Digital Interventions for People With Dementia and Carers: effective, cost-effective and equitable?

Knapp, Martín; Shehaj, Xheni; Wong, Gloria

doi:10.2217/nmt-2022-0025

Cited by 13 publications

(12 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Linked to the equity factor of available support, staff and unpaid carers may be pivotal in successful implementation of technologies for PlwD, and their skills, attitudes and experiences may influence the uptake of new innovations [ 81 ]. In one primary study staff directly influenced study outcomes through bias against bed alarms, which were considered unreliable and intrusive.…”

Section: Discussionmentioning

confidence: 99%

Digital technologies to prevent falls in people living with dementia or mild cognitive impairment: a rapid systematic overview of systematic reviews

Eost-Telling,

Yang,

Norman

et al. 2024

Age and Ageing

Self Cite

View full text Add to dashboard Cite

Objective Falls are a common cause of potentially preventable death, disability and loss of independence with an annual estimated cost of £4.4bn. People living with dementia (PlwD) or mild cognitive impairment (MCI) have an increased fall risk. This overview evaluates evidence for technologies aiming to reduce falls and fall risk for PlwD or MCI. Methods In October 2022, we searched five databases for evidence syntheses. We used standard methods to rapidly screen, extract data, assess risk of bias and overlap, and synthesise the evidence for each technology type. Results We included seven systematic reviews, incorporating 22 relevant primary studies with 1,412 unique participants. All reviews had critical flaws on AMSTAR-2: constituent primary studies were small, heterogeneous, mostly non-randomised and assessed as low or moderate quality. Technologies assessed were: wearable sensors, environmental sensor-based systems, exergaming, virtual reality systems. We found no evidence relating to apps. Review evidence for the direct impact on falls was available only from environmental sensors, and this was inconclusive. For wearables and virtual reality technologies there was evidence that technologies may differentiate PlwD who fell from those who did not; and for exergaming that balance may be improved. Conclusions The evidence for technology to reduce falls and falls risk for PlwD and MCI is methodologically weak, based on small numbers of participants and often indirect. There is a need for higher-quality RCTs to provide robust evidence for effectiveness of fall prevention technologies. Such technologies should be designed with input from users and consideration of the wider implementation context.

show abstract

Section: Discussionmentioning

confidence: 99%

Digital technologies to prevent falls in people living with dementia or mild cognitive impairment: a rapid systematic overview of systematic reviews

Eost-Telling,

Yang,

Norman

et al. 2024

Age and Ageing

Self Cite

View full text Add to dashboard Cite

show abstract

“…Staff observed that cognitively impaired residents struggled to use technology. ICTs can be used in combination with existing interventions to benefit specific groups in the care home community for which it is appropriate (Knapp et al, 2022). Even in non-pandemic contexts, the acceptance of technology by older adults is influenced by perceptions of personal proficiency in utilising technology as well as the properties of the technology itself (Peek et al, 2016).…”

Section: Discussionmentioning

confidence: 99%

“…Such technologies included phone or video calling via telephone, smartphone or tablet, and television-based telemedicine services (Elbaz et al, 2021). This widespread implementation of alreadyexisting technology in the pandemic context has been seen as a large-scale trial of feasibility during an unprecedented time (Knapp et al, 2022).…”

Section: Introductionmentioning

confidence: 99%

“…Technology overcomes various barriers to care faced by in-person services, including staffing issues, geographical barriers and difficulties with mobility in the older population (Knapp et al, 2022). Though the literature has widely discussed the benefits of technology use in an aging population, evidence for the positive effects of ICT use for older adults is limited (Hitch et al, 2017;Noone et al, 2020).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Navigating WeChat in COVID Times as a Chinese Care Home Resident

Zhang

Cheung

Cullum

et al. 2022

Journal of Long Term Care

View full text Add to dashboard Cite

In New Zealand, COVID-19-related lockdowns led to the implementation of visiting restrictions in care homes. This placed residents at risk of isolation. The Chinese community is a fast-growing ethnic group and faces additional difficulties, including language and cultural barriers. Information and communication technologies (ICTs) may enhance communication and maintain social connectedness between families and care homes during lockdowns. Objective(s):To explore the role of technology in the experiences of Chinese care home residents living in New Zealand during three lockdown periods from 2020 to mid-2021. Method(s):We performed semi-structured interviews with predominantly Chinese individuals (n = 18) across two Chinese-run care homes in Auckland, New Zealand. Participants included residents (n = 6), family members (n = 6) and facility staff (n = 6). Interviews were conducted and transcribed in either English or Mandarin Chinese, then coded and analysed to synthesise themes. Findings:We identified five themes: (i) an online care home community via WeChat, (ii) benefits of technology, (iii) barriers to technology use, (iv) the infodemic: technology as information overload and (v) the use of technology post-lockdowns.Limitations: Sample sizes for each sub-group were limited. The generalisability of findings is limited to those with no dementia or mild dementia. Residents with more severe dementia were excluded from the study but might also have benefitted from the intervention. Implications:The main finding of this study is that WeChat is an effective means of maintaining social connections in the Chinese care home community, particularly when usage is facilitated by staff. We recommend care homes consider using social media platforms to connect residents with the outside world. Sufficient resources, training and staff are needed to advocate for care home residents to be part of a digital community in a way that is culturally relevant.

show abstract

“…Although Nguyen et al (2018) suggested online health care as an area for future research, no further investigation into potential reasons for limited digital health options has been undertaken. With the increasing prevalence of dementia and the limitations of the health workforce across rural areas, in addition to the recent worldwide pandemic, there is an increasing need for digital health interventions ( Knapp et al, 2022 ). A greater understanding of current digital health CPT interventions in dementia and their feasibility is therefore essential to support the accessibility of CPT.…”

Section: Background and Objectivesmentioning

confidence: 99%

The Effectiveness and Characteristics of Communication Partner Training Programs for Families of People With Dementia: A Systematic Review

Folder,

Power,

Rietdijk

et al. 2023

The Gerontologist

View full text Add to dashboard Cite

Background and Objectives Communication partner training (CPT) is essential in dementia care. Despite families being the largest group of community carers, previous reviews primarily focus on formal carers. This study aimed to understand the characteristics and effectiveness of CPT for families of people with dementia. Research Design and Methods The systematic review included intervention/protocol studies on dementia CPT for families, excluding formal carers and programs not focused on communication. CINAHL, PsycINFO, SpeechBITE, Medline, SCOPUS, and Embase were searched between 30 th November and 6 th December 2021. After deduplication, 3172 records were screened. Quality assessment used JBI Critical Appraisal tools and the Mixed Methods Appraisal Tool. Data synthesis utilised three reporting tools, the International Classification of Functioning, Disability and Health, and content analysis. Results Of 30 studies (27 programs) there were 10 quasi-experimental, five RCTs, four mixed-methods, four case studies, four qualitative, and two protocols. Studies were published between 1998-2021 and included 671 family members. Characteristics varied with 7/27 programs including consumers during creation and one program including telehealth. One study included all reporting tool criteria. Programs typically used four intervention functions, with 12/27 programs addressing three behaviour change areas. 33/74 outcome measures targeted the ‘Environment’ of the person with dementia. Studies showed positive improvements in communication skills and knowledge, with mixed results on behaviour/psychosocial outcomes. Qualitative results identified improvements in conversation and attitudes. Discussion and Implications CPT for families improves communication outcomes, however quality of studies varied significantly. Future research should address gaps in telehealth, consumer involvement, and intervention descriptions.

show abstract

Digital Interventions for People With Dementia and Carers: effective, cost-effective and equitable?

Cited by 13 publications

References 15 publications

Digital technologies to prevent falls in people living with dementia or mild cognitive impairment: a rapid systematic overview of systematic reviews

Digital technologies to prevent falls in people living with dementia or mild cognitive impairment: a rapid systematic overview of systematic reviews

Navigating WeChat in COVID Times as a Chinese Care Home Resident

The Effectiveness and Characteristics of Communication Partner Training Programs for Families of People With Dementia: A Systematic Review

Contact Info

Product

Resources

About