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Heaslip VA, Shannon M, Janes G, Phillips N, Hamilton C, Reid J, Oxholm RA, Lüdemann B, Gentil J, Langins M. Engaging nursing and midwifery policymakers and practitioners in digital transformation: an international nursing and midwifery perspective. BMJ LEADER 2024:leader-2024-000990. [PMID: 38839279 DOI: 10.1136/leader-2024-000990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Accepted: 05/24/2024] [Indexed: 06/07/2024]
Affiliation(s)
- Vanessa Ann Heaslip
- Nursing and Midwifery, University of Salford, Salford, UK
- Social Science, University of Stavanger, Stavanger, Norway
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Scheibe S, Timpel P, Mäder M, Heinrich R, Kugler J, Schönfelder T. [The effectiveness of digital care applications in people with need of home care: A systematic review]. Pflege 2024. [PMID: 38411152 DOI: 10.1024/1012-5302/a000983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/28/2024]
Abstract
The effectiveness of digital care applications in people with need of home care: A systematic review Abstract: Background: The growing need for long-term care poses challenges for healthcare systems. In June 2021, digital care applications (DiPA) were introduced as a new service in the statutory long-term care insurance in Germany. Their aim is to counteract the increased care need and/or support independence in the home. Aim: This project systematically identified and reported on national and international evidence on DiPA effectiveness, as described by the Federal Institute for Drugs and Medical Devices (BfArM). Methods: The systematic review was conducted in accordance with the PRISMA statement by means of systematic searches in the databases Medline and Cinahl, and supplemented by an extensive manual search (08/2022). Study quality was assessed using the Risk of Bias Tool (RoB2). The results were synthesized narratively. Results: Eight randomized controlled studies were included; improvements in cognition, activities of daily living, and mobility in home care patients, were reported. Study quality was low to moderate, due to mostly unblinded study designs and low case numbers. Conclusions: The currently available evidence fails to provide a reliable basis for assessing the benefits of DiPA, to neither DiPA manufacturers, nor to responsible parties in the healthcare system. Further research on DiPA effectiveness, particularly with high-quality studies, are necessary to assess its potential in the German care sector.
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Affiliation(s)
- Sandy Scheibe
- WIG2 GmbH, Wissenschaftliches Institut für Gesundheitsökonomie und Gesundheitssystemforschung, Leipzig, Deutschland
- Lehrstuhl Gesundheitswissenschaften/Public Health, Technische Universität Dresden, Deutschland
| | - Patrick Timpel
- WIG2 GmbH, Wissenschaftliches Institut für Gesundheitsökonomie und Gesundheitssystemforschung, Leipzig, Deutschland
| | - Melanie Mäder
- WIG2 GmbH, Wissenschaftliches Institut für Gesundheitsökonomie und Gesundheitssystemforschung, Leipzig, Deutschland
- Lehrstuhl Health Economics and Management, Wirtschaftswissenschaftliche Fakultät, Universität Leipzig, Deutschland
| | - Ria Heinrich
- WIG2 GmbH, Wissenschaftliches Institut für Gesundheitsökonomie und Gesundheitssystemforschung, Leipzig, Deutschland
| | - Joachim Kugler
- Lehrstuhl Gesundheitswissenschaften/Public Health, Technische Universität Dresden, Deutschland
| | - Tonio Schönfelder
- WIG2 GmbH, Wissenschaftliches Institut für Gesundheitsökonomie und Gesundheitssystemforschung, Leipzig, Deutschland
- Lehrstuhl Gesundheitswissenschaften/Public Health, Technische Universität Dresden, Deutschland
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Wong D, Pike K, Stolwyk R, Allott K, Ponsford J, McKay A, Longley W, Bosboom P, Hodge A, Kinsella G, Mowszowski L. Delivery of Neuropsychological Interventions for Adult and Older Adult Clinical Populations: An Australian Expert Working Group Clinical Guidance Paper. Neuropsychol Rev 2023:10.1007/s11065-023-09624-0. [PMID: 38032472 DOI: 10.1007/s11065-023-09624-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 10/16/2023] [Indexed: 12/01/2023]
Abstract
Delivery of neuropsychological interventions addressing the cognitive, psychological, and behavioural consequences of brain conditions is increasingly recognised as an important, if not essential, skill set for clinical neuropsychologists. It has the potential to add substantial value and impact to our role across clinical settings. However, there are numerous approaches to neuropsychological intervention, requiring different sets of skills, and with varying levels of supporting evidence across different diagnostic groups. This clinical guidance paper provides an overview of considerations and recommendations to help guide selection, delivery, and implementation of neuropsychological interventions for adults and older adults. We aimed to provide a useful source of information and guidance for clinicians, health service managers, policy-makers, educators, and researchers regarding the value and impact of such interventions. Considerations and recommendations were developed by an expert working group of neuropsychologists in Australia, based on relevant evidence and consensus opinion in consultation with members of a national clinical neuropsychology body. While the considerations and recommendations sit within the Australian context, many have international relevance. We include (i) principles important for neuropsychological intervention delivery (e.g. being based on biopsychosocial case formulation and person-centred goals); (ii) a description of clinical competencies important for effective intervention delivery; (iii) a summary of relevant evidence in three key cohorts: acquired brain injury, psychiatric disorders, and older adults, focusing on interventions with sound evidence for improving activity and participation outcomes; (iv) an overview of considerations for sustainable implementation of neuropsychological interventions as 'core business'; and finally, (v) a call to action.
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Affiliation(s)
- Dana Wong
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia.
| | - Kerryn Pike
- School of Psychology and Public Health & John Richards Centre for Rural Ageing Research, La Trobe University, Melbourne, Australia
- School of Applied Psychology, Griffith University, Gold Coast, Australia
| | - Rene Stolwyk
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia
- Monash-Epworth Rehabilitation Research Centre, Melbourne, Australia
| | - Kelly Allott
- , Orygen, Parkville, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Australia
| | - Jennie Ponsford
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia
- Monash-Epworth Rehabilitation Research Centre, Melbourne, Australia
| | - Adam McKay
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia
- MERRC, Rehabilitation and Mental Health Division, Epworth HealthCare, Richmond, Australia
| | - Wendy Longley
- Rehabilitation Studies Unit, Sydney Medical School, University of Sydney, Sydney, Australia
- The Uniting War Memorial Hospital, Waverley, Sydney, Australia
| | - Pascalle Bosboom
- MindLink Psychology, West Perth, Australia
- School of Psychological Science, University of Western Australia, Crawley, Australia
| | | | - Glynda Kinsella
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - Loren Mowszowski
- Faculty of Science, School of Psychology & Brain and Mind Centre, The University of Sydney, Sydney, Australia
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Schepens Niemiec SL, Lee E, Saunders R, Wagas R, Wu S. Technology for activity participation in older people with mild cognitive impairment or dementia: expert perspectives and a scoping review. Disabil Rehabil Assist Technol 2023; 18:1555-1576. [PMID: 36067094 PMCID: PMC9986344 DOI: 10.1080/17483107.2022.2116114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Accepted: 08/17/2022] [Indexed: 10/14/2022]
Abstract
PURPOSE This two-phased study aimed to collate, summarize and characterize - through the lens of an occupation-based, person-centred framework - ongoing research and practice featuring activity participation-supportive digital health technology (DHT) for direct use by older persons with mild cognitive impairment or Alzheimer's disease and related dementias (PwMCI/ADRD). MATERIALS AND METHODS Phase 1: Using scoping review procedures, PubMed, MEDLINE and PsycInfo were searched to identify primary research studies. Phase 2: Semi-structured interviews were completed with MCI/ADRD expert stakeholders identified through publicly available biographies and snowball referral. Thematic analysis was used to identify, synthesize and cross-compare emergent themes from both data sources that were subsequently organized into core facets of the Human Activity Assistive Technology (HAAT) model. RESULTS The scoping review resulted in 28 studies, which were primarily feasibility work with small sample sizes. Interviewed experts (N = 17) had 4+ years of MCI/ADRD experience, came from a variety of settings, and held myriad roles. Real world and research-based use of DHTs held some commonalities, particularly around support for social participation and instrumental activities of daily engagement. No DHT for sleep or work/volunteerism were noted in either phase. People with milder MCI/ADRD conditions were most often targeted users. Soft technology strategies facilitating implementation centred on product design (e.g., prompting software, customisability, multimedia/multisensory experiences), instructional methods and technology partner involvement. CONCLUSIONS This study demonstrates that although DHT supportive of activity participation is being studied and integrated into the lives of PwMCI/ADRD, there are still key opportunities for growth to meet the needs of diverse MCI/ADRD end users.Implications for rehabilitationMainstream digital health technologies (DHTs) are being utilized by persons with mild cognitive impairment and Alzheimer's disease and related dementias (PwMCI/ADRD) in everyday life, in limited capacities, to support social participation, leisure, health management and instrumental activities of daily living (IADL).Innovative research-based technologies to be used directly by PwMCI/ADRD are under development, particularly to facilitate management of ADL, social participation and IADL in persons with mild-to-moderate forms of cognitive impairment.Soft technology strategies to support technology implementation with MCI/ADRD target users include close attention to design of the technology (e.g., customisability, sensory stimulators and prompting features), instructional strategies that promote learning and motivation and involvement of technology partners to facilitate engagement with the technology.Future studies will require more robust research designs with transparent reports of participant characteristics and facilitative instructional methods to expand DHT's potential to account for and better meet the needs of diverse MCI/ADRD communities in real-world contexts.
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Affiliation(s)
- Stacey L. Schepens Niemiec
- Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA, USA
| | - Elissa Lee
- Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA, USA
| | - Raquel Saunders
- Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA, USA
| | - Rafael Wagas
- Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA, USA
| | - Shinyi Wu
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, USA
- Daniel J. Epstein Department of Industrial and Systems Engineering, University of Southern California, Los Angeles, CA, USA
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Tsertsidis A, Kolkowska E, Rapado I. Consumer direction in the field of digital technologies and people with dementia: a literature review. Disabil Rehabil Assist Technol 2023; 18:1364-1376. [PMID: 34927508 DOI: 10.1080/17483107.2021.2008529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 11/12/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE Digital technologies have a great potential to improve the quality of life of people with dementia. However, this group is usually not involved in their development and dissemination. A consumer-directed role in the delivery of digital technologies could allow this group to regain autonomy and certain independence. This article aims to conceptualise the components of the Consumer Direction theory in the context of digital technologies and people with dementia. METHOD A literature review was conducted. We searched for studies within the aforementioned context in five relevant databases, covering the years 2012-2020. Identified studies were screened and assessed for inclusion. The data were categorised using two-stage qualitative content analysis. RESULTS Forty articles were included. The results provide definitions of the four components of the Consumer Direction theory in the context of this study. Namely, what it means for people with dementia to be (1) in control of technology use, (2) offered a variety of technological options, (3) informed and supported regarding the use and training of digital technologies, and (4) actively participating in systems design. These can lead to the empowerment of people with dementia. CONCLUSION The four theoretical components of the Consumer Direction theory are conceptualised differently in the context of this study. By providing new definitions, this paper contributes to research and practice. We expect the definitions to be deployed by researchers, practitioners, and policymakers for the creation of a more consumer-directed delivery of digital technologies to people with dementia.Implications for rehabilitationDigital technologies have a great potential to improve the quality of life of people with dementia.A consumer-directed role in the delivery of digital technologies could empower people with dementia and give them the opportunity to take control over the offered services as well as maintain a degree of independence.The Consumer Direction theory and its components should be conceptualised differently in the context of digital technologies and people with dementia than in previous contexts that used the theory.The new definitions can be utilised by researchers, practitioners and policymakers for the creation of a more consumer-directed delivery of digital technologies to people with dementia.
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Affiliation(s)
| | - Ella Kolkowska
- Department of Informatics, Örebro University, Örebro, Sweden
| | - Irene Rapado
- Department of Philosophy, Linguistics and Theory of Science, Gothenburg University, Gothenburg, Sweden
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Daly-Lynn J, Ryan A, McCormack B, Martin S. Stakeholder's experiences of living and caring in technology-rich supported living environments for tenants living with dementia. BMC Geriatr 2023; 23:62. [PMID: 36726077 PMCID: PMC9889957 DOI: 10.1186/s12877-023-03751-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 01/12/2023] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Technology innovation provides an opportunity to support the rising number of people living with dementia globally. The present study examines experiences of people who have dementia and live in technology enriched supported care models. Additionally, it explores caregiver's attitudes towards technology use with the housing scheme. METHODS A qualitative research design was adopted, and eight housing schemes consented to take part in the study. A technology audit was undertaken in addition to participant interviews and caregiver survey. Seven peer researchers conducted semi-structured interviews with 22 people living with dementia. Interviews were analysed using thematic analysis. Informal and formal caregivers were invited to complete a survey to capture their attitudes towards technology use. A total of 20 informal and 31 formal caregiver surveys were returned. All surveys were input into Survey Monkey and downloaded into excel for analysis. Closed questions were analysed using descriptive statistics and open-ended questions were organised into themes and described descriptively. RESULTS The technology audit identified that technologies were in place from as early as 2002. Technology heterogeneity of, both passive and active devices, was found within the housing schemes. Technologies such as wearable devices were reportedly used according to need, and mobile phone use was widely adopted. The themes that developed out of the tenant interviews were: Attitudes and Engagement with Technology; Technology Enhancing Tenants Sense of Security; Seeking Support and Digital Literacy; and Technology Enabled Connection. A lack of awareness about living alongside technology was a major finding. Technologies enabled a sense of reassurance and facilitated connections with the wider community. The interaction with technology presented challenges, for example, remembering passwords, access to Wi-Fi and the identification of its use in an emergency. The caregiver survey reported a range of facilitators and barriers for the use of technology within care. Both types of caregivers held relatively similar views around the benefits of technology, however their views on issues such as privacy and consent varied. Safety was considered more important than right to privacy by family caregivers. CONCLUSIONS The present study provides new insight into stakeholder's experiences of living, working and caregiving alongside technology in supported living environments. As the generation of people living with dementia become more tech savvy, harnessing everyday technologies to support care could enable holistic care and support the transition through the care continuum. Advance care planning and technology assessments are at the very core of future technology provision. It is evident that a paternalistic attitudes towards technology use could impact the multitude of benefits technology can play in both health and leisure for people living with dementia and their caregivers.
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Affiliation(s)
- Jean Daly-Lynn
- grid.12641.300000000105519715School of Health Sciences, Ulster University, Newtownabbey, Northern Ireland
| | - Assumpta Ryan
- School of Nursing, Ulster University, Magee, Northern Ireland
| | - Brendan McCormack
- grid.104846.fHead of Division of Nursing, Queen Margaret University, Scotland, UK
| | - Suzanne Martin
- grid.12641.300000000105519715School of Health Sciences, Ulster University, Newtownabbey, Northern Ireland
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Schwartz J, Ballard DH. Feasibility of Customized Pillboxes to Enhance Medication Adherence: A Randomized Controlled Trial. Arch Phys Med Rehabil 2022; 103:2288-2295. [PMID: 35430239 DOI: 10.1016/j.apmr.2022.03.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 03/16/2022] [Accepted: 03/29/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To test the (1) feasibility of an assistive technology based pillbox intervention on medication adherence; (2) feasibility of trial procedures; and (3) preliminary effectiveness of the pillbox intervention on medication adherence. DESIGN A single-blinded randomized controlled clinical trial was conducted during 2-4 weeks. SETTING Researchers recruited a convenience sample to participate in this university laboratory-based study. PARTICIPANTS English-speaking consumers of 2 or more daily medications (N=15) participated in the study. Individuals with cognitive impairment or who did not manage their own medications were excluded. INTERVENTIONS Participants were randomized to 1 of 3 pillbox interventions: (1) standard-of-care pillbox; (2) customized off-the-shelf pillbox; or (3) customized 3-dimensional (3D) printed pillbox. MAIN OUTCOME MEASURES Outcome measures were divided among the 3 goals of the study. In addition to feasibility metrics, the Adherence to Refills and Medications Scale was used to measure the primary outcome measure, medication adherence. The Quebec User Evaluation of Satisfaction with Assistive Technology was used to measure pillbox satisfaction. RESULTS Researchers successfully administered 6 standard-of-care, 5 custom off-the-shelf, and 4 custom 3D printed pillboxes. Compared with the standard-of-care pillboxes, customized 3D printed pillboxes had large (d=1.04) and customized off-the-shelf pillboxes had medium (d=0.67) effects on medication adherence. CONCLUSIONS Prescription of customized pillboxes using a manualized and novel assistive technology approach that leverages 3D printing is feasible.
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Affiliation(s)
- Jaclyn Schwartz
- Program in Occupational Therapy, Washington University in St. Louis School of Medicine, St. Louis, MO.
| | - David H Ballard
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, MO
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Chan A, Cohen R, Robinson KM, Bhardwaj D, Gregson G, Jutai JW, Millar J, Ríos Rincón A, Roshan Fekr A. Evidence and User Considerations of Home Health Monitoring for Older Adults: Scoping Review. JMIR Aging 2022; 5:e40079. [PMID: 36441572 DOI: 10.2196/40079] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 10/03/2022] [Accepted: 10/10/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Home health monitoring shows promise in improving health outcomes; however, navigating the literature remains challenging given the breadth of evidence. There is a need to summarize the effectiveness of monitoring across health domains and identify gaps in the literature. In addition, ethical and user-centered frameworks are important to maximize the acceptability of health monitoring technologies. OBJECTIVE This review aimed to summarize the clinical evidence on home-based health monitoring through a scoping review and outline ethical and user concerns and discuss the challenges of the current user-oriented conceptual frameworks. METHODS A total of 2 literature reviews were conducted. We conducted a scoping review of systematic reviews in Scopus, MEDLINE, Embase, and CINAHL in July 2021. We included reviews examining the effectiveness of home-based health monitoring in older adults. The exclusion criteria included reviews with no clinical outcomes and lack of monitoring interventions (mobile health, telephone, video interventions, virtual reality, and robots). We conducted a quality assessment using the Assessment of Multiple Systematic Reviews (AMSTAR-2). We organized the outcomes by disease and summarized the type of outcomes as positive, inconclusive, or negative. Second, we conducted a literature review including both systematic reviews and original articles to identify ethical concerns and user-centered frameworks for smart home technology. The search was halted after saturation of the basic themes presented. RESULTS The scoping review found 822 systematic reviews, of which 94 (11%) were included and of those, 23 (24%) were of medium or high quality. Of these 23 studies, monitoring for heart failure or chronic obstructive pulmonary disease reduced exacerbations (4/7, 57%) and hospitalizations (5/6, 83%); improved hemoglobin A1c (1/2, 50%); improved safety for older adults at home and detected changing cognitive status (2/3, 66%) reviews; and improved physical activity, motor control in stroke, and pain in arthritis in (3/3, 100%) rehabilitation studies. The second literature review on ethics and user-centered frameworks found 19 papers focused on ethical concerns, with privacy (12/19, 63%), autonomy (12/19, 63%), and control (10/19, 53%) being the most common. An additional 7 user-centered frameworks were studied. CONCLUSIONS Home health monitoring can improve health outcomes in heart failure, chronic obstructive pulmonary disease, and diabetes and increase physical activity, although review quality and consistency were limited. Long-term generalized monitoring has the least amount of evidence and requires further study. The concept of trade-offs between technology usefulness and acceptability is critical to consider, as older adults have a hierarchy of concerns. Implementing user-oriented frameworks can allow long-term and larger studies to be conducted to improve the evidence base for monitoring and increase the receptiveness of clinicians, policy makers, and end users.
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Affiliation(s)
- Andrew Chan
- Faculty of Rehabilitation Medicine, Department of Occupational Therapy, University of Alberta, Edmonton, AB, Canada.,Innovation and Technology Hub, Glenrose Rehabilitation Research, Edmonton, AB, Canada
| | - Rachel Cohen
- KITE Research Institute, Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada.,Institute of Biomedical Engineering, University of Toronto, Toronto, ON, Canada
| | - Katherine-Marie Robinson
- School of Engineering Design and Teaching Innovation, Faculty of Engineering, University of Ottawa, Ottawa, ON, Canada.,Department of Philosophy, Faculty of Arts, University of Ottawa, Ottawa, ON, Canada
| | - Devvrat Bhardwaj
- Department of Electrical Engineering and Computer Science, Faculty of Engineering, University of Ottawa, Ottawa, ON, Canada
| | - Geoffrey Gregson
- Faculty of Rehabilitation Medicine, Department of Occupational Therapy, University of Alberta, Edmonton, AB, Canada.,Innovation and Technology Hub, Glenrose Rehabilitation Research, Edmonton, AB, Canada
| | - Jeffrey W Jutai
- Interdisciplinary School of Health Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada.,LIFE Research Institute, University of Ottawa, Ottawa, ON, Canada
| | - Jason Millar
- School of Engineering Design and Teaching Innovation, Faculty of Engineering, University of Ottawa, Ottawa, ON, Canada.,Department of Philosophy, Faculty of Arts, University of Ottawa, Ottawa, ON, Canada
| | - Adriana Ríos Rincón
- Faculty of Rehabilitation Medicine, Department of Occupational Therapy, University of Alberta, Edmonton, AB, Canada.,Innovation and Technology Hub, Glenrose Rehabilitation Research, Edmonton, AB, Canada
| | - Atena Roshan Fekr
- KITE Research Institute, Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada.,Institute of Biomedical Engineering, University of Toronto, Toronto, ON, Canada
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Sriram V, Jenkinson C, Peters M. Carers using assistive technology in dementia care at home: a mixed methods study. BMC Geriatr 2022; 22:490. [PMID: 35672662 PMCID: PMC9173970 DOI: 10.1186/s12877-022-03167-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Accepted: 05/23/2022] [Indexed: 11/17/2022] Open
Abstract
Introduction Informal carers support persons with dementia to live at home, even with deteriorating physical, social and cognitive issues. This study aims to examine the experiences and impact of Assistive Technology (AT) on carers, providing care for a person with dementia. Methods This is an explanatory sequential mixed methods study. The quantitative phase was an online and postal survey using the Carers Assistive Technology Experience Questionnaire and Short Form-12 (SF-12) questionnaire, with carers of persons with dementia in the UK, who used AT. The qualitative phase involved in-depth telephone interviews with a purposive sample of survey respondents and was analysed using hermeneutic phenomenology to develop, compare and explain the findings of the survey. Results The survey included data from 201 carers. Smartphones (45.5%) and tablet computers (45.0%) were the most frequently used AT. Multiple AT were used in the care of persons with dementia predominantly for safety (78.5%), communication (66.0%), and reminders (62.5%). The SF-12 indicated that carers in the 46–65 age group and carers who were not extremely satisfied with AT had lower mental component scores whilst carers who lived with the person with dementia and older carers had lower physical component scores. Twenty-three carers participated in the interviews, and 5 themes with 14 sub-themes were identified. The interviews helped confirm data from the survey on the impact of AT on the physical, mental and social wellbeing of the carers. It helped describe reasons for satisfaction with AT; how AT was used in daily life and strengthened caring relationships and how wider support systems enhanced the care of a person with dementia using AT. Conclusions This study describes the use of AT in the real-world context. AT supplements the care provided to people with dementia in the community. Appropriate use, access to AT and abilities of the carer can enhance the support provided through AT to both carers and the person with dementia. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-022-03167-4.
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Affiliation(s)
- Vimal Sriram
- Health Services Research Unit, Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Old Road Campus, Oxford, OX3 7LF, UK.
| | - Crispin Jenkinson
- Health Services Research Unit, Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Old Road Campus, Oxford, OX3 7LF, UK
| | - Michele Peters
- Health Services Research Unit, Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Old Road Campus, Oxford, OX3 7LF, UK
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Warner L, Tipping L. "Can Everyday Assistive Technologies Provide Meaningful Support to Persons With Dementia and Their Informal Caregivers? Evaluation of Collaborative Community Program". J Appl Gerontol 2022; 41:2022-2032. [PMID: 35586889 DOI: 10.1177/07334648221101041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
One of the most challenging caregiving roles today is providing informal care to an individual with dementia. A new program, "AT-Home with Dementia," was created by three collaborative social service agencies to offer simple assistive technologies to persons with dementia and their informal caregivers. Staff, equipped with a traveling kit of everyday devices, offered items during home visits to enhance memory, functional activities, safety, and comfort of persons with dementia. A limited formative program review led to improvements in the new program's reach, service delivery, and data. The results showed that the program enhanced the home environment of the caregiving dyad and led to greater independence of persons with dementia (PWD) and self-assurance among caregivers. Existing community agencies may refer to this program to serve individuals with early-stage dementia. Finally, community agencies and funders may consider adapting this program to provide support to the informal care providers and PWD.
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Affiliation(s)
- Lora Warner
- Department of Public & Environmental Affairs, 14749University of Wisconsin - Green Bay, Green Bay, WI, USA
| | - LaReina Tipping
- Aging & Disability Resource Center of Brown County, formerly employed at Curative Connections, Inc, Green Bay, WI, USA
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Dementia caregiving across Latin America and the Caribbean and brain health diplomacy. LANCET HEALTHY LONGEVITY 2021; 2:e222-e231. [PMID: 34790905 PMCID: PMC8594860 DOI: 10.1016/s2666-7568(21)00031-3] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The prevalence of dementia in Latin America and the Caribbean is growing rapidly, increasing the burden placed on caregivers. Exacerbated by fragile health-care systems, unstable economies, and extensive inequalities, caregiver burden in this region is among the highest in the world. We reviewed the major challenges to caregiving in Latin America and the Caribbean, and we propose regional and coordinated actions to drive future change. Current challenges include the scarcity of formal long-term care, socioeconomic and social determinants of health disparities, gender-biased burdens, growing dementia prevalence, and the effect of the current COVID-19 pandemic on families affected by dementia. Firstly, we propose local and regional short-term strategic recommendations, including systematic identification of specific caregiver needs, testing of evidence-based local interventions, contextual adaptation of strategies to different settings and cultures, countering gender bias, strengthening community support, provision of basic technology, and better use of available information and communications technology. Additionally, we propose brain health diplomacy (ie, global actions aimed to overcome the systemic challenges to brain health by bridging disciplines and sectors) and convergence science as frameworks for long-term coordinated responses, integrating tools, knowledge, and strategies to expand access to digital technology and develop collaborative models of care. Addressing the vast inequalities in dementia caregiving across Latin America and the Caribbean requires innovative, evidence-based solutions coordinated with the strengthening of public policies.
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Rezaei AM, Stevens MC, Argha A, Mascheroni A, Puiatti A, Lovell NH. An Unobtrusive Fall Detection System Using Low Resolution Thermal Sensors and Convolutional Neural Networks. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2021; 2021:6949-6952. [PMID: 34892702 DOI: 10.1109/embc46164.2021.9631059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Human activity recognition has many potential applications. In an aged care facility, it is crucial to monitor elderly patients and assist them in the case of falls or other needs. Wearable devices can be used for such a purpose. However, most of them have been proven to be obtrusive, and patients reluctate or forget to wear them. In this study, we used infrared technology to recognize certain human activities including sitting, standing, walking, laying in bed, laying down, and falling. We evaluated a system consisting of two 24×32 thermal array sensors. One infrared sensor was installed on side and another one was installed on the ceiling of an experimental room capturing the same scene. We chose side and overhead mounts to compare the performance of classifiers. We used our prototypes to collect data from healthy young volunteers while performing eight different scenarios. After that, we converted data coming from the sensors into images and applied a supervised deep learning approach. The scene was captured by a visible camera and the video from the visible camera was used as the ground truth. The deep learning network consisted of a convolutional neural network which automatically extracted features from infrared images. Overall average F1-score of all classes for the side mount was 0.9044 and for the overhead mount was 0.8893. Overall average accuracy of all classes for the side mount was 96.65% and for the overhead mount was 95.77%. Our results suggested that our infrared-based method not only could unobtrusively recognize human activities but also was reasonably accurate.
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Curnow E, Rush R, Gorska S, Forsyth K. Differences in assistive technology installed for people with dementia living at home who have wandering and safety risks. BMC Geriatr 2021; 21:613. [PMID: 34717561 PMCID: PMC8556981 DOI: 10.1186/s12877-021-02546-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Accepted: 10/12/2021] [Indexed: 02/04/2023] Open
Abstract
Background Assistive Technology for people with dementia living at home is not meeting their care needs. Reasons for this may be due to limited understanding of variation in multiple characteristics of people with dementia including their safety and wandering risks, and how these affect their assistive technology requirements. This study therefore aimed to explore the possibility of grouping people with dementia according to data describing multiple person characteristics. Then to investigate the relationships between these groupings and installed Assistive Technology interventions. Methods Partitioning Around Medoids cluster analysis was used to determine participant groupings based upon secondary data which described the person characteristics of 451 people with dementia with Assistive Technology needs. Relationships between installed Assistive Technology and participant groupings were then examined. Results Two robust clustering solutions were identified within the person characteristics data. Relationships between the clustering solutions and installed Assistive Technology data indicate the utility of this method for exploring the impact of multiple characteristics on Assistive technology installations. Living situation and caregiver support influence installation of assistive technology more strongly than level of risk or cognitive impairment. People with dementia living alone received different AT from those living with others. Conclusions Results suggest that caregiver support and the living situation of the person with dementia influence the type and frequency of installed Assistive Technology. Reasons for this include the needs of the caregiver themselves, the caregiver view of the participants’ needs, caregiver response to alerts, and the caregiver contribution to the assistive technology assessment and selection process. Selection processes should be refined to account for the needs and views of both caregivers and people with dementia. This will require additional assessor training, and the development of validated assessments for people with dementia who have additional impairments. Policies should support the development of services which provide a wider range of AT to facilitate interventions which are focused on the needs of the person with dementia.
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Affiliation(s)
- Eleanor Curnow
- School of Health Sciences, Queen Margaret University, Edinburgh, EH21 6UU, UK.
| | - Robert Rush
- School of Health Sciences, Queen Margaret University, Edinburgh, EH21 6UU, UK
| | - Sylwia Gorska
- School of Health Sciences, Queen Margaret University, Edinburgh, EH21 6UU, UK
| | - Kirsty Forsyth
- School of Health Sciences, Queen Margaret University, Edinburgh, EH21 6UU, UK
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14
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Sriram V, Jenkinson C, Peters M. Carers' experiences of assistive technology use in dementia care: a cross sectional survey. BMC Geriatr 2021; 21:471. [PMID: 34433416 PMCID: PMC8385483 DOI: 10.1186/s12877-021-02417-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 08/09/2021] [Indexed: 11/10/2022] Open
Abstract
Background Assistive Technology (AT) supports persons with dementia and their carers (family, friends and neighbours), yet little is known about experiences and the impact of AT on carers. We report on an exploratory survey that examined the types, uses, costs and impact of AT on carers as well as their quality of life. Methods A cross-sectional survey using the Carers Assistive Technology Experience Questionnaire collected data from carers in the UK, who used at least one AT in the previous year and provided more than 10 h of care for a person with dementia, living at home. Carers completed the questionnaire online or on paper and information on AT, socio-demographic details, and Short-Form Health Survey (SF-12) data were collected. Descriptive and inferential statistics were used to report results and draw conclusions. Results Data from 201 carers was analysed. Smartphones and tablet computers were the most frequently used AT. AT were used predominantly for safety, communication, and reminders. Carers usually make decisions on buying and continued use of AT. Multiple AT devices were used in the care of persons with dementia and number of AT used was associated with perceived satisfaction. Satisfaction with AT was not related to age, living arrangements and relationship of carers. From the SF-12, Mean Physical Component Score was 49.19 (95%CI- 47.75 to 50.63) and Mental Component Score was 45.37 (95%CI- 43.93 to 46.80). Women, carers in the 46–65 age group and carers who were not extremely satisfied with AT had lower MCS scores. Carers who lived with the person with dementia and older carers had lower PCS scores. Conclusions Carers report that AT has a beneficial impact. Carers use multiple ATs, perceive AT to be satisfactory and recommend AT use to others. To support carers, we recommend establishment of centrally funded information sources and a loan store for AT. Further research on incremental addition of AT and changes to formal/paid care because of using AT should be undertaken. Practitioners, academics, manufactures and policy makers should consider the experiences of carers in research, development and use of AT to facilitate improved community living of people with dementia. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-021-02417-1.
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Affiliation(s)
- Vimal Sriram
- Health Services Research Unit, Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Old Road Campus, Oxford, OX3 7LF, UK.
| | - Crispin Jenkinson
- Health Services Research Unit, Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Old Road Campus, Oxford, OX3 7LF, UK
| | - Michele Peters
- Health Services Research Unit, Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Old Road Campus, Oxford, OX3 7LF, UK
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15
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Behera CK, Condell J, Dora S, Gibson DS, Leavey G. State-of-the-Art Sensors for Remote Care of People with Dementia during a Pandemic: A Systematic Review. SENSORS (BASEL, SWITZERLAND) 2021; 21:4688. [PMID: 34300428 PMCID: PMC8309480 DOI: 10.3390/s21144688] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 05/31/2021] [Accepted: 07/02/2021] [Indexed: 01/10/2023]
Abstract
In the last decade, there has been a significant increase in the number of people diagnosed with dementia. With diminishing public health and social care resources, there is substantial need for assistive technology-based devices that support independent living. However, existing devices may not fully meet these needs due to fears and uncertainties about their use, educational support, and finances. Further challenges have been created by COVID-19 and the need for improved safety and security. We have performed a systematic review by exploring several databases describing assistive technologies for dementia and identifying relevant publications for this review. We found there is significant need for appropriate user testing of such devices and have highlighted certifying bodies for this purpose. Given the safety measures imposed by the COVID-19 pandemic, this review identifies the benefits and challenges of existing assistive technologies for people living with dementia and their caregivers. It also provides suggestions for future research in these areas.
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Affiliation(s)
- Chandan Kumar Behera
- Intelligent Systems Research Centre, Faculty of Computing, Engineering and Built Environment, University of Ulster, Northland Road, Londonderry BT48 7JL, UK; (C.K.B.); (S.D.); (G.L.)
| | - Joan Condell
- Intelligent Systems Research Centre, Faculty of Computing, Engineering and Built Environment, University of Ulster, Northland Road, Londonderry BT48 7JL, UK; (C.K.B.); (S.D.); (G.L.)
| | - Shirin Dora
- Intelligent Systems Research Centre, Faculty of Computing, Engineering and Built Environment, University of Ulster, Northland Road, Londonderry BT48 7JL, UK; (C.K.B.); (S.D.); (G.L.)
| | - David S. Gibson
- Northern Ireland Centre for Stratified Medicine (NICSM), Biomedical Sciences Research Institute, University of Ulster, Altnagelvin Area Hospital, C-TRIC Building, Glenshane Road, Londonderry BT47 6SB, UK;
| | - Gerard Leavey
- Intelligent Systems Research Centre, Faculty of Computing, Engineering and Built Environment, University of Ulster, Northland Road, Londonderry BT48 7JL, UK; (C.K.B.); (S.D.); (G.L.)
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16
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Luscombe N, Morgan-Trimmer S, Savage S, Allan L. Digital technologies to support people living with dementia in the care home setting to engage in meaningful occupations: protocol for a scoping review. Syst Rev 2021; 10:179. [PMID: 34148547 PMCID: PMC8214930 DOI: 10.1186/s13643-021-01715-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 05/19/2021] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND People living with all stages of dementia should have the opportunity to participate in meaningful occupations. For those living in care homes, this may not always occur and residents may spend significant parts of the day unengaged, especially those living with more advanced dementia. Digital technologies are increasingly being used in health care and could provide opportunities for people living with dementia (PLWD) in care homes to engage in meaningful occupations and support care staff to provide these activities. With technology advancing at a rapid rate, the objective of this scoping review is to provide an up-to-date systematic map of the research on the diverse range of digital technologies that support engagement in meaningful occupations. In particular, focus will be given to barriers and facilitators to inform future intervention design and implementation strategies, which have not yet been clearly mapped across the full range of these digital technologies. METHOD A scoping review will be conducted to systematically search for published research using a comprehensive search strategy on thirteen databases. Published, peer-reviewed studies that focused on PLWD in the care home setting and assessed any form of digital technology that supported a meaningful occupation will be included. All methodologies which meet the criteria will be included. Data will be extracted and charted to report the range of digital technologies, underlying mechanisms of action, facilitators and barriers to implementation. DISCUSSION Mapping the range of technologies to support PLWD to engage in meaningful occupations will identify gaps in research. The systematic search will include a diverse range of technologies such as software to enhance care planning, tablets devices, smartphones, communication robots and social media platforms, rather than focussing on a specific design or interface. This will enable comparison between mechanisms of action, barriers and facilitators to implementation which will be useful for future research and intervention design. TRIAL REGISTRATION Open Science Framework https://doi.org/10.17605/OSF.IO/7UDM2.
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Affiliation(s)
- Nicholas Luscombe
- The Centre for Research in Ageing and Cognitive Health (REACH), University of Exeter Medical School, St. Luke's Campus, Heavitree Road, Exeter, EX1 2LU, UK.
| | - Sarah Morgan-Trimmer
- Institute of Health Research, College House, University of Exeter, St Luke's Campus, Heavitree Road, Exeter, EX1 2LU, UK
| | - Sharon Savage
- School of Psychology, The University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia
| | - Louise Allan
- The Centre for Research in Ageing and Cognitive Health (REACH), University of Exeter Medical School, St. Luke's Campus, Heavitree Road, Exeter, EX1 2LU, UK
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17
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Howard R, Gathercole R, Bradley R, Harper E, Davis L, Pank L, Lam N, Talbot E, Hooper E, Winson R, Scutt B, Ordonez Montano V, Nunn S, Lavelle G, Bateman A, Bentham P, Burns A, Dunk B, Forsyth K, Fox C, Poland F, Leroi I, Newman S, O’Brien J, Henderson C, Knapp M, Woolham J, Gray R. The effectiveness and cost-effectiveness of assistive technology and telecare for independent living in dementia: a randomised controlled trial. Age Ageing 2021; 50:882-890. [PMID: 33492349 PMCID: PMC8099012 DOI: 10.1093/ageing/afaa284] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Indexed: 11/14/2022] Open
Abstract
Objectives The use of assistive technology and telecare (ATT) has been promoted to manage risks associated with independent living in people with dementia but with little evidence for effectiveness. Methods Participants were randomly assigned to receive an ATT assessment followed by installation of all appropriate ATT devices or limited control of appropriate ATT. The primary outcomes were time to institutionalisation and cost-effectiveness. Key secondary outcomes were number of incidents involving risks to safety, burden and stress in family caregivers and quality of life. Results Participants were assigned to receive full ATT (248 participants) or the limited control (247 participants). After adjusting for baseline imbalance of activities of daily living score, HR for median pre-institutionalisation survival was 0.84; 95% CI, 0.63 to 1.12; P = 0.20. There were no significant differences between arms in health and social care (mean -£909; 95% CI, -£5,336 to £3,345, P = 0.678) and societal costs (mean -£3,545; 95% CI, -£13,914 to £6,581, P = 0.499). ATT group members had reduced participant-rated quality-adjusted life years (QALYs) at 104 weeks (mean − 0.105; 95% CI, −0.204 to −0.007, P = 0.037) but did not differ in QALYs derived from proxy-reported EQ-5D. Discussion Fidelity of the intervention was low in terms of matching ATT assessment, recommendations and installation. This, however, reflects current practice within adult social care in England. Conclusions Time living independently outside a care home was not significantly longer in participants who received full ATT and ATT was not cost-effective. Participants with full ATT attained fewer QALYs based on participant-reported EQ-5D than controls at 104 weeks.
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Affiliation(s)
| | | | - Rosie Bradley
- Medical Research Council Population Health Research Unit, UK
| | - Emma Harper
- Medical Research Council Population Health Research Unit, UK
| | - Lucy Davis
- Medical Research Council Population Health Research Unit, UK
| | - Lynn Pank
- Medical Research Council Population Health Research Unit, UK
| | - Natalie Lam
- Medical Research Council Population Health Research Unit, UK
| | - Emma Talbot
- Norfolk and Suffolk NHS Foundation Trust, UK
| | - Emma Hooper
- Lancashire Care NHS Foundation Trust and University of Manchester, UK
| | - Rachel Winson
- Cambridgeshire and Peterborough NHS Foundation Trust, UK
| | | | | | | | | | | | - Peter Bentham
- Birmingham and Solihull Mental Health NHS Foundation Trust, UK
| | | | - Barbara Dunk
- South London and Maudsley NHS Foundation Trust, UK
| | | | | | | | | | | | | | | | - Martin Knapp
- London School of Economics and Political Science, UK
| | | | - Richard Gray
- Medical Research Council Population Health Research Unit, UK
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18
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Baruah U, Varghese M, Loganathan S, Mehta KM, Gallagher-Thompson D, Zandi D, Dua T, Pot AM. Feasibility and preliminary effectiveness of an online training and support program for caregivers of people with dementia in India: a randomized controlled trial. Int J Geriatr Psychiatry 2021; 36:606-617. [PMID: 33491811 DOI: 10.1002/gps.5502] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 01/22/2021] [Indexed: 12/14/2022]
Abstract
OBJECTIVES Internet-based interventions involving elements of cognitive behavior therapy, psychoeducation, relaxation and skills training for caregivers of people with dementia have been found to be promising in Western countries. Given these outcomes, the adapted version of a multi-component online caregiver skills training and support program of the World Health Organization, called iSupport, was tested for feasibility and preliminary effectiveness in India. METHODS One hundred fifty-one caregivers of family members with a diagnosis of Alzheimer's disease or dementia were randomized to either the intervention arm (iSupport; n = 74) or to the control group (an education-only e-book program; n = 77). Participants were assessed using self-rated measures of depression and perceived burden, which were the primary outcome measures, at baseline and 3-month follow-up. Person-centered attitude, self-efficacy, mastery and self-rated health were also assessed. RESULTS Fifty-five caregivers (29 in the iSupport group and 26 in the control condition) completed the study. The recruitment and retention rate of the study were 44.67% and 36.42% respectively. No significant differences were found between the two groups at 3-month follow-up on the primary outcomes. Among the secondary outcomes, significant improvement was only seen in caregivers' person-centered attitude towards persons with dementia in the iSupport group (t = 2.228; p < 0.05). CONCLUSIONS Despite efforts to recruit and retain participants to the online program, this study had a low recruitment and retention rate, which require closer attention and indicates a need for further adaptations of the Indian version of the iSupport program to improve its acceptability and accessibility. The lessons learned from this study will guide the further development of caregiver training and support interventions in India. The trial was registered with the Clinical Trials Registry-India (Trial Registration No. CTRI/2017/02/007876).
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Affiliation(s)
- Upasana Baruah
- Department of Psychiatry, Geriatric Clinic and Services, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India
| | - Mathew Varghese
- Department of Psychiatry, Geriatric Clinic and Services, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India
| | - Santosh Loganathan
- Department of Psychiatry, Geriatric Clinic and Services, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India
| | - Kala M Mehta
- Department of Epidemiology and Biostatistics, University of California, San Francisco, California, USA
| | - Dolores Gallagher-Thompson
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California, USA.,Betty Irene Moore School of Nursing, University of California, Davis, California, USA
| | - Diana Zandi
- Department of Integrated Health Services, World Health Organization (WHO), Geneva, Switzerland
| | - Tarun Dua
- Department of Mental Health and Substance Use, World Health Organization (WHO), Geneva, Switzerland
| | - Anne Margriet Pot
- Department of Mental Health and Substance Use, World Health Organization (WHO), Geneva, Switzerland
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19
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Pappadà A, Chattat R, Chirico I, Valente M, Ottoboni G. Assistive Technologies in Dementia Care: An Updated Analysis of the Literature. Front Psychol 2021; 12:644587. [PMID: 33841281 PMCID: PMC8024695 DOI: 10.3389/fpsyg.2021.644587] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 02/25/2021] [Indexed: 12/17/2022] Open
Abstract
Objectives: Technology can assist and support both people with dementia (PWD) and caregivers. Recently, technology has begun to embed remote components. Timely with respect to the pandemic, the present work reviews the most recent literature on technology in dementia contexts together with the newest studies about technological support published until October 2020. The final aim is to provide a synthesis of the timeliest evidence upon which clinical and non-clinical decision-makers can rely to make choices about technology in the case of further pandemic waves. Methods: A review of reviews was performed alongside a review of the studies run during the first pandemic wave. PsycInfo, CINAHL, and PubMed-online were the databases inspected for relevant papers published from January 2010. Results: The search identified 420 articles, 30 of which were reviews and nine of which were new studies meeting the inclusion criteria. Studies were first sorted according to the target population, then summarized thematically in a narrative synthesis. The studies targeting technologies for PWD were categorized as follows: monitoring and security purposes, sustaining daily life, and therapeutic interventions. Each category showed potential benefits. Differently, the interventions for caregivers were classified as informative, psycho-education programs, psychosocial-supportive, therapeutic, and cognitive/physical training. Benefits to mental health, skills learning, and social aspects emerged. Conclusions: The evidence shows that technology is well-accepted and can support PWD and caregivers to bypass physical and environmental problems both during regular times and during future pandemic waves. Nevertheless, the lack of a common methodological background is revealed by this analysis. Further and more standardized research is necessary to improve the implementation of technologies in everyday life while respecting the necessary personalization.
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Affiliation(s)
| | - Rabih Chattat
- Department of Psychology, University of Bologna, Bologna, Italy
| | - Ilaria Chirico
- Department of Psychology, University of Bologna, Bologna, Italy
| | - Marco Valente
- Department of Psychology, University of Bologna, Bologna, Italy
| | - Giovanni Ottoboni
- Department of Psychology, University of Bologna, Bologna, Italy.,"G. Prodi" Interdipartimental Center for Cancer Research, Bologna, Italy
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20
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Huter K, Krick T, Domhoff D, Seibert K, Wolf-Ostermann K, Rothgang H. Effectiveness of Digital Technologies to Support Nursing Care: Results of a Scoping Review. J Multidiscip Healthc 2020; 13:1905-1926. [PMID: 33328736 PMCID: PMC7734078 DOI: 10.2147/jmdh.s286193] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 11/05/2020] [Indexed: 12/19/2022] Open
Abstract
Background The field of digital technologies being developed or applied to support nursing care is extensive. The aim of this scoping review is to provide an overview on technologies for which results on positive or negative effects on persons in need of care, caregivers or care institutions are available and to appraise the reliability of these results. Methods A scoping review design has been used to identify studies focussing on the effectiveness of digital technologies in nursing care for persons in need of care, caregivers or care institutions. The screening process included 19,510 scientific publications from 9 databases. Results A total of 123 single studies and 31 reviews were subjected to the analysis. The included technologies comprise nursing and health information technologies, such as assistive devices, information and communication technologies, sensors and robotics. The results show that there are many studies that demonstrate positive effects, but the level of evidence is mostly low and study sizes are often small. Hardly any technology has been researched intensively enough to produce conclusive results. Studies on a high level of evidence (RCTs) lack for most technological areas. Heterogeneous results in some areas indicate that effects may depend strongly on the mode and specific context into which the technologies are introduced. Conclusion Due to the limited evidence on effectiveness of digital technologies in nursing care, it is not surprising that care institutions are reluctant to put innovative technologies into practice. The scoping review indicates technology areas that should be subject to future research with higher quality studies. Research on outpatient, informal and cross-sectoral care should be intensified to further exploit the potential of digital technologies with a view to improving independence of care-recipients and unburdening formal and informal carers.
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Affiliation(s)
- Kai Huter
- University of Bremen, SOCIUM Research Center on Inequality and Social Policy, Bremen, Germany.,University of Bremen, High-Profile Area of Health Sciences, Bremen, Germany
| | - Tobias Krick
- University of Bremen, SOCIUM Research Center on Inequality and Social Policy, Bremen, Germany.,University of Bremen, High-Profile Area of Health Sciences, Bremen, Germany
| | - Dominik Domhoff
- University of Bremen, High-Profile Area of Health Sciences, Bremen, Germany.,University of Bremen, Institute for Public Health and Nursing Research, Bremen, Germany
| | - Kathrin Seibert
- University of Bremen, High-Profile Area of Health Sciences, Bremen, Germany.,University of Bremen, Institute for Public Health and Nursing Research, Bremen, Germany
| | - Karin Wolf-Ostermann
- University of Bremen, High-Profile Area of Health Sciences, Bremen, Germany.,University of Bremen, Institute for Public Health and Nursing Research, Bremen, Germany
| | - Heinz Rothgang
- University of Bremen, SOCIUM Research Center on Inequality and Social Policy, Bremen, Germany.,University of Bremen, High-Profile Area of Health Sciences, Bremen, Germany
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21
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Lauriks S, Meiland F, Osté JP, Hertogh C, Dröes RM. Effects of Assistive Home Technology on quality of life and falls of people with dementia and job satisfaction of caregivers: Results from a pilot randomized controlled trial. Assist Technol 2020; 32:243-250. [PMID: 30592439 DOI: 10.1080/10400435.2018.1531952] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVES Determine the effects of the implementation of Assistive Home Technology (AHT) in group homes on the quality of life (QoL) of people with dementia and on job satisfaction of caregivers. METHOD Pilot randomized controlled trial in nine in-patient care group homes (group homes with vs. without AHT). Participants were 54 people with dementia and 25 professionals. Outcome measurements were QoL, fall incidents, needs, use of restraints, job satisfaction, workload, and general health. RESULTS Living in a group home with AHT had a positive effect on four QoL domains: 'social isolation', 'having things to do', 'esthetics', and 'quality of life appreciation'. No effects were found on 12 other QoL domains. Fall incidents during bathroom visits were significantly reduced by the application of AHT. During this implementation phase, in the AHT group home, a moderate negative effect was found on caregiver's appreciation of work circumstances. No effects on other outcome measures were found. CONCLUSION Positive effects were found on aspects of QoL and fall incidents in the bathroom. The lower caregiver appreciation of work circumstances in the AHT group confirms the importance of intensive support and guidance of personnel during the implementation of AHT.
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Affiliation(s)
- Steve Lauriks
- Amsterdam Public Health Service (GGD Amsterdam), Department of Epidemiology, Health promotion and Care innovation, Amsterdam , The Netherlands
| | - Franka Meiland
- Amsterdam University Medical Centers, location VUmc, Department of Psychiatry, Amsterdam Public Health Research Institute , Amsterdam, The Netherlands
| | - Johan P Osté
- Amsterdam Public Health Service (GGD Amsterdam), Department of Epidemiology, Health promotion and Care innovation, Amsterdam , The Netherlands
| | - Cees Hertogh
- Amsterdam University Medical Centers, location VUmc, Department of General Practice and Elderly Care Medicine, Amsterdam Public Health Research Institute , Amsterdam, The Netherlands
| | - Rose-Marie Dröes
- Amsterdam University Medical Centers, location VUmc, Department of Psychiatry, Amsterdam Public Health Research Institute , Amsterdam, The Netherlands
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22
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Kruse CS, Fohn J, Umunnakwe G, Patel K, Patel S. Evaluating the Facilitators, Barriers, and Medical Outcomes Commensurate with the Use of Assistive Technology to Support People with Dementia: A Systematic Review Literature. Healthcare (Basel) 2020; 8:E278. [PMID: 32824711 PMCID: PMC7551699 DOI: 10.3390/healthcare8030278] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 08/04/2020] [Accepted: 08/14/2020] [Indexed: 12/01/2022] Open
Abstract
Background: Assistive technologies (AT) have been used to improve the daily living conditions of people living with dementia (PWD). Research supports the positive impact of the use of AT such as decreased burden on caregivers and behavioral support for people with dementia. Four reviews in the last six years have analyzed AT and PWD, but none have incorporated the dimension of medical outcomes. Objectives: The purpose of this review is to identify the facilitators, barriers, and medical outcomes commensurate with the use of AT with PWD. Method: This review queried The Cumulative Index of Nursing and Allied Health Literature (CINAHL), Web of Science, Science Direct, and PubMed databases for peer-reviewed publications in the last five years for facilitators, barriers, and medical outcomes commensurate with the use of AT with PWD. The study is reported and conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) and the Kruse Protocol for conducting a systematic review. Results: 48 studies were analyzed. Fourteen types of AT, 17 facilitators, 17 barriers, and 16 medical outcomes were identified in the literature. The two most frequently mentioned ATs were cognitive stimulators (9/48, 19%) and social robots (5/48, 10%). The two most frequently mentioned facilitators were caregivers want AT (8/68, 12%) and enables increased independence (7/68, 10%). The top two barriers were cost (8/75, 11%) and PWD reject AT (8/75, 11%). The top medical outcomes were improved cognitive abilities (6/69, 9%), increased activities of daily living (ADLs), and increased autonomy (each at 5/69, 7%): Zero negative outcomes were reported. Conclusion: The systematic review revealed the positive relations that occur when PWD and their caregivers use AT. Although many reservations surrounding the use of AT exist, a majority of the literature shows a positive effect of its use. Research supports a strong support for AT by caregivers due to many positive medical outcomes, but also a reticence to adopt by PWD. If ATs for PWD are a way to reduce stress on caregivers, barriers of cost and complexity need to be addressed through health policy or grants.
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Affiliation(s)
- Clemens Scott Kruse
- School of Health Administration, Texas State University, San Marcos, TX 78666, USA; (J.F.); (G.U.); (K.P.); (S.P.)
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Holthe T, Halvorsrud L, Thorstensen E, Karterud D, Laliberte Rudman D, Lund A. Community Health Care Workers' Experiences on Enacting Policy on Technology with Citizens with Mild Cognitive Impairment and Dementia. J Multidiscip Healthc 2020; 13:447-458. [PMID: 32547050 PMCID: PMC7245453 DOI: 10.2147/jmdh.s246180] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Accepted: 04/23/2020] [Indexed: 11/24/2022] Open
Abstract
Purpose Assistive technologies and digitalization of services are promoted through health policy as key means to manage community care obligations efficiently, and to enable older community care recipients with mild cognitive impairment (MCI) and dementia (D) to remain at home for longer. The overall aim of this paper is to explore how community health care workers enacted current policy on technology with home-dwelling citizens with MCI/D. Participants and Methods Twenty-four community health care workers participated in one of five focus group discussions that explored their experiences and current practices with technologies for citizens with MCI/D. Five researchers took part in the focus groups, while six researchers collaboratively conducted an inductive, thematic analysis according to Braun & Clarke. Results Two main themes with sub-themes were identified: 1) Current and future potentials of technology; i) frequently used technology, ii) cost-effectiveness and iii) “be there” for social contact and 2) Barriers to implement technologies; i) unsystematic approaches and contested responsibility, ii) knowledge and training and iii) technology in relation to user-friendliness and citizen capacities. Conclusion This study revealed the complexity of implementing policy aims regarding technology provision for citizens with MCI/D. By use of Lipsky’s theory on street-level bureaucracy, we shed light on how community health care workers were situated between policies and the everyday lives of citizens with MCI/D, and how their perceived lack of knowledge and practical experiences influenced their exercise of professional discretion in enacting policy on technology in community health care services. Overall, addressing systematic technology approaches was not part of routine care, which may contribute to inequities in provision of technologies to enhance occupational possibilities and meaningful activities in everyday lives of citizens with MCI/D. Trial registration NSD project number 47996.
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Affiliation(s)
- Torhild Holthe
- Oslo Metropolitan University, Faculty of Health Sciences, Department of Occupational Therapy, Prosthetics and Orthotics, Oslo, Norway
| | - Liv Halvorsrud
- Oslo Metropolitan University, Faculty of Health Sciences, Department of Nursing and Health Promotion, Oslo, Norway
| | - Erik Thorstensen
- Oslo Metropolitan University, Work Research Institute, Centre for Welfare and Labour Research, Oslo, Norway
| | - Dag Karterud
- Oslo Metropolitan University, Faculty of Health Sciences, Department of Nursing and Health Promotion, Oslo, Norway
| | - Debbie Laliberte Rudman
- University of Western Ontario, School of Occupational Therapy & Graduate Program in Health and Rehabilitation Sciences, London, Canada
| | - Anne Lund
- Oslo Metropolitan University, Faculty of Health Sciences, Department of Occupational Therapy, Prosthetics and Orthotics, Oslo, Norway
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Krick T, Huter K, Seibert K, Domhoff D, Wolf-Ostermann K. Measuring the effectiveness of digital nursing technologies: development of a comprehensive digital nursing technology outcome framework based on a scoping review. BMC Health Serv Res 2020; 20:243. [PMID: 32209099 PMCID: PMC7092516 DOI: 10.1186/s12913-020-05106-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Accepted: 03/12/2020] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Digital nursing technologies (DNT) comprise an expanding, highly diverse field of research, explored using a wide variety of methods and tools. Study results are therefore difficult to compare, which raises the question how effectiveness of DNT can be adequately measured. Methods currently used might not be sufficient for certain specific nursing contexts. A comprehensive outcome framework that shows the multitude of possible outcome areas could be useful to generate more comparable results. The aim of the present study is to develop an outcome framework for DNT and to indicate which outcome areas have been most frequently evaluated in previous studies and how this has been done. METHODS We combined an inductive and deductive approach to develop the framework. The numerical analysis is based on a scoping review focussing on the effectiveness of DNT for persons in need of care, formal or informal caregivers or care institutions. Nine databases were included in the screening: Medline, Scopus, CINAHL, Cochrane Library, ACM Digital Library, IEEE Xplore, the Collection of Computer Science Bibliographies, GeroLit and CareLit. Additional literature searches and expert interviews were included. RESULTS The developed framework comprises four outcome target groups and 47 outcome areas. There are considerable differences in the researched outcome areas for the individual outcome target groups. Persons in need of care were by far the most frequently surveyed, particularly with respect to their psychological health. There are much fewer studies on formal and informal caregivers, and it is particularly noticeable that the quality of life of both groups has rarely been investigated. Care process quality was most frequently researched for organisations. CONCLUSION We were able to provide a comprehensive DNT outcome framework, thereby identifying the outcome tools used and the less researched outcome areas. We recommend a detailed investigation of all areas and tools in future research projects with a view to initiating a discussion on the differing importance of existing outcome areas and on a standardisation of outcome tools. We also recommend the development of outcome areas for the macro level of effectiveness assessment.
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Affiliation(s)
- Tobias Krick
- SOCIUM Research Center on Inequality and Social Policy, University of Bremen, Mary-Somerville-Straße 3, 28359, Bremen, Germany.
- High-profile Area of Health Sciences, University of Bremen, 28359, Bremen, Germany.
| | - Kai Huter
- SOCIUM Research Center on Inequality and Social Policy, University of Bremen, Mary-Somerville-Straße 3, 28359, Bremen, Germany
- High-profile Area of Health Sciences, University of Bremen, 28359, Bremen, Germany
| | - Kathrin Seibert
- High-profile Area of Health Sciences, University of Bremen, 28359, Bremen, Germany
- Institute for Public Health and Nursing Research, University of Bremen, Grazer Straße 4, 28359, Bremen, Germany
| | - Dominik Domhoff
- High-profile Area of Health Sciences, University of Bremen, 28359, Bremen, Germany
- Institute for Public Health and Nursing Research, University of Bremen, Grazer Straße 4, 28359, Bremen, Germany
| | - Karin Wolf-Ostermann
- High-profile Area of Health Sciences, University of Bremen, 28359, Bremen, Germany
- Institute for Public Health and Nursing Research, University of Bremen, Grazer Straße 4, 28359, Bremen, Germany
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Cooper J, Burrow S, Pusey H. What are the perceptions of people living with dementia, family carers, professionals and other potential stakeholders to the use of global positioning systems to promote safer outdoor walking?: a qualitative literature review. Disabil Rehabil Assist Technol 2019; 16:614-623. [PMID: 31711328 DOI: 10.1080/17483107.2019.1686074] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVE Walking outdoors has many benefits which can improve quality of life for people living with dementia. However, due to the risk of getting lost, many people with dementia are denied the opportunity to be outdoors. There has been increased interest in using global positioning systems (GPS) to facilitate independent outdoor mobility for people with dementia, but this interest has been accompanied by ethical debate focussing on the rights of an individual with dementia to maintain privacy and autonomy. The objective was to establish what people, those with dementia, those who provide support for people with dementia and wider society perceive to be the issues around GPS use. Method: An adapted qualitative systematic review was conducted between November 2018 and December 2018. Medical, social and technological databases were searched for papers with no date restriction. Initial search terms displayed nine hundred and sixty citations. Titles and if necessary abstracts were read to determine which studies might be potentially relevant. Forty papers were identified as potentially relevant and their abstracts and references examined. This produced a further four potential studies. Following application of the exclusion criteria thirty papers were eliminated.Fourteen were accepted, appraised and thematically analyzed. Results: The ethical debate was reflected in the opinions of the study respondents. There was a willingness to relinquish some privacy for safety but people with dementia were not prepared to sacrifice their autonomy-believing they alone should decide whether GPS was appropriate. Conclusion: GPS was felt to have the potential to facilitate independent outdoor walking, but systems need to be tailored to the individual. There is also a need to contradict negative societal perceptions of the ability of people with dementia to live a fulfilled life which is in danger of diminishing GPS's potential to improve quality of life for people with dementia.Implications for RehabilitationWhilst dementia is a disabling and incurable disease, taking advantage of technological developments such as GPS can diminish its negative impact.Appropriate development and use of GPSs offers the potential to enable people with dementia to explore the outdoors independently with subsequent improvement in self-confidence, independence and autonomy.Professionals working with people with dementia need to be aware of the GPS technology available and the ethical issues involved to support the use of GPS.
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Affiliation(s)
- Janet Cooper
- Tameside and Glossop Integrated Care NHS Foundation Trust, Tameside General Hospital, Ashton-under-Lyne, UK
| | - Simon Burrow
- Faculty of Biology, Medicine and Health, Division of Nursing, Midwifery and Social Work, School of Health Sciences, University of Manchester, Manchester, UK
| | - Helen Pusey
- Faculty of Biology, Medicine and Health, Division of Nursing, Midwifery and Social Work, School of Health Sciences, University of Manchester, Manchester, UK
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Daly Lynn J, Rondón-Sulbarán J, Quinn E, Ryan A, McCormack B, Martin S. A systematic review of electronic assistive technology within supporting living environments for people with dementia. DEMENTIA 2019; 18:2371-2435. [PMID: 28990408 DOI: 10.1177/1471301217733649] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Health and social care provision needs to change in order to meet the needs of an increase in the number of people living with dementia. Environmental design, technology and assistive devices have the potential to complement care, help address some of the challenges presented by this growing need and impact on the lived experience of this vulnerable population. This systematic review was undertaken to identify the research on the use of electronic assistive technology within long-term residential care settings. A total of 3229 papers published from the inception of each of the databases up until May 2016 were retrieved from searches in four major databases. Sixty-one were identified to be included in the review. The inclusion criteria were: original peer reviewed journals; an electronic assistive technology intervention; with residents or tenants living with dementia or their family or paid caregivers; in supported living environments or residential care. The data extracted from the included studies focused on the methodology, technology, outcomes and the role of people living with dementia within the research. Overall, an extensive variety of technical interventions were found, with a broad range of methodological heterogeneity to explore their effect. Additionally, wide-spanning outcomes to support the potential of technology solutions and the challenges presented by such intervention were found.
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Brims L, Oliver K. Effectiveness of assistive technology in improving the safety of people with dementia: a systematic review and meta-analysis. Aging Ment Health 2019; 23:942-951. [PMID: 29634287 DOI: 10.1080/13607863.2018.1455805] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Objectives: Assistive technology (AT) may enable people with dementia to live safely at home for longer, preventing care home admission. This systematic review assesses the effectiveness of AT in improving the safety of people with dementia living in the domestic setting, by searching for randomised controlled trials, non-randomised controlled trials and controlled before-after studies which compared safety AT with treatment as usual. Measures of safety include care home admission; risky behaviours, accidents and falls at home; and numbers of deaths. The review updates the safety aspect of Fleming and Sum's 2014 systematic review. Method: Seven bibliographic databases, the Social Care Institute for Excellence website and the Alzheimer's Society website were searched for published and unpublished literature between 2011-2016. Search terms related to AT, dementia and older people. Common outcomes were meta-analysed. Results: Three randomised controlled trials were identified, including 245 people with dementia. No significant differences were found between intervention and control groups in care home admission (risk ratio 0.85 95% CI [0.37, 1.97]; Z = 0.37; p = 0.71). The probability of a fall occurring was 50% lower in the intervention group (risk ratio 0.50 95% CI [0.32, 0.78]; Z = 3.03; p = 0.002). One included study found that a home safety package containing AT significantly reduced risky behaviour and accidents (F(45) = 4.504, p < 0.001). Limitations include the few studies found and the inclusion of studies in English only. Conclusion: AT's effectiveness in decreasing care home admission is inconclusive. However, the AT items and packages tested improved safety through reducing falls risk, accidents and other risky behaviour.
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Affiliation(s)
- Lucy Brims
- a Department of Social Policy and Intervention , University of Oxford , Oxford , UK
| | - Kathryn Oliver
- a Department of Social Policy and Intervention , University of Oxford , Oxford , UK.,b Department of Social and Environmental Health , London School of Hygiene and Tropical Medicine , London , UK
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Sriram V, Jenkinson C, Peters M. Informal carers' experience and outcomes of assistive technology use in dementia care in the community: a systematic review protocol. Syst Rev 2019; 8:158. [PMID: 31269995 PMCID: PMC6610817 DOI: 10.1186/s13643-019-1081-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Accepted: 06/28/2019] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Dementia is one of the greatest health and care priorities globally. Caring for persons with dementia is a challenge and often leads to negative psychological, physiological and financial consequences for informal carers (family members or friends). Many informal carers experience moderate to severe levels of burden. Advances in technology have the potential to assist persons with dementia and their carers, through assistive technology (AT) devices such as electronic medication dispensers, robotic devices and motion detectors. However, little is known about informal carers' experience and the impact of these technologies on them. This review aims to investigate the outcomes and experience of carers of persons with dementia, who live at home and use AT. METHOD MEDLINE, Embase, CINAHL, AMED, ALOIS, PsycINFO, Trial registries and OpenGrey databases will be searched for studies of any design that have investigated carer experience and/or outcomes of AT use for persons with dementia living at home. Manual searches from reference lists of relevant papers will also be undertaken. Outcomes of interest are carers' self-reported outcomes (which include perceived burden, quality of life and wellbeing) and carer experiences (such as usefulness, benefits and disadvantages of AT and impact on caregiver/care receiver relationship). Two independent reviewers will screen identified papers with pre-defined eligibility criteria and extract data using a bespoke extraction form. Discrepancies will be resolved in discussion with a third reviewer. A synthesis of eligible studies and summary will be provided. DISCUSSION A systematic review of quantitative, qualitative and mixed methods evidence of informal carers' experience of AT use in dementia in the community will be carried out. It is anticipated that this will highlight (1) investigations on impact of AT use on carers, (2) outcome measures and experience questionnaires that have been used and (3) the types of studies carried out so far on this topic. The results from the review will be presented in a summary matrix of common types (e.g. mobile phones, alarms) and uses (e.g. communication, safety, personal care) of AT in dementia care and also identify AT that is not usually available through government or health system funding. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42017082268 .
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Affiliation(s)
- Vimal Sriram
- Health Services Research Unit, Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Old Road Campus, Oxford, OX3 7LF UK
| | - Crispin Jenkinson
- Health Services Research Unit, Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Old Road Campus, Oxford, OX3 7LF UK
| | - Michele Peters
- Health Services Research Unit, Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Old Road Campus, Oxford, OX3 7LF UK
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Ludden GDS, van Rompay TJL, Niedderer K, Tournier I. Environmental design for dementia care - towards more meaningful experiences through design. Maturitas 2019; 128:10-16. [PMID: 31561816 DOI: 10.1016/j.maturitas.2019.06.011] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Revised: 06/15/2019] [Accepted: 06/27/2019] [Indexed: 11/17/2022]
Abstract
Dementia is generally considered to be one of the most pressing societal issues now and in the years to come. Although insights from different disciplines have contributed to a better understanding of dementia and the development of interventions targeting dementia symptoms, there is a lack of integration of insights from these different perspectives for the purposes of design for dementia. The aim of this paper is to show how insights from environmental psychology and advances in technology can inform a user-centred multidisciplinary design approach. To this end, first a brief meta-review of (systematic) reviews from the fields of assistive technology for dementia care and healing environments research is presented, after which gaps and opportunities for a multidisciplinary design approach are identified. To illustrate what such an approach could look like, two exploratory case studies are presented in which technology-enhanced prototypes of an experience handrail (aimed at facilitating wayfinding by providing meaningful sensory experiences) and a virtual nature installation (aimed at providing relaxation and stimulating social engagement) were implemented at a Dutch care centre for people with dementia. Preliminary evaluations indicate that these designs contribute to the wellbeing of people with dementia and confirm the fruitfulness of the design approach presented in this paper. Furthermore, this approach may not only provide a means to optimize existing environments and enhance ease of living, but may also lead to novel solutions to the challenges people with dementia face on a day-to-day basis, and improve their quality of life.
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Krick T, Huter K, Domhoff D, Schmidt A, Rothgang H, Wolf-Ostermann K. Digital technology and nursing care: a scoping review on acceptance, effectiveness and efficiency studies of informal and formal care technologies. BMC Health Serv Res 2019; 19:400. [PMID: 31221133 PMCID: PMC6585079 DOI: 10.1186/s12913-019-4238-3] [Citation(s) in RCA: 67] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Accepted: 06/10/2019] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND The existence, usage and benefits of digital technologies in nursing care are relevant topics in the light of the current discussion on technologies as possible solutions to problems such as the shortage of skilled workers and the increasing demand for long-term care. A lack of good empirical overviews of existing technologies in the present literature prompted us to conduct this review. Its purpose was to map the field of digital technologies for informal and formal care that have already been explored in terms of acceptance, effectiveness and efficiency (AEE), and to show the scope of the used methods, target settings, target groups and fields of support. METHODS A systematic literature search was conducted using Medline, Scopus, CINAHL, Cochrane Library, ACM Digital Library, IEEE Xplore, the Collection of Computer Science Bibliographies, GeroLit and CareLit. In addition, project websites were manually screened for relevant publications. RESULTS Seven hundred fifteen papers were included in the review. Effectiveness studies have been most frequently performed for ICT, robots and sensors. Acceptance studies often focussed on ICT, robots and EHR/EMR. Efficiency studies were generally rare. Many studies were found to have a low level of evidence. Experimental designs with small numbers and without control groups were the most common methods used to evaluate acceptance and effectiveness. Study designs with high evidence levels were most commonly found for ICT, robots and e-learning. Technologies evaluated for informal caregivers and children or indicated for formal care at home or in cross-sectoral care were rare. CONCLUSION We recommend producing high-quality evaluations on existing digital technologies for AEE in real-life settings rather than systematic reviews with low-quality studies. More focus should be placed on research into efficiency. Future research should be devoted to a closer examination of the applied AEE evaluation methods. Policymakers should provide funding to enable large-scale, long-term evaluations of technologies in the practice of care, filling the research gaps for technologies, target settings and target groups identified in this review.
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Affiliation(s)
- Tobias Krick
- SOCIUM Research Center on Inequality and Social Policy, University of Bremen, Mary-Somerville-Straße 3, 28359 Bremen, Germany
- High-profile Area of Health Sciences, University of Bremen, Bremen, Germany
| | - Kai Huter
- SOCIUM Research Center on Inequality and Social Policy, University of Bremen, Mary-Somerville-Straße 3, 28359 Bremen, Germany
- High-profile Area of Health Sciences, University of Bremen, Bremen, Germany
| | - Dominik Domhoff
- Institute for Public Health and Nursing Research, University of Bremen, Grazer Straße 4, 28359 Bremen, Germany
- High-profile Area of Health Sciences, University of Bremen, Bremen, Germany
| | - Annika Schmidt
- Institute for Public Health and Nursing Research, University of Bremen, Grazer Straße 4, 28359 Bremen, Germany
- High-profile Area of Health Sciences, University of Bremen, Bremen, Germany
| | - Heinz Rothgang
- SOCIUM Research Center on Inequality and Social Policy, University of Bremen, Mary-Somerville-Straße 3, 28359 Bremen, Germany
- High-profile Area of Health Sciences, University of Bremen, Bremen, Germany
| | - Karin Wolf-Ostermann
- Institute for Public Health and Nursing Research, University of Bremen, Grazer Straße 4, 28359 Bremen, Germany
- High-profile Area of Health Sciences, University of Bremen, Bremen, Germany
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McCarron HR, Zmora R, Gaugler JE. A Web-Based Mobile App With a Smartwatch to Support Social Engagement in Persons With Memory Loss: Pilot Randomized Controlled Trial. JMIR Aging 2019; 2:e13378. [PMID: 31518270 PMCID: PMC6715400 DOI: 10.2196/13378] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Revised: 04/25/2019] [Accepted: 05/14/2019] [Indexed: 01/23/2023] Open
Abstract
Background It is estimated that the number of individuals living with dementia worldwide will increase from 50 million in 2017 to 152 million by 2050. Assistive technology has been recognized as a promising tool to improve the lives of persons living with memory loss and their caregivers. The use of assistive technology in dementia care is expanding, although it is most often intended to manage care and promote safety. There is a lack of assistive technology designed to aid persons with memory loss in participating in meaningful activities. The Social Support Aid (SSA) is a mobile phone-based app that employs facial recognition software. It was designed to assist persons with memory loss remember the names and relationships of the people they interact with to promote social engagement. Objective This study uses a pilot randomized controlled trial (RCT) design to evaluate the SSA. The objectives were to ascertain (1) the feasibility and utility of the SSA, (2) whether the outcomes of SSA use suggest potential benefits for persons living with memory loss and their care partners, and (3) how study design components could inform subsequent RCTs. Methods Persons with memory loss were randomized to the SSA (n=20) or the usual care control group (n=28). Quantitative data were collected at three timepoints (baseline, 3 months, and 6 months). Participants in the intervention group participated in qualitative interviews following completion of their 6-month survey. Results Participant eligibility, willingness to be randomized, and retention were not barriers to conducting a full-scale RCT; however, recruitment strategies should be addressed before doing so. Feasibility and utility scores indicated that participants felt neutral about the technology. Use of the SSA was not significantly associated with changes in quality of social interactions or quality of life measures over the 6 months of follow-up (P>.05). The qualitative analysis revealed three themes that described how and why the SSA worked or not: (1) outcomes, (2) reasons why it was or was not useful, and (3) recommendations. Conclusions There is a need to develop effective assistive technology that improves the quality of life of persons with memory loss. Assistive technology that allows persons living with memory loss to maintain some level of autonomy should be a priority for future research. This study suggests reasons why the SSA facial recognition software did not appear to improve the quality of social interaction and quality of life of people with memory loss. Results also provide recommendations for future assistive technology development and evaluation. Trial Registration ClinicalTrials.gov NCT03645694; https://clinicaltrials.gov/ct2/show/NCT03645694 (Archived by WebCite at http://www.webcitation.org/78dcVZIqq)
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Affiliation(s)
- Hayley R McCarron
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, United States
| | - Rachel Zmora
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, United States
| | - Joseph E Gaugler
- Division of Health Policy and Management, School of Public Health, University of Minnesota, Minneapolis, MN, United States
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Sriram V, Jenkinson C, Peters M. Informal carers' experience of assistive technology use in dementia care at home: a systematic review. BMC Geriatr 2019; 19:160. [PMID: 31196003 PMCID: PMC6567448 DOI: 10.1186/s12877-019-1169-0] [Citation(s) in RCA: 60] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Accepted: 05/23/2019] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Dementia is a health and care priority globally. Caring for persons with dementia is a challenge and can lead to negative psychological, physiological and financial consequences for informal carers. Advances in technology have the potential to assist persons with dementia and their carers, through assistive technology devices such as electronic medication dispensers, robotic devices trackers and motion detectors. However, little is known about carers' experience and the impact of these technologies on them. This review aims to investigate the outcomes and experience of carers of persons with dementia, who live at home and use assistive technology. METHODS A systematic search in seven databases and manual searches were carried out using pre-defined inclusion and exclusion criteria to identify studies on carers of persons with dementia involving the use of assistive technology. The search identified 56 publications with quantitative, qualitative and mixed-method designs. RESULTS The studies reported positive and negative findings and focused on a wide variety of assistive technology devices. There were large differences in the uses of assistive technology, outcome measures used and the quality of studies. Knowledge and acceptance, competence to use and ethical issues when using assistive technology were themes that emerged from the studies. Carers generally appreciated using assistive technology and their experience of use varied. CONCLUSIONS The intention of this systematic review is to list and classify the various types of assistive technology used by carers of persons with dementia and explores the positive and negative aspects, knowledge, acceptance and ethical issues in the use of assistive technology by carers of persons with dementia. We recommend the use of a standard and person-centred system of classifying and naming assistive technology devices and systems and for future research efforts in assistive technology to incorporate a family/carer centred model. SYSTEMATIC REVIEW REGISTRATION PROSPERO - CRD42017082268 .
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Affiliation(s)
- Vimal Sriram
- Health Services Research Unit, Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Old Road Campus, Oxford, OX3 7LF UK
| | - Crispin Jenkinson
- Health Services Research Unit, Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Old Road Campus, Oxford, OX3 7LF UK
| | - Michele Peters
- Health Services Research Unit, Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Old Road Campus, Oxford, OX3 7LF UK
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Harding AJE, Morbey H, Ahmed F, Opdebeeck C, Lasrado R, Williamson PR, Swarbrick C, Leroi I, Challis D, Hellstrom I, Burns A, Keady J, Reilly ST. What is important to people living with dementia?: the 'long-list' of outcome items in the development of a core outcome set for use in the evaluation of non-pharmacological community-based health and social care interventions. BMC Geriatr 2019; 19:94. [PMID: 30917790 PMCID: PMC6437989 DOI: 10.1186/s12877-019-1103-5] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Accepted: 03/12/2019] [Indexed: 01/07/2023] Open
Abstract
Background Core outcome sets (COS) prioritise outcomes based on their importance to key stakeholders, reduce reporting bias and increase comparability across studies. The first phase of a COS study is to form a ‘long-list’ of outcomes. Key stakeholders then decide on their importance. COS reporting is described as suboptimal and this first phase is often under-reported. Our objective was to develop a ‘long-list’ of outcome items for non-pharmacological interventions for people with dementia living at home. Methods Three iterative phases were conducted. First, people living with dementia, care partners, health and social care professionals, policymakers and researchers (n = 55) took part in interviews or focus groups and were asked which outcomes were important. Second, existing dementia trials were identified from the ALOIS database. 248 of 1009 pharmacological studies met the inclusion criteria. Primary and secondary outcomes were extracted from a 50% random sample (n = 124) along with eight key reviews/qualitative papers and 38 policy documents. Third, extracted outcome items were translated onto an existing qualitative framework and mapped into domains. The research team removed areas of duplication and refined the ‘long-list’ in eight workshops. Results One hundred seventy outcome items were extracted from the qualitative data and literature. The 170 outcome items were consolidated to 54 in four domains (Self-Managing Dementia Symptoms, Quality of Life, Friendly Neighbourhood & Home, Independence). Conclusions This paper presents a transparent blueprint for ‘long-list’ development. Though a useful resource in their own right, the 54 outcome items will be distilled further in a modified Delphi survey and consensus meeting to identify core outcomes.
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Affiliation(s)
- Andrew J E Harding
- Faculty of Health and Medicine, Division of Health Research, Lancaster University, Lancaster, UK
| | - Hazel Morbey
- Faculty of Health and Medicine, Division of Health Research, Lancaster University, Lancaster, UK
| | - Faraz Ahmed
- Faculty of Health and Medicine, Division of Health Research, Lancaster University, Lancaster, UK
| | - Carol Opdebeeck
- Department of Psychology, Manchester Metropolitan University, Manchester, UK
| | - Reena Lasrado
- Division of Nursing, Midwifery & Social Work, University of Manchester, Manchester, UK
| | - Paula R Williamson
- Clinical Trials Research Centre, University of Liverpool, Liverpool, UK.,Medical Research Council North West Hub for Trials Methodology Research, Liverpool, UK
| | - Caroline Swarbrick
- Division of Nursing, Midwifery & Social Work, University of Manchester, Manchester, UK
| | - Iracema Leroi
- Division of Neuroscience & Experimental Psychology, University of Manchester, Manchester, UK
| | - David Challis
- Division of Population Health, Health Services Research & Primary Care, University of Manchester, Manchester, UK
| | - Ingrid Hellstrom
- Department of Social and Welfare Studies, Linköping University, Linköping, Sweden
| | - Alistair Burns
- Division of Neuroscience & Experimental Psychology, University of Manchester, Manchester, UK
| | - John Keady
- Division of Nursing, Midwifery & Social Work, University of Manchester, Manchester, UK.,Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Siobhan T Reilly
- Faculty of Health and Medicine, Division of Health Research, Lancaster University, Lancaster, UK.
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Koumakis L, Chatzaki C, Kazantzaki E, Maniadi E, Tsiknakis M. Dementia Care Frameworks and Assistive Technologies for Their Implementation: A Review. IEEE Rev Biomed Eng 2019; 12:4-18. [DOI: 10.1109/rbme.2019.2892614] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Whelan BM, Angus D, Wiles J, Chenery HJ, Conway ER, Copland DA, Atay C, Angwin AJ. Toward the Development of SMART Communication Technology: Automating the Analysis of Communicative Trouble and Repair in Dementia. Innov Aging 2018; 2:igy034. [PMID: 30539162 PMCID: PMC6276976 DOI: 10.1093/geroni/igy034] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Communication difficulties have been reported as one of the most stress-inducing aspects of caring for people with dementia. Notably, with disease progression comes an increase in the frequency of communication difficulty and a reduction in the effectiveness of attempts to remedy breakdowns in communication. The aim of the current research was to evaluate the utility of an automated discourse analysis tool (i.e., Discursis) in distinguishing between different types of trouble and repair signaling behaviors, demonstrated within conversations between people with dementia and their professional care staff. RESEARCH DESIGN AND METHODS Twenty conversations between people with dementia and their professional care staff were human-coded for instances of interactive/noninteractive trouble and typical/facilitative repair behaviors. Associations were then examined between these behaviors and recurrence metrics generated by Discursis. RESULTS Significant associations were identified between Discursis metrics, trouble-indicating, and repair behaviors. DISCUSSION AND IMPLICATIONS These results suggest that discourse analysis software is capable of discriminating between different types of trouble and repair signaling behavior, on the basis of term recurrence calculated across speaker turns. The subsequent recurrence metrics generated by Discursis offer a means of automating the analysis of episodes of conversational trouble and repair. This achievement represents the first step toward the future development of an intelligent assistant that can analyze conversations in real time and offers support to people with dementia and their carers during periods of communicative trouble.
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Affiliation(s)
- Brooke-Mai Whelan
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia
| | - Daniel Angus
- School of Communication and Arts, Faculty of Humanities and Social Sciences, University of Queensland, Brisbane, Australia
| | - Janet Wiles
- School of Information Technology and Electrical Engineering, Faculty of Engineering, Architecture and Information Technology, University of Queensland, Brisbane, Australia
| | - Helen J Chenery
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia
| | - Erin R Conway
- School of Allied Health, Faculty of Health Sciences, Australian Catholic University, Brisbane, Queensland, Australia
| | - David A Copland
- UQ Centre for Clinical Research, Faculty of Medicine
- School of Health and Rehabilitation Sciences, Faculty of Health and Behavioural Sciences, University of Queensland, Brisbane, Australia
| | - Christina Atay
- School of Information Technology and Electrical Engineering, Faculty of Engineering, Architecture and Information Technology, University of Queensland, Brisbane, Australia
| | - Anthony J Angwin
- School of Health and Rehabilitation Sciences, Faculty of Health and Behavioural Sciences, University of Queensland, Brisbane, Australia
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Bunn F, Goodman C, Jones PR, Russell B, Trivedi D, Sinclair A, Bayer A, Rait G, Rycroft-Malone J, Burton C. Managing diabetes in people with dementia: a realist review. Health Technol Assess 2018; 21:1-140. [PMID: 29235986 DOI: 10.3310/hta21750] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Dementia and diabetes mellitus are common long-term conditions that coexist in a large number of older people. People living with dementia and diabetes may be at increased risk of complications such as hypoglycaemic episodes because they are less able to manage their diabetes. OBJECTIVES To identify the key features or mechanisms of programmes that aim to improve the management of diabetes in people with dementia and to identify areas needing further research. DESIGN Realist review, using an iterative, stakeholder-driven, four-stage approach. This involved scoping the literature and conducting stakeholder interviews to develop initial programme theories, systematic searches of the evidence to test and develop the theories, and the validation of programme theories with a purposive sample of stakeholders. PARTICIPANTS Twenty-six stakeholders (user/patient representatives, dementia care providers, clinicians specialising in dementia or diabetes and researchers) took part in interviews and 24 participated in a consensus conference. DATA SOURCES The following databases were searched from 1990 to March 2016: MEDLINE (PubMed), Cumulative Index to Nursing and Allied Health Literature, Scopus, The Cochrane Library (including the Cochrane Database of Systematic Reviews), Database of Abstracts of Reviews of Effects, the Health Technology Assessment (HTA) database, NHS Economic Evaluation Database, AgeInfo (Centre for Policy on Ageing - UK), Social Care Online, the National Institute for Health Research (NIHR) portfolio database, NHS Evidence, Google (Google Inc., Mountain View, CA, USA) and Google Scholar (Google Inc., Mountain View, CA, USA). RESULTS We included 89 papers. Ten papers focused directly on people living with dementia and diabetes, and the rest related to people with dementia or diabetes or other long-term conditions. We identified six context-mechanism-outcome (CMO) configurations that provide an explanatory account of how interventions might work to improve the management of diabetes in people living with dementia. This includes embedding positive attitudes towards people living with dementia, person-centred approaches to care planning, developing skills to provide tailored and flexible care, regular contact, family engagement and usability of assistive devices. A general metamechanism that emerges concerns the synergy between an intervention strategy, the dementia trajectory and social and environmental factors, especially family involvement. A flexible service model for people with dementia and diabetes would enable this synergy in a way that would lead to the improved management of diabetes in people living with dementia. LIMITATIONS There is little evidence relating to the management of diabetes in people living with dementia, although including a wider literature provided opportunities for transferable learning. The outcomes in our CMOs are largely experiential rather than clinical. This reflects the evidence available. Outcomes such as increased engagement in self-management are potential surrogates for better clinical management of diabetes, but this is not proven. CONCLUSIONS This review suggests that there is a need to prioritise quality of life, independence and patient and carer priorities over a more biomedical, target-driven approach. Much current research, particularly that specific to people living with dementia and diabetes, identifies deficiencies in, and problems with, current systems. Although we have highlighted the need for personalised care, continuity and family-centred approaches, there is much evidence to suggest that this is not currently happening. Future research on the management of diabetes in older people with complex health needs, including those with dementia, needs to look at how organisational structures and workforce development can be better aligned to the needs of people living with dementia and diabetes. STUDY REGISTRATION This study is registered as PROSPERO CRD42015020625. FUNDING The NIHR HTA programme.
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Affiliation(s)
- Frances Bunn
- Centre for Research in Primary and Community Care, University of Hertfordshire, Hatfield, UK
| | - Claire Goodman
- Centre for Research in Primary and Community Care, University of Hertfordshire, Hatfield, UK
| | | | - Bridget Russell
- Centre for Research in Primary and Community Care, University of Hertfordshire, Hatfield, UK
| | - Daksha Trivedi
- Centre for Research in Primary and Community Care, University of Hertfordshire, Hatfield, UK
| | - Alan Sinclair
- Foundation for Diabetes Research in Older People, Diabetes Frail Ltd, Luton, UK
| | - Antony Bayer
- Cochrane Institute of Primary Care and Public Health, Cardiff University, Cardiff, UK
| | - Greta Rait
- Research Department of Primary Care and Population Health, University College London Medical School, London, UK
| | | | - Chris Burton
- School of Healthcare Sciences, Bangor University, Bangor, UK
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Personalisation, customisation and bricolage: how people with dementia and their families make assistive technology work for them. AGEING & SOCIETY 2018. [DOI: 10.1017/s0144686x18000661] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AbstractAssistive technologies (ATs) are being ‘mainstreamed’ within dementia care, where they are promoted as enabling people with dementia to age in place alongside delivering greater efficiencies in care. AT provision focuses upon standardised solutions, with little known about how ATs are used by people with dementia and their carers within everyday practice. This paper explores how people with dementia and carers use technologies in order to manage care. Findings are reported from qualitative semi-structured interviews with 13 people with dementia and 26 family carers. Readily available household technologies were used in conjunction with and instead of AT to address diverse needs, replicating AT functions when doing so. Successful technology use was characterised by ‘bricolage’ or the non-conventional use of tools or methods to address local needs. Carers drove AT use by engaging creatively with both assistive and everyday technologies, however, carers were not routinely supported in their creative engagements with technology by statutory health or social care services, making bricolage a potentially frustrating and wasteful process. Bricolage provides a useful framework to understand how technologies are used in the everyday practice of dementia care, and how technology use can be supported within care. Rather than implementing standardised AT solutions, AT services and AT design in future should focus on how technologies can support more personalised, adaptive forms of care.
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Asghar I, Cang S, Yu H. Impact evaluation of assistive technology support for the people with dementia. Assist Technol 2018; 31:180-192. [PMID: 29701503 DOI: 10.1080/10400435.2017.1411405] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
Abstract
This study explores important factors of assistive technology (AT) and evaluates their relative impact on AT effectiveness and retention. Questionnaire based survey is used for data collection from 327 people with dementia (PWD). This empirical study uses statistical techniques including exploratory factor analysis for factor identification, linear regression for impact study, Kruskal Wallis H and Mann Whitney U tests for the statistical significant study in terms of demographic and characteristics. The exploratory factor analysis results into 11 factors: operational support, physical support, psychological support, social support, cultural match, reduced external help, affordability, travel help, compatibility, effectiveness and retention. The results reveal that social support, psychological support and travel help and reduced external help strongly impact on AT effectiveness and retention. The users are motivated by socialization support through using AT without any external help. The use of AT during travelling improves confidence of the PWD and helps them psychologically.
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Affiliation(s)
- Ikram Asghar
- Faculty of Science and Technology, Bournemouth University , Poole , UK
| | - Shuang Cang
- Newcastle Business School, Northumbria University , Newcastle , UK
| | - Hongnian Yu
- Faculty of Science and Technology, Bournemouth University , Poole , UK
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Collins ME. Occupational Therapists' Experience with Assistive Technology in Provision of Service to Clients with Alzheimer's Disease and Related Dementias. PHYSICAL & OCCUPATIONAL THERAPY IN GERIATRICS 2018. [DOI: 10.1080/02703181.2018.1458770] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Megan Edwards Collins
- Winston-Salem State University Occupational Therapy Department, Winston- Salem, NC, United States
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Characteristics of the built environment for people with dementia in East and Southeast Asian nursing homes: a scoping review. Int Psychogeriatr 2018; 30:469-480. [PMID: 29094669 DOI: 10.1017/s1041610217002241] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
UNLABELLED ABSTRACTBackground:This scoping review explores the characteristics of the current built environment used to accommodate people with dementia in East and Southeast Asia. It is structured around the eight principles of design found in the Environmental Audit Tool High-Care. In addition, the review examines the level of knowledge and other influences contributing to the development of nursing homes in the region. METHODS The review was carried out utilizing the methodological framework recommended by Arksey and O'Malley. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses provided an overarching structural framework for the reporting process and the Population, Intervention, Comparison, Outcomes, and Context framework defined the scope of the review and focused on the research question. Six databases were accessed for the search, and 1,846 publications between 2001 and 2015 were retrieved. RESULTS A total of 48 articles from 9 countries met the inclusion criteria. All articles presented discussions that fundamentally included at least one principle of design and with some including all principles. The most prevailing principle discussed, found in 59% of all the articles was the need for familiarity for residents in the environmental design of facilities. CONCLUSIONS The review found that the eight principles of design, when applied with cultural sensitivity in countries in East and Southeast Asia can identify gaps in knowledge of the design for dementia enabling environments and suggest areas for improvement. An assessment tool based on the principles of design will be able to provide a guide for stakeholders in the design, development, or modification of nursing home environments.
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Asghar I, Cang S, Yu H. Usability evaluation of assistive technologies through qualitative research focusing on people with mild dementia. COMPUTERS IN HUMAN BEHAVIOR 2018. [DOI: 10.1016/j.chb.2017.08.034] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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King AC, Dwan C. Electronic memory aids for people with dementia experiencing prospective memory loss: A review of empirical studies. DEMENTIA 2017; 18:1994-2007. [DOI: 10.1177/1471301217735180] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This paper details a review of the literature on the use of electronic aids for prospective memory for people with dementia. Key findings of the review are that: electronic memory aids show potential for supporting people’s prospective memory but the devices and software applications need further development in order to function reliably; sample sizes of studies are often very small, limiting the generalisability of their findings; few studies of devices are conducted in users’ home environments; and most of the studies focus on the effectiveness of the electronic memory aid, rather than outcomes for users, such as improved daily functioning, quality of life, or social connectedness. The review concludes that future studies with robust devices are required that explicitly focus on the varying needs and capacities of people with dementia, in order to generate additional evidence for the effectiveness of electronic memory aids for this cohort.
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Jayatilaka A, Ranasinghe DC, Falkner K, Visvanathan R, Wilson A. Care workers' voices in designing assistive technologies for preventing malnutrition in older people with dementia: Innovative Practice. DEMENTIA 2017; 19:505-511. [PMID: 28776410 DOI: 10.1177/1471301217722852] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Technology may be considered a way to promote nutritional health in people with dementia living in their home. For technologies to be effective and accepted by users, understanding technological needs prior to technology development is crucial; however, this necessitates greater research investment. Consequently, our focus is to derive needs for nutritional health promoting technologies for older people with dementia by understanding perceptions of care workers recruited by the aged care industry. In this paper, we provide a brief description of the theoretical framework that underpins the research study and the research methods selected. Significant learning outcomes related to the research methods include managing hierarchical relationships among participants, engagement with the care workers working in the community and using external material to spark discussion.
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Affiliation(s)
| | | | | | | | - Anne Wilson
- The University of Adelaide, Australia; Flinders University of South Australia, Australia; University of New South Wales, Australia
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Bunn F, Goodman C, Reece Jones P, Russell B, Trivedi D, Sinclair A, Bayer A, Rait G, Rycroft-Malone J, Burton C. What works for whom in the management of diabetes in people living with dementia: a realist review. BMC Med 2017; 15:141. [PMID: 28750628 PMCID: PMC5532771 DOI: 10.1186/s12916-017-0909-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Accepted: 07/04/2017] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Dementia and diabetes mellitus are common long-term conditions and co-exist in a large number of older people. People living with dementia (PLWD) may be less able to manage their diabetes, putting them at increased risk of complications such as hypoglycaemia. The aim of this review was to identify key mechanisms within different interventions that are likely to improve diabetes outcomes in PLWD. METHODS This is a realist review involving scoping of the literature and stakeholder interviews to develop theoretical explanations of how interventions might work, systematic searches of the evidence to test and develop the theories and their validation with a purposive sample of stakeholders. Twenty-six stakeholders - user/patient representatives, dementia care providers, clinicians specialising in diabetes or dementia and researchers - took part in interviews, and 24 participated in a consensus conference. RESULTS We included 89 papers. Ten focused on PLWD and diabetes, and the remainder related to people with either dementia, diabetes or other long-term conditions. We identified six context-mechanism-outcome configurations which provide an explanatory account of how interventions might work to improve the management of diabetes in PLWD. This includes embedding positive attitudes towards PLWD, person-centred approaches to care planning, developing skills to provide tailored and flexible care, regular contact, family engagement and usability of assistive devices. An overarching contingency emerged concerning the synergy between an intervention strategy, the dementia trajectory and social and environmental factors, especially family involvement. CONCLUSIONS Evidence highlighted the need for personalised care, continuity and family-centred approaches, although there was limited evidence that this happens routinely. This review suggests there is a need for a flexible service model that prioritises quality of life, independence and patient and carer priorities. Future research on the management of diabetes in older people with complex health needs, including those with dementia, needs to look at how organisational structures and workforce development can be better aligned to their needs. TRIAL REGISTRATION PROSPERO, CRD42015020625. Registered on 18 May 2015.
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Affiliation(s)
- Frances Bunn
- Centre for Research in Primary and Community Care, University of Hertfordshire, College Lane, Hatfield, Hertfordshire, AL10 9AB, UK.
| | - Claire Goodman
- Centre for Research in Primary and Community Care, University of Hertfordshire, College Lane, Hatfield, Hertfordshire, AL10 9AB, UK
| | | | - Bridget Russell
- Centre for Research in Primary and Community Care, University of Hertfordshire, College Lane, Hatfield, Hertfordshire, AL10 9AB, UK
| | - Daksha Trivedi
- Centre for Research in Primary and Community Care, University of Hertfordshire, College Lane, Hatfield, Hertfordshire, AL10 9AB, UK
| | - Alan Sinclair
- Foundation for Diabetes Research in Older People, Diabetes Frail Ltd, Luton, LU1 3UA, UK
| | - Antony Bayer
- Division of Population Medicine, Cardiff University, Cardiff, Wales, CF10 3AT, LL57 2EF, UK
| | - Greta Rait
- Research Department of Primary Care and Population Health, UCL Medical School (Royal Free Campus), Rowland Hill Street, London, NW3 2PF, UK
| | | | - Christopher Burton
- Centre for Research in Primary and Community Care, University of Hertfordshire, College Lane, Hatfield, Hertfordshire, AL10 9AB, UK
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Van der Roest HG, Wenborn J, Pastink C, Dröes R, Orrell M. Assistive technology for memory support in dementia. Cochrane Database Syst Rev 2017; 6:CD009627. [PMID: 28602027 PMCID: PMC6481376 DOI: 10.1002/14651858.cd009627.pub2] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND The sustained interest in electronic assistive technology in dementia care has been fuelled by the urgent need to develop useful approaches to help support people with dementia at home. Also the low costs and wide availability of electronic devices make it more feasible to use electronic devices for the benefit of disabled persons. Information Communication Technology (ICT) devices designed to support people with dementia are usually referred to as Assistive Technology (AT) or Electronic Assistive Technology (EAT). By using AT in this review we refer to electronic assistive devices. A range of AT devices has been developed to support people with dementia and their carers to manage their daily activities and to enhance safety, for example electronic pill boxes, picture phones, or mobile tracking devices. Many are commercially available. However, the usefulness and user-friendliness of these devices are often poorly evaluated. Although reviews of (electronic) memory aids do exist, a systematic review of studies focusing on the efficacy of AT for memory support in people with dementia is lacking. Such a review would guide people with dementia and their informal and professional carers in selecting appropriate AT devices. OBJECTIVES Primary objectiveTo assess the efficacy of AT for memory support in people with dementia in terms of daily performance of personal and instrumental activities of daily living (ADL), level of dependency, and admission to long-term care. Secondary objectiveTo assess the impact of AT on: users (autonomy, usefulness and user-friendliness, adoption of AT); cognitive function and neuropsychiatric symptoms; need for informal and formal care; perceived quality of life; informal carer burden, self-esteem and feelings of competence; formal carer work satisfaction, workload and feelings of competence; and adverse events. SEARCH METHODS We searched ALOIS, the Specialised Register of the Cochrane Dementia and Cognitive Improvement Group (CDCIG), on 10 November 2016. ALOIS is maintained by the Information Specialists of the CDCIG and contains studies in the areas of dementia prevention, dementia treatment and cognitive enhancement in healthy people. We also searched the following list of databases, adapting the search strategy as necessary: Centre for Reviews and Dissemination (CRD) Databases, up to May 2016; The Collection of Computer Science Bibliographies; DBLP Computer Science Bibliography; HCI Bibliography: Human-Computer Interaction Resources; and AgeInfo, all to June 2016; PiCarta; Inspec; Springer Link Lecture Notes; Social Care Online; and IEEE Computer Society Digital Library, all to October 2016; J-STAGE: Japan Science and Technology Information Aggregator, Electronic; and Networked Computer Science Technical Reference Library (NCSTRL), both to November 2016; Computing Research Repository (CoRR) up to December 2016; and OT seeker; and ADEAR, both to February 2017. In addition, we searched Google Scholar and OpenSIGLE for grey literature. SELECTION CRITERIA We intended to review randomised controlled trials (RCTs) and clustered randomised trials with blinded assessment of outcomes that evaluated an electronic assistive device used with the single aim of supporting memory function in people diagnosed with dementia. The control interventions could either be 'care (or treatment) as usual' or non-technological psychosocial interventions (including interventions that use non-electronic assistive devices) also specifically aimed at supporting memory. Outcome measures included activities of daily living, level of dependency, clinical and care-related outcomes (for example admission to long-term care), perceived quality of life and well-being, and adverse events resulting from the use of AT; as well as the effects of AT on carers. DATA COLLECTION AND ANALYSIS Two review authors independently screened all titles and abstracts identified by the search. MAIN RESULTS We identified no studies which met the inclusion criteria. AUTHORS' CONCLUSIONS This review highlights the current lack of high-quality evidence to determine whether AT is effective in supporting people with dementia to manage their memory problems.
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Affiliation(s)
- Henriëtte G Van der Roest
- VU University Medical CenterDepartment of General Practice and Elderly Care Medicine, EMGO Institute for Health and Care ResearchPO Box 7057AmsterdamNetherlands1007 MB
| | - Jennifer Wenborn
- University College LondonDivision of Psychiatryc/o Research & Development, North East London NHS Foundation TrustGoodmayes Hospital, Barley LaneLondonUKIG3 8XJ
| | - Channah Pastink
- VU University Medical CenterDepartment of Psychiatry, EMGO Institute for Health and Care ResearchPO Box 7057AmsterdamNetherlands1007 MB
| | - Rose‐Marie Dröes
- VU University Medical CenterDepartment of Psychiatry, EMGO Institute for Health and Care ResearchPO Box 7057AmsterdamNetherlands1007 MB
| | - Martin Orrell
- University of NottinghamInstitute of Mental HealthTriumph RoadNottinghamNottinghamshireUK
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Jackson TA, Gladman JRF, Harwood RH, MacLullich AMJ, Sampson EL, Sheehan B, Davis DHJ. Challenges and opportunities in understanding dementia and delirium in the acute hospital. PLoS Med 2017; 14:e1002247. [PMID: 28291818 PMCID: PMC5349650 DOI: 10.1371/journal.pmed.1002247] [Citation(s) in RCA: 71] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
In an Essay, Andrew Jackson and colleagues discuss challenges in the diagnosis and management of older people with dementia and delirium in acute hospitals.
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Affiliation(s)
- Thomas A. Jackson
- Institute of Inflammation and Ageing, University of Birmingham, Birmingham, United Kingdom
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom
- * E-mail:
| | - John R. F. Gladman
- Division of Rehabilitation and Ageing, Queen’s Medical Centre, Nottingham, United Kingdom
| | - Rowan H. Harwood
- Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom
| | | | - Elizabeth L. Sampson
- Marie Curie Palliative Care Research Department, Division of Psychiatry, University College London, London, United Kingdom
| | - Bart Sheehan
- Psychological Medicine, Rehabilitation and Cardiac Division, John Radcliffe Hospital, Oxford, United Kingdom
| | - Daniel H. J. Davis
- MRC Unit for Lifelong Health & Ageing, University College London, London, United Kingdom
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Ienca M, Fabrice J, Elger B, Caon M, Scoccia Pappagallo A, Kressig RW, Wangmo T. Intelligent Assistive Technology for Alzheimer’s Disease and Other Dementias: A Systematic Review. J Alzheimers Dis 2017; 56:1301-1340. [DOI: 10.3233/jad-161037] [Citation(s) in RCA: 127] [Impact Index Per Article: 18.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Affiliation(s)
- Marcello Ienca
- Institute for Biomedical Ethics, Faculty of Medicine, University of Basel, Switzerland
| | - Jotterand Fabrice
- Institute for Biomedical Ethics, Faculty of Medicine, University of Basel, Switzerland
- Institute for Health and Society, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Bernice Elger
- Institute for Biomedical Ethics, Faculty of Medicine, University of Basel, Switzerland
- University Center for Legal Medicine, University of Geneva, Switzerland
| | - Maurizio Caon
- Department of Computer Science, HumanTech Institute, University of Applied Sciences and Arts Western Switzerland, Fribourg, Switzerland
| | | | - Reto W. Kressig
- University Center for Medicine of Aging, Felix Platter Hospital, Basel, Switzerland
- Chair of Geriatrics, University of Basel, Switzerland
| | - Tenzin Wangmo
- Institute for Biomedical Ethics, Faculty of Medicine, University of Basel, Switzerland
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Meiland F, Innes A, Mountain G, Robinson L, van der Roest H, García-Casal JA, Gove D, Thyrian JR, Evans S, Dröes RM, Kelly F, Kurz A, Casey D, Szcześniak D, Dening T, Craven MP, Span M, Felzmann H, Tsolaki M, Franco-Martin M. Technologies to Support Community-Dwelling Persons With Dementia: A Position Paper on Issues Regarding Development, Usability, Effectiveness and Cost-Effectiveness, Deployment, and Ethics. JMIR Rehabil Assist Technol 2017; 4:e1. [PMID: 28582262 PMCID: PMC5454557 DOI: 10.2196/rehab.6376] [Citation(s) in RCA: 149] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Revised: 10/16/2016] [Accepted: 10/24/2016] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND With the expected increase in the numbers of persons with dementia, providing timely, adequate, and affordable care and support is challenging. Assistive and health technologies may be a valuable contribution in dementia care, but new challenges may emerge. OBJECTIVE The aim of our study was to review the state of the art of technologies for persons with dementia regarding issues on development, usability, effectiveness and cost-effectiveness, deployment, and ethics in 3 fields of application of technologies: (1) support with managing everyday life, (2) support with participating in pleasurable and meaningful activities, and (3) support with dementia health and social care provision. The study also aimed to identify gaps in the evidence and challenges for future research. METHODS Reviews of literature and expert opinions were used in our study. Literature searches were conducted on usability, effectiveness and cost-effectiveness, and ethics using PubMed, Embase, CINAHL, and PsycINFO databases with no time limit. Selection criteria in our selected technology fields were reviews in English for community-dwelling persons with dementia. Regarding deployment issues, searches were done in Health Technology Assessment databases. RESULTS According to our results, persons with dementia want to be included in the development of technologies; there is little research on the usability of assistive technologies; various benefits are reported but are mainly based on low-quality studies; barriers to deployment of technologies in dementia care were identified, and ethical issues were raised by researchers but often not studied. Many challenges remain such as including the target group more often in development, performing more high-quality studies on usability and effectiveness and cost-effectiveness, creating and having access to high-quality datasets on existing technologies to enable adequate deployment of technologies in dementia care, and ensuring that ethical issues are considered an important topic for researchers to include in their evaluation of assistive technologies. CONCLUSIONS Based on these findings, various actions are recommended for development, usability, effectiveness and cost-effectiveness, deployment, and ethics of assistive and health technologies across Europe. These include avoiding replication of technology development that is unhelpful or ineffective and focusing on how technologies succeed in addressing individual needs of persons with dementia. Furthermore, it is suggested to include these recommendations in national and international calls for funding and assistive technology research programs. Finally, practitioners, policy makers, care insurers, and care providers should work together with technology enterprises and researchers to prepare strategies for the implementation of assistive technologies in different care settings. This may help future generations of persons with dementia to utilize available and affordable technologies and, ultimately, to benefit from them.
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Affiliation(s)
- Franka Meiland
- Department of Psychiatry, VU University medical centre, Amsterdam, Netherlands
| | - Anthea Innes
- Universities of Salford and Stirling UK, Manchester, Stirling, United Kingdom
| | - Gail Mountain
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, United Kingdom
| | - Louise Robinson
- Institute for Ageing, Newcastle University, Newcastle, United Kingdom
| | - Henriëtte van der Roest
- Department of General Practice and Elderly Care Medicine, VU university medical centre, Amsterdam, Netherlands
| | - J Antonio García-Casal
- Iberian Research Psychosciences Institute, Psychosocial Rehabilitation Centre, Intras Foundation, Zamora, Spain
| | | | - Jochen René Thyrian
- German Center for Neurodegenerative Diseases (DZNE), Site Rostock, Greifswald, Germany
| | - Shirley Evans
- Association for Dementia Studies, University of Worcester, Worcester, United Kingdom
| | - Rose-Marie Dröes
- Department of Psychiatry, VU University medical centre, Amsterdam, Netherlands
| | - Fiona Kelly
- Centre for Person-centred Practice Research, Queen Margaret University, Edinburgh, United Kingdom
| | | | - Dympna Casey
- School of Nursing and Midwifery, National University of Ireland Galway, Galway, Ireland
| | - Dorota Szcześniak
- Department of Psychiatry, Wroclaw Medical University, Wroclaw, Poland
| | - Tom Dening
- Division of Psychiatry & Applied Psychology, University of Nottingham, Nottingham, United Kingdom
| | - Michael P Craven
- NIHR MindTech Healthcare Technology Co-operative, Institute of Mental Health, University of Nottingham Innovation Park, Nottingham, United Kingdom
- Bioengineering Research Group, Faculty of Engineering, University of Nottingham, Nottingham, United Kingdom
| | - Marijke Span
- Windesheim University of Applied Sciences, Zwolle, Netherlands
| | | | - Magda Tsolaki
- Memory and dementia outpatient clinic, 3rd Department of Neurology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Manuel Franco-Martin
- Iberian Research Psychosciences Institute, Psychiatric Department in Zamora Hospital, Salamanca University, Zamora, Spain
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49
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Preferences of Informal Carers on Technology Packages to Support Meal Production by People Living with Dementia, Elicited from Personalised AT and ICT Product Brochures. INFORMATICS 2017. [DOI: 10.3390/informatics4010001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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50
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Dröes RM, Chattat R, Diaz A, Gove D, Graff M, Murphy K, Verbeek H, Vernooij-Dassen M, Clare L, Johannessen A, Roes M, Verhey F, Charras K. Social health and dementia: a European consensus on the operationalization of the concept and directions for research and practice. Aging Ment Health 2017; 21:4-17. [PMID: 27869503 DOI: 10.1080/13607863.2016.1254596] [Citation(s) in RCA: 119] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Because the pattern of illnesses changes in an aging population and many people manage to live well with chronic diseases, a group of health care professionals recently proposed reformulating the static WHO definition of health towards a dynamic one based on the ability to physically, mentally and socially adapt and self-manage. This paper is the result of a collaborative action of the INTERDEM Social Health Taskforce to operationalize this new health concept for people with dementia, more specifically the social domain, and to formulate directions for research and practice to promote social health in dementia. METHOD Based on the expertise of the Social Health Taskforce members (N = 54) three groups were formed that worked on operationalizing the three social health dimensions described by Huber et al.: (1) capacity to fulfil potential and obligations; (2) ability to manage life with some degree of independence; (3) participation in social activities. For each dimension also influencing factors, effective interventions and knowledge gaps were inventoried. After a consensus meeting, the operationalizations of the dimensions were reviewed by the European Working Group of People with Dementia (EWGPWD). RESULTS The social health dimensions could be well operationalized for people with dementia and are assessed as very relevant according to the Social Health Taskforce and EWGPWD. Personal (e.g. sense of coherence, competencies), disease-related (e.g. severity of cognitive impairments, comorbidity), social (support from network, stigma) and environmental factors (e.g. enabling design, accessibility) that can influence the person with dementia's social health and many interventions promoting social health were identified. CONCLUSION A consensus-based operationalization of social health in dementia is proposed, and factors that can influence, and interventions that improve, social health in dementia identified. Recommendations are made for research and practice.
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Affiliation(s)
- R M Dröes
- a Department of Psychiatry, Alzheimer Centre , EMGO Institute for Health and Care Research, VU University Medical Centre , Amsterdam , The Netherlands
| | - R Chattat
- b Department of Psychology , University of Bologna , Bologna , Italy
| | - A Diaz
- c Alzheimer Europe , Luxembourg , Luxembourg
| | - D Gove
- c Alzheimer Europe , Luxembourg , Luxembourg
| | - M Graff
- d Radboud University Medical Centre, Radboud Institute for Health Sciences, Scientific Institute for Quality of Healthcare, Radboud Alzheimer Centre , Nijmegen , The Netherlands
| | - K Murphy
- e School of Nursing and Midwifery, Aras Loyola, National University of Irelands , Galway , Ireland
| | - H Verbeek
- f Research School CAPHRI, Department of Health Services Research , Maastricht University , Maastricht , The Netherlands
| | - M Vernooij-Dassen
- d Radboud University Medical Centre, Radboud Institute for Health Sciences, Scientific Institute for Quality of Healthcare, Radboud Alzheimer Centre , Nijmegen , The Netherlands
| | - L Clare
- g Centre for Research in Ageing and Cognitive Health (REACH) , School of Psychology, University of Exeter, and PenCLAHRC, University of Exeter Medical School , Exeter , United Kingdom
| | - A Johannessen
- h Norwegian National Advisory Unit on Ageing and Health , VID Specialized University , Oslo , Norway
| | - M Roes
- i German Center for Neurodegenerative Diseases, Department of Nursing Science, Faculty of Health , University of Witten/Herdecke , Witten , Germany
| | - F Verhey
- j Department of Psychiatry and Neuropsychology , Maastricht University , Maastricht , The Netherlands
| | - K Charras
- k Fondation Médéric Alzheimer , Psychosocial Interventions Department , Paris , France
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