My research is based in the dementia field and it ranges from dementia care to health and social policy regarding dementia. On the EU-FP7-project, Dementia Ambient Care (Dem@Care, www.demcare.eu) I researched the use of ambient and wearable sensors to provide individualised support for people with mild dementia in five areas: physical activity, sleep, activities of daily living, social interaction and mood. These technologies have the potential to enable the independence of people with dementia by supporting their health, lifestyle and safety unobtrusively.
During this study, we ran a small multiple case study pilot (n=6; 3 female, mean age = 77) to investigate how the Dem@Care technology could be used to support a cognitive rehabilitation intervention in a person’s home. We based our program on Linda Clare’s work in the area, where cognitive rehabilitation specifically aims to prevent or reduce excess disability for the person with dementia, and to maximise their engagement in activities and in social participation, thereby increasing their overall quality of life.
Each participant took part in 12-14 sessions (90-120 minutes each) with one of four therapists with backgrounds in psychology nursing and occupational therapy. Participants identified their own goals at the outset and multi-disciplinary team meetings were held to identify the best strategies and technologies to support these goals.
We found that people with dementia have a diverse range of goals and needs and some were better suited to technology than others. We found that technology was not a ‘quick fix’ for psychosocial needs, for example: ‘George’ was experiencing low mood and anxiety. He was a retired IT consultant and analytical by nature. He decided to try a wearable sensor to monitor stress levels but found the device confusing, disliked the design and disengaged quickly.
“It was just the frustration of putting on, and getting it to stay on, and by the time you did that, then to remember which button to press or not to press, you were forgetting it… well I was forgetting it, and reaching for the notes again.”
Other goals were much better suited to technology, such as managing confusion and time-of-day disorientation (dementia friendly clock, morning/evening checklists, reminders), maintaining the ability to cook a meal (checklists, audiovisual prompts), and learning how to use a mobile phone (simple phone, prompted practise sessions, checklists).
The therapists’ comfort levels with technology and with the idea of using technology to support people with dementia also had an impact. Those less engaged with the tools themselves were quicker to move back to traditional supports. All needed time to adjust to including technology in their repertoire.
Overall, we found that person-to-person social interaction is important to people with dementia and that technology can support, but should not replace this. When considering the use of technology with people with dementia, consider if it can provide a solution, if this is the best solution for the person, and if it will be easy to use and acceptable to them.
Dr Louise Hopper
School of Nursing and Human Sciences
Dublin City University
References
Clare, L. (2007). Neuropsychological rehabilitation and people with dementia. Psychology Press
Clare, L., Bayer, A., Burns, A., Corbett, A., Jones, R., Knapp, M., … & Pool, J. (2013). Goal-oriented cognitive rehabilitation in early-stage dementia: study protocol for a multi-centre single-blind randomised controlled trial (GREAT). Trials, 14(1), 1.
Clare, L., Linden, D. E., Woods, R. T., Whitaker, R., Evans, S. J., Parkinson, C. H., … & Rugg, M. D. (2010). Goal-oriented cognitive rehabilitation for people with early-stage Alzheimer disease: a single-blind randomized controlled trial of clinical efficacy. The American journal of geriatric psychiatry, 18(10), 928-939.
Kelly, P., Marshall, S. J., Badland, H., Kerr, J., Oliver, M., Doherty, A. R., & Foster, C. (2013). An ethical framework for automated, wearable cameras in health behavior research. American journal of preventive medicine, 44(3), 314-31
McHugh, J. E., Smeaton, A., Irving, K., & Newman, E. (2013). SIGCHI Workshop on Designing For-and-With Vulnerable People: The Dem@Care “Toolbox” Approach.
If you have any questions or comments please contact Martin on m.davoren@ucc.ie