Using assistive technology to support therapeutic interventions with people with dementia: Findings from the Dem@Care intervention studies in Ireland.

摘要

Background: With expected increases in dementia prevalence figures as our population ages, there is a great need to find acceptable, efficient, and cost-effective solutions that enable people with dementia to live well at home and to remain integrated with their communities for longer. Technology-based approaches have been suggested as a potential means of meeting these needs, but attitudes to, and lack of familiarity with technology can reduce their effectiveness in the home environment without sufficient support. The “Dementia Ambient Care” (Dem@Care) project piloted a psychosocial intervention to reduce excess disability and increase subjective quality of life while introducing assistive technologies with direct therapist support. ududMethods: Five participants (3 female, mean age 77) living at home with early to moderate stage dementia took part. Four therapists delivered the intervention; each participant had one therapist working with them. Prominent every-day difficulties were first identified, and then the therapist, person with dementia, and caregiver set therapeutic goals relating to these difficulties, and selected strategies and appropriate Dem@Care sensors to address these goals. Each participant subsequently took part in 12-14 therapeutic sessions at home (90-120 minutes each). A rolling consent process was used throughout. Periodic multidisciplinary meetings were also held to facilitate therapist interaction and feedback.ududResults: In all cases the intervention had a positive impact and all participants felt they achieved their primary goals. Therapists found it difficult at times to introduce technology and to successfully integrate it into goal strategies, in part due to the nature of some of the participant’s goals (e.g. managing feelings of anxiety), but also due to the nature of the cognitive impairments experienced by the participant. High levels of learning support were required, even with those familiar with technology.ududConclusions: While appreciating the potential of technology to support psychosocial interventions and to provide a basis for ongoing remote management and support of dementia, many primary goals were unsuited to a technology-based solution and the importance of human interaction remained evident. We demonstrate that technology should not aim to replace this interaction; rather it should be added to therapeutic work in a meaningful way.ud