Best Practice Guidance
Human Interaction with Technology in Dementia

Recommendations

Practical, cognitive & social factors to improve usability of technology for people with dementia

Technologies are increasingly vital in today’s activities in homes and communities. Nevertheless, little attention has been given to the consequences of the increasing complexity and reliance on them, for example, at home, in shops, traffic situations, meaningful activities and health care services. The users’ ability to manage products and services has been largely neglected or taken for granted. People with dementia often do not use the available technology because it does not match their needs and capacities. This section provides recommendations to improve the usability of technology used in daily life, for meaningful activities, in healthcare and in the context of promoting the Social Health of people with dementia.
Technology in everyday life

Consider different needs

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Guidance

During the development or use of technological devices, the individual needs of the person with cognitive impairments (e.g. dementia or MCI) and carer should be considered. This includes not only everyday technology, but also surveillance technology (ST) and technology used during cognitive training sessions. Increased awareness and offered assistance is recommended.

Explanation and Examples

People with dementia tend to face more and other difficulties than people with MCI when using relevant everyday technologies such as cash machines, calling or texting with a cell phone or using a DVD player, and thus need more assistance in technology use. This may also be the case with ST and technology used for cognitive training.

For example, ST are often presented as a neutral technology, which enables carers to minimise risk. However, the views of users have not been sought by ST developers, which limits the usefulness of ST and suggests the need for the empowerment of user groups. Therefore, a study of audience reception was undertaken through focus groups, online discussions (Netherlands) and PPI (UK). Hereby people with dementia could speak for themselves, which has allowed their needs to be compared with carers. There was no clear recognition that such needs differed between people with dementia and carers, and it has not previously been recognized that this leads to a mismatch between a user’s situation and the product design and how this plays out in the acceptance and use of ST. Although, carers and people with dementia have not yet reached an agreement on the privacy debate and on how the media should portray dementia, it is clear that carers often tamper with ST to make up for a lack in current designs. The results suggest that ST are being resold or rebranded by providers to use for dementia, whilst users may experience physical and cognitive barriers to using such technologies for safety reasons.

Regarding technology for cognitive training: As older people have little experience with technological devices, and so may experience problems, professionals involved in cognitive training should monitor training sessions from the outset. The professional must observe and ensure the ability of the older person to understand the instructions given through the technological device, so that the person can really benefit from the cognitive training by computer. For example, in sessions with GRADIOR, a cognitive rehabilitation program, there is always a professional in charge who helps older people to understand the exercises they may experience difficulty with.

Type of evidence

Yvette Vermeer (INDUCT ESR1), Sara Bartels (INDUCT ESR9), Angie Alejandra Diaz (INDUCT ESR 15)

Literature review, RCT, cross-sectional and focus group studies, online discussions, PPI

References

Vermeer Y, Higgs P, Charlesworth G. What do we require from surveillance technology? A review of the needs of people with dementia and informal caregivers. J Rehabil Assist Technol Eng. 2019 Dec 2;6. https://doi.org/10.1177/2055668319869517

Vermeer, Y., van Santen, J., Charlesworth, G., & Higgs, P. (2020). People with dementia and carers online discussing surveillance. Journal of Enabling Technologies, 14(1), 55-70. https://doi.org/10.1108/JET-07-2019-0032

L. Bartels, S. Assander, A.-H. Patomella, J. Jamnadas-Khoda & C. Malinowsky (2019): Do you observe what I perceive? The relationship between two perspectives on the ability of people with cognitive impairments to use everyday technology, Aging & Mental Health, ePub 6May2019 https://doi.org/10.1080/13607863.2019.1609902

See also

Assessing the Ability to Use Everyday Technologies by self-perceived reports as well as observations