Review of Technology-Supported Multimodal Solutions for People with Dementia

Delivery of Neuropsychological Interventions for Adult and Older Adult Clinical Populations: An Australian Expert Working Group Clinical Guidance Paper

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.

Are Smart Homes Adequate for Older Adults with Dementia?

Smart home technologies can enable older adults, including those with dementia, to live more independently in their homes for a longer time. Activity recognition, in combination with anomaly detection, has shown the potential to recognise users’ daily activities and detect deviations. However, activity recognition and anomaly detection are not sufficient, as they lack the capacity to capture the progression of patients’ habits across the different stages of dementia. To achieve this, smart homes should be enabled to recognise patients’ habits and changes in habits, including the loss of some habits. In this study, we first present an overview of the stages that characterise dementia, alongside real-world personas that depict users’ behaviours at each stage. Then, we survey the state of the art on activity recognition in smart homes for older adults with dementia, including the literature that combines activity recognition and anomaly detection. We categorise the literature based on goals, stages of dementia, and targeted users. Finally, we justify the necessity for habit recognition in smart homes for older adults with dementia, and we discuss the research challenges related to its implementation.