Best Practice Guidance
Human Interaction with Technology in Dementia

target groups: Dementia-friendly communities

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

Take a multi-perspective approach when procuring public space technologies to improve usability internationally

Guidance

When selecting technologies for use in public spaces, procurers should involve occupational therapists and designers with expertise in dementia, and people living with dementia.  Public space technologies should:

  1. have the most cognitively enabling and inclusive design features (i.e. minimal steps and memory demands),
  2. be sited in the most supportive physical location (i.e. secure vestibule, busy thoroughfare) and
  3. identify and account for wider sociocultural preferences (i.e. continued face-to-face services).

Explanation and Examples

Life outside home in most countries increasingly demands the use of everyday technologies (ETs i.e. transport ticket and parking machines, ATMs, airline self-check in machines, fuel pumps). However, ETs can present challenges, particularly for people with dementia, and differences in design and location may mean some ETs are easier to use than others.

To investigate variation in the challenge of ETs; the Everyday Technology Use Questionnaire was administered with 315 people with and without dementia (73 in Sweden, 114 in the USA, 128 in England) in a cross-sectional, quantitative study. Modern statistical analysis found 5/16 public space ETs differed in challenge level between countries (specifically: ATM, airline self-check-in, bag drop, automatic ticket gates, fuel pump).

These differences result from variation in design features or siting of technologies. However, they may also be due to differing habits between users in different countries (i.e. necessity and frequency of use, preference for particular modes of transport, concerns about security, embarrassment) or varying progress towards technologised rather than face-to-face services (i.e. towards cashlessness).

Taking account of inter-country differences could lead to selecting the most useable technologies and services. This could improve inclusiveness of public space internationally for older adults with and without dementia.

Read more >

Cashback is a replacement banking service rurally and local retailers must be aware of legal obligations to accept chip and signature cards

Guidance

Due to UK bank and post office closures, local shops have a more central role in ensuring that older adults have continued, secure access to cash via face-to-face services offering card payments and cashback. Staff, managers and proprietors need to be aware of legal obligations to accept customers’ chip and signature cards, which support some people with dementia to access their finances. Other countries may need to make legal provisions to ensure financial services and retailers do not discriminate against people with disabilities regarding payment methods and access to cash.

Explanation and Examples

Cash can be a preferred option among people of all ages – including some older adults with dementia – who prefer to retain visual control over their spend. Bank and post office closures have occurred across the UK, affecting particularly people in rural areas, who may now face increased travel distances to reach a branch.

Technologies (ATMs and chip and PIN devices) are therefore becoming less avoidable in the process of accessing cash, however, can present problems for people living with dementia. A case study of 13 rurally dwelling older adults in the UK with mild dementia gathered data from in home interviews involving two structured questionnaires, observations, maps, and subsequent relevant document collation (i.e. public transport timetables, local news reports).

The importance of local grocery shops and supermarkets in providing a trusted, face-to-face option for accessing cash was highlighted, particularly among cases who lived alone. Subsequent document analysis found some retailers were unaware of legal obligations to accept chip and signature cards leading to occasional refusals.

Raising retailer awareness of the importance of card payment options rurally, and obligations to accept signature cards, could support people living with dementia to continue independently accessing their finances locally.

Read more >

Private surveillance car parking companies must not discriminate against drivers with dementia and must ensure useability by giving control and feedback to users

Guidance

Private car parking companies that use vehicle number plate recognition and surveillance technologies must make accessible provisions that account for memory difficulties common among drivers with mild dementia. Parking facilities must allow users control and provide feedback about time of arrival. Contractors of these companies must ensure the systems they agree to are useable for their customers living with dementia.

Explanation and Examples

Driving remains essential for daily life in rural parts of the UK where public transport infrastructure is sparse. Driving also means handling continually evolving technologies: parking ticket machines (cash, cashless, SMS/app, number plate inputting), automated barriers, fuel pumps, parking surveillance systems.

These technologies may increase the complexity of parking and driving, particularly for people living with dementia’, and could impact some people’s ability to complete everyday activities. A case study of 13 rurally dwelling older adults with mild dementia gathered data from in-home interviews involving two structured questionnaires, observations, maps, and subsequent relevant document collation (i.e. public transport timetables, local news reports).

Driving was highlighted as centrally important to daily life, particularly for cases living alone. Carparks which used number plate surveillance on entry and exit were highlighted by one case as particularly problematic. These types of parking technologies offer drivers no feedback about time of arrival, nor any method by which drivers can control their own actions in relation to rules and restrictions leading to unfair discrimination.

Short term memory difficulties common among people with mild dementia increase their risk of being unfairly penalised by these systems, leading to curtailed or abandoned activities, or handling complex administration of fines.

Read more >