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Ageing well with assistive technology: co-producing technology solutions with older people: a scoping review of the evidence
- Authors:
- ROLFE Steve, et al
- Publisher:
- University of Stirling
- Publication year:
- 2021
- Pagination:
- 20
- Place of publication:
- Stirling
In order to develop guidance around the introduction and use of assistive and everyday technology for older people, this report reviews three areas of the existing research evidence. Firstly, we look at the evidence around co-production, to understand what works in terms of involving older people effectively. Secondly, we provide a broad overview of the types of technology available and explore what the current evidence base tells us about potential impacts on wellbeing and social connectedness. And lastly, we summarise the evidence regarding barriers and facilitators in relation to the use of technology by older people. The evidence base related to involvement and co-production is relatively limited, and many studies go no further than the design stage for new pieces of technology (see section 3). Nevertheless, there are useful points of learning from research which examines how older people engage with and use different forms of technology in their homes. Different devices, apps and online services are now available to support older people with aspects of social connectedness, autonomy and independence, mental health and wellbeing, physical health, and safety. However, the evidence about the real-world impacts of such technology, whilst promising, is still quite limited – many studies focus on prototypes in the lab, rather than the messy complexity of real life. Alongside this, a significant number of studies attest to the difficulties that can arise in the processes of identifying, installing and using technology. Whilst co-production cannot solve every difficulty with technology, engaging older people themselves, as well as family members, housing and care staff, can help to ensure that technology is appropriate, accessible, practically useful and therefore less likely to be abandoned. (Edited publisher abstract)
What does the literature say about using electronic pillboxes for older adults? A systematic literature review
- Authors:
- MIGUEL CRUZ Antonio, BOHORQUEZ Andres Felipe, PARRA Pedro Antonio Aya
- Journal article citation:
- Disability and Rehabilitation: Assistive Technology, 14(8), 2019, pp.776-787.
- Publisher:
- Taylor and Francis
- Place of publication:
- London
Purpose: The purpose of this study is to answer two research questions: (1) What is the clinical evidence for the reported outcomes in studies on electronic pillboxes for older adults? and (2) What is the technology readiness level (TRL) of the electronic pillboxes used, or intended to be used, for older adults? Methods: The scholarly literature was systematically searched and analyzed. Articles were included if they reported results about electronic pillboxes that were used or intended to be used for older adults’ medication. Results: Clinical studies used commercially well-established electronic pillboxes with a high TRL. New electronic pillboxes in development had a low TRL. The discovered outcome was mainly adherence to medication. The overall mean adherence to medication regimens for all the studies using an electronic pillbox was higher than the gold standard of a good adherence level cut-off point (mean adherence 88.8%>80%). However, the study found a large variation in this variable (SD = 10.7). With regard to an older adult population’s adherence to medication regimens, for the outcome variable of those who had undergone a kidney transplant, the clinical evidence that electronic pillboxes have a positive impact was strong (1b); for those with a chronic hepatitis C medical condition, the clinical evidence was medium (3), and for those with arterial hypertension and multiple chronic (diabetes and hypertension) medical conditions, the clinical evidence was weak (5). Conclusion: More research is needed in this area using designs that provide greater validity. (Edited publisher abstract)
Scoping review on the use of socially assistive robot technology in elderly care
- Authors:
- ABDI Jordan, et al
- Journal article citation:
- BMJ Open, 8(2), 2018, Online only
- Publisher:
- BMJ Publishing Group
Objective: With an elderly population that is set to more than double by 2050 worldwide, there will be an increased demand for elderly care. This poses several impediments in the delivery of high-quality health and social care. Socially assistive robot (SAR) technology could assume new roles in health and social care to meet this higher demand. This review qualitatively examines the literature on the use of SAR in elderly care and aims to establish the roles this technology may play in the future. Design Scoping review.: Data sources Search of CINAHL, Cochrane Library, Embase, MEDLINE, PsychINFO and Scopus databases was conducted, complemented with a free search using Google Scholar and reference harvesting. All publications went through a selection process, which involved sequentially reviewing the title, abstract and full text of the publication. No limitations regarding date of publication were imposed, and only English publications were taken into account. The main search was conducted in March 2016, and the latest search was conducted in September 2017. Eligibility criteria: The inclusion criteria consist of elderly participants, any elderly healthcare facility, humanoid and pet robots and all social interaction types with the robot. Exclusions were acceptability studies, technical reports of robots and publications surrounding physically or surgically assistive robots. Results: In total, 61 final publications were included in the review, describing 33 studies and including 1574 participants and 11 robots. 28 of the 33 papers report positive findings. Five roles of SAR were identified: affective therapy, cognitive training, social facilitator, companionship and physiological therapy. Conclusions: Although many positive outcomes were reported, a large proportion of the studies have methodological issues, which limit the utility of the results. Nonetheless, the reported value of SAR in elderly care does warrant further investigation. Future studies should endeavour to validate the roles demonstrated in this review. (Edited publisher abstract)
An evidence-based adoption of technology model for remote monitoring of elders' daily activities
- Author:
- MAHONEY Diane Feeney
- Journal article citation:
- Ageing International, 36(1), March 2011, pp.66-81.
- Publisher:
- Springer
- Place of publication:
- New York
A meta-synthesis of adoption of technology related findings from four innovative monitoring intervention research studies with older adults and their informal and/or formal caregivers is presented. Each study employed mixed methods analyses to find out variables that influenced adoption of telephone and Internet based wireless remote monitoring technologies. The studies were conducted in homes ranging from solo residences to multi-story independent living residential buildings. Insights highlighted the complex interplay of family-elder-staff dynamics around balancing safety and independence. Findings resulted in an adoption of technology model for remote monitoring of elders' daily activities derived from evidence based research to advance both practical and theoretical development in the field of gerontechnology.
Ethics of using assistive technology in the care for community-dwelling elderly people: an overview of the literature
- Authors:
- ZWIJSEN Sandra, NIEMEIJER Alistair, HERTOGH Cees
- Journal article citation:
- Aging and Mental Health, 15(4), May 2011, pp.419-427.
- Publisher:
- Taylor and Francis
This review examines existing literature on the ethical considerations in the field of assistive technology. It specifically focuses on community-dwelling older people with dementia. In the 46 papers meeting the inclusion criteria, three main themes were uncovered. The first theme, personal living environment, involves the subthemes privacy, autonomy and obtrusiveness. The second, the outside world, involves the subthemes stigma and human contact. The third, the design of assistive technology devices, involves the subthemes individual approach, affordability and safety. However, ethical debate does not appear to be a priority. The little discussion there is relies heavily on concepts such as autonomy and obtrusiveness. Most ethical objections discussed originate from the view that people should be independent and self-determinant. The authors conclude that other ethical approaches that view people as social and reciprocal might be more applicable in the debate on ethical aspects of assistive technology use.
Supporting healthy aging through the scale-up, spread, and sustainability of assistive technology implementation: a rapid realist review of participatory co-design for assistive technology with older adults
- Authors:
- CARROLL Simon, et al
- Journal article citation:
- Gerontology and Geriatric Medicine, 7(January-December), 2021,
- Publisher:
- Sage
Objective: To identify the key mechanisms, contexts, and outcomes that drive the successful participatory co-design of assistive technologies. Method: A rapid realist review was conducted using a systematic search strategy. After screening, a final set of 28 articles were included. Articles were analyzed for evidence relevant to our initial program theory (IPT), and context-mechanism-outcome configurations were developed, resulting in a revised program theory. Results: All 28 articles included were highly relevant to the IPT, and had sufficient detail regarding the process of participatory co-design. The findings of this review highlight several key context-mechanism-outcome configurations as potential patterns in the data under the two dimensions of the evolving program theory: knowledge integration and the ethico-political dimension. Discussion: This review revealed the key mechanisms of mutual awareness, mutual learning, trust, and reciprocity that need to be taken into account in AT development and assessment. We concluded that participatory co-design requires a restructuring of power relations between end-users and those traditionally in control of technology design. These findings inform the development and assessment of AT for older adults and help guide policy/decision-makers to move forward with the now urgent agenda for scale-up and spread, initiated by the burning platform of the COVID-19 pandemic. (Edited publisher abstract)
Methods to evaluate perspectives of safety, independence, activity, and participation in older persons using welfare technology. A systematic review
- Authors:
- ZANDER V, JOHANSSON-PAJALA R.M., GUSTAFSSON C.
- Journal article citation:
- Disability and Rehabilitation: Assistive Technology, 15(4), 2020, pp.373-393.
- Publisher:
- Taylor and Francis
- Place of publication:
- London
Purpose: To conduct a systematic review of existing methods to evaluate the individual aspects of welfare technology from the perspectives of independence, safety, activity, and participation. Furthermore, the study aimed to describe outcomes that have been the focus of previous research to evaluate individual aspects of welfare technology in older persons living in ordinary housing. Materials and methods: A systematic literature review in PubMed, CINAHL Plus, PsycINFO, Scopus, and Web of Science. Studies selected were those that explored the use of assistive and welfare technology devices from older persons’ perspectives, and which considered the concepts of independence, safety, activity and participation, and quality of life. Results: A broad spectrum of instruments was applied in the studies. For independence, three questionnaires were used in the identified studies. For safety, one instrument was used in two versions. To study activity and participation as well as quality of life, several scales were used. Additionally, several studies included qualitative approaches for evaluation, such as interviews, or posed one or more questions regarding the effects of welfare technology. Conclusions: The integration of digital assistive and welfare technology should be based on the needs of older persons, and those needs must be assessed using reliable and relevant instruments. The heterogeneity of the target group, i.e., older persons, together with the fact that assessments must give consideration to identifying goals, obstacles, and risks as well as users’ preferences, implies a person-centred approach. (Publisher abstract)
Understanding adherence to assistive devices among older adults: a conceptual review
- Authors:
- TUAZON Joshua R., JAHAN Alhadi, JUTAI Jeffery W.
- Journal article citation:
- Disability and Rehabilitation: Assistive Technology, 14(5), 2019, pp.424-433.
- Publisher:
- Taylor and Francis
- Place of publication:
- London
Purpose: The aim of this study was to identify and examine how existing literature has conceptualised adherence to assistive devices (ADs) among older adults. Methods: English articles were searched in MEDLINE, PubMed, and CINAHL (January 1990 to October 2017) for the key words “acceptance”, “adherence”, “assistive devices”, “compliance”, “concept,” and relevant synonyms. Bibliographies of selected articles were also examined. Articles were analysed if the following conditions were met conjointly: (1) attempted to define or conceptualise adherence to some degree; (2) were concerned with any AD for older adults; (3) were concerned with adults aged 65 years or older. Results: Sixteen of the 484 articles were included. Adherence to ADs among older adults seemed to be conceptualised under three core themes: psychological, contextual, and functional factors; each with their own unique considerations related to adherence that are analysed in this study. Conclusion: This review identified a large gap in knowledge about adherence to ADs. Adherence is multi-factorial and highly specific to the individual’s circumstances and their relationship with their health care practitioner. Further empirical research should focus on how the three core themes of adherence interact with and influence each other. (Edited publisher abstract)
The development of safer walking technology: a review
- Authors:
- WOOD Esme, WARD Gillian, WOOLHAM John
- Journal article citation:
- Journal of Assistive Technologies, 9(2), 2015, pp.100-115.
- Publisher:
- Emerald
Purpose: The purpose of this paper is to gain a greater understanding of the development of safer walking technology for people with dementia through contemporary literature. Design/methodology/approach: A two stage systematic approach to searching the literature was adopted. Initially this involved searching the literature to gain a broad overview of the development of safer walking technology and the context in which it has been developed. Then, this literature was examined in detail to look at published evidence surrounding the use of safer walking technology by people with dementia. These articles were quality appraised and a meta ethnographic approach taken to synthesis of the findings. Findings: There is a small but growing body of literature within this field. Whilst there is only limited evidence to support the use of safer walking technologies for people with dementia, the evidence to date indicates great potential for its use. If provided with the right support and guidance, safer walking technology has the potential to increase freedoms and independence for people with dementia; gaining them improved access to outdoor spaces and environments to support their health and wellbeing. However, if the safer walking technology continues to be associated with only risk management it will not achieve this potential. Research limitations/implications: The published literature within this field is small and has limited generalisability as much of it was generated in recent years has been by the same small research teams, often reusing data sets. There is also very little research that examines the experience of actually using safer walking technology and even less which explores the views of people with dementia. It is evident that a greater breadth and depth of knowledge is needed within this field to develop a clearer understanding of how this technology is used and perceived by all stakeholders concerned. In particular the literature would benefit from greater consideration of the views and experiences of people with dementia themselves. Practical implications: For many people with dementia, health and social care professionals can play an important role in ensuring appropriate assessment and support in the decision-making process when using safer walking technology. However, greater support is needed in decision making for all people with dementia, especially those people not currently engaged with specialist services. Therefore greater awareness of the benefits and limitations of this technology is needed by all health and social care professionals as well as the general public. Originality/value: At the time of conducting this review the author is unaware of any other systematic search of literature or overview of research on the use of safer walking technology and its use by people with dementia. Despite this safer walking technology is growing in popularity, commonly recommended by health and social care practitioners and often marketed and purchased directly by people with dementia and their families. This review offers an insight into the development of the technology and the current evidence base for its use. (Publisher abstract)
The role of telecare in meeting the care needs of older people: themes, debates and perspectives in the literature on ageing and technology
- Author:
- AKTIVE CONSORTIUM
- Publisher:
- Inventya Ltd
- Publication year:
- 2013
- Pagination:
- ix, 101
- Place of publication:
- Daresbury
This review of the literature provides a context for the AKTIVE project, which was established to explore how older people, particularly those susceptible to falls or who have cognitive impairments, may benefit from having access in and around their homes to various types of telecare technology. The review considers the social, economic and financial costs of falls and dementia, providing an overview of the demographic changes in the UK. It offers insights into telecare both from the sociology of technology and ageing and from a design-focused perspective. It also explores the policy context around telecare and some of the evidence base used in commissioning telecare, giving examples from local authorities and discussing the role of ‘personalisation’ as an additional driver behind the telecare agenda. In addition, the review considers the limits and barriers to the take-up and adoption of telecare, focusing on psycho-social barriers, impairment diversity, limited funding and poor design. (Edited publisher abstract)