualitative studies, we investigated the influence of the social environment on the movements of older people on the dementia journey. How does interaction between residents and care staff contribute to the residents' activeness? We did interviews with residents and care staff, organised focus group sessions, made observations and shadowed staff.
- Care personnel use 9 strategies to stimulate residents on the dementia journey: using humour and optimism, awareness, stimulating self-confidence, creating a safe environment, personal attention, giving them time to try something by themselves first, adopting a resolute position, emphasising ‘doing together’, and playing along with their experiences.
- Whether the residents join in with activities or do them independently is strongly influenced by their reactions. Residents can be cooperative, willing, hesitant or oppositional.
- There are differences among care staff: some staff have a more standoffish attitude, some are supportive and some are very nurturing.
- Residents can stimulate or demotivate each other. Mutual contact is necessary to do things together and motivate each other, but a mutually created demotivating atmosphere can also emerge.
This research is discussed in a chapter of Hester Le Riche's PhD thesis
Game design and dementia
The brain’s deterioration, a consequence of dementia, influences how older people experience the world around them, and so influences how they play games. To determine which games are suitable for older people at the different stages of Alzheimer's, Hester Le Riche, together with amongst others Prof. Dr. Erik Scherder, looked at the literature on neuropsychology.
- The stage of the dementia journey has such a large influence on what games are suitable that designing a game for all 'older people on the dementia journey' is impossible.
- Gaming experiences that are suitable for all stages are: sensory stimulation, relaxation and reminiscence.
- Gaming experiences that are suitable for people on the early stage of the dementia journey are: sympathy, care, fellowship, expression, humour, eroticism, upheaval and challenge.
- The game experience ‘exploration’ is not suitable for people with Alzheimer's.
The article was accepted by the International Journal of Design*.
Read the scientific publication
Co-designing the Tovertafel Original
The Tovertafel Original came about through close collaboration with residents from care provider Careyn. This research and design method is known as ‘participatory design’ or ‘co-design’. By involving the target group in the design process, we made sure that the Tovertafel is suited to what older people can do and what they enjoy best.
- The game must take the initiative to encourage older people to take part. They will not begin playing without prompting.
- By continually reminding older people what they are doing, they keep active for longer.
- Light projections that are rich in terms of colour, movement and detail are most valued by older people.
- Nothing can go wrong during play, creating a safe situation where older people are free to try things.
- Games in which older people at different stages on the dementia journey can take part means that no one is excluded. This creates a relaxed, positive atmosphere of 'being together'.