Sustaining Our Relationship: Dyadic Interactions Supported by Technology for People with Dementia and Their Informal Caregivers

Abstract

Impaired memory function and challenges in communication affect the ability of people living with dementia to interact with family caregivers socially. The onset of dementia in a family member and the communication challenges that follow can lead to conflict, isolation and loss of closeness in the relationship. I-CARE is a tablet-based technology providing leisure activities specifically designed for people living with dementia to do in tandem with caregivers. The intention is that caregiving dyads engage with I-CARE together, using the activities contained in the system as the basis for positive social interactions. This paper reports on a mixed-methods feasibility study of I-CARE, evaluating the system’s usability and assessing the impact on caregiving dyads. We also explored barriers and facilitators to independent use of the technology among community-dwelling people living with dementia and their family caregiver. Results suggest that I-CARE is a feasible tool to facilitate positive experiences in dementia caregiving dyads. Important relationship outcomes for the participating dyads were enrichment in social interactions, facilitated communication, having a shared activity and relationship sustenance. Successful uptake requires continuous proactive support tailored to the needs and preconditions of users over an extended time until they feel confident using the system independently.

Impact of digital assistive technologies on the quality of life for people with dementia: A scoping review

“…The topic of engagement and social interaction was highlighted in 64 studies. They differentiated between cases where DATs increased social interaction [20], [28], [29], [34], [35], [38], [41], [45], [54], [59], [64], [70], [72], [80], [82], [83], [85], [100], [102], [112], [113], [123], [129], [131], [133], [134] and fostered higher engagement (i.e., in therapy settings) [23], [26], [29], [34], [36]–[38], [40]–[42], [45], [53]–[55], [57], [60], [62], [63], [66]–[68], [70], [73], [76]–[79], [84], [85], [87], [88], [90], [91], [96], [100], [109], [112], [114], [116], [118], [122], [127], [130], [131], [133], [135], [136], [138], [139], [141].…”

“…62 of the included studies demonstrated that digital therapeutics play a significant role in promoting social interaction and engagement [20], [23], [26], [28], [29], [34]–[38], [40]–[42], [45], [53]–[55], [57], [59], [60], [62]–[64], [66]–[68], [70], [72], [73], [76]–[80], [82], [84], [85], [87], [88], [90], [91], [96], [100], [102], [109], [112]–[114], [116], [118], [123], [127], [129]–[131], [133]–[136], [138], [139], [141], including other DATs from the patient monitoring [123] and care support categories [53], [95].…”

Enrichment of dementia caregiving relationships through psychosocial interventions: A scoping review

“…The three core elements of enrichment have been operationalized following the definition proposed by Cartwright et al (29), outlined in detail under "Concept" and summarized in Table 1. The process of operationalizing and contextualizing the core elements of enrichment was supported by findings from our preceding empirical studies focusing on dyadic relationships in dementia caregiving (48,49), as well as the work of the INTERDEM Social Health Taskforce (30)(31)(32)(33)(34) (Supplementary Appendix 1). Within this context, this review mapped out existing types of psychosocial interventions and components that contribute to enrichment in dyadic relationships in formal and informal dementia caregiving contexts.…”

“…The first core element, acquired symbolic meaning , refers to the significance, value or intent of an activity or an object, with symbolic meaning extending beyond the utility of the given object or activity ( 29 ). Supported by empirical findings ( 49 ), this core element of enrichment is operationalized as shared activities that can lay the groundwork for positive relationship gains. A key element of psychosocial interventions is that they serve as a communication channel for PLWD to engage, interact and talk with others ( 31 , 46 ).…”

Perspective Chapter: Assistive Technology Ecosystem for Effective Self-Care – Application to Alzheimer’s and Related Dementia

“…This has been challenged by activists and scholars within and outside the AT community [17]. There is increasing recognition of the importance of social and cultural factors in AT use and growing evidence that social relationships can enable PwADRD to lead meaningful lives and improve the well-being of their caregivers [17,18]. Therefore, "independence" is no longer suffice as the primary goal of AT design.…”