Promotors and barriers to the implementation and adoption of assistive technology and telecare for people with dementia and their caregivers: a systematic review of the literature

Abstract

Background One of the most pressing issues in our society is the provision of proper care and treatment for the growing global health challenge of ageing. Assistive Technology and Telecare (ATT) is a key component in facilitation of safer, longer, and independent living for people with dementia (PwD) and has the potential to extend valuable care and support for caregivers globally. The objective of this study was to identify promotors and barriers to implementation and adoption of ATT for PwD and their informal (family and friends) and formal (healthcare professionals) caregivers. Methods Five databases Medline (Ovid), CINAHL, Web of Science, APA PsycINFO and EMBASE were searched. PRISMA guidelines have been used to guide all processes and results. Retrieved studies were qualitative, mixed-method and quantitative, screened using Rayyan and overall quality assessed using Critical Appraisal Skills Programme (CASP) and Mixed Methods Assessment Tool (MMAT). Certainty of evidence was assessed using Grading of Recommendations Assessment, Development and Evaluation (GRADE) criteria and assigned within categories of high, moderate, or low. NVivo was used for synthesis and analysis of article content. A narrative synthesis combines the study findings. Results Thirty studies (7 quantitative, 19 qualitative and 4 mixed methods) met the inclusion criteria. Identified primary promotors for the implementation and adoption of ATT were: personalized training and co-designed solutions, safety for the PwD, involvement of all relevant stakeholders, ease of use and support, and cultural relevance. Main barriers for the implementation and adoption of ATT included: unintended adverse consequences, timing and disease progress, technology anxiety, system failures, digital divide, and lack of access to or knowledge of available ATT. Conclusion The most crucial elements for the adoption of ATT in the future will be a focus on co-design, improved involvement of relevant stakeholders, and the adaptability (tailoring related to context) of ATT solutions over time (disease process).

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

“…Using the FARSEEING taxonomy [ 25 ] all included technologies were classified as Systems although they differed in Locations (i.e. they were all Systems technologies which were either body worn/fixed; environmental or portable) ( Table 2 ).…”

“…Whilst technology holds considerable promise it also presents complex challenges in the context of PlwD or MCI [ 25 , 26 ] and this applies to falls prevention applications. For example, changes in visual perception and comprehension can hinder interactions with complicated interfaces; difficulties in processing auditory signals may cause confusion and anxiety if unfamiliar alarms sound and slower comprehension of verbal and written instructions can create frustration and barriers to use [ 27 ].…”

Harnessing digital health interventions to bridge the gap in prevention for older adults

“…The design and execution of digital health initiatives necessitate the consideration of cultural views, linguistic preferences, and diverse degrees of digital competence. By tailoring interventions to be congruent with local cultures and educational levels and gaining insight into the technical challenges that older adults encounter will empower developers to craft future digital interventions that are precisely attuned to their needs ( 38 ).…”

Ten Years of TeleHealth and Digital Healthcare: Where Are We?

“…COVID-19 has also lead to bottlenecks. The digital divide represents a major obstacle for the use of TH and DH [ 56 , 57 , 58 , 59 , 60 , 61 ]. Literacy with IT tools (essential for interacting with DH and TH) is often inadequate and opportunities are lost, even in wealthy countries.…”