Best Practice Guidance
Human Interaction with Technology in Dementia

Guidance

Occupational therapists must adopt telehealth practices as a supplement to in-person occupational therapy to avoid service disruption in times of crisis. This requires legislation and public promotion, clear strategies and guidelines for health service managers, and finally, training and continuous support for end-users.

Explanation and Examples

A global online needs-assessment survey among occupational therapists was undertaken to determine the impact of the COVID-19 pandemic on telehealth practices in occupational therapy worldwide and to get insight into facilitators and barriers in utilising this form of service delivery. The survey was circulated in the occupational therapy community by the World Federation of Occupational Therapists (WFOT) between April and July 2020, collecting responses to closed-ended questions, in addition to free-text comments. 2750 individual responses from 100 countries were received. The results revealed a significant increase in the use of telehealth strategies during COVID-19, with many reported benefits. Occupational therapists who used telehealth were more likely to score higher feelings of safety and positive work morale and perceived their employer’s expectations to be reasonable. Restricted access to technology, limitations of remote practice, funding issues and slow pace of change were identified as barriers for some respondents to utilising telehealth. Facilitators included availability of supportive policy, guidelines and strategies, in addition to education and training.

Guidance

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.

Explanation and examples

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.