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This paper presents a real-time vision-based system to assist a person with dementia wash their hands. The system uses only video inputs, and assistance is given as either verbal or visual prompts, or through the enlistment of a human caregiver’s help. The system combines a Bayesian sequential estimation framework for tracking hands and towel, with a decision-theoretic framework for computing policies of action. The decision making system is a partially observable Markov decision process, or POMDP. Decision policies dictating system actions are computed in the POMDP using a point-based approximate solution technique. The tracking and decision making systems are coupled using a heuristic method for temporally segmenting the input video stream based on the continuity of the belief state. A key element of the system is the ability to estimate and adapt to user psychological states, such as awareness and …