HDRC knowledge and learning exchange event 2019 – Assistive technology for people living with dementia: the aspirational and the achievable

The annual Housing and Dementia Research Consortium (HDRC) conference took place 23rd May, and the HDRC Coordinator Julie Barrett provides a summary of the event. Over to you Julie:

The theme of this year’s HDRC conference was assistive technology that can support daily living, social participation and leisure for people affected by dementia.

Just over 50 delegates attended and the day went smoothly, thanks to the help of the Association for Dementia Studies team. Delegates were from a mix of professions and organisations including occupational therapists, housing and care providers, adult health and social care services, NHS Trusts, Local Authorities, third sector organisations, academics and architects. The delegates seemed engaged and interested throughout and were willing to express their views and ask questions.

Delegates at the HDRC conference

The presentations

The first presentation was from Rupert Lawrence who is the Head of Worcestershire Telecare, a provider of technology enabled care services. Rupert gave a good introduction to assistive technology and how it is changing particularly in view of recent technological developments that have become part of everyday life and which have assistive functions, such as the Amazon Echo. He explained the challenges and opportunities presented by people living with dementia in terms of finding appropriate technology to support an individual and their carers and how crucial it is to have early introduction, adjust solutions as things change, have good assessment and have support network involvement. He demonstrated these aspects with two case studies. Finally, he played a video that demonstrated how sophisticated cooking safety technology had become. Worcestershire Telecare also had a stand at the event, displaying a selection of assistive technology devices that can help support people living with dementia. Worcestershire Telecare have an Assistive Technology Showcase facility at Berrington Court that people can visit to see such technology demonstrated in an extra care housing apartment.

Assitive technology items on the Worcestershire Telecare stand
The Worcestershire Telecare stand

Dr Simon Evans (Principal Research Fellow at the Association for Dementia Studies) then described the findings of the Dementia Dwelling Grant project, which showed that even simple, low cost, devices or aids can make a difference to the ease of daily living for a person with dementia. After a refreshment break, Alex Sleat from University of West England and Bristol Robotics Laboratory described their Ambient Assisted Living Studio, the Internet of Things, the connected home, and various assistive technology devices currently available and their applications. Alex also outlined the technical challenges presented by the various interconnecting devices and highlighted important considerations that should be taken into account when looking at assistive technology for an individual living with dementia. Finally, Alex described the very latest innovations in cognitive support, physical support and telepresence – the latter being rather reminiscent of Dr Sheldon Cooper’s Mobile Presence Device! Alex is currently trialling devices at ExtraCare Charitable Trust extra care housing villages.

Professor Tracey Williamson (Professor of Family Care, Association for Dementia Studies) described an undergraduate student project that she supervised in 2018 when she worked at The University of Salford. The project concerned television as meaningful occupation for people living with dementia and identifying the barriers, facilitators and design requirements for dementia-friendly television news programmes. The final presentation before lunch was by Dr Shirley Evans (Senior Research Fellow, Association for Dementia Studies) who explored technologies to support community-dwelling persons with dementia in terms of the issues regarding development, usability, cost effectiveness, implementation and ethics.

After lunch the delegates heard from an ‘end user’, Maria Attwood, who spoke about the positive impact a home monitoring system had made to the life of her family and her ability to care for her mother-in-law who is living with Alzheimer’s disease. The system has enabled her mother-in-law to live independently in her own home for longer, ensured her safety and security, given her family piece of mind and enabled Maria to focus on caring for her grandchildren while keeping an eye on her mother-in-law’s health and wellbeing. Like Rupert, Maria emphasised the importance of introducing such technology at an early stage of dementia to foster acceptance.

Panel debate

There followed a panel debate on the motion: this House believes we shouldn’t bother with costly technology when small-scale aids/adaptations can make a big difference. Simon Evans proposed the motion, Rupert Lawrence opposed, and we heard the views of a panel comprising Shirley Evans, Maria Attwood, Alex Sleat – who were against the motion – and, giving a housing provider’s perspective, Wendy Wells (The Guinness Partnership), who was on the fence.

The panel for the debate
The panel

Shirley drew attention to the speed of technological change and the need, therefore, for a centralised strategy to address this to ensure that professionals have up to date knowledge of what is available and the skills needed to optimise support for end users. The delegates were then asked for their views and several expressed the opinion that no one size fits all and assistive technology must meet the needs of the individual. Again, it was emphasised that, to improve the chances of acceptance by the person living with dementia, the technology needs to be introduced at an early stage of the dementia. There were some concerns from the delegates about costs and who will fund the assistive technology. Maria pointed out that the home monitoring system was cheaper than live-in care or a care home and, for her, the benefits far outweighed the costs. There was also concern about the need for good family support for such technology to be successful and what could be done for those that did not have such support. Rupert pointed out that there are alternatives to family support. The majority of delegates voted against the motion, a few were on the fence and one delegate voted for the motion.

Round table discussions

The conference finished with round table discussions on the theme: how do your experiences of assistive technology compare with the research and rhetoric? Each table reported to the room the key issues they discussed. These issues included:

  • Assessment for assistive technology needs to be individualised – what can we do to improve that person’s life? Is the equipment right for that person?
  • There can be privacy issue e.g. full CCTV in every room.
  • Evaluation and re-evaluation is important – we need to keep monitoring use of assistive technology as the dementia progresses and consider on-going need.
  • The information available and whether the Local Authority will provide funding for assistive technology depends on where you live (postcode lottery)
  • Reliability issue – what happens if the assistive technology goes wrong? Also, we need to be up-front about maintenance requirements.
  • The need to consider human responses and relationships and how individuals interact with the technology.
  • Pyramid of responses and support network – does it match with the pyramid of assistive technology?
  • Need to consider capacity, informed consent and previous wishes.
  • Occupational Therapists find home monitoring systems useful as assessment tools.
  • The view of commissioners and Local Authorities has an impact on cost.
  • “Digital by Design” – we keep being told that everything will be ‘all singing and dancing’ in 5 years’ time; how does Digital by Design fit in with what Local Authorities are doing and thinking about spending money?
  • We need an answer as to where the funding for this technology will come from – the HDRC is well placed to do such a study.

The first point was mentioned by a few of the tables.

Summary of the day

Some key points emerged from the conference:

  • It is important to introduce the technology at the early stages of dementia to improve the chances of acceptance by the individual concerned.
  • Technology is developing rapidly; there needs to be a centralised strategy to address this to ensure that professionals have up to date knowledge of what is available and the skills needed to optimise support for end users.
  • There is no one size fits all; assessment must be individualised to ensure that the assistive technology meets the needs of the individual and actually improves their life; the individual also need to be regularly re-assessed as the dementia progresses and their needs change.
  • There needs to be a support system in place for the technology to be successful – either the family or a response service.
  • Concerns about funding for assistive technology need to be addressed.

The conference presentations are available on the HDRC website.

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