Assistive Technologies used by people with dementia and their carers for the performance of Activities of Daily Living at home and in care homes

摘要

Activities of Daily Living (ADLs) are the basic activities that every adult must perform each day to be considered independent: washing and bathing; grooming and dressing; toileting and continence; and feeding and eating. As people with dementia develop cognitive and physical impairments and functional limitations, their performance of ADLs may be affected. This may necessitate human and technological assistance. The use of Assistive Technologies (ATs) is promoted in policies as enabling people with dementia to live well in their own homes.The study aim was to investigate informal (family) carers’ and formal (paid) carers’ perceptions of whether ATs could be used to assist people with dementia to conduct ADLs; and if so, how. This included an exploration of family members’ perceptions concerning the contributory role that ATs for ADLs may play in a relocation decision. A mixed-methods study was designed. First, quantitative analyses were conducted on a large, nationally representative dataset. Then, qualitative case studies were created, using care record and interview data.Key findings of the study demonstrated that carers perceived the use of ATs for ADLs to supplement, but not substitute, human assistance. Device-use was limited by people with dementia when they lived at home, with the exception of mobility-related ATs. Potential use of other ATs was generally unsuccessful; people with dementia lacked insight into their need for human and technological assistance, and could not learn to use new devices. Decisions concerning relocation were triggered by a fall or by the person with dementia becoming lost when outside alone. While mobility-related technologies were perceived to have made life safer for the person with dementia, they had little influence on the decision to enter a care home. Nevertheless, device use was perceived to contribute to quality dementia care in communities and care homes. The key findings have practical implications for policy-makers, social care providers, and AT companies.