Technology-Assisted Home Care for People With Dementia and Their Relatives: Scoping Review

Abstract

Background Assistive technologies for people with dementia and their relatives have the potential to ensure, improve, and facilitate home care and thereby enhance the health of the people caring or being cared for. The number and diversity of technologies and research have continuously increased over the past few decades. As a result, the research field has become complex. Objective The goal of this scoping review was to provide an overview of the research on technology-assisted home care for people with dementia and their relatives in order to guide further research and technology development. Methods A scoping review was conducted following a published framework and by searching 4 databases (MEDLINE, CINAHL, PsycInfo, and CENTRAL) for studies published between 2013 and 2018. We included qualitative and quantitative studies in English or German focusing on technologies that support people with dementia or their informal carers in the home care setting. Studies that targeted exclusively people with mild cognitive impairment, delirium, or health professionals were excluded as well as studies that solely consisted of assessments without implication for the people with dementia or their relatives and prototype developments. We mapped the research field regarding study design, study aim, setting, sample size, technology type, and technology aim, and we report relative and absolute frequencies. Results From an initial 5328 records, we included 175 studies. We identified a variety of technology types including computers, telephones, smartphones, televisions, gaming consoles, monitoring devices, ambient assisted living, and robots. Assistive technologies were most commonly used by people with dementia (77/175, 44.0%), followed by relatives (68/175, 38.9%), and both target groups (30/175, 17.1%). Their most frequent goals were to enable or improve care, provide therapy, or positively influence symptoms of people with dementia (eg, disorientation). The greatest proportions of studies were case studies and case series (72/175, 41.1%) and randomized controlled trials (44/175, 25.1%). The majority of studies reported small sample sizes of between 1 and 50 participants (122/175, 69.7%). Furthermore, most of the studies analyzed the effectiveness (85/233, 36.5%) of the technology, while others targeted feasibility or usability or were explorative. Conclusions This review demonstrated the variety of technologies that support people with dementia and their relatives in the home care setting. Whereas this diversity provides the opportunity for needs-oriented technical solutions that fit individual care arrangements, it complicates the choice of the right technology. Therefore, research on the users’ informational needs is required. Moreover, there is a need for larger studies on the technologies’ effectiveness that could contribute to a higher acceptance and thus to a transition of technologies from research into the daily lives of people with dementia and their relatives.

Use of Digital Technologies to Maintain Older Adults’ Social Ties During Visitation Restrictions in Long-Term Care Facilities: Scoping Review

“…To avoid a tendency for technological solutionism [ 50 ], considering that the implementation and appropriation of technologies are synonyms, it seems essential to finely define the implications and entanglements and identify the contributions and limitations of digital solutions used to maintain or develop social ties. This aim can be achieved through an increased number of studies based on empirical methods [ 51 ]. Indeed, previous studies on long-term care facility residents’ remote social ties have used standardized scales, such as the Geriatric Depression Scale [ 10 ], combined with loneliness and social support behavior scales [ 11 ] or with loneliness and quality of life scales [ 30 ].…”

“…None of the studies considered the perspective of the residents, as previous research has stated. The need for well-developed and tested interventions was indeed highlighted by Palmdorf et al [ 51 ], who showed that there is a lack of information about the actual needs of the users of digital technologies.…”

Refining a Digital Therapeutic Platform for Home Care Agencies in Dementia Care to Elicit Stakeholder Feedback: Focus Group Study With Stakeholders

“…The focus group findings highlight the complex and dynamic implications of providing care for persons living with dementia in their homes. More importantly, this study contributes to the growing literature on how technology can support care for people with dementia living in the community [ 18 , 19 ] and the importance of a user-centered design approach [ 20 ]. Overall, the stakeholder group participants share a widespread belief about the benefits of technology in general and about the Generation Connect platform, specifically with regard to the platform’s support efforts for caring for individuals with dementia in their homes.…”

Effects of technology‐assisted interventions for people with dementia: A systematic review and meta‐analysis

“…Technology‐assisted interventions can be used to bridge communication, reduce burden, improve health outcomes, and manage the costs in dementia care (Hirt et al, 2019; Palmdorf et al, 2021), expanding the ability to provide remote services to monitor, enhance, and enable home care, improving the health and well‐being of both caregivers and patients (Greenhalgh et al, 2015; Palmdorf et al, 2021; Welch et al, 2021). Technology‐assisted interventions refer to any treatment that employs technology as a mediating factor to create, produce, or offer health promotion materials and practices (Wang, Fadhil, et al, 2019).…”

“…Only one systematic review and meta‐analysis has examined the outcomes of technology‐assisted interventions in people with dementia, which found that these interventions can successfully decrease risky behaviors (Brims & Oliver, 2019). The results of the two prior scoping reviews showed improved safety for persons with dementia (Budak et al, 2021; Palmdorf et al, 2021). No systematic review or meta‐analysis has yet been reported examining the efficacy of technology‐assisted interventions on physical or psychological functional outcomes in the population of individuals with dementia.…”