Preferred computer activities among individuals with dementia: a pilot study

Digital technologies to support people living with dementia in the care home setting to engage in meaningful occupations: protocol for a scoping review

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.

In Quest of Tablet Apps for Elders With Alzheimer's Disease: A Descriptive Review

Caregivers search for mobile device apps that offer meaningful and enjoyable activities to simultaneously enhance the preserved cognitive and functional abilities of those in their care. The purpose of this review article was to describe the current state of tablet apps with which elders with Alzheimer's disease and related forms of dementia may engage as users. Using the keywords "app," "Alzheimer's," and "dementia," a sample of 83 apps was selected from the iTunes Store, Google, and discussion boards of Apple Support Communities. A descriptive content analysis was conducted using a coding scheme on the characteristics of tablet app activity and the requirements for functional abilities of the users. This review found that the activities of the selected apps included games, simple watching and viewing, music and sounds, memory training, learning and information, and social interaction starters. A high-level cognitive and physical ability such as eye-hand coordination is often required to play the majority of the game apps. A few apps are designed specifically for the population. Individuals' variability in cognitive and functional abilities necessitates a person-centered approach in designing and selecting games and activities for apps in order to increase engagement and promote positive experiences in older adults.

The use of technology to promote meaningful engagement for adults with dementia in residential aged care: a scoping review

INTRODUCTION

A considerable number of adults with dementia live in residential aged care facilities, where loneliness and boredom are common. Computer-based and electronic technologies have advanced significantly and there is potential for such technologies to improve engagement of residents with dementia. However, the nature and extent of the evidence supporting the use of these technologies is unclear.

OBJECTIVES

The aim of this study was to investigate the use of computer-based and electronic technologies for enhancing meaningful engagement of adults with dementia living in residential aged care.

METHODS

A scoping review was conducted. Nine databases were searched from 2008-2018. Included studies were summarized, compared and synthesized according to technology type.

RESULTS

Twenty studies were included. Most studies were conducted in Australia (n = 7) and Europe (n = 8). Study designs were quantitative (n = 12), mixed methods (n = 5), descriptive (n = 2) or qualitative (n = 1). Studies aimed to investigate interaction, engagement, behaviors or quality of life (n = 14), to examine the feasibility of technologies (n = 3), or had both aims (n = 3). Technology type fell into two categories: robotics (n = 14) and multi-media computer programs (n = 6). Across both technology types, there were conflicting results in relation to positive impact on meaningful engagement. Studies only investigated the doing, belonging and connecting aspects of meaningful engagement. Additionally, there was a lack of consistency across studies in how activity, interaction and engagement were measured.

CONCLUSION

The role and potential of new technologies to enhance meaningful engagement for those with dementia should focus on creating human-to-human interactions while taking individual preference and person-centered principles into account.

Engaging in Preferred Computer Activities and Cognitive Outcome

Valuing an individual's choice in activities is important in person-centered dementia care. This study examined changes in cognitive function among long-term care residents with dementia, following engagement in preferred computer activities. Over a seven-week period, a total of 585 observational activity-monitoring logs from 26 participants were collected. The most frequently selected computer activities were playing computer games and watching audio-visual media. Cognitive function significantly improved more in participants who spent more than 580 minutes on computer activities than those who spent less. A regression analysis showed that time spent in playing computer games was the only predictor to explain changes in cognitive function. The findings suggested that engaging in preferred computer activities may not only be meaningful and enjoyable but also promote cognitive function.

Design Recommendations for Recreational Systems Involving Older Adults Living With Dementia

As the population ages, an increasing number of people will be diagnosed with dementia. Studies have found that insufficient activities are offered in memory care units to people with dementia, even though people benefit tremendously from participating in recreational activities. Information and communication technologies (ICT) can potentially facilitate activities in this setting, yet there is little guidance for designers to develop systems that can support people with dementia in engaging in recreational activities. To fill this gap, recommendations were generated through fieldwork and refined in two rounds of expert feedback. Areas covered include hardware, content, applications, and navigation. Systems should be usable by people with dementia, in addition to staff, to counter disempowerment by not enabling people to use their full abilities. In addition, a diversity of materials is needed to appeal to individuals with dementia who have widely varying backgrounds, abilities, interests, and preferences.