Thursday, May 10, 2007

Does Anybody Really Know What Time It Is?

Reading Time Vs. Telling Time

It’s interesting to note that our grandparents, their grandparents and even their grandparents would have no trouble telling time with the analog clock on the wall. Analog clocks are essentially unchanged over the last several hundred years.

Digital clocks can into widespread use in the early 70s, with the advent of LEDs. Every digital device seems to include a digital clock these days, and unlike the clocks of many old VCRs perpetually flashing 12:00, most usually display the correct time.

Even with digital clocks being ubiquitous, the hundreds-of-year-old technology of analog clocks is still going strong. Other analog technologies, based on colors and geometric shapes, just haven’t caught on.

Reading a clock is one of the first skills we learn in grade school, and sadly one that the elderly can have problems with. Digital clocks make reading the time simple, so why haven’t they taken over?

The simple fact is that reading the time isn’t the same as telling the time. Digital clocks make it simple to read the time to the nearest minute, second, or even to a fraction of a second. You’d think they’d be the ideal solution for the elderly. I know I did until recently, and only on this very day have my suspicions been confirmed. Reading the time is not the same as telling the time. Consider the two clocks shown.

From the digital display, it’s a snap to see that the time is 9:53:27. A little kid who knows his numbers can tell you this, as can most elderly folks. I’ll concede that the time shown on the analog clock is the same, but when I look at it, I see the time is nearly 10 o’clock. I know that if I have to be at a meeting at 10:00, I need to think about going. It’s simple to read the digital clock, but for the cognitively-impaired, 9:53:27 doesn’t tell them that it’s time to walk down the hall for chair exercises at 10 o’clock.

Depending on the type of impairments a person has, reading and understanding one type of clock may be easier than the other, but it’s not as clear-cut as you might initially think.

From a pragmatic point of view, I can offer a couple guidelines. When selecting an analog clock, look for a clear, high contrast face. Simple block numbers with distinct minute and hour hands. No Roman numerals and no stylized designs that omit numbers.

For digital clocks, be wary of displays that present too much information. The time is great. Displaying the day of the week is a nice add-on. When the display includes the date, temperature, etc, etc, it becomes difficult for the cognitively impaired to pick out the time from the clutter.

Talking clocks are an option we haven't explored yet. There are some sweet clocks that can be programmed with different messages at different times of day. Another up-and-coming adventure.

Tuesday, May 1, 2007

I’d Like To Buy A Clue – Part 1

Helping The Elderly Stay Oriented

As people age, they may become less attuned to circadian rhythms and the passage of time. The elderly may not be aware of the things we take for granted, such as knowing when to get up, go to bed and eat meals.

When Cal moved to a new facility about a year ago, he went from a facility having meals at fixed, announced times to having a flex schedule for eating with each meal available any time over a two hour window. Even after much explaining, this led to many missed meals because he simply doesn’t recognize the passage of time.

To solve this problem, the “meal clock” was born. In a normal clock, the hour hand makes two revolutions a day. If the hour hand is pointing directly right, it could mean 3 AM or 3 PM. With a 24-hour clock on the other hand (no pun intended) the hour hand makes just one rotation per day. The hour hand might point straight up at 6 AM, straight right at noon, straight down at 6 PM and so on. A bit confusing to read as a clock, but perfect as the basis of a meal clock or as a reminder for events that occur during the same time period each day. Only the hour hand is installed; when it is over a colored region, it’s time to eat. The illustration shows how this works. Note that the numbers indicating the hours are shown just for reference – they don’t actually appear on the face of the meal clock.

You make be thinking “great idea” but the only place you’ve seen a 24 hour clock is in Dr. Strangelove. (ok, I couldn't find a Dr. Stranglove picture including a 24 hour clock, but I'm sure there is one in the movie someplace!) It’s surprisingly easy to make a meal clock/daily reminder clock. You may have noticed that all the cheap clocks you see these days are powered by one AA battery and have a module that’s about 3” x 3” to turn the hands. 24 hour movements are available in the same package.

To build a meal clock, start with any clock using one of these standard modules. The cheapest wall clock at Ikea, the Rusch, is a great starting point.

Remove the face, gently pull off the hands and remove the clock movement by loosening the nut.

Press the movement out the back. It may be held in place with double-face tape or some locking tabs. Insert the 24 hour movement and tighten the nut. Next, replace the clock face with a new one showing meal times or other daily events. I’d recommend clearly defined and labeled areas and avoid presenting too much information. I’ve altered the traditional 24 hour clock arrangement, and made 6 AM be straight up. This means that the “day time” is shown on the right side of the clock face, evening at the lower left. Secure the face in position with double-face tape or a glue stick. Finally, install the hour hand. I cut the pointer off the second hand and installed the “button” on the clock to give it a finished look.

Setting the clock takes a little care. If possible, set it at the edge of one of the event times, at noon (straight right) or 6 PM (straight down).

Explain the operation to your loved one, showing that the hand shows when it’s time to eat or time for another activity. Don’t mention that it’s a clock as this may just lead to confusion.

This is the recently updated meal clock, with changes to reflect new meal times. The clock face is a little lighter than desired because HP wants money for a new toner cartridge. The small circles shown at 8:00, 3:30 and 8:30 PM are medication times, there for future reference if needed. The shaded area on the left side is labeled "Bed Time" - we've explained to Cal that he should be asleep during this time, and that it's not a good time to call people on the phone unless it's an emergency.

Next Time: Lighting Control Systems for Day/Night Orientation