...disabled people's organisations; a call for evidence; interviews with expert stakeholders; identification of case studies of good practice and innovation; and focus group with the Dementia Coffee Morning Group. This report outlines tangible actions that government and industry can take to support independent living and improve the quality of life of disabled and older people and their families, while
(Edited publisher abstract)
This report highlights the findings from the Smart Homes and Independent Living Commission that examined how smart home technology is an opportunity for disabled and older people to take control of their lives, to live independently with more choice and control over their lives. The Commission gathered evidence from three roundtable evidence sessions with a variety of stakeholders including disabled people's organisations; a call for evidence; interviews with expert stakeholders; identification of case studies of good practice and innovation; and focus group with the Dementia Coffee Morning Group. This report outlines tangible actions that government and industry can take to support independent living and improve the quality of life of disabled and older people and their families, while also reducing financial pressures on the NHS and the social care system. Recommendations include: ensure that disabled and older people are involved at the commissioning and design stages of technology; place independent living at the heart of health and social care policy and practice; reform the Disabled Facilities Grant; pilot an Independent Living Technology Grant that would provide funding for disabled and older people to buy low-cost technology and any support they might need to use it; upskill the health and social care sector staff; and deliver a public awareness campaign for technology and independent living designed to boost the consumer market for these products and services. The report includes brief case studies: Disabilities Trust ConnectAbility project; Yorkshire and Humber Academic Health Science Network; and Adapt Tech, Accessible Technology project.
(Edited publisher abstract)
Subject terms:
independent living, assistive technology, disabilities, older people, independence, innovation, service development, skills, capacity building, commissioning, grants, government policy, co-production;
Design and Methods: A systematic search of 6 key databases found 11,895 citations published between 2010 and 2021. Studies were included if they involved community-dwelling older adults with or without cognitive impairment arising from acquired brain injury, mild cognitive impairment, or dementia, and if they evaluated everyday smartphone or tablet device use for cognition, memory, or activities...
(Edited publisher abstract)
Background and Objectives: A systematic review was conducted to explore the use of smartphones and tablet computers as cognitive and memory aids by older adults with and without cognitive impairment, specifically the effects of smartphone and tablet use on participants’ cognition and memory, and the barriers and facilitators to smartphone and tablet use for cognitive and memory support. Research Design and Methods: A systematic search of 6 key databases found 11,895 citations published between 2010 and 2021. Studies were included if they involved community-dwelling older adults with or without cognitive impairment arising from acquired brain injury, mild cognitive impairment, or dementia, and if they evaluated everyday smartphone or tablet device use for cognition, memory, or activities of daily living. Results: A total of 28 papers were included in the narrative synthesis. There was some evidence that the use of smartphones and tablets could aid cognitive function in older adults without cognitive impairment, particularly executive function and processing speed. There was modest evidence that smartphone and tablet use could support memory in both older adults without cognitive impairment and those with acquired brain injury and dementia. Discussion and Implications: Smartphones and tablets were seen by users as acceptable, enjoyable, and nonstigmatizing alternatives to conventional assistive technology devices; however, current use of smartphone and tablet devices is hindered by the digital literacy of older adults, a lack of accommodation for older adult users' motor and sensory impairments, and a lack of input from clinicians and researchers. Much of the evidence presented in this review derives from case studies and small-scale trials of smartphone and tablet training interventions. Further research is needed into older adults' use of smartphones and tablets for cognitive support before and after the onset of cognitive impairment in order to develop effective evidence-based smart technology cognition and memory aids.
(Edited publisher abstract)
Background: Pet robots have been employed as viable substitutes to pet therapy in nursing homes. Despite their potential to enhance the psychosocial health of residents with dementia, there is a lack of studies that have investigated determinants of implementing pet robots in real-world practice. This study aims to explore the determinants of implementing pet robots for dementia care in nursing...
(Edited publisher abstract)
Background: Pet robots have been employed as viable substitutes to pet therapy in nursing homes. Despite their potential to enhance the psychosocial health of residents with dementia, there is a lack of studies that have investigated determinants of implementing pet robots in real-world practice. This study aims to explore the determinants of implementing pet robots for dementia care in nursing homes, from the perspectives of healthcare professionals and organisational leaders. Methods: A descriptive qualitative study, conceptualised and guided using the Consolidated Framework of Implementation Research (CFIR), was conducted. We conducted semi-structured interviews with healthcare professionals and organisational leaders from nursing homes. Data was transcribed and analysed using Framework Analysis, based on the CFIR as an a priori framework. Results: A total of 22 participants from eight nursing homes were included. Determinants were mapped to constructs from all five CFIR domains. Determinants relating to the characteristics of pet robots include their design, realisticness and interactivity, affordability, cleanability, perceived evidence strength and comparative advantages to live pets. Determinants relating to external influences (outer setting) include national regulatory guidelines, funding and networks with other organisations. With regards to characteristics of nursing homes (inner setting), determinants include the relevance of pet robots in relation to the needs of residents with dementia, alignment with care processes, infection control mandates and their relative priority. In the domain 'characteristics of individuals', determinants were associated with individuals' beliefs on the role of technology, desires to enhance residents' quality of life, and differential attitudes on the use of robots. Finally, in the domain ‘implementation process', assessments and care planning were identified as determinants. Conclusions: Overall, while sentiments around determinants within CFIR domains of pet robots' characteristics, outer setting and implementation process were similar, participants' opinions on the determinants within the 'inner setting' and 'characteristics of individuals' were more varied. This could be due to different organisational structures, disciplinary differences and personal experiences of using pet robots. Many determinants in different domains were interrelated. Findings provide a springboard for identifying and designing implementation strategies to guide the translation of pet robots from research into real-world practice.
(Edited publisher abstract)
Journal of Gerontological Nursing, 48(1), 2022, pp.35-41.
Publisher:
Healio
The purpose of the current pilot study was to determine the impact of an ambient activity technology, ABBY, on responsive behavior and family visiting in a long-term care (LTC) home. We were also interested in family and staff perceptions of the technology. A mixed methods research study was conducted over a 6-month period and data were collected using standardized measures and focus groups. Although no significant differences were noted in responsive resident behaviours, focus group data showed the ABBY enriched the care environment and provided additional opportunities for families and staff to engage residents. Although the introduction of a new technology can create challenges for staff, with time, these challenges can be overcome.
(Edited publisher abstract)
The purpose of the current pilot study was to determine the impact of an ambient activity technology, ABBY, on responsive behavior and family visiting in a long-term care (LTC) home. We were also interested in family and staff perceptions of the technology. A mixed methods research study was conducted over a 6-month period and data were collected using standardized measures and focus groups. Although no significant differences were noted in responsive resident behaviours, focus group data showed the ABBY enriched the care environment and provided additional opportunities for families and staff to engage residents. Although the introduction of a new technology can create challenges for staff, with time, these challenges can be overcome.
(Edited publisher abstract)
Subject terms:
residential care, family relations, carer views, staff views, digital technology, behaviour, participation, assistive technology, dementia, behaviour problems;
...on research into the barriers to use by adults with chronic conditions. They analysed 40 papers covering a wide range of health conditions such as dementia, stroke and impaired mobility. The studies included a mixture of assistive technologies. The research team identified six main barriers to the use of assistive technologies: design and function, including lack of user and therapist involvement
(Edited publisher abstract)
Summarises findings of a study exploring why up to seven in ten people abandon their assistive technology. In some cases, this is because their condition has improved, but it can also be because the technology does not meet their needs. Assistive technologies include a diverse range of devices such as prosthetics (artificial body parts such as a leg for after amputation), hearing aids, mobility aids such as wheelchairs and walking sticks, memory/planning aids, communication aids for people unable to use their own voice, and devices to help people use household items. The researchers wanted to identify the barriers that prevent people with chronic conditions using assistive technologies. The researchers reviewed published studies on assistive technologies from around the world. They focussed on research into the barriers to use by adults with chronic conditions. They analysed 40 papers covering a wide range of health conditions such as dementia, stroke and impaired mobility. The studies included a mixture of assistive technologies. The research team identified six main barriers to the use of assistive technologies: design and function, including lack of user and therapist involvement in the design process, lack of options for customising it, high purchase and maintenance costs, and not being easy to use; information and awareness, including a lack of training or instructions; service provision, including a lack of person-centred care; psychological barriers, such as a user’s previous disappointment with the technology; support network, including negative views, and a lack of encouragement to use the technology, from family and carers; and societal barriers, such as stigma.
(Edited publisher abstract)
Subject terms:
assistive technology, telecare, user views, information technology, digital technology;
NIHR Greater Manchester Patient Safety Translational Research Centre
Publication year:
2021
Pagination:
7
Place of publication:
Manchester
Findings from this patient and public involvement and engagement work which explored the experiences of people living with dementia in the community during the pandemic. Our conversations with people living with dementia and their carers provided glimpses of the hard reality of self-isolation. The pandemic has been described as an isolating and lonely experience by many of the people we spoke...
(Edited publisher abstract)
Findings from this patient and public involvement and engagement work which explored the experiences of people living with dementia in the community during the pandemic. Our conversations with people living with dementia and their carers provided glimpses of the hard reality of self-isolation. The pandemic has been described as an isolating and lonely experience by many of the people we spoke to. However, our conversations also revealed the resourcefulness of many people in finding new ways to support one another and maintain the essential pleasure of social interaction. Family and support workers acted as mediators or facilitators for people living with dementia in accessing activities. They needed others to gently direct them to material they found engaging and motivating. This may have been by using smartphones and tablets to talk to relatives who could not visit, or finding pictures about a person’s 6 specific interest to talk about. As one support worker said ‘we are their link to the outside world, we bring the outside in’. Technology was used for a variety of purposes that, on occasions, became essential for health and wellbeing, such as health consultations, staying in touch with family and friends and saying goodbye to dying loved ones remotely. Video-calling and online resources were described as a valuable lifeline for many people, but generally older people and those living with dementia could not use these resources independently and relied on family and support workers to set up and manage technology. Concerns were raised that any time allocated to overseeing the use of technology could have implications for time available for essential care, particularly when support was purchased for specific aspects of care.
(Edited publisher abstract)
Subject terms:
dementia, Covid-19, social isolation, loneliness, older people, digital technology, assistive technology;
ALL PARTY PARLIAMENTARY GROUP ON HOUSING AND CARE FOR OLDER PEOPLE
Publisher:
Housing Learning and Improvement Network
Publication year:
2021
Pagination:
52
Place of publication:
London
Findings of an Inquiry to explore the policy changes needed to help people live as well as possible with dementia in their own homes – from mainstream housing to specialist provision such as extra care housing or assisted living schemes. The Inquiry sought expert evidence on: the lived experience of people with dementia; the links between housing, health, and social care to improve the journey...
(Edited publisher abstract)
Findings of an Inquiry to explore the policy changes needed to help people live as well as possible with dementia in their own homes – from mainstream housing to specialist provision such as extra care housing or assisted living schemes. The Inquiry sought expert evidence on: the lived experience of people with dementia; the links between housing, health, and social care to improve the journey of someone affected by dementia; the design of new homes; ways to increase supply of specialist dementia-friendly properties; changes and adaptations to existing homes to enable people to live well with dementia; and the role of innovative technology to improve the delivery of better care and support. The Inquiry sought evidence on all aspects of housing with care for older people with dementia, but did not include residential care or nursing homes. The Inquiry heard about the housing and care experiences of older people living with dementia and their carers. It was told about the importance of planning for well-designed dementia-ready housing and how the planners, architects, developers, commissioners, and landlords all have a role to play. The Inquiry heard how people live better when their housing is integral to the local community. There is a recognition that many people with dementia live in housing that was not purpose built to be dementia-ready. The Inquiry considered how technology, aids, and adaptations can help or hinder someone with dementia to live well. It makes recommendations to improve the wellbeing of individuals by working with them to harness technology and adapt the environment. In conclusion, crucially the Inquiry heard that “every decision about care is a decision about housing” and makes recommendations to optimise the costs and benefits of an integrated approach to housing and care decisions.
(Edited publisher abstract)
Subject terms:
housing, dementia, supported housing, extra care housing, older people, home adaptations, home improvements, assistive technology, integrated care;
Background and Objectives: Dementia and central nervous system degeneration are common problems in aging societies with regard to the number of people affected and total medical expenses. Socially assistive robotic technology has gradually matured; currently, most scholars believe it can be used as companions in long-term care facilities and to work as caregivers alongside staff to improve...
(Edited publisher abstract)
Background and Objectives: Dementia and central nervous system degeneration are common problems in aging societies with regard to the number of people affected and total medical expenses. Socially assistive robotic technology has gradually matured; currently, most scholars believe it can be used as companions in long-term care facilities and to work as caregivers alongside staff to improve the social interaction and mental state of older adults and patients with dementia. Therefore, this study measured the effect of the duration of exposure to socially assistive robots in older adults with dementia. Research Design and Methods: Seven databases were searched up to February 2019 through the consultation of appropriate Internet sites and the use of criteria lists recommended by relevant experts. Randomized controlled trials comparing socially assistive robot use with a control group in older adults with dementia and using at least one of the primary outcomes of agitation, depression, and quality of life were included. Results: Thirteen randomized controlled trials were identified from 873 articles, 7 of which were included in the meta-analysis. The pooled effect estimate from 3 trials with 214 participants revealed that the pet-type robot improved patients' agitation level, with a standardized mean difference of -0.37 (95% CI: -0.64 to -0.10, p < .01) and no heterogeneity (I2 = 0%). The results also revealed that length of each session and pet-type robot exposure time per week were associated with reduced depression levels (β = −0.06, Q = 21.213, df = 1, p < .001 and β = -0.019, Q = 7.532, df = 1, p < .01, respectively). However, the results for quality of life were nonsignificant. Discussion and Implications: Pet-type robot systems seem to be a potential activity in long-term care facilities for dementia care. Further research is warranted to establish a comprehensive intervention plan related to the use of pet-type robots.
(Edited publisher abstract)
Subject terms:
agitation, dementia, assistive technology, systematic reviews, evidence, older people, long term care, pets, telecare, evaluation, outcomes, intervention;
Health Technology Assessment, 25(19), 2021, Online only
Publisher:
National Institute for Health Research
Place of publication:
London
Background: Assistive technology and telecare have been promoted to manage the risks associated with independent living for people with dementia, but there is limited evidence of their effectiveness. Objectives: This trial aimed to establish whether or not assistive technology and telecare assessments and interventions extend the time that people with dementia can continue to live independently...
(Edited publisher abstract)
Background: Assistive technology and telecare have been promoted to manage the risks associated with independent living for people with dementia, but there is limited evidence of their effectiveness. Objectives: This trial aimed to establish whether or not assistive technology and telecare assessments and interventions extend the time that people with dementia can continue to live independently at home and whether or not they are cost-effective. Caregiver burden, the quality of life of caregivers and of people with dementia and whether or not assistive technology and telecare reduce safety risks were also investigated. Design: This was a pragmatic, randomised controlled trial. Blinding was not undertaken as it was not feasible to do so. All consenting participants were included in an intention-to-treat analysis. Setting: This trial was set in 12 councils in England with adult social services responsibilities. Participants: Participants were people with dementia living in the community who had an identified need that might benefit from assistive technology and telecare. Interventions: Participants were randomly assigned to receive either assistive technology and telecare recommended by a health or social care professional to meet their assessed needs (a full assistive technology and telecare package) or a pendant alarm, non-monitored smoke and carbon monoxide detectors and a key safe (a basic assistive technology and telecare package). Main outcome measures: The primary outcomes were time to admission to care and cost-effectiveness. Secondary outcomes assessed caregivers using the 10-item Center for Epidemiological Studies Depression Scale, the State–Trait Anxiety Inventory 6-item scale and the Zarit Burden Interview. Results: Of 495 participants, 248 were randomised to receive full assistive technology and telecare and 247 received the limited control. Comparing the assistive technology and telecare group with the control group, the hazard ratio for institutionalisation was 0.76 (95% confidence interval 0.58 to 1.01; p = 0.054). After adjusting for an imbalance in the baseline activities of daily living score between trial arms, the hazard ratio was 0.84 (95% confidence interval 0.63 to 1.12; p = 0.20). At 104 weeks, there were no significant differences between groups in health and social care resource use costs (intervention group – control group difference: mean –£909, 95% confidence interval –£5336 to £3345) or in societal costs (intervention group – control group difference: mean –£3545; 95% confidence interval –£13,914 to £6581). At 104 weeks, based on quality-adjusted life-years derived from the participant-rated EuroQol-5 Dimensions questionnaire, the intervention group had 0.105 (95% confidence interval –0.204 to –0.007) fewer quality-adjusted life-years than the control group. The number of quality-adjusted life-years derived from the proxy-rated EuroQol-5 Dimensions questionnaire did not differ between groups. Caregiver outcomes did not differ between groups over 24 weeks. Conclusions: A full package of assistive technology and telecare did not increase the length of time that participants with dementia remained in the community, and nor did it decrease caregiver burden, depression or anxiety, relative to a basic package of assistive technology and telecare. Use of the full assistive technology and telecare package did not increase participants’ health and social care or societal costs. Quality-adjusted life-years based on participants’ EuroQol-5 Dimensions questionnaire responses were reduced in the intervention group compared with the control group; groups did not differ in the number of quality-adjusted life-years based on the proxy-rated EuroQol-5 Dimensions questionnaire.
(Edited publisher abstract)
Subject terms:
assistive technology, telecare, independent living, independence, dementia, randomised controlled trials, adult social care, intervention, evaluation, outcomes;
Ageing and Society, early cite November 2021, pp.1-27.
Publisher:
Cambridge University Press
The primary aim of this scoping review was to explore the contribution of housing adaptations to supporting everyday life for people with dementia living at home in the community. The study adopted a scoping review methodology which was guided by the Joanna Briggs Institute Reviewers Manual. Four review questions were developed which subsequently informed the inclusion criteria and search terms...
(Edited publisher abstract)
The primary aim of this scoping review was to explore the contribution of housing adaptations to supporting everyday life for people with dementia living at home in the community. The study adopted a scoping review methodology which was guided by the Joanna Briggs Institute Reviewers Manual. Four review questions were developed which subsequently informed the inclusion criteria and search terms. Eight databases were searched resulting in 2,339 records, with 13 papers being included in the review. Evidence from the review found that the most common adaptations were recommended and/or implemented to compensate for a person's physical limitations and for safety reasons, rather than adaptations to support activities of daily living for a person with dementia. Support to implement adaptations was provided by a range of professionals coupled with ‘trial and error’ approaches adopted by the person themselves, and these were seen as key enablers. Barriers to implementing and using adaptations were fourfold: (a) access to information, (b) knowing when to make changes, (c) carer resistance, and (d) the unsuitability of the home. It would appear that housing adaptations have a positive impact on both the person with dementia and the carer (where one is present), with some adaptations having a relatively sustained impact and being particularly effective if implemented early in the lived trajectory of dementia.
(Edited publisher abstract)
Subject terms:
literature reviews, assistive technology, home care, dementia, home adaptations, housebound people, home safety, access to information;