Best Practice Guidance
Human Interaction with Technology in Dementia

themes: Community setting

3.1

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.
3.1.6
Social Health Domain 3: Technology to promote social participation
3.1.6.7

Robotic platform features and applications need to be tailored to the needs and preferences of end-users before implementing them in community-based dementia care

3.1.6.7. Photo 2 - man using an Ipad with a Mini robot

Guidance

To successfully integrate social robotic platforms in community-based dementia care, such as Meeting Centres for people with dementia and carers and daycare centres, their features and applications need to be tailored to the needs and preferences of the end-users, the dynamics of group interactions, and the Meeting Centres’ activity policies and settings.

Explanation and Examples:

Research through focus groups and interviews with stakeholders on potential facilitators and barriers in the implementation of the social robot MINI indicated that for a successful implementation of social robots in Meeting Centres and daycare centres for people with dementia, it is expected to be crucial for social robot designers and developers to consider the following recommendations to guide the design of the robotic platform:

  • Evaluate the needs and preferences of the participants of Meeting Centre. Qualitative research with end-users and care professionals is essential before and during the robot development phase. This will ensure the acceptance and usefulness of the robot in such contexts.
  • Given the preference for group activities in Meeting Centres over individual activities, it is crucial to integrate the robot into a group setting so that it can interact with multiple users. For example, a multi-player game could allow two or more individuals to interact with a social robot at the same time.
  • Avoid designing games and quiz-like activities for use on social robots to avoid, in line with the activity policy of Meeting Centres, confronting persons with dementia with their shortcomings in activities that have high cognitive and memory function demands. Instead, fun, enjoyable, and relaxing applications and games would be most appealing and beneficial.
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3.2

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.
3.2.5
Social Health Domain 2: Manage ones own life and promote independence
3.2.5.2

Ensure the appropriate methodology for evaluating social robots

Guidance

Ensure that the methodology for the evaluation of social robots for older adults with and without dementia is appropriate for the purpose of the study, to strengthen the results of the study.

Explanation and examples

Social robots are seen promising for supporting daily functioning and promoting overall social health of cognitively impaired older people, particularly those with dementia. Our scoping review into methodologies used to study the feasibility, usability, efficacy, and effectiveness of social robots for elderly adults with and without dementia showed that, despite promising results, the quality of studies remains low due to various methodological limitations. We have therefore formulated recommendations focusing on different types of studies that can help future researchers develop appropriate study designs to evaluate social robots, allowing for more reliable information on study outcomes:

  • For feasibility and usability studies an experimental design with mixed-methods of data collection (qualitative and quantitative) are recommended. Multiple interaction sessions with the social robot are recommended as they may reveal changes in feasibility and usability, when the novelty effect gradually fades and people get used to the robot.
  • Appropriate designs for efficacy and effectiveness studies are RCTs, or quasi-experimental designs when randomization is not feasible. Sample sizes should be sufficiently large, and individual interaction sessions with the social robot running for more than one month would serve best for such studies to obtain relatively robust and reliable results. Efficacy and effectiveness should only be studied in fully functioning social robots.
  • It is strongly recommended not to combine different aims in one study. The preferred designs to study the feasibility and usability of a social robot, differ significantly from the designs needed to study efficacy or effectiveness.
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3.3

Implementation of technology in dementia care: facilitators & barriers

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.
3.3.6
Social Health Domain 3: Technology to promote social participation