Best Practice Guidance
Human Interaction with Technology in Dementia

themes: eHealth

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.
Technology for meaningful activities

Take actions to alleviate carers’ involvement in eHealth research

Guidance

Effectiveness research into eHealth interventions for community dwelling persons with dementia, often rely on information from and involvement of family carers. As they may already be (over)burdened by their caregiver tasks, participation in effectiveness research may be denied. It will be helpful to think of methods to support informal carers to participate in research.

Explanation and example

In the exergaming project, a bottleneck of participation of couples into the effectiveness study, was the refusal of family carers to participate because they were already (over)burdened. To accommodate caregivers they were offered support in filling out questionnaires and a little present to thank them for their contribution. This seems to have added slightly in the number of participants in our study. Other strategies to alleviate burden of participation in eHealth research may also be considered, like data logging or ecological momentary assessments.

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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.

Explore and consult with the eHealth context to facilitate implementation of eHealth interventions

Guidance

To develop an eHealth intervention for caregivers of people with dementia that will be used in practice, developers should investigate the needs of the target population (people with dementia and their caregivers), and the needs of the people who will be implementing these interventions after a trial phase (such as case managers, hospital workers, volunteers or professionals associated with advocacy groups).

Explanation and examples

A systematic search was conducted into the implementation of studies including the terms ‘dementia’, ‘eHealth’, and ‘caregivers’. 2524 abstracts and 122 full texts were read, resulting in 46 studies meeting all criteria. Containing 204 statements on implementation. Most implementation statements could be grouped into 2 main themes: ‘Determinants associated with the eHealth intervention’ and ‘Determinants associated with the caregiver’. Very few statements were in the themes ‘Determinants associated with the implementing organization’ and ‘Determinants associated with the wider context’. Absence of knowledge on the contextual environment creates significant difficulties for health system planners and implementers who aim to translate these interventions into practice.

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Start making eHealth financing and business plans at the start of the development phase

Guidance

To ensure that the eHealth interventions for caregivers of people with dementia will continue to be available, supported, updated and compatible with changing software and hardware requirements, financing and business plans should be developed from the beginning.

Explanation and examples

A mixed-methods study followed up on the 12 publications included in Boots et al.’s (2014) widely cited systematic review on eHealth interventions for informal caregivers of people with dementia, to explore implementation into practice. Publicly available online information, implementation readiness (ImpRess checklist scores), and survey responses were assessed. The majority of survey respondents identified commercialization and having a business plan as facilitators to implementation. There was little evidence for any of the 12 applications being put into practice.

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