Carers using assistive technology in dementia care at home: a mixed methods study

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.

Technology for dementia care: what would good technology look like and do, from carers’ perspectives?

“…In the context of dementia care, assistive technology has demonstrated potential to address some of the long-term care needs of PLWD and their carers [ 3 ] and can engage with a consumer-driven model that promotes ‘active ageing’ and/or improvements to participation and quality of life for PLWD [ 5 ]. For carers, benefits of assistive technology can include a reduction in the demands of caring, more opportunities for enjoyment and meaningful activities, and reduced stress [ 6 ].…”

“…In recent decades, there has been a growth in research examining the role that digital technologies can play as a tool to support carers by compensating for the functional cognitive and physical decline on the PLWD’s capacities to engage in everyday life [ 6 – 8 ]. Emerging technology may also play a key role in addressing broader social issues arising from population ageing, including a shortage of care staff and high care costs associated with older adults living within formal residential care settings [ 2 ].…”

“…Research findings suggest benefits such as mood enhancement, social engagement, and a reduction in agitation, anxiety, and loneliness [ 12 , 13 ]. Also, to address carers’ safety concerns [ 6 , 8 ], and the risks associated with PLWD “wandering away”, wearable monitoring devices and movement sensors have been developed [ 4 ]. In addition, assistive technology has been trialled to support the completion of ‘activities of daily living’ (ADL) such as hand and body washing, toilet assistance, dressing, food preparation, and cleaning (e.g., [ 14 – 17 ]).…”

“…General challenges include the usability and acceptability of technology for older populations, the different effects of technology on different people, and the ethical considerations associated with use with a vulnerable people group [ 22 ]. Specific barriers include the complexity of the device, a lack of familiarity with the technology, the PLWD’s difficulty remembering to use the device and/or recall where they put it, and the inability to “trouble-shoot” when something goes wrong [ 6 ]. These challenges are further exacerbated by the progressive nature of dementia.…”

Informal carers’ experiences in everyday life and the use of digital assistive technology for time management in persons with dementia or mild cognitive impairment

“…This approach allows researchers to gain a more comprehensive and nuanced understanding of a research problem. Previous mixed-method studies that reported the usefulness of DAT mainly focused on well-being [ 24 ], counselling [ 25 ], social participation [ 26 ], and activity monitoring [ 27 ]. However, there is a lack of mixed-method studies focusing on time management.…”