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Sad, but essentially this article is about benign warehousing of individuals with senile dementia in their waning years with a description of bland distraction

Sad, but essentially this article is about benign warehousing of individuals with senile dementia in their waning years with a description of bland distraction methodologies employed by institutions. A question arises as to whether the possibility of coupling individually tailored AI with VR headsets or even OLED panels in rooms could be utilized to provide suitable stimulation for these individuals in this state. Reverence was made to Nozick's 1974 thought experiment called the experience machine (his intent then was to refute thesis of hedonism) which was to provide an individual any experiences the person chose, for the rest of their life but one of his arguments against its use was We want to do certain things, and not just have the experience of doing them but as medical ethicist Schermer points out When there is only pain and no capacity left to deal with that pain, to really understand or come to grips with it, nor even to remember it for very long, then the truth cannot contribute to a good life So I see no reason why an individually tailored interactive VR environment couldn't be used to provide these entities with some degree of stimulation to alleviate their sense of depression and frustration.

trimtab 8y ago
Because the person with dementia does not have a stable level of cognition. It changes continuously. The article mentions this. At higher levels of cognition they will know whatever the simulation is false and it will upset them. Spend some time with dementia patients and you'll quickly realize the issue. Any VR would have to be able to determine current cognitive ability to not cause as much frustration and harm as relief.
- jimduk 8y ago
  Good point, but it's also the case they forget being upset quickly. My father-in-law had dementia, and as he progressed I found it useful (for me) to interact with him as if he was like an X yr old child (without a medium/long term memory). e.g. If X was 6-8 we would talk about family, have a walk, point things out, express preferences, tell stories. If X was 3-4 we would talk about people and things in the room, discuss food, check he was comfortable, smile and be upbeat. I had much better time with him like this, than seeing other families who were trying to be 'grown up' and have serious conversations. YMMV. Dementia is awful.
- nabla9 8y ago
  Declining cognitive state is very random. Not being able to recognize oneself from a mirror and being spooked by stranger in the mirror. Shadows or even floor lamp in the corner may be scary person. The rest of life can become scary hell where you don't know what is going and where you are. Even very peaceful persons become aggressive when they are confused and scared. Forget VR. If I get Alzheimer I want euthanasia or drugs. Maybe gradually increasing opiates that take all pain away and I eventually stop breathing at night.
themodelplumber 8y ago
I like the way you think. If not AI right off the bat, we can certainly build a gradual ramp up to it. For example, at level 1 the person has access to a radio, tv, a certain level of guaranteed interaction, notification of N local volunteer groups that they are in the facility and could use visitors at times; at level 2 we introduce media of specific types calculated to fulfill what we know of the subject's interests, or specific kinds of people--maybe they love firemen, so those people are notified, etc.; At level 3 we go more immersive with technology, including maybe even remote access to others or even participatory access for others, so they can be in the same virtual world as Grandpa and watch or try to interact. Well, anyway with some kind of universal levels or standards in place, there is this new level of awareness, and everyone has a more helpful point of reference rather than trusting random bullet points on a facility flyer, or whatever.
bonniemuffin 8y ago
This is a really ideal use for advance medical directives to allow people to choose what kind of care they want before they lose their cognitive abilities. For example, for myself, while I'm young and healthy, I want the world to know: if I get dementia someday, LIE TO ME. Lie your ass off. If I can't think for myself, I just want to be kept happy in a blissful illusion. If you can get an AI robot to keep me as a pet, that would be ideal.
- pmoriarty 8y ago
  The article addresses the issue of advance care directives. It turns out they might not always be the ideal solution they might seem at first glance: "It might be possible to deal with the problem of lying and dementia by means of advance directives. People already specify what sorts of medical treatment they want and don’t want in the future, in case they later lose the capacity to make those decisions; could they not also specify how they want to be treated in other ways? Someone who most values happiness, however simple, might choose lies and medicine; someone who feels that life with late-stage dementia, without a certain degree of awareness, is not worth living might choose truth and death. The trouble is, advance directives themselves bring up all kinds of problems in the context of dementia. Suppose a woman signs a directive that she is not to be lied to but, at a later stage of the disease, suffers terrible bereavement each day as a consequence--should her family feel obliged to respect her wishes? Or suppose a man believes that life with late-stage dementia is not worth living, and signs an advance directive to have all medical treatment withheld, even antibiotics, once he reaches that point; but then, when he does reach it, he seems very happy with his life--he still enjoys visits (even if he can’t identify the visitor), his meals, beloved music, walks in the sun. Should his directive be respected, ending his life? "The late philosopher Ronald Dworkin believed such advance directives should be respected. People don’t just live for pleasure, he argued; they also want to preserve their dignity, and to feel that their life as a whole has integrity and coherence. When people dread the total dependency of late-stage dementia, they don’t just dread its effect on others; they dread the way it warps the shape and story of their life. For some, the prospect that they might live their last years content with childlike pleasures, kept happy with benevolent lies, would not be a relief but a horror. In the case of such a person, Dworkin believed, it is no more legitimate or kind to contradict their advance directive in late-stage dementia than it would be if they were in a permanent vegetative state. "Dworkin assumed that the man who dreaded late-stage dementia and the one who is perfectly happy are the same person. But what if the happy person can no longer remember anything about the man he once was--is he still the same person in any meaningful sense? And, if not, is it right to end his happy life in order to preserve the dignity of, in effect, somebody else? Also, does it make a difference what his family thinks about this? Whether they feel, in the later stages, that the person they loved is gone; or whether they feel that that person, though much changed, is still there--still recognizable in his body, in his smell, in his eyes, in his hands when held, in some of the things he appears still to delight in? Why should a person be defined by thoughts and memories? Aren’t emotions and bodies enough?"

trimtab 8y ago

Because the person with dementia does not have a stable level of cognition. It changes continuously. The article mentions this. At higher levels of cognition they will know whatever the simulation is false and it will upset them. Spend some time with dementia patients and you'll quickly realize the issue. Any VR would have to be able to determine current cognitive ability to not cause as much frustration and harm as relief.

jimduk 8y ago
Good point, but it's also the case they forget being upset quickly. My father-in-law had dementia, and as he progressed I found it useful (for me) to interact with him as if he was like an X yr old child (without a medium/long term memory). e.g. If X was 6-8 we would talk about family, have a walk, point things out, express preferences, tell stories. If X was 3-4 we would talk about people and things in the room, discuss food, check he was comfortable, smile and be upbeat. I had much better time with him like this, than seeing other families who were trying to be 'grown up' and have serious conversations. YMMV. Dementia is awful.
nabla9 8y ago
Declining cognitive state is very random. Not being able to recognize oneself from a mirror and being spooked by stranger in the mirror. Shadows or even floor lamp in the corner may be scary person. The rest of life can become scary hell where you don't know what is going and where you are. Even very peaceful persons become aggressive when they are confused and scared. Forget VR. If I get Alzheimer I want euthanasia or drugs. Maybe gradually increasing opiates that take all pain away and I eventually stop breathing at night.

themodelplumber 8y ago

I like the way you think. If not AI right off the bat, we can certainly build a gradual ramp up to it. For example, at level 1 the person has access to a radio, tv, a certain level of guaranteed interaction, notification of N local volunteer groups that they are in the facility and could use visitors at times; at level 2 we introduce media of specific types calculated to fulfill what we know of the subject's interests, or specific kinds of people--maybe they love firemen, so those people are notified, etc.; At level 3 we go more immersive with technology, including maybe even remote access to others or even participatory access for others, so they can be in the same virtual world as Grandpa and watch or try to interact. Well, anyway with some kind of universal levels or standards in place, there is this new level of awareness, and everyone has a more helpful point of reference rather than trusting random bullet points on a facility flyer, or whatever.

bonniemuffin 8y ago

This is a really ideal use for advance medical directives to allow people to choose what kind of care they want before they lose their cognitive abilities. For example, for myself, while I'm young and healthy, I want the world to know: if I get dementia someday, LIE TO ME. Lie your ass off. If I can't think for myself, I just want to be kept happy in a blissful illusion. If you can get an AI robot to keep me as a pet, that would be ideal.

pmoriarty 8y ago
The article addresses the issue of advance care directives. It turns out they might not always be the ideal solution they might seem at first glance: "It might be possible to deal with the problem of lying and dementia by means of advance directives. People already specify what sorts of medical treatment they want and don’t want in the future, in case they later lose the capacity to make those decisions; could they not also specify how they want to be treated in other ways? Someone who most values happiness, however simple, might choose lies and medicine; someone who feels that life with late-stage dementia, without a certain degree of awareness, is not worth living might choose truth and death. The trouble is, advance directives themselves bring up all kinds of problems in the context of dementia. Suppose a woman signs a directive that she is not to be lied to but, at a later stage of the disease, suffers terrible bereavement each day as a consequence--should her family feel obliged to respect her wishes? Or suppose a man believes that life with late-stage dementia is not worth living, and signs an advance directive to have all medical treatment withheld, even antibiotics, once he reaches that point; but then, when he does reach it, he seems very happy with his life--he still enjoys visits (even if he can’t identify the visitor), his meals, beloved music, walks in the sun. Should his directive be respected, ending his life? "The late philosopher Ronald Dworkin believed such advance directives should be respected. People don’t just live for pleasure, he argued; they also want to preserve their dignity, and to feel that their life as a whole has integrity and coherence. When people dread the total dependency of late-stage dementia, they don’t just dread its effect on others; they dread the way it warps the shape and story of their life. For some, the prospect that they might live their last years content with childlike pleasures, kept happy with benevolent lies, would not be a relief but a horror. In the case of such a person, Dworkin believed, it is no more legitimate or kind to contradict their advance directive in late-stage dementia than it would be if they were in a permanent vegetative state. "Dworkin assumed that the man who dreaded late-stage dementia and the one who is perfectly happy are the same person. But what if the happy person can no longer remember anything about the man he once was--is he still the same person in any meaningful sense? And, if not, is it right to end his happy life in order to preserve the dignity of, in effect, somebody else? Also, does it make a difference what his family thinks about this? Whether they feel, in the later stages, that the person they loved is gone; or whether they feel that that person, though much changed, is still there--still recognizable in his body, in his smell, in his eyes, in his hands when held, in some of the things he appears still to delight in? Why should a person be defined by thoughts and memories? Aren’t emotions and bodies enough?"