Best Practice Guidance
Human Interaction with Technology in Dementia

target groups: Government

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

Addressing stigma through online and offline service options


Service providers should counter the stigmatising effect of not having access to, or not being a skilled user of, Everyday Technologies, for people with dementia and consider strategies to enhance participation, providing offline and online choices for all public services.

Explanation and Examples

Interviews were performed with 128 older people with and without dementia in the UK, and 69 people with and without dementia in Sweden. In both the UK and Swedish studies, people with dementia reported significantly lower use of Everyday Technologies compared to older people without dementia. People with dementia also reported significantly lower participation in places and activities within public space. Reduced ability to use Everyday Technologies was linked to reduced participation in places visited and activities within public space for people with dementia. Community-based consultations with older people with and without dementia across London showed that Everyday Technologies can provide opportunities to participate in services, e.g. eHealth and online banking. However, without face-to-face or written options (e.g. offline), people with dementia are at risk of stigma associated with digital exclusion. Barriers to participation in their everyday lives can lead to social isolation.

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


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.

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Evaluating the effectiveness of specific contemporary technology

The rapid growth of the technological landscape and related new services have the potential to improve the effectiveness and cost-effectiveness of health and social services and facilitate social participation and engagement in activities. But which technology is effective and how is this evaluated best? This section provides recommendations to evaluate the effectiveness of technology in daily life, meaningful activities and healthcare services as well as of technologies aimed to promote the Social Health of people with dementia. Examples of useful technologies in some of these areas are provided.
Social Health Domain 2: Manage ones own life and promote independence

Technologies designed to improve social health in people with dementia should be evaluated in high quality studies to effectively support decision-making


More high quality, ecologically valid, controlled studies must be planned, funded and executed in order to properly evaluate the effectiveness of technologies designed to be used by people with dementia and to improve social participation and self-management.

Explanation and examples

A systematic review found that in the whole world only nine controlled evaluation studies with technologies designed for people with dementia have been carried out in ecologically valid settings, to assess effectiveness in improving social participation and self-management. Controlled studies are the most effective way of conducting unbiased evaluations, from which causal inference can be drawn. Policy-makers should be demanding this level of evidence as a condition of investment in such technologies. So far, studies have been conducted with VR-based technologies, other wearable technologies, and software applications. However, only a single study was found to be of good quality. Other technologies for people with dementia have not yet been the subject of a single ecologically-valid, controlled study with these outcomes (this includes, for example, social robots). In order to conduct high quality studies, researchers must ensure that studies are adequately statistically powered based on a sufficiently large sample; include active technology-based control interventions, so that is controlled for attention; and conduct and report intention-to-treat analyses, taking into account data of all participant to the study, including dropouts, and not only those who completed the intervention. Funding bodies must recognize the need to fund such studies accordingly. Clinicians, healthcare providers, policymakers and users of technology should expect and demand that such high-quality evidence is available to support decision-making.

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Social Health Domain 3: Technology to promote social participation