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Timm L, Guidetti S, Taloyan M. POSITIVE: experiences of an intervention aiming for reversing and preventing frailty using a home monitoring and communication platform within primary health care. BMC Geriatr 2024; 24:382. [PMID: 38689226 PMCID: PMC11061984 DOI: 10.1186/s12877-024-04990-7] [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: 01/15/2024] [Accepted: 04/17/2024] [Indexed: 05/02/2024] Open
Abstract
BACKGROUND Frailty is increasing worldwide as the population ages. Physical activity is one component that has been shown to hinder and even reverse the process. The POSITIVE system (i.e., maintaining and imPrOving the intrinSIc capaciTy Involving primary care and caregiVErs) is a prevention program that consists of home-monitoring equipment and a communication platform to support the initial treatment of frailty symptoms in primary health care. The participants, older aged (+ 70) frail persons and those at risk for frailty, took part in the program that promoted physical activity at home for six months. The aim was to explore and describe older persons' experiences of participating in a new prevention program using the POSITIVE system including technological tools intended to prevent the development of frailty. METHODS Nine interviews were conducted about experiences of participating in an intervention including use of technological tools to support physical activity. Qualitative content analysis was applied. RESULTS Two themes revealed: (1) Perceptions of being old are seldom positive, and (2) A rewarding and fruitful participation in the project with suggestions for improvement. Becoming older was related to physical pain and tiredness reducing the performance of former meaningful activities as well as an increase in mental stress. There was also a tendency to postpone the start of everyday activities, and in general, fewer activities were planned for one day than at younger ages. Participating in a physical activity intervention, including the use of technical tools, was considered meaningful and added motivation for engaging in other physical activities, this despite some difficulties with technical tools provided by the program. The contact with health care and the research team was appreciated. In addition, contact with other participants was requested and reported to be highly valued if added to the intervention, which could have been an expression of loneliness. CONCLUSION Participation in a prevention program motivated activities and social interaction. Adding opportunities for participants to meet each other is suggested for improving the intervention in terms of increasing the social dimensions. Our findings conclude that despite difficulties with handling the technical tools for the home-monitoring and communication platform, participation in the POSITIVE intervention was in general a positive experience.
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Affiliation(s)
- Linda Timm
- Division of Occupational Therapy, Department of Neurobiology Care Sciences and Society, Karolinska Institutet, Alfred Nobels Alle 23, B4, Huddinge, Stockholm 141 83, Stockholm, Sweden.
| | - Susanne Guidetti
- Division of Occupational Therapy, Department of Neurobiology Care Sciences and Society, Karolinska Institutet, Alfred Nobels Alle 23, B4, Huddinge, Stockholm 141 83, Stockholm, Sweden
- Medical Unit Occupational Therapy and Physiotherapy, Women´s Health and Allied Health Professionals Theme, Karolinska University Hospital, Stockholm, Sweden
| | - Marina Taloyan
- Division of Family Medicine and Primary Care, Department of Neurobiology Care Sciences and Society, Academic Primary Healthcare Centre, Karolinska Institutet, Region Stockholm, Sweden
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2
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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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3
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Heatwole Shank KS. "You Know, I Swipe My Card and Hope for the Best": Technology and Cognition as Dual Landscapes of Change. Gerontol Geriatr Med 2022; 8:23337214221128402. [PMID: 36203744 PMCID: PMC9530556 DOI: 10.1177/23337214221128402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 08/06/2022] [Accepted: 09/07/2022] [Indexed: 11/07/2022] Open
Abstract
Mild cognitive impairment (MCI), or objective and subjective cognitive decline,
affects an estimated 15%–20% of individuals over the age of 65 . People with MCI
generally live in community settings but may be at risk for functional changes
in out-of-home participation, particularly when their instrumental activities
are cognitively demanding or complex. Technology is part of the interface in
complex person-place relationships. The purpose of this study is to examine the
nature of everyday technology use in the context of out-of-home participation
for community-dwelling older adults with MCI. Community-dwelling older adults
with MCI (MoCA <26, >17; (n = 10)) were recruited for
data collection using a Go-along method (naturalistic observation,
semi-structured interviews, and photography) for multiple out-of-home
activities. Findings from this project suggested that participants felt that
technology, like their cognition, was out of their control and difficult to
predict or change. Four ways the participants experienced the “technology
landscape” in their daily lives included: enabling being present, facilitating
participation, impeding goals, and constricting options. We present a model of
the intersection of cognition, participation, and technology in daily life, and
discuss ways that technology can most effectively be used to extend well-being
for a population aging in place.
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Affiliation(s)
- Kendra S. Heatwole Shank
- Towson University, MD, USA,Kendra S. Heatwole Shank, Department of
Occupational Therapy and Occupational Science, Towson University, 8000 York Rd.,
Towson, MD 21252, USA.
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4
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Li K, Cui C, Zhang H, Jia L, Li R, Hu HY. Exploration of combined physical activity and music for patients with Alzheimer’s disease: A systematic review. Front Aging Neurosci 2022; 14:962475. [PMID: 36051308 PMCID: PMC9425638 DOI: 10.3389/fnagi.2022.962475] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 07/19/2022] [Indexed: 11/13/2022] Open
Abstract
Objective Alzheimer’s disease (AD) can be treated in different ways, one of which is combined physical activity and music intervention, which is a non-pharmacological one. This study provided a thorough systematic review on the application of combined physical activity and music intervention in patients with AD. Method Online sources, such as PubMed, Web of Science, SAGE Premier, EBSCO, and Cochrane, published from January 2002 to March 2022 were searched for articles. Reviewer screened articles on inclusion criteria and identified relevant studies. 200 studies were selected as potentially relevant; of these, eight met all the inclusion criteria. Results The systemic review looked at eight studies, two of which had high methodological quality and six were of moderate quality. Various types of research were included: randomized controlled tails, single-subject study, crossover study, and case report. Music intervention was conducted during an exercise program in six studies. A cognitive stimulation was applied with music therapy and physical activities among two studies. The physical activities or movements included balance training, stretching, strengthening, and different sports activities. Outcome assessment, including the Barthel index in two studies and the functional independence measure, was conducted to evaluate the daily functional score. Mental health was evaluated by Mini-Mental State Examination in three studies. Conclusion Combined physical activity and music intervention are beneficial and improve the cognition, function and well-being of patients with AD. Supporting combined physical and music intervention will play a key role in helping clinical guidelines for both physical therapists and music therapists.
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Affiliation(s)
- Kailimi Li
- School of Exercise and Health, Shanghai University of Sport, Shanghai, China
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
| | - CanCan Cui
- College of Music and Dance, Guangzhou University, Guangzhou City, China
| | - Haipeng Zhang
- School of Exercise and Health, Shanghai University of Sport, Shanghai, China
| | - Luning Jia
- School of Exercise and Health, Shanghai University of Sport, Shanghai, China
| | - Rui Li
- School of Exercise and Health, Shanghai University of Sport, Shanghai, China
| | - Hao-Yu Hu
- School of Exercise and Health, Shanghai University of Sport, Shanghai, China
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
- Department of Sport Rehabilitation Medicine, Shanghai Shangti Orthopedic Hospital, Shanghai, China
- *Correspondence: Hao-Yu Hu,
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5
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Nygård L, Ryd C, Astell A, Nedlund AC, Boger J, Mäki Petäjä Leinonen A, Issakainen M, Larsson Lund M. Self-initiated management approaches in everyday occupations used by people with acquired cognitive impairment. Scand J Occup Ther 2021; 29:139-151. [PMID: 34410888 DOI: 10.1080/11038128.2021.1925740] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Striving to cope with day-to-day challenges is a basic human behaviour. Self-initiated management approaches provide a resource that has yet to be discovered and systematically used in occupational therapy practice. This resource might be especially important for people with dementia who are less likely to adopt management approaches initiated by others. AIMS/OBJECTIVES Based on the findings of former studies on management and problem-solving actions among people with cognitive impairment, this article aims to identify and categorize the study participants' self-initiated management approaches and how these may be manifested in strategies in everyday occupations. MATERIAL AND METHODS The study utilized a form of meta-synthesis; an aggregated analysis, where findings from 11 studies published 2004-2020 were compared and categorized, incorporating the views of participants with dementia/mild cognitive impairment, or acquired brain injury. RESULTS Thirty strategies were identified and grouped into seven categories of management approaches, used in a variety of everyday occupations and situations. A majority of the strategies were found in both populations, suggesting that management approaches are more similar than different across populations with cognitive impairment. CONCLUSIONS AND SIGNIFICANCE Attending to the rich variation of self-initiated management approaches/strategies among persons with cognitive impairment offers possibilities for developing occupational therapy interventions.
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Affiliation(s)
- Louise Nygård
- Division of Occupational Therapy, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet, Huddinge, Sweden
| | - Charlotta Ryd
- Division of Occupational Therapy, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet, Huddinge, Sweden.,Stockholm Gerontology Research Center, Stockholm, Sweden
| | - Arlene Astell
- Occupational Sciences & Occupational Therapy and Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Ann-Charlotte Nedlund
- Department of Health, Medicine and Caring Sciences, Division of Society and Health, Unit of Health care Analysis, Linköping University, Linköping, Sweden
| | - Jennifer Boger
- Systems Design Engineering, University of Waterloo, Waterloo, ON, Canada
| | | | - Mervi Issakainen
- Faculty of Social Sciences and Business Studies, Department of Social Sciences, University of Eastern Finland, Finland
| | - Maria Larsson Lund
- Division of Health, Medicine and Rehabilitation, Department of Health, Education and Technology, Luleå University of Technology, Luleå, Sweden
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6
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Givon Schaham N, Vitek H, Donda N, Elbo Golan I, Buckman Z, Rand D. The Development and Feasibility of TECH: Tablet Enhancement of Cognition and Health, a Novel Cognitive Intervention for People with Mild Cognitive Impairment. Games Health J 2020; 9:346-352. [PMID: 33054487 DOI: 10.1089/g4h.2019.0157] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Objectives: Cognitive training using technology has potential to be an effective treatment method for people with mild cognitive impairment (MCI). Touchscreen tablet applications might provide a fun and motivating way to engage in cognitive training for people with MCI. This study presents the development of TECH: "Tablet Enhancement of Cognition and Health," a novel cognitive intervention utilizing touchscreen tablet applications for self-training, and we aimed to examine TECH's feasibility and satisfaction for older adults with MCI. Materials and Methods: TECH development was based on the review of research evidence to identify important demands for effective cognitive training, and discussions with occupational therapists with experience using touchscreen tablets for treating individuals with cognitive impairments. Feasibility of TECH was assessed in terms of adherence (session attendance), compliance (total self-training hours), and satisfaction from the intervention. Results: Twenty-eight community-dwelling older adults with MCI participated in the study and received TECH. Participants attended at least 80% of group sessions, they self-trained a mean (standard deviation [SD]) 20.9 (7.2) sessions for 5 weeks, mean (SD) total training time of 24.4 (11.9) hours, 4.9 h/week. Very high satisfaction with the intervention was reported by 78% of the 23 participants who filled in the questionnaire. Conclusions: The newly developed TECH intervention was found to be feasible for older adults with MCI. Participants were willing and able to perform the self-training at home, which provided a motivating cognitive leisure activity facilitated by weekly group sessions. Data are now collected to establish the effectiveness of TECH as a cognitive intervention, compared with a control group, for people with MCI.
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Affiliation(s)
- Noa Givon Schaham
- Department of Occupational Therapy, Sackler Faculty of Medicine, Steyer School of Health Professions, Tel Aviv University, Tel Aviv, Israel.,Maccabi Healthcare Services, Tel Aviv, Israel
| | - Hila Vitek
- Department of Occupational Therapy, Sackler Faculty of Medicine, Steyer School of Health Professions, Tel Aviv University, Tel Aviv, Israel
| | - Noam Donda
- Department of Occupational Therapy, Sackler Faculty of Medicine, Steyer School of Health Professions, Tel Aviv University, Tel Aviv, Israel
| | | | - Zvi Buckman
- Maccabi Healthcare Services, Tel Aviv, Israel
| | - Debbie Rand
- Department of Occupational Therapy, Sackler Faculty of Medicine, Steyer School of Health Professions, Tel Aviv University, Tel Aviv, Israel
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7
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Jakobsson E, Nygård L, Kottorp A, Bråkenhielm Olsson C, Malinowsky C. Does the purpose matter? A comparison of everyday information and communication technologies between eHealth use and general use as perceived by older adults with cognitive impairment. Disabil Rehabil Assist Technol 2020; 17:897-906. [PMID: 32954891 DOI: 10.1080/17483107.2020.1821103] [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: 10/23/2022]
Abstract
BACKGROUND AND OBJECTIVE Everyday information and communication technologies (EICTs) are increasingly being used in our society, for both general and health-related purposes. This study aims to compare how older adults with cognitive impairment perceive relevance and level of EICT challenge between eHealth use and general use. METHODS This cross-sectional study includes 32 participants (65-85 years of age) with cognitive impairment of different origins (due to e.g., stroke or dementia). The Short Everyday Technology Use Questionnaire+ (S-ETUQ+) was used, providing information about the relevance of EICTs and measuring the EICT level of challenge. Data were analysed with descriptive statistics, standardized z-tests and Fisher's exact tests. The significance level was set to p < .05. RESULTS The result shows that the perceived amount of relevant EICTs for eHealth use was lower in all 16 EICTs compared to those of general use. About the perceived level of challenge, a significant difference was detected in one of the seven included EICTs between eHealth use and general use. CONCLUSIONS In this sample, all EICTs were perceived as having lower relevance for eHealth use compared to general use, suggesting that the purpose of using an EICT affects the perceived relevance of it. Also, once an EICT is perceived as relevant and used for eHealth purposes, there seem to be little to no differences in perceived challenge compared to the same EICT used for general purposes.Implications for rehabilitationAll stakeholders, including health care providers, need to be aware of the hindrances that come with digitalization, making it challenging to many citizens to make use of digital solutions.It is of great importance that social services including eHealth services be tailored to suit the individual/target group.Older adults may need support and an introduction to EICTs to discover the potential relevance of the specific device and/or service.
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Affiliation(s)
- Elin Jakobsson
- Division of Occupational Therapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
| | - Louise Nygård
- Division of Occupational Therapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
| | - Anders Kottorp
- Faculty of Health and Society, Malmö University, Malmö, Sweden
| | | | - Camilla Malinowsky
- Division of Occupational Therapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
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8
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Rocheleau JN, Cobigo V, Chalghoumi H, Jahan A, Jutai J, Lake J, Farrell S, Lachapelle Y. Factors affecting information technology use from the perspective of aging persons with cognitive disabilities: A scoping review of qualitative research. ACTA ACUST UNITED AC 2020. [DOI: 10.3233/tad-190242] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Affiliation(s)
| | - Virginie Cobigo
- School of Psychology and Centre for Research on Educational and Community Services, University of Ottawa, Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada
| | | | - Alhadi Jahan
- School of Rehabilitation Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Jeffrey Jutai
- Interdisciplinary School of Health Sciences and LIFE Research Institute, University of Ottawa, Ottawa, ON, Canada
| | - Johanna Lake
- Centre for Addiction and Mental Health, University of Toronto, Toronto, ON, Canada
| | | | - Yves Lachapelle
- Psychoéducation Department, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
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9
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Ruggiano N, Brown EL, Shaw S, Geldmacher D, Clarke P, Hristidis V, Bertram J. The Potential of Information Technology to Navigate Caregiving Systems: Perspectives from Dementia Caregivers. JOURNAL OF GERONTOLOGICAL SOCIAL WORK 2019; 62:432-450. [PMID: 30422754 DOI: 10.1080/01634372.2018.1546786] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Revised: 11/06/2018] [Accepted: 11/07/2018] [Indexed: 06/09/2023]
Abstract
Technologies designed to support caregivers of adults with Alzheimer's disease and related dementias (AD/RD) have been developing at an increasingly rapid pace. However, little remains known about caregivers' perspectives on how technologies can and should help them navigate larger service systems they interact with to engage in caregiving. This study involved in-depth interviews and a beta test of an AD/RD caregiver app to learn more about how they currently use technologies and how potential technological features and functions can best meet their needs. Thematic findings suggest a conceptual model for designing AD/RD caregiver technologies. The findings suggest that eHealth and individual technologies may not fully meet the needs of caregivers as they navigate the larger systems within which they provide care. Findings highlight the need to develop technologies for caregivers that are effective, easy to use, and more widely disseminated - especially for caregivers from disadvantaged backgrounds.
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Affiliation(s)
- Nicole Ruggiano
- a School of Social Work , University of Alabama , Tuscaloosa , Alabama
| | - Ellen L Brown
- b Nicole Wertheim College of Nursing and Health Sciences , Florida International University , Miami , Florida , USA
| | - Shanae Shaw
- a School of Social Work , University of Alabama , Tuscaloosa , Alabama
| | - David Geldmacher
- c Department of Neurology, School of Medicine , University of Alabama at Birmingham , Birmingham , Alabama
| | - Peter Clarke
- d School of Computing and Information Sciences, College of Engineering and Computing , Florida International University , Miami , Florida , USA
| | - Vagelis Hristidis
- e Computer Science & Engineering , University of California , Riverside , California , USA
| | - Jessica Bertram
- a School of Social Work , University of Alabama , Tuscaloosa , Alabama
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10
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Patomella AH, Lovarini M, Lindqvist E, Kottorp A, Nygård L. Technology use to improve everyday occupations in older persons with mild dementia or mild cognitive impairment: A scoping review. Br J Occup Ther 2018. [DOI: 10.1177/0308022618771533] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
| | | | - Eva Lindqvist
- Affiliated PhD, Division of Occupational Therapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Head of Nestor Research and Development Centre, Stockholm County, Handen, Sweden
| | - Anders Kottorp
- Professor, University of Illinois at Chicago, Chicago, USA; Associate Professor, Karolinska Institutet, Stockholm, Sweden
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11
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Lindqvist E, PerssonVasiliou A, Hwang AS, Mihailidis A, Astelle A, Sixsmith A, Nygård L. The contrasting role of technology as both supportive and hindering in the everyday lives of people with mild cognitive deficits: a focus group study. BMC Geriatr 2018; 18:185. [PMID: 30119653 PMCID: PMC6098644 DOI: 10.1186/s12877-018-0879-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Accepted: 08/13/2018] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND It is well known that people with mild cognitive deficits face challenges when performing complex everyday activities, and that the use of technology has become increasingly interwoven with everyday activities. However, less is known of how technology might be involved, either as a support or hindrance, in different areas of everyday life and of the environments where challenges appear. The aim of this study was to investigate the areas of concern where persons with cognitive deficits meet challenges in everyday life, in what environments these challenges appear and how technology might be involved as part of the challenge and/or the solution to the challenge. METHODS Data were gathered through four focus group interviews with participants that live with cognitive deficits or cohabit with a person with cognitive deficits, plus health professionals and researchers in the field. Data were transcribed, coded and categorized, and finally synthesized to trace out the involvement of technology. RESULTS Five areas of concern in everyday life were identified as offering challenges to persons with cognitive deficits: A) Managing personal finances, B) Getting around, C) Meeting family and friends, D) Engaging with culture and media and, E) Doing everyday chores. Findings showed that the involvement of technology in everyday activities was often contrastive. It could be hindering and evoke stress, or it could bring about feelings of control; that is, being a part of the solution. The involvement of technology was especially obvious in challenges linked to Managing personal finances, which is a crucial necessity in many everyday activities. In contrast, technology was least obviously involved in the area Socializing with family and friends. CONCLUSIONS The findings imply that technology used for orientation and managing finances, often used outside home, would benefit from being further developed in order to be more supportive; i.e. accessible and usable. To make a positive change for many people, the ideas of inclusive design fit well for this purpose and would contribute to an age-friendly society.
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Affiliation(s)
- Eva Lindqvist
- Department of Neurobiology, Care Sciences and Society (NVS), Division of Occupational Therapy, Karolinska Institutet, Fack 23 200, SE-141 83 Huddinge, Sweden
| | - Annika PerssonVasiliou
- Department of Neurobiology, Care Sciences and Society (NVS), Division of Occupational Therapy, Karolinska Institutet, Fack 23 200, SE-141 83 Huddinge, Sweden
| | - Amy S. Hwang
- University of Toronto and Toronto Rehab Institute-UHN, Toronto, Canada
| | - Alex Mihailidis
- University of Toronto and Toronto Rehab Institute-UHN, Toronto, Canada
| | | | | | - Louise Nygård
- Department of Neurobiology, Care Sciences and Society (NVS), Division of Occupational Therapy, Karolinska Institutet, Fack 23 200, SE-141 83 Huddinge, Sweden
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12
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Benge JF, Dinh KL, Logue E, Phenis R, Dasse MN, Scullin MK. The smartphone in the memory clinic: A study of patient and care partner's utilisation habits. Neuropsychol Rehabil 2018; 30:101-115. [PMID: 29661059 DOI: 10.1080/09602011.2018.1459307] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Smartphones have potential as cognitive aids for adults with cognitive impairments. However, little is known about how patients and their care partners utilise smartphones in their day-to-day lives. We collected self-reported smartphone utilisation data from patients referred for neuropsychological evaluations (N = 53), their care partners (N = 44), and an Amazon Mechanical Turk control sample (N = 204). Patient participants were less likely to own a smartphone than controls, with increasing age associated with less utilisation of smartphone features in all groups. Of the patients who owned smartphones, spontaneous use of cognitive aid features (e.g., reminders and calendars) occurred on only a monthly-to-weekly basis; by comparison, patients reported utilising social/general features (e.g., email and internet) on a weekly-to-daily basis. Individuals referred for geriatric cognitive disorder evaluations were less likely to own and use smartphones than individuals referred for other reasons. Care partners reported using their smartphones more frequently than control group adults, with 55% of care partners endorsing utilising their device in caring for the patient. Building upon existing smartphone use habits to increase the use of cognitive aid features may be a feasible intervention for some patients, and including care partners in such interventions is encouraged.
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Affiliation(s)
- Jared F Benge
- Division of Neuropsychology, Department of Neurology, Baylor Scott & White Health, Temple, TX, USA.,Plummer Movement Disorders Center, Baylor Scott & White Health, Temple, TX, USA.,Department of Internal Medicine, Texas A&M Health Science Center, Temple, TX, USA
| | - Kara L Dinh
- Division of Neuropsychology, Department of Neurology, Baylor Scott & White Round Rock Clinic, Round Rock, TX, USA
| | - Erin Logue
- Division of Neuropsychology, Department of Neurology, Baylor Scott & White Round Rock Clinic, Round Rock, TX, USA
| | - Richard Phenis
- Division of Neuropsychology, Department of Neurology, Baylor Scott & White Health, Temple, TX, USA.,Plummer Movement Disorders Center, Baylor Scott & White Health, Temple, TX, USA.,Department of Internal Medicine, Texas A&M Health Science Center, Temple, TX, USA
| | - Michelle N Dasse
- Department of Psychology and Neuroscience, Baylor University, Waco, TX, USA
| | - Michael K Scullin
- Department of Psychology and Neuroscience, Baylor University, Waco, TX, USA
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13
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Rosenberg L, Nygård L. Learning and knowing technology as lived experience in people with Alzheimer's disease: a phenomenological study. Aging Ment Health 2017; 21:1272-1279. [PMID: 27592720 DOI: 10.1080/13607863.2016.1222347] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVES Most research on learning in the field of dementia has studied teaching approaches, while little is known about learning as experienced and enacted by the people with dementia. The aim was to explore the lived experience of learning and maintaining knowledge related to technology among people with mild to moderate stage dementia. METHOD Seven persons with dementia were interviewed in-depth, and data were analyzed with a phenomenological approach. RESULTS The participants positioned themselves on a continuum from 'Updating and expanding is not for me' to 'Updating and expanding is really for me'. They used different ways of learning in their everyday life - relying on one's habituated repertoire of actions, on other people or on technology itself, or belonging to a learning context. CONCLUSIONS We have much to gain from better understanding of how people with dementia strive to learn and maintain their skills and knowledge related to technology. This is particularly important as they seem to use other approaches than those employed in current teaching methods. The necessity of learning stands out particularly when it comes to the interaction with the current multitude and ever-changing designs of technologies, including assistive technologies developed specifically to support people with dementia.
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Affiliation(s)
- Lena Rosenberg
- a Division of Occupational Therapy, Department of Neurobiology, Caring Sciences and Society , Karolinska Institutet , Stockholm , Sweden
| | - Louise Nygård
- a Division of Occupational Therapy, Department of Neurobiology, Caring Sciences and Society , Karolinska Institutet , Stockholm , Sweden
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14
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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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Kenigsberg PA, Aquino JP, Bérard A, Brémond F, Charras K, Dening T, Droës RM, Gzil F, Hicks B, Innes A, Nguyen SM, Nygård L, Pino M, Sacco G, Salmon E, van der Roest H, Villet H, Villez M, Robert P, Manera V. Assistive Technologies to Address Capabilities of People with Dementia: From Research to Practice. DEMENTIA 2017; 18:1568-1595. [PMID: 28699364 DOI: 10.1177/1471301217714093] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Assistive technologies became pervasive and virtually present in all our life domains. They can be either an enabler or an obstacle leading to social exclusion. The Fondation Médéric Alzheimer gathered international experts of dementia care, with backgrounds in biomedical, human and social sciences, to analyze how assistive technologies can address the capabilities of people with dementia, on the basis of their needs. Discussion covered the unmet needs of people with dementia, the domains of daily life activities where assistive technologies can provide help to people with dementia, the enabling and empowering impact of technology to improve their safety and wellbeing, barriers and limits of use, technology assessment, ethical and legal issues. The capability approach (possible freedom) appears particularly relevant in person-centered dementia care and technology development. The focus is not on the solution, rather on what the person can do with it: seeing dementia as disability, with technology as an enabler to promote capabilities of the person, provides a useful framework for both research and practice. This article summarizes how these concepts took momentum in professional practice and public policies in the past 15 years (2000-2015), discusses current issues in the design, development and economic model of assistive technologies for people with dementia, and covers how these technologies are being used and assessed.
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Affiliation(s)
| | | | | | | | | | - Tom Dening
- Institute of Mental Health, University of Nottingham, UK
| | - Rose-Marie Droës
- Department of Psychiatry, VU University Medical Center, Amsterdam, The Netherlands
| | | | - Ben Hicks
- Bournemouth University Dementia Institute, UK
| | - Anthea Innes
- Salford Institute for Dementia University of Salford, Salford, United Kingdom
| | - Sao-Mai Nguyen
- Lab-STICC, Institut Mines-Télécom Bretagne, Brest, France
| | - Louise Nygård
- Department of Neurobiology, Care sciences and Society, Karolinska Institute, Stockholm, Sweden
| | - Maribel Pino
- Laboratoire Lusage, Hôpital Broca, Assistance publique-Hôpitaux de Paris, France
| | - Guillaume Sacco
- Centre Mémoire de Ressources et de Recherche, CHU de Nice; Université Côte-d'Azur, CoBTeK, Nice, France
| | - Eric Salmon
- Department of Neurology, Liège University Hospital, Belgium
| | - Henriëtte van der Roest
- Department of General Practice and Elderly Care Medicine, Amsterdaù Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands
| | | | - Marion Villez
- Laboratoire LIRTES, Université Paris-Est-Val de Marne, Créteil, France
| | - Philippe Robert
- Université Côte-d'Azur, CoBTeK, & Innovation Alzheimer Association, Nice, France
| | - Valeria Manera
- Université Côte-d'Azur, INRIA STARS & CoBTeK, Nice, France
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van der Wardt V, Hancox J, Gondek D, Logan P, Nair RD, Pollock K, Harwood R. Adherence support strategies for exercise interventions in people with mild cognitive impairment and dementia: A systematic review. Prev Med Rep 2017; 7:38-45. [PMID: 28593121 PMCID: PMC5447393 DOI: 10.1016/j.pmedr.2017.05.007] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Accepted: 05/15/2017] [Indexed: 02/02/2023] Open
Abstract
Exercise-based therapy may improve health status for people with Mild Cognitive Impairment (MCI) or dementia but cannot work without adherence, which has proven difficult. This review aimed to evaluate strategies to support adherence among people with MCI or Dementia and was completed in Nottingham/UK in 2017. A narrative synthesis was used to investigate the effectiveness or usefulness of adherence support strategies. Fifteen adherence support strategies were used including theoretical underpinning (programmes based on behavior change theories), individual tailoring, worksheets and exercise booklets, goal setting, phone calls or reminders, newsletters, support to overcome exercise barriers, information, adaptation periods, individual supervision, support for clinicians, group setting, music, accelerometers/pedometers and emphasis on enjoyable activities. Music was the only strategy that was investigated in a comparative design but was found to be effective only for those who were generally interested in participating in activities. A wide range of adherence support strategies are being included in exercise interventions for people with MCI or dementia, but the evidence regarding their effectiveness is limited.
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Affiliation(s)
- Veronika van der Wardt
- Division of Rehabilitation and Ageing, School of Medicine, University of Nottingham, Nottingham NG7 2UH, United Kingdom
| | - Jennie Hancox
- Division of Rehabilitation and Ageing, School of Medicine, University of Nottingham, Nottingham NG7 2UH, United Kingdom
| | - Dawid Gondek
- Division of Rehabilitation and Ageing, School of Medicine, University of Nottingham, Nottingham NG7 2UH, United Kingdom
| | - Pip Logan
- Division of Rehabilitation and Ageing, School of Medicine, University of Nottingham, Nottingham NG7 2UH, United Kingdom
| | - Roshan das Nair
- Division of Psychiatry & Applied Psychology, School of Medicine, University of Nottingham, Nottingham NG7 2UH, United Kingdom
| | - Kristian Pollock
- Division of Rehabilitation and Ageing, School of Medicine, University of Nottingham, Nottingham NG7 2UH, United Kingdom
| | - Rowan Harwood
- Nottingham University Hospital NHS Trust, Nottingham NG7 2UH, United Kingdom
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17
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Patomella AH, Kottorp A, Ferreira M, Rosenberg L, Uppgard B, Nygård L. Everyday technology use among older adults in Sweden and Portugal. Scand J Occup Ther 2017; 25:436-445. [PMID: 28385092 DOI: 10.1080/11038128.2017.1311940] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Technology use is relevant for engaging in everyday occupations and aging in place and difficulties might limit participation. AIM The aim of the present study was two-fold: to investigate the internal scale validity of the Everyday Technology Use Questionnaire (ETUQ) in a matched Portuguese and a Swedish sample of older adults without known cognitive impairments and to compare everyday technology use (i.e., the relevance of Everyday Technology (ET) and perceived difficulty of using ET). METHODS The Rasch rating scale model was used to investigate the psychometric properties of the data from the two countries. Analyses were then used to compare the samples. RESULTS There is evidence of internal scale and person response validity in the Swedish and Portuguese ETUQ datasets. The Swedish sample demonstrated almost 25% more ETs to be relevant, as compared to the Portuguese sample (p < .05). The samples' means of perceived difficulty in using ETs were similar. CONCLUSIONS The results support that the ETUQ is a valid assessment for measuring the relevance of and perceived difficulty of ET use and is able to detect differences and similarities between older adults in these European countries in relation to ET use in the home and society.
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Affiliation(s)
- Ann-Helen Patomella
- a Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy , Karolinska Institutet , Stockholm , Sweden
| | - Anders Kottorp
- a Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy , Karolinska Institutet , Stockholm , Sweden.,b College of Applied Health Sciences, Department of Occupational Therapy , University of Illinois at Chicago , Chicago , IL , US
| | - Manuela Ferreira
- c Occupational Therapy Department , Escola Superior de Saúde do Alcoitão (Health High School of Alcoitão) , Alcabideche , Portugal
| | - Lena Rosenberg
- a Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy , Karolinska Institutet , Stockholm , Sweden
| | - Brittmari Uppgard
- a Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy , Karolinska Institutet , Stockholm , Sweden
| | - Louise Nygård
- a Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy , Karolinska Institutet , Stockholm , Sweden
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Malinowsky C, Fallahpour M, Lund ML, Nygård L, Kottorp A. Skill clusters of ability to manage everyday technology among people with and without cognitive impairment, dementia and acquired brain injury. Scand J Occup Ther 2017; 25:99-107. [PMID: 28276961 DOI: 10.1080/11038128.2017.1298665] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND In order to develop supporting interventions for people demonstrating problems ET use, a detailed level of description of strengths and deficits is needed. AIMS To explore clusters of specific performance skill required when using ET, and to evaluate if and in what way such clusters are associated with age, gender, diagnosis, and types of ETs managed. MATERIALS AND METHODS A secondary analysis of 661 data records from 203 heterogeneous samples of participants using the Management of Everyday Technology Assessment (META) was used. Ward's method and a hierarchical tree cluster analysis were used to determine and define the skill clusters. RESULTS Four distinct clusters of performance skill item profiles were found, across the 661 data records. These were then, based on each individuals' cluster profiles in managing ET, categorized into two groups. The two groups were associated with, diagnosis and type of ETs managed. CONCLUSIONS AND SIGNIFICANCE The findings support a more dyadic person-ET approach in evaluation of ET management. The information from the skill clusters can be used to develop targeted intervention guides for occupational therapy and healthcare.
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Affiliation(s)
- Camilla Malinowsky
- a Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy , Karolinska Institutet , Stockholm , Sweden
| | - Mandana Fallahpour
- a Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy , Karolinska Institutet , Stockholm , Sweden.,b Department of Health Sciences , Luleå University of Technology , Luleå , Sweden
| | - Maria Larsson Lund
- b Department of Health Sciences , Luleå University of Technology , Luleå , Sweden
| | - Louise Nygård
- a Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy , Karolinska Institutet , Stockholm , Sweden
| | - Anders Kottorp
- a Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy , Karolinska Institutet , Stockholm , Sweden.,c Department of Occupational Therapy, College of Applied Health Sciences , University of Illinois , Chicago , IL , USA
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Hedman A, Lindqvist E, Nygård L. How older adults with mild cognitive impairment relate to technology as part of present and future everyday life: a qualitative study. BMC Geriatr 2016; 16:73. [PMID: 27036538 PMCID: PMC4815058 DOI: 10.1186/s12877-016-0245-y] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Accepted: 03/19/2016] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Existing everyday technology as well as potential future technology may offer both challenges and possibilities in the everyday occupations of persons with cognitive decline. To meet their wishes and needs, the perspective of the persons themselves is an important starting point in intervention planning involving technology. The aim of this study was to explore how persons with mild cognitive impairment relate to technology as a part of and as potential support in everyday life - both present and future. METHODS Qualitative in-depth interviews with six participants aged 61-86 were conducted and analyzed, using a grounded theory approach. RESULTS The findings describe the participants' different ways of relating to existing and potential future technology in everyday occupations as a continuum of downsizing, retaining, and updating. Multiple conditions in different combinations affected both their actions taken and assumptions made towards technology in this continuum. Both when downsizing doing and technology use to achieve simplicity in everyday life and when striving for or struggling with updating, trade-offs between desired and adverse outcomes were made, challenging take-off runs were endured, and negotiations of the price worth paying took place. CONCLUSIONS Our findings suggest that persons with mild cognitive impairment may relate to technology in various ways to meet needs of downsized doing, but are reluctant to adopt video-based monitoring technology intended to support valued occupations. Feasibility testing of using already-incorporated everyday technologies such as smartphones and tablets as platforms for future technology support in everyday occupations is suggested.
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Affiliation(s)
- Annicka Hedman
- Department of Neurobiology, Care Sciences and Society (NVS), Division of Occupational Therapy, Karolinska Institutet, Fack 23 200, SE-141 83 Huddinge, Sweden
| | - Eva Lindqvist
- Department of Neurobiology, Care Sciences and Society (NVS), Division of Occupational Therapy, Karolinska Institutet, Fack 23 200, SE-141 83 Huddinge, Sweden
| | - Louise Nygård
- Department of Neurobiology, Care Sciences and Society (NVS), Division of Occupational Therapy, Karolinska Institutet, Fack 23 200, SE-141 83 Huddinge, Sweden
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Gomersall T, Astell A, Nygård L, Sixsmith A, Mihailidis A, Hwang A. Living With Ambiguity: A Metasynthesis of Qualitative Research on Mild Cognitive Impairment. THE GERONTOLOGIST 2015; 55:892-912. [PMID: 26315317 PMCID: PMC4580312 DOI: 10.1093/geront/gnv067] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2015] [Accepted: 04/17/2015] [Indexed: 11/30/2022] Open
Abstract
Purpose of the study: Mild Cognitive Impairment (MCI) is a diagnosis proposed to describe an intermediate state between normal cognitive aging and dementia. MCI has been criticised for its conceptual fuzziness, its ambiguous relationship to dementia, and the tension it creates between medical and sociological understandings of “normal aging”. Design and Methods: We examined the published qualitative literature on experiences of being diagnosed and living with MCI using metasynthesis as the methodological framework. Results: Two overarching conceptual themes were developed. The first, MCI and myself-in-time, showed that a diagnosis of MCI could profoundly affect a person’s understanding of their place in the world. This impact appears to be mediated by multiple factors including a person’s social support networks, which daily activities are affected, and subjective interpretations of the meaning of MCI. The second theme, Living with Ambiguity, describes the difficulties people experienced in making sense of their diagnosis. Uncertainty arose, in part, from lack of clarity and consistency in the information received by people with MCI, including whether they are even told MCI is the diagnosis. Implications: We conclude by suggesting an ethical tension is always at play when a MCI diagnosis is made. Specifically, earlier support and services afforded by a diagnosis may come at the expense of a person’s anxiety about the future, with continued uncertainty about how his or her concerns and needs can be addressed.
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Affiliation(s)
- Tim Gomersall
- School of Health & Related Research, University of Sheffield, Sheffield, UK.
| | - Arlene Astell
- School of Health & Related Research, University of Sheffield, Sheffield, UK
| | - Louise Nygård
- Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Stockholm, Sweden
| | - Andrew Sixsmith
- Department of Gerontology, Simon Fraser University, Vancouver, Canada
| | - Alex Mihailidis
- Toronto Rehabilitation Institute, University of Toronto, Toronto, Canada
| | - Amy Hwang
- Toronto Rehabilitation Institute, University of Toronto, Toronto, Canada
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