Best Practice Guidance
Human Interaction with Technology in Dementia

Guidance

Technology developers should be aware that the challenge of using everyday information communication technologies can be high for older adults, including some people with dementia. They should use inclusive design that addresses cognitive useability to reduce the level of challenge so that more people with cognitive impairments can use ICTs.

Explanation and Examples

A standardized questionnaire investigated how 35 people living with dementia and 34 people with no known cognitive impairment in Sweden perceived their ability to use 90 ETs on a 5 step rating scale. This data was analysed (in a Rasch model) to produce a challenge measure for each of the 31 EICTs, showing how difficult or easy they were to use. Landline telephone was the easiest EICT to use. Scores for smartphone functions (make calls, receive calls, alarm, camera) were at the easier end of the challenge hierarchy and comparable to (or lower than) the challenge of the same functions on a push button mobile phone. These smartphone functions were less relevant to the group of people with dementia than the group without. Using a computer for the full range of functions (shopping, banking, email etc.) scored in the top half of the challenge of the hierarchy and using a tablet to search the web was most difficult. No other tablet functions (i.e. banking, email) could be scored since not enough people considered those functions relevant. Several smartphone functions (i.e. game, social media, transaction) could not be scored for the same reason

Guidance

People with dementia are active on social media platforms. For this reason, researchers recruiting participants for their studies on the development, testing or evaluation of psychosocial technological interventions should consider advertising the study details on different social media platforms.

Explanation and Examples:

Devices using information and communication technology (ICT) are increasingly being used by older people, including people with dementia. We conducted an online survey with 143 people with dementia to explore if and how they use social media. Results from the survey revealed that more than half of the participants actively use social media. More people with young-onset dementia were active on social media, though a large proportion of people with dementia who were 65 years and older were actively using social media too. In addition, a large proportion of the participants themselves were recruited through Twitter and Facebook. Our results suggest that people with dementia can be reached through social media, which is of relevance for researchers looking to recruit participants for the development, testing or evaluation of psychosocial technological interventions.

Guidance

Consider involving occupational therapists in providing interventions that enable people with dementia to use the everyday information and communication technologies they have.

Explanation and Examples

A standardized questionnaire mapped how many Everyday Information & Communication Technologies (EICT) (maximum 31) were relevant to 35 people living with dementia and 34 people with no known cognitive impairment in Sweden. A relevant EICT is one that is being used, or has been used in the past, or is planned for use in future. The median amount of relevant EICTs was shown to be 11 in the group without dementia, and 7 (significantly less) in the group with dementia. Each person also rated their ability to use (maximum 90) relevant Everyday Technologies (ETs) on a 5 step rating scale. This data was analysed (in a Rasch model) to produce a score for each person’s ability to use ET. When we compared ability to use ET with amount of relevant ETs in each group, the more EICTs a person counts as relevant, the higher was their ability to use ET. This pattern was only found in the group of people with dementia, and not the group without. The amount of relevant EICTs is affected by a person’s ability to use them. So some people may need support to identify the usefulness and possibility to use an EICT function that they have access to.

Guidance

To avoid excluding some people with dementia, service developers should provide alternative non-ICT options when they deliver services and interventions that rely on smartphones, tablets and computers.

Explanation and Examples

A standardized questionnaire mapped how many Everyday Information & Communication Technologies (EICTs) (maximum 31) were relevant to 35 people living with dementia and 34 people with no known cognitive impairment in Sweden. In the same questionnaire, each person also rated their perceived their ability to use (maximum 90) relevant ETs on a 5 step rating scale. A relevant EICT is one that is being used, or has been used in the past, or is planned for use in future. This data was analysed (in a Rasch model) to produce a score for each person’s ability to use ET, and a challenge measure for each of the 31 EICTs to show how difficult or easy they were to use compared to each other. EICTs on smartphones and tablets were not relevant for a high proportion of both groups. Combined with a lower ability to use ET, particularly for people in the group with dementia, and high challenge measures for computer and automated telephone service functions, this could mean some people cannot access EICT-based services and interventions on computerized devices. However, the landline telephone was easiest to use and relevant to the majority of both groups, so this, together with face-to-face options could provide viable alternatives.

The study is currently under review and will be available under open access.

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

Social media have the potential to be an additional supportive medium for people with dementia. It is recommended to signpost individuals with dementia to social media platforms to leverage their potential.

Explanation and Examples:

We conducted an online survey with 143 people with dementia to explore how they used social media platforms and what kind of information they shared on their accounts. Our findings show that people with dementia use various different social media platforms like Facebook or Twitter to raise awareness, give and receive support, and to share their experiences of living with dementia. As subsequent older generations will use technology more and, consequently, will become more tech-savvy, social media platforms will become more relevant for this population. As post-diagnostic support is often lacking, social media platforms can be used as medium that is widely available and easily accessible to offer people with dementia additional (peer) support. Examples of these platforms include online forums like Talking Point by the Alzheimer’s Society UK, Facebook groups run by charities or dementia organisations, or Twitter where many people with dementia are active. Signposting people with dementia to these social media platforms is therefore recommended.

Guidance

See recommendation no. 3.3.5.5