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A Clock That Does Not Tell The Time

By Hazel Boyd (User Interface Engineer) and Nina Evans (Occupational Therapist)

Why was a Day Clock needed?

The team at Designability had been receiving more and more contacts from relatives of people with dementia who were looking for a clock that could help them to understand time. They were finding that the existing calendar products did not always meet their needs because they were displaying the exact time and date which is too detailed for some.

Our days are structured around what day of the week it is and what part of the day it is. Knowing this can be difficult for people with dementia who struggle with ‘time orientation’, i.e. the ability to know where they are in their day in relation to time.

We were keen to respond to the feedback that people want to be reassured of the day, and what part of the day, it is. This led us to research and develop the Day Clock whilst keeping people with dementia and their families at the heart of its design to reflect their needs and particular requirements.

What exactly is the Day Clock?

The Day Clock takes the form of a clear digital display that shows the day of the week and what part of the day (morning, afternoon, evening or night) it is, rather than telling you the time.

Can you explain time orientation in more detail?

Time is the way we measure our past, present and future. Time comes and passes in terms of day, date or year. Time orientation means that we have an acute awareness of where we are in relation to time.

The ability to use our memory, attention and sense of time to understand our place in time is something many of us take for granted. But being aware of time is actually an awareness of our natural ‘body clock’ combined with the measurements of time we learned in childhood, as well as the social conventions we all follow which add structure to our day.

Imagine your day today. Perhaps it’s mid-morning on a Thursday and you’re busy at work. You are probably planning to be in bed asleep at night-time and then you might have a plan to meet a friend tomorrow afternoon. The ability to link time to routine is a really important aspect of daily life.

Why do people with memory loss struggle with time orientation?

For people living with dementia the structure and chemistry of the brain are affected, which means that their ability to remember, understand, communicate and reason is impaired. This can create difficulties in knowing what day or time it is, or whether it is day or night.

We know that time orientation is very complex which means that disorientation can fluctuate. Not knowing where you are in relation to time can cause great anxiety for the person experiencing it as well as those caring for them. Memory loss and dementia affects both the sense of time as well as the ability to tell the time.

Why does it say “Now it’s”?

We added the words “Now it’s” to give the time display some context. Displaying the information as a statement helps to clarify that the display is always current and not just a static phrase.

How does this help people with memory loss or dementia?

The Day Clock is a useful reminder of the part of day which links directly to the familiar pattern of our everyday lives. There are a number of key features which make it helpful:

• It lets the person know if it is day or night which is particularly useful during times of the year when it is dark in the morning or lighter in the evening.
• The minimal, clear presentation of the key text means that there is only a limited amount of information to process.
• The simplicity of the display is useful for people who can still read but who are experiencing time disorientation and cannot make sense of the exact time or date.

What user testing was involved in the design of the Day Clock?

We consulted with carers, people with dementia and occupational therapists to determine the requirements for the clock, review the concepts and user test the design.

How did you test the Day Clock to ensure it was useful?

We constructed four original prototypes which were trialled by four pairs of volunteers and provided some promising feedback. One volunteer described how her relative was able to see the correct day and part of the day so she could understand when to expect care workers and when to watch television (she only liked to watch it in the afternoons and evenings).

Designability then produced a first market version of the Day Clock using digital photo frames which proved popular but not sustainable. To be able to meet a growing demand for the product we engaged with DF Sales Ltd. who are now the manufacturers and suppliers of the Day Clock.

Further evaluation feedback has since been generated through our engagement with the Memory Technology Library project in Bath 2013-14. This project collated over a hundred reviews of the Day Clock using goal setting as a measure. The goals identified by carers for using the Day Clock were:

• to reduce persistent questions
• to provide reassurance
• to help to determine day and night
• to help follow a routine.

We are pleased to say that the Day Clock managed to meet most of the goals that were set.

How many have been sold?

Over 10,000 clocks have been sold worldwide and it is now available in seven languages.

Finally the question “Why don’t you just add?”

We are often asked “why not add extra messages or additional information to the Day Clock?” We believe that the simplicity of the Day Clock belies the thought behind the design and that the requirements identified by the users, carers and therapists are key to its success.
However, we do plan to continue our work in the use of these kinds of reminders to support the needs of people with dementia.

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