Successful implementation of technology in dementia care depends not merely on its effectiveness but also on other facilitating or impeding factors related to e.g. the personal living environment (privacy, autonomy and obtrusiveness); the outside world (stigma and human contact); design (personalisability, affordability and safety), and ethics on these subjects. This section provides recommendations on the implementation of technology in everyday life, for meaningful activities, healthcare technology and technology promoting Social Health.
See recommendation no. 3.3.4.4
Read more >Understanding how social robots positively impact nursing home residents as well as analysing practical challenges are important when implementing robotic assistive technology in nursing homes
An important facilitating factor to the acceptance of social robots in nursing homes is understanding and seeing how social robots positively impact residents, for example by improving the communication, decreasing loneliness, providing joy to residents, calming agitated residents or generally increasing their wellbeing. Understanding these benefits will facilitate the acceptance of social robots by staff as well as by relatives, but is also important for the resident to accept the social robot, as their acceptance will be influenced by the views and attitudes of staff and relatives.
On the other hand, one of the key hindering factors to the acceptance of social robots in nursing homes are practicalities of everyday life in the nursing home, such as storage, hygiene, finding a quiet place, scheduling time for robot use or the need to charge the robot.
We conclude, that applying an acceptance model of social robots (here the Almere Model) is an interesting and feasible way to trace facilitators and barriers of implementation of social technology in nursing homes, where involvement in social activities and enhancing positive experiences are important foci of interventions to improve social health.
Read more >Technology developers and researchers should be aware of the different contextual factors that can affect the translation of research on social robots to real-world use.
Barriers and facilitators affecting the implementation of social robots can occur at different levels. For example, they relate to the social robots’ features, or relate to organisational factors or external policies. A scoping review was conducted to understand the barriers and facilitators to the implementation of social robots for older adults and people living with dementia. 53 studies were included in this review. Most existing studies have disproportionately focused on understanding barriers and facilitators relating to the social robots, such as their ease of use. However, there is significantly less research that has been conducted to understand organisational factors or wider contextual factors that can affect their implementation in real-world practice. Future research should pay more attention to investigating the contextual factors, using an implementation framework, to identify barriers and facilitators on different levels to guide the further implementation of social robots.
Read more >Implementing assistive technology could be promising in long-term care to address loneliness in dementia, but further studies are needed to tailor assistive technology to people living with dementia in different care settings and to investigate its effect on loneliness.
Active & Assisted Living (AAL) technology aims to support coping with the consequences of dementia. A scoping review was conducted to learn if and how AAL addresses loneliness in people living with dementia in long-term care. Although, only one study focused directly on the impact of AAL technology on loneliness, findings suggest that AAL were used in the context of psychosocial interventions and proved to have had an impact on loneliness in people living with dementia. It remains unclear why loneliness was almost never included as an outcome in technology studies. Since we were not able to derive clear effects of assistive technology on loneliness from the included studies, we recommend using loneliness outcome measures in future intervention studies into AAL technology.
Read more >See recommendation no. 3.3.4.1
Read more >See recommendation no. 3.3.4.2
Read more >Technological solutions that can safeguard the social health of nursing home residents with dementia should be implemented as an integrated part of caregiving procedures. This requires formally incorporated technology guidelines and continuous training of staff. As developing and implementing technology to promote social participation faces substantial barriers as long as social health is not recognized on equal terms as the physical and mental health domains, first, social health needs to be acknowledged as a priority which requires major efforts at the societal-, organizational and individual levels.
Cross-sectional data from a national online survey conducted among German nursing homes, on the impact of the COVID-19 pandemic, showed that efforts were made to ensure social participation among residents with dementia, and the use of technology in doing so.A large proportion of respondents observed an increase in at least one Behavioural and Psychological Symptom in Dementia (BPSD) in residents with dementia. Many reported that social activities in the nursing home were cancelled, which was due to COVID-19 cases and staff shortages from 5 % and up, revealing just how easily neglectable social health strategies in nursing homes are. Half of all respondents reported having had no formal training in the use of social technology to engage their residents with dementia. Although more than 70% had provided opportunities for using technology for social purposes, the low frequency of established procedures seems to indicate ad hoc solutions to ensure the social health of residents with dementia.
At the micro-, meso- and macro level requirements were identified to promote social participation using technology. These requirements revealed that integrating technological solutions in institutional settings, requires efforts at individual-, organisational and societal level.
Read more >To minimise potential distress and negative impacts from using pet robots, researchers and care providers should assess their suitability for individuals with dementia, and facilitate their use based on each individual’s preference, needs and abilities. As the needs of people with dementia can fluctuate, care providers should also monitor and re-evaluate the use of pet robots.
Findings from a scoping review of eight studies showed that some people with dementia did not respond to pet robots. Some had negative responses such as agitation, or became jealous when the robot was shared with other residents in care facilities. An analysis of 1,327 consumer reviews on a low-cost robotic cat showed similar findings. Likewise, interviews with care providers from nursing homes revealed that they had similar experiences. To minimise the risks of potential negative impacts, the use of pet robots for each individual has to be carefully considered. This should encompass:
Assess the individual’s preferences, needs, functional abilities and needs (e.g. occupational needs, and physical, cognitive, and sensory abilities). If used in a care setting, consider discussing the use of pet robots with family members.
Based on the assessment, provide facilitation or tailored support to individuals. For example, if the individual has difficulties initiating interactions with the pet robot, consider providing assistance
Monitor and evaluate the individual’s reaction to pet robots, and intervene if the individual shows signs of distress. These observations should be shared with and discussed with other care providers if used in care facilities
Residents with dementia and their family members should be involved when planning to introduce pet robots in long-term care settings and when using pet robots.
In a consensus-building exercise involving 56 international experts (care professionals, organisational leaders and researchers), experts established the importance of including residents with dementia and their family in the implementation of pet robots in long-term care facilities. When planning to adopt pet robots in long-term care facilities, the opinions of residents with dementia and their family members must be sought. Examples include
When using pet robots, residents with dementia and their family members must be supported to be actively involved. For example:
Before introducing pet robots in a long-term care facility, consensus discussions among stakeholders, such as care professionals and managers, should be conducted, to discuss whether (and why) pet robots should or should not be introduced for residents with dementia. In addition, the facility’s readiness to introduce pet robots should be carefully considered.
In a modified Delphi study involving 56 international experts (care professionals, organisational leaders and researchers), experts agreed that these strategies are critical to support the implementation of pet robots in long-term care facilities. Consensus discussions should involve all care providers who may be directly or indirectly involved in the care of residents with dementia. Examples of discussions may include:
In addition, the organisation’s readiness to implement pet robots should also be assessed. Examples include:
Care staff should be educated about the use of pet robots in dementia care through educational meetings that are tailored to the needs of different staff. In addition, they should be provided with ongoing trainings to support them in applying this knowledge as part of their delivery of dementia care.
In a modified Delphi study involving 56 international experts (care professionals, organisational leaders and researchers), educational meetings and ongoing trainings are identified as critical strategies to support the implementation of pet robots in long-term care facilities. The purpose of conducting educational meetings is to provide care staff with overall knowledge on the role of pet robots for dementia care. Such sessions should be tailored to the different needs of each care professional. Examples of content may include:
While the purpose of education is to provide overall knowledge about pet robots, the purpose of conducting ongoing training is to support care professionals to acquire practical skills and confidence to use pet robots in dementia care giving. Examples include:
The cost of pet robots can prohibit their uptake in long-term care facilities for dementia care. There may also be additional costs involved in implementing pet robots, such as manpower and time related costs. Different funding sources need to be considered to acquire sufficient funding to support the implementation effort.
In a qualitative study involving 22 care providers from nursing homes, the cost of purchasing pet robots have been reported as a concern. Some care providers reported the use of charity funds to support the purchase of pet robots. In a modified Delphi study, experts (care professionals, organisational leaders and researchers) established that it is necessary to creatively seek and acquire funding to support the implementation of pet robots in long-term care facilities. Examples of potential funding sources may include:
The funds may be used to support different aspects of implementation. Examples include:
There are many considerations when planning to implement technological interventions. The issues can be grouped into context, implementation and mechanism of impact factors. Evidence from the FindMyApps project has identified, within these categories, specific factors that are important for successful implementation of a tablet-based intervention, such as FindMyApps. Potential tablet-users and care providers are advised to base their decisions on this evidence.
The FindMyApps project compared the FindMyApps intervention to usual tablet use by community-dwelling people with mild cognitive impairment (MCI) or mild dementia. The following factors were identified as influencing the success of implementation of both the FindMyApps intervention and a standard tablet:
To successfully implement psychosocial applications of technology in dementia care, it is recommended to carry out implementation processes adapted to the context of interest and to adapt training materials socio-culturally.
A qualitative study was performed to trace facilitators and barriers to implementing an evidence-based Dutch psychosocial support programme for people with dementia and carers with greater social integration and better cost-benefit ratio, the Meeting Centres Support Programme (MCSP), in Spanish-speaking countries. Among the potential barriers identified, the most relevant were associated with the lack of adapted training materials to the sociocultural context and the difference between urban and rural populations, particularly the access to populations living in remote areas.
It is therefore recommended that an implementation process be carried out that takes into account the characteristics of the region concerned, in addition to developing actions to overcome specific barriers, such as the creation of technological tools to offer the support programme remotely to provide access to the rural population. For example, as a result of this study, the ‘Introductory Online Course for the Implementation of Meeting Centres for People with Dementia and their Caregivers’ was developed and adapted for Spanish-speaking countries in the Spanish language (available at https://e4you.org/es/moocs/implementacion-de-centros-de-encuentro-para-personas-con-demencia-y-sus-cuidadores). The course consists of eight modules setting out the theoretical background and practical implementation steps in the preparation, implementation and continuation phase.
Also, to offer an alternative to the face-to-face caregivers’ programme included in the MCSP, the iSupport-Sp, an evidence-based training and support programme for caregivers of people with dementia, was developed in an online e-learning format in the Spanish language (available at https://learning.bluece.eu/). This platform aims to offer a support service for caregivers living in remote rural areas in Spain.
Read more >See recommendation no. 3.3.5.5
Read more >See recommendation no. 3.3.4.4
Read more >See recommendation no. 3.1.6.7
Read more >
As the INDUCT project manager, most of my tasks have been ‘behind the scenes’. I have been responsible for submitting scientific deliverables, writing reports for the funder, negotiating deadlines and updating the EU Portal. A project manager functions as a middleman between the EC Project Officer, beneficiaries, partners and ESRs.
As training manager of INDUCT, I am responsible for the overall coordination and organization of the individual and network-wide training of our 15 ESRs. My main task is the organization of five INDUCT Summer and Winter Schools. Together with the local and management team, we identify needs and interests among the ESRs, compose a varied program for the week including training sessions, project meetings and social and networking events, invite academic and non-academic expert speakers, organize practical matters, and afterwards we evaluate the event, write a report, and try to incorporate all suggestions in our future training events.