How the humble corded telephone is transforming wellbeing for people living with dementia 

As the AI revolution gathers pace, ideas to transform dementia healthcare through technology are proliferating. However, far too many innovations fall by the wayside because they ignore one simple principle: people must want and be able to use them. 

For the team at MemoryAid, good innovation means making something familiar and easy to use, tailored to each user’s needs. “Accessibility is really at the heart of our whole design,” says Celia Harris, MemoryAid project lead and cognitive scientist at the MARCS Institute for Brain, Behaviour and Development at Western Sydney University. “Tech developers are interested in the cutting edge, but the cutting edge, of course, is only as good as somebody [being able to] buy it and use it.” Some of the most pioneering interfaces fail because they confuse and alienate users. 

With this in mind, MemoryAid – recently named one of five finalists on the Longitude Prize on Dementia – turns to a design style familiar to many older people from diverse cultures and socioeconomic backgrounds: a ringing corded telephone. The solution combines a telephone handset with a tablet preprogrammed by caregivers so that the telephone rings the person with dementia to deliver reminders about daily activities and tasks. For example, these could be reminders to take medication, do physiotherapy exercises, or drink water, as well as recreational or emotionally meaningful activities such as journalling. “We know that initiation is a particular problem for people with dementia – so getting the activity started can often be the key to that independence,” Celia explains. The device also supports simple video calling, activated by picking up the handset rather than fiddling with smartphone touchscreens. 

Academic insights, cutting-edge software

MemoryAid grew out of a partnership between cognitive scientists and psychologists at the MARCS Institute, and software and AI researchers at Deakin University. The project’s interdisciplinary team and approach – including co-design with users – “is a real strength  because everybody understands the whole picture,” Celia says. MemoryAid’s Lived Experience Advisory Panel is also core to this: “They challenge us and help us prioritise. They tell us what’s important. They correct us when we’re thinking the wrong way.” 

The project draws on years of rigorous academic research into technology for people with dementia. During the COVID-19 pandemic, Celia conducted research into older people’s experience of assistive technology for dementia. Using tablet technology to carry out research remotely “convinced me these tablet devices were not suitable technologies for people with dementia,” she says. Touchscreen interfaces are a “disempowering, disabling interface for lots of older people, regardless of whether they have dementia or not,” she adds. Older people often have drier skin and may have shakier hands and poor vision,  making it more difficult to operate touchscreens. Celia’s research showed that, “the [mainstream] device itself was a barrier and provoked anxiety – people were very worried about pressing the wrong thing, breaking the machine, or something unexpected happening.” 

“The design [of MemoryAid] came from witnessing that worry,” she says. “Our device is intentionally designed to avoid that feeling – you’re never going to press the wrong thing.” Instead, it is both familiar and easy to use: “You can [pick up the MemoryAid telephone] if your hands shake, […] if you have different kinds of poor vision, poor hearing.” 

Focus on the familiar 

By centering the familiar, MemoryAid applies research on autobiographical memory. The device draws on the idea that “the things from our life that are going to be easiest and most familiar for us are going to come from our ‘reminiscence bump’ period of adolescence and young adulthood,” Celia explains. “Even as we’re starting to experience cognitive decline and may start to forget things that have happened more recently, we’ll hold onto memories from that early time in our lives.” MemoryAid’s use of a traditional corded telephone makes use of skills developed over a lifetime for most older people: “someone’s going to be able to look at it and say ‘yep, I know what to do with that’.” It also draws on research into the different types of tools people use to support memory in everyday life.

The power of connection 

The team also worked to simplify video calls – “an important feature that’s really highly valued, especially among people who live at distance from their family.” Again, Celia’s experience during the COVID-19 pandemic – seeing care home staff running around trying to organise tablet video calls for residents – made clear the importance of older people having access to less complicated video call interfaces. Rather than fiddling with smartphone screens, MemoryAid users “can just answer the video call by picking up the phone handset like you would a landline phone […] so that it’s something that you can do everyday,” Celia says. 

Putting tech to the test 

Over the past year, the team has been testing their prototype in people’s homes for two-week periods. “The feedback was amazing,” Celia says. “Our user testing showed that it absolutely did work and the vast majority of people … answered the phone the first time that it rang without needing to be told what to do.” Using a familiar and intuitive tool meant “there was no learning curve [for people] for how to interact with and use the device.” 

There was much “positive and heartwarming” feedback about the device’s impact. One caregiver, whose husband needs reminders to do his physiotherapy exercises, said MemoryAid prompts meant “he did [his exercises] religiously, every single day.” Since returning the device, “he had not done his exercises a single day. The impact of “that little prompt, that little nudge that gets people to independently do things” is vital, Celia explains. It also gives caregivers a “break from being the nag […] freeing them up to focus more on their relationship and less on that carer role.” 

One system, multiple uses 

Such feedback demonstrates the impressive flexibility of MemoryAid – how it brings emotional, psychological, and relational benefits, as well as help with practical, domestic, and medical tasks. Caregivers can customise it to focus on different activities, and these “can be broken down into steps,” depending on a user’s particular needs. For example, if someone can’t wash their hands independently because they always forget to turn off the tap, “you can’t just prompt somebody to go and wash their hands,” Celia explains. “They need that extra reminder that says: ‘oh yes, and turn off the tap,’.” 

“It was important to us that all that be entirely personalisable […] because of that idiosyncrasy in what people need, and the real importance – the absolute number one priority – of making sure that you match people’s needs and give them the prompts that are right for them, to avoid creating confusion or giving irrelevant information,” she says.

MemoryAid also allows people to choose what voice they want prompts to be delivered in. “Some people prefer their own voice, so they recognise it […] and don’t feel like they’re being told what to do by somebody else.” Others prefer a loved one’s voice, or the machine’s voice. Prompt templates are available in multiple languages: “we know that people with dementia, even if they have acquired English as a second language, may lose it, or may be much more comfortable or fluent in their first language,” Celia explains. 

Expanding the testing

The team will spend the first half of 2025 testing the updated prototype among a larger and more diverse sample of people, over longer periods – enabling them to iterate the design and identify the types of data the machine could measure and learn from. Diversity is key here. The MARCS Institute has good relationships with local communities, care home providers, and carer support networks, who will help them select testers from different backgrounds. “Australia is very diverse […] and our older population is rapidly diversifying,” Celia says. “Cultural and language diversity is a priority in our development and in our thinking.” 

From prototype to market 

The second focus for the Finalist stage is to develop MemoryAid’s business plan, working with industrial designers to manufacture an affordable, commercial product – supported by “exceptional” guidance and mentorship from the Longitude Prize on Dementia. “We’re university academics not business people, but we’re learning,” Celia says. “We’re really comfortable in the user testing, really comfortable talking to people and learning about what they think. But it’s figuring out that whole other world of commercialisation that’s been a learning curve for us, and the Longitude Prize on Dementia has helped enormously.”