Best Practice Guidance
Human Interaction with Technology in Dementia

Guidance

Technology developers and researchers should be aware of the different contextual factors that can affect the translation of research on social robots to real-world use.

Explanation and examples

Barriers and facilitators affecting the implementation of social robots can occur at different levels. For example, they relate to the social robots’ features, or relate to organisational factors or external policies. A scoping review was conducted to understand the barriers and facilitators to the implementation of social robots for older adults and people living with dementia. 53 studies were included in this review. Most existing studies have disproportionately focused on understanding barriers and facilitators relating to the social robots, such as their ease of use. However, there is significantly less research that has been conducted to understand organisational factors or wider contextual factors that can affect their implementation in real-world practice. Future research should pay more attention to investigating the contextual factors, using an implementation framework, to identify barriers and facilitators on different levels to guide the further implementation of social robots.

Guidance

Residents with dementia and their family members should be involved when planning to introduce pet robots in long-term care settings and when using pet robots.

Explanation and examples

In a consensus-building exercise involving 56 international experts (care professionals, organisational leaders and researchers), experts established the importance of including residents with dementia and their family in the implementation of pet robots in long-term care facilities. When planning to adopt pet robots in long-term care facilities, the opinions of residents with dementia and their family members must be sought. Examples include

• Seeking their opinions on which pet robot to purchase by showing them different pet robots, and asking or observing their reactions to each robot
• Seeking feedback on their preferred ways of using robots, such as whether they prefer the robots to be individualised or shared with other residents.

When using pet robots, residents with dementia and their family members must be supported to be actively involved. For example:

• Residents may be involved in “taking care” of robots.
• Family members could provide support or use the robots as topics of conversations during visits.

Guidance

Before introducing pet robots in a long-term care facility, consensus discussions among stakeholders, such as care professionals and managers, should be conducted, to discuss whether (and why) pet robots should or should not be introduced for residents with dementia. In addition, the facility’s readiness to introduce pet robots should be carefully considered.

Explanation and examples

In a modified Delphi study involving 56 international experts (care professionals, organisational leaders and researchers), experts agreed that these strategies are critical to support the implementation of pet robots in long-term care facilities. Consensus discussions should involve all care providers who may be directly or indirectly involved in the care of residents with dementia. Examples of discussions may include:

• The importance of bringing in/using pet robots to address a chosen problem (e.g. to address residents’ needs or support care staff in their delivery of care for residents with dementia)
• Appropriateness of using pet robots to address the problem(s), such as whether they align with workflows.

In addition, the organisation’s readiness to implement pet robots should also be assessed. Examples include:

• Assessment of financial resources
• Assessment of manpower and logistical resources (e.g. sufficient space and charging point).

Guidance

Care staff should be educated about the use of pet robots in dementia care through educational meetings that are tailored to the needs of different staff. In addition, they should be provided with ongoing trainings to support them in applying this knowledge as part of their delivery of dementia care.

Explanation and examples

In a modified Delphi study involving 56 international experts (care professionals, organisational leaders and researchers), educational meetings and ongoing trainings are identified as critical strategies to support the implementation of pet robots in long-term care facilities. The purpose of conducting educational meetings is to provide care staff with overall knowledge on the role of pet robots for dementia care. Such sessions should be tailored to the different needs of each care professional. Examples of content may include:

• Evidence supporting the use of pet robots in dementia care, such as information about their impacts on residents, who may benefit and who may be at risk of distress
• How pet robots can support caregiving

While the purpose of education is to provide overall knowledge about pet robots, the purpose of conducting ongoing training is to support care professionals to acquire practical skills and confidence to use pet robots in dementia care giving. Examples include:

• On-the-job training
• Structured supervision
• Training based on each staff experiences/knowledge.

Guidance

The cost of pet robots can prohibit their uptake in long-term care facilities for dementia care. There may also be additional costs involved in implementing pet robots, such as manpower and time related costs. Different funding sources need to be considered to acquire sufficient funding to support the implementation effort.

Explanation and examples

In a qualitative study involving 22 care providers from nursing homes, the cost of purchasing pet robots have been reported as a concern. Some care providers reported the use of charity funds to support the purchase of pet robots. In a modified Delphi study, experts (care professionals, organisational leaders and researchers) established that it is necessary to creatively seek and acquire funding to support the implementation of pet robots in long-term care facilities. Examples of potential funding sources may include:

• Existing funding resources
• Raising private funds (such as donations or charity)
• Shifting or (re)prioritising the use of funds within the organisation based on their impact on people with dementia

The funds may be used to support different aspects of implementation. Examples include:

• Fund the introduction and adoption of pet robots
• Support other time limited actions needed for initial implementation, such as purchasing cleaning materials
• Training (e.g. developing educational materials)