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+[1]Jan Miksovsky’s Blog • [2]Archive • [3]2024 [4]About • [5]RSS • [6]JSON • 
+[7]Contact [8]
+
+MomBoard: E-ink display for a parent with amnesia
+
+November 12, 2024
+
+E-ink display on a bathroom counter showing birthday messages
+
+Today marks two years since I first set up an e-ink display in my mom’s
+apartment to help her live on her own with amnesia. The display has worked
+extremely well during those two years, so I’m sharing the basic set-up in case
+others find it useful for similar situations.
+
+Note: unless you have specific experience caring for someone who has amnesia
+but not dementia, please do not offer care suggestions.
+
+The patient
+
+In June 2022 the side-effects of a long surgery left my mom with permanent
+anterograde amnesia: she can no longer form new long-term memories. Memory
+isn’t just one neurological system, so very occasionally she will be able to
+remember certain types of things. But for the most part, if she hears or sees
+something, a few minutes later she will no longer remember it.
+
+To medical professionals her condition looks a lot like dementia — amnesia is a
+common symptom of dementia — but she doesn’t have dementia. One difference is
+that (as I understand it) dementia is a progressive disease, while this amnesia
+is stable. There is no cure.
+
+Someday I might post about the experience about caring for her, but for now
+I’ll just say that this type of amnesia is not something one should wish on
+one’s worst enemies.
+
+Needs
+
+My mom still lives on her own in an apartment. Because she cannot remember
+things, she goes through each day in a state of low-grade anxiety about where
+her grown children are and whether they are all right. She feels she hasn’t
+heard from any of us in a long time. This anxiety manifests as extremely
+frequent attempts to call or text us.
+
+Paper notes and other forms of reminders didn’t seem to help, and would become
+out of date even if they weren’t misplaced. My siblings and I would call to let
+her know we were okay, but five minutes later she’d be back to being worried.
+She wasn’t in the habit of scrolling back through text messages, so once she’d
+read a message, it was immediately forgotten and effectively lost.
+
+I thought some sort of unobtrusive, always-on device installed in her apartment
+might be able to show her notes written by my siblings and me.
+
+Design goals
+
+My goal was to find a display that:
+
+ 1. Could stay on for months on end
+ 2. Would let my siblings and I easily post short messages to it that would
+    remain visible until replaced
+ 3. Was large enough and easy enough to read without glasses
+ 4. Required no interaction to wake or read and was relatively foolproof
+    (touching it wouldn’t disrupt it)
+ 5. Was resilient to network failures
+ 6. Didn’t glow at nighttime
+ 7. Didn’t require hardware hackery (I’m a software person)
+ 8. Would boot directly into displaying messages (no interaction needed to
+    start an app)
+ 9. Was not enshittified with a subscription service or proprietary app store
+10. Was reasonably affordable
+11. Would not look out of place in a home
+
+Device
+
+Given the above design goals, I searched for a tablet-size electronic ink
+display with Wi-Fi connectivity and a decent web browser.
+
+One device that seemed to fit my parameters was the [9]BOOX Note Air2 Series.
+At the time it cost US$500, which is expensive but is still far cheaper than
+screens intended for use as commercial retail displays. It’s marketed as a
+note-taking device and ebook reader, but it also has a capable web browser.
+It’s big enough to read from a few feet away.
+
+A critical question I couldn’t answer online was whether I’d be able to have
+the device automatically start its web browser and have that browser display a
+designated start page. Happily, when the device arrived I was able to confirm
+it could do both of those things.
+
+The physical case of the Note Air2 looks reasonably nice and not particularly
+tech-y. The e-ink display is clear and legible; it refreshes quickly enough to
+not be distracting. By default the device’s backlight was turned on but I could
+turn it off.
+
+I found a small metal stand to serve an easel for the display so that it felt
+more like a picture frame.
+
+Web software
+
+Since the physical device was satisfactory, the next step was writing a simple
+website that could drive the display. The site would have two pages:
+
+ 1. A Board page showing the messages. The e-ink device would boot into showing
+    this page. This is the only page my mom needed to see.
+ 2. A Compose page my siblings and I write messages and save them to be
+    displayed.
+
+The device needed to run for months, and needed to be resilient in the case of
+network and service failures. At the same time, I also needed to be able to
+remotely update not only the messages being displayed, but the software
+displaying those messages.
+
+With that in mind, I factored the Board page into an outer frame and an inner
+page:
+
+ 1. The top-level outer frame acts as a thin shell around the inner page. At
+    top of every hour, the outer frame reloads the inner page to pick up
+    potential software changes. If the network is down and the inner page
+    doesn’t reload, the frame just tries again an hour later. To maximize
+    reliability, the outer frame has very little logic and no external
+    dependencies.
+ 2. The inner page actually displays the messages. Every 5 minutes it queries a
+    simple web service for message data and displays the messages. The inner
+    page contains a small amount of logic, but as few dependencies as possible.
+
+Since it’s essentially impossible to debug anything that happens on the device,
+I made as much use of vanilla HTML and CSS as possible. I used a small amount
+of JavaScript but no framework or other libraries.
+
+Compose form for posting a message to the display
+
+The Compose page presents a simple web form my siblings and I can use to
+compose and save a message. I designed the form to work well on a phone screen
+so that we can write messages when we’re out and about. A small web app
+manifest lets us save the Compose page to a phone’s home screen as an icon for
+quick access.
+
+The whole site is tiny, entails no build process, and with the exception of the
+service (below) is just static files.
+
+Visual design
+
+I was concerned about the possibility of e-ink burn-in, so the Board page
+randomly changes which message appears where. Other visual elements like the
+date and time alternate from side to side, with the intention that no single
+pixel is always on.
+
+To style the note text I chose the free [10]Architect’s Daughter font for a
+handwritten feel. This font works well on the e-ink display. Labels are
+displayed in [11]Open Sans.
+
+One small challenge was maximizing the size of the message text. Sometimes a
+message is just a word or two; other times it might be several sentences. A
+single font size can’t accommodate such a wide range of text content. I
+couldn’t find a pure CSS way to automatically maximize font size so that a text
+element with word wrapping would display without clipping.
+
+I ended up writing a small JavaScript function to maximize font size: it makes
+the text invisible (via CSS visibility: hidden), tries displaying the text at a
+very large size, and then tries successively smaller font sizes until it finds
+a size that lets all the text fit. It then makes the text visible again.
+
+Service
+
+Just a tiny amount of text data is necessary to drive the display, so I was
+happy to find the minimalist [12]JsonStorage service that was perfect for this
+project. A single JSON object stores the text and metadata for the current set
+of messages. The Compose page can save to the service with a POST request, and
+the Board page can retrieve the data with a GET.
+
+The service has a free tier that I started with, but I liked the service so
+much that I eventually paid for a $1/month basic tier. (It appears that tier is
+now $5/month.)
+
+Trial and installation
+
+I spent a couple of weeks working on the software and letting it run for long
+periods of time. I was pleasantly surprised that the Boox display worked as
+well as it did and seemed to stay up indefinitely.
+
+I brought the display over to my mom’s apartment on November 12, 2022, turned
+it on, joined it to her Wi-Fi, and rebooted it to confirm everything worked in
+the new environment.
+
+I thought the bathroom counter might be a good place for it, but my mom thought
+she’d rather have it in her bedroom, so we found a home for it on a windowsill.
+
+My mom was happy with the display right away.
+
+Retrospective
+
+Despite her amnesia, my mom came to remember that this display exists and what
+it’s for. She looks forward to seeing updates from her children on it.
+
+If we tell her about something that’s coming up, she often asks whether we’ve
+already put that event on the MomBoard. On the flip side, we have to be careful
+to keep it up to date; if we fail to take down a message that no longer
+applies, it confuses her.
+
+Looking back, the display is essentially the only intervention of any kind
+we’ve tried that’s actually been successful at improving her quality of life
+(and ours). One reason it’s worked so well is that it didn’t require her to
+learn anything new. Without the ability to remember new things, it’s virtually
+impossible for her to learn a new skill or to form new habits.
+
+The device’s reliability has surpassed my expectations. There was one period
+where the device seemed to stop working, but I traced the problem to a faulty
+Wi-Fi hub; after that was replaced, it’s worked flawlessly since. For my part,
+keeping the software as simple as possible and sticking to vanilla web
+technologies surely helped avoid bugs.
+
+The display still looks great, and it still displays messages day in and day
+out.
+
+If you want to try to set up something similar to what I describe here, I’m
+happy to answer technical questions or share advice.
+
+Update: I’ve published the [13]MomBoard source code on GitHub.
+
+[14]Jan Miksovsky’s Blog • [15]Archive • [16]2024 [17]About • [18]RSS • [19]
+JSON • [20]Contact
+
+References:
+
+[1] https://jan.miksovsky.com/
+[2] https://jan.miksovsky.com/posts/
+[3] https://jan.miksovsky.com/posts/2024/
+[4] https://jan.miksovsky.com/about
+[5] https://jan.miksovsky.com/rss.xml
+[6] https://jan.miksovsky.com/feed.json
+[7] https://jan.miksovsky.com/contact
+[8] https://jan.miksovsky.com/posts/2024/11-12-momboard
+[9] https://shop.boox.com/products/noteair2
+[10] https://fonts.google.com/specimen/Architects+Daughter
+[11] https://fonts.google.com/specimen/Open+Sans
+[12] https://www.jsonstorage.net/
+[13] https://github.com/JanMiksovsky/momboard
+[14] https://jan.miksovsky.com/
+[15] https://jan.miksovsky.com/posts/
+[16] https://jan.miksovsky.com/posts/2024/
+[17] https://jan.miksovsky.com/about
+[18] https://jan.miksovsky.com/rss.xml
+[19] https://jan.miksovsky.com/feed.json
+[20] https://jan.miksovsky.com/contact