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Mario the Robot - a supportive companion for people with dementia

mario with Mary Gannon

Resident Mary Gannon enjoying time with MARIO at St Brendan’s Care Home, Loughrea, Co Galway

Loneliness and isolation can be a common theme in old age, particularly for people with dementia. But one group of people with dementia enjoyed the company of a unique guest recently – MARIO the robot.

MARIO is a specially-designed assistive robot who talks to them, plays music, reminds them of everyday tasks and gives them the latest news. Although researchers acknowledge that it cannot replace human care, it can help improve a person’s day-to-day life.

The MARIO project was coordinated by the School of Nursing and Midwifery in the National University of Ireland, Galway (NUIG), led by Professor Dympna Casey. The robot was tested trialled in Ireland, the UK and Italy. In Ireland, MARIO interacted with some of the residents of St Brendan's Care Centre, Loughrea, Co Galway.

"We had one gentleman with real severe dementia. And he would spend his days walking alone in the corridors, not really engaging and interacting with anybody. And with MARIO, using his game applications, this man would actually sit down and use a painting application; he actually sat in and painted for 40 minutes." said Sally Whelan, a researcher from NUIG.

A panel of experts from the healthcare sector, robotics industry and dementia groups were created to develop the MARIO social companion robot to combat loneliness and isolation for people with dementia.

This led to the three-year MARIO project, which received €4m in funding from the European Union’s Horizon 2020 - the Framework Programme for Research and Innovation (2014–2020). The project involved five EU countries and a team of up to 40 people, and was completed in January 2018. 

“MARIO was an ambitious project from the beginning. We managed to combine an array of expertise through pan-European partnerships. We brought together expertise in robotics, semantic data analytics, artificial intelligence and interactive touchscreen technology, as well as healthcare and nursing knowledge,” explained Professor Casey.

Globally, around 50 million people are living with dementia, with this number set to increase as the number of people living into old age rises. Although human companionship is the best way of reducing social isolation, the resources to provide this service is often not available. MARIO addresses the difficult challenges of loneliness, isolation and dementia in older persons through innovative interventions delivered by companion robots.

A user-led design process was used and the MARIO robot was tested in three pilot sites, including the Co Galway residential care home. Three phases of testing were undertaken where MARIO engaged with people with dementia in each pilot site. This resulted in the development of a number of personalised robot applications including: My Chat, My Memories, My Music, My Games, My News, My Calendar, and My Family & Friends.

Des O'Doherty, who has dementia, explained how MARIO can prompt him to remember simple things that he struggles with.

“I can't remember for instance what time of the day it is, what time I need to go for my breakfast, what time I need to go to the toilet. This machine would allow me to relate to it, and I would hopefully get back information that would allow me to do what I wanted to do,” he explained.

In the final phase, the impact of the MARIO robot was evaluated using questionnaires, observations and interviews. People with dementia, their family members, formal carers, and managers across all three pilot sites were involved in the final evaluation.

Professor Casey paid tribute to the staff and participants with dementia who participated in the study and interacted with MARIO.

“The most critical element was the older people with dementia and their caregivers, who welcomed MARIO into their lives and allowed us, through their insights and knowledge, to make MARIO into the success it has become,” she said.

Adam Santorelli, an engineer from NUIG, and a member of the project team explained that MARIO is able to prompt a person’s memory through music or familiar songs.

“People with dementia, they might not remember some of the immediate daily activities, but they remember all the words in these types of songs that they remember from their youth. It is really something nice to see, and it really brings them happiness.”

John Coen, a carer at St Brendan’s, said he was very impressed by the impact the robot had on people with dementia.

“You have music and lights, and there are lots of things that the robot can do. It helps them to talk. Once they see it, they are amazed about what it can do, of what the robot is capable of doing,” he said.

The user-led design of the robot led to the development of applications that were tailored to the needs of people living with dementia. These applications allowed people with dementia to access the newspapers, listen to their favourite songs, provide reminders of upcoming events, store family photos and connect with their friends and families.

“Overall, attitudes towards the MARIO robot were positive. People enjoyed spending time with MARIO, saw him as a companion, a source of entertainment and a source of interaction,” said one of the researchers.

“The findings from this study provide evidence related to the potential for the use of companion robots. The MARIO project established that companion robots are an acceptable part of social care for people with dementia. They have an important role to play in combatting the perceptions of loneliness, can decrease the amount of time people with dementia spend alone, and increase levels of engagement. The positive impact of MARIO on the quality of life, social and cognitive health, and loneliness in people with dementia is evident.” 

Project coordinators believe the technology is almost ready for MARIO to hit the market in five to six years, possibly even sooner.

“It might come before that, because technology, actually the speed in which innovations are happening, are very, very quick now. So it could happen before that. But it does require more fine-tuning before it can hit the market,” said Professor Casey.