Adults With Early-Stage Dementia Share Their Views on Technology

Abstract

Date Presented Accepted for AOTA INSPIRE 2021 but unable to be presented due to online event limitations.

This qualitative, interview-based research project explores the views of adults with early-stage dementia and their care partners about technology. We describe the participants' acclaim for, expectations of, and frustrations with current technology as well as recommendations for future, helpful digital technology. This important information relates to incorporating smart assistive technologies into effective OT practice, especially for those with cognitive impairments.

Primary Author and Speaker: Regula H. Robnett

Additional Authors and Speakers: Susan Wehry

Contributing Authors: Cory Breidt, Taylor Gallant, Kathryn Maiato, and Haley McOsker

The purpose of this study was to examine the current use of, ease with, and openness to using smart assistive technologies (SATs) by adults living with early stage dementia (and their care partners). The use of digital technology (e.g., tablets, computers, communication devices) has become commonplace, even more now in this time of pandemic. Technology may promote independence and safety, improve communication, and enhance personal creativity (Moyle, 2019). Digital technologies may support engagement in daily occupations and enhance quality of life (Meiland et al., 2012; Leuty et al., 2013). Adopting and learning how to use these devices can be challenging, especially for older adults who did not grow up in a ‘digital society' (Egan & Pot, 2016, p. 359). Understanding and acceptance can be even more challenging for people with decreased cognition (Meiland et al., 2012). Egan and Pot (2016) used focus groups (including four persons living with dementia [PLWD]), to explore the common barriers of assistive health technologies they encountered. These included a lack of awareness of what is available and how to use it, and the stigma that accompanies the use of assistive technology ‘for dementia patients' (p. 360). A complaint raised was that the designers of the technology expect that the user will adapt to the product, rather than considering the specific end-user initially. Our design was a qualitative phenomenological analysis of opinions about technology among PLWD (early stage, self-reported) and their care partners. Likert questions (1-10 scale) were also used to assess the participant's acceptance of, and comfort with digital technology. Participants were interviewed, offered a device of their choosing (with set-up if needed), and re-interviewed about their experience a month later.

METHOD: A sample of convenience consisting of 6 dyads (one PLWD and their caregivers) and 4 other PLWD were recruited through support networks, resulting in a total of 16 people participating in interviews.

RESULTS: Interviews lasted 20 to 180 minutes, including basic device set up when needed. SATs introduced to PLWD included voice activated home assistants, a smart frame and video caller, smart phone applications, and smart glasses. Four interviews did not result in sharing of devices. Following in-depth line-by-line coding, and collaborative team analysis several themes emerged: voice-activated assistants work well for orienting and reminding those with mild to moderate memory impairments; set up of devices is relatively easy, but syncing those devices to other devices and using them to full capacity can be overwhelming; devices need to be convenient or they will not be used; caregivers expressed concern about technology taking over their valued role as caretaker and detracting from face-to-face human interactions. In addition, those who had been immersed in technology use prior to the onset of neurocognitive impairments, continued to find SATs extremely helpful to cope with day-to-day organizational and communication challenges.

CONCLUSION: Opinions about technology of PLWD and their care partners need to be considered by designers of SATs and health care professionals alike. A disconnect between the design of digital technologies and the needs of the end user currently exists. While SATs offer great promise for improved life skills and enjoyment, the devices must be user friendly for people of varying cognitive abilities.

IMPACT STATEMENT: This research project offers information on current use of, willingness to learn about, and preferences for potential technology by PLWD and their care partners. The knowledge may help practitioners in supporting adults of all cognitive levels to use new technologies for improving their daily lives.

References

Egan, K. J., & Pot, A. M. (2016). Encouraging innovation for assistive health technologies in dementia: Barriers, enablers and next steps to be taken. Journal of The American Medical Directors Association, 17(4), 357-363. https://doi.org/10.1016/j.jamda.2016.01.010

Leuty, V., Boger, J., Young, L., Hoey, J., & Mihailidis, A. (2013). Engaging older adults with dementia in creative occupations using artificially intelligent assistive technology. Assistive Technology: The Official Journal of RESNA, 25(2), 72-79. https://doi.org/10.1080/10400435.2012.715113

Meiland, F. J., Bouman, A. I., Sävenstedt, S., Bentvelzen, S., Davies, R. J., Mulvenna, M. D., Nugent, C.D., Moelaert, F., Hettinga, M.E., Bengtsson, J.E. & Dröes, R. M. (2012). Usability of a new electronic assistive device for community-dwelling persons with mild dementia. Aging & Mental Health, 16(5), 584-591. https://doi.org/10.1080/13607863.2011.651433

Moyle, W. (2019). The promise of technology in the future of dementia care. Nature Reviews Neurology, 15(6), 353-359. https://doi.org/10.1038/s41582-019-0188-y