Research finds that 90% of nursing home residents with dementia suffer from apathy, which negatively influences their physical, cognitive, and emotional well-being. The goal of this project-grounded research is to develop a product-service system that stimulates nursing homes residents, living with moderate to severe dementia, to reduce their apathy. This thesis entails three preceding studies to inform the design project. A systematic literature review that addressed empirical studies that measured the effects of environmental stimuli on the level of physical activity of nursing home residents living with dementia. A qualitative exploration of the social environment of residents in nursing homes to explore the effect of the social aspects on their participation in daily and leisure activities. And a literature review to determine which play experiences can be expected to be suitable for persons in different stages of Alzheimer’s disease. During a co-design process the Active Cues Tovertafel was designed together with the people with dementia, their relatives and carers making use of a ‘Wizard of Oz’ prototype. We developed six serious games for the Tovertafel, which projects playful interactive light animations on existing dining tables in the nursing home environment. The games were evaluated on their effect on the apathy of the residents with moderate to severe dementia during a small-scale study and the results show significant improvement in physical activity. Moreover, the results also indicate improvements in social interaction, happiness, and reduction of anger, fear and sadness. In sum, the present study shows that co-designed serious games can play a beneficial role in the dementia care context.@en

Most older persons with dementia living in nursing homes spend their days without engaging in much physical activity. This study therefore looked at the influence that the environment has on their level of physical activity, by reviewing empirical studies that measured the effects of environmental stimuli on the physical activity of nursing home residents suffering from dementia. The electronic databases PubMed, PsycINFO, EMBASE, CINAHL and the Cochrane Library were used for the search. The search covered studies published between January 1993 and December 2012, and revealed 3187 abstracts. 326 studies were selected as potentially relevant; of these, 24 met all the inclusion criteria. Positive results on the residents' levels of physical activity were found for music, a homelike environment and functional modifications. Predominantly positive results were also found for the small-scale group living concepts. Mixed results were found for bright or timed light, the multisensory environment and differences in the building footprint.

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