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P19. INTERDEM: Symposium on implementations of technologies to support people living with dementia and carers

Detailed programme, abstracts and presentations

Although research into technology based interventions in dementia care is increasing and results are promising, the use in daily dementia care is lagging behind. In this symposium we will focus on key issues that may promote implementation of assistive technologies.

P19.1. The importance of organizational and contextual determinants in the implementation of eHealth interventions for caregivers of people with dementia

CHRISTIE Hannah, BARTELS Sara, BOOTS Lizzy, TANGE Huibert, VERHEY Frans, de VUGT Marjolein

Maastricht University, Maastricht, Netherlands

Objectives:Despite a wealth of efficacy research proving eHealth interventions for caregivers of people with dementia to be effective in improving a range of psychological outcomes in caregivers (such as the reduction of caregiver depression, anxiety, stress and burden, and increasing positive aspects of caregiving, caregiver self-efficacy, and confidence), little is known about how to ensure that these interventions are successfully implemented (i.e. put into practice). The objectives of this systematic review were to (1) identify the literature on the implementation of eHealth interventions for informal caregivers of people with dementia, and (2) map the determinants of the successful implementation of these interventions.

Methods:Online databases were searched for articles about eHealth interventions for informal caregivers of people with dementia, providing information on their implementation. Articles were independently screened and inductively analyzed using qualitative analysis. The analysis was mapped onto the Consolidated Framework for Implementation Research (CFIR; Damschroder et al., 2009).

Findings:46 articles containing 204 statements on implementation were included. The statements on implementation were grouped into four categories: Determinants associated with the eHealth application, informal caregiver, implementing organization, or wider context. Mapping of the determinants on the CFIR revealed that studies have focused mostly on characteristics of the intervention and informal caregiver. Limited attention has been paid to organizational determinants and the wider context.

Conclusions:Despite prolific effectiveness and efficacy research on eHealth interventions for caregivers of people with dementia, there is a critical dearth of implementation research. Furthermore, there is a mismatch between eHealth intervention research and implementation frameworks, especially concerning organizational factors and wider context. Without this knowledge, these interventions will be hard-pressed to convince stakeholders and decision makers of their practical use, and thus allow these innovative and exciting interventions to make a difference in the lives of the caregivers who should benefit from them.

P19.2. Implementation Issues: how can people use technology in daily practice

WALLCOOK Sarah1, MALINOWSKY Camilla1, KOTTORP Anders1,2, NYGÅRD Louise1

1Karolinska Institutet, Huddinge, Sweden, 2Malmö University, Malmö, Sweden

Background: Increasingly everyday information communication technologies (EICTs) are suggested as suitable devices to mediate a range of services and health interventions including for people with dementia. However, there is little foundational knowledge about how older adults living with and without dementia perceive both the relevance of EICT devices and their functions, and their abilities to use them.

Aim: To map the perceived relevance and use of EICT devices (i.e. smartphone) and functions (i.e. internet searching) between a group of older adults living with dementia and a control group with no known cognitive impairment (controls).

Method: One-to-one, in-home interviews were carried out using the standardised Everyday Technology Use Questionnaire. Two groups of people from Sweden took part; 35 people with dementia and 34 controls. Variables were compared using descriptive statistics and t-testing with the significance set to p<0.05.

Results: Of a maximum 31 EICT device functions, the group of people with dementia reported that significantly fewer were relevant to them (median 7) than the control group (median 11) (Mann-Whitney U Test, p<0.05). Furthermore, the group of people with dementia used less EICT device functions (median 5, controls median 10.5; p<0.001).

Conclusion: Services and interventions could build upon the implications of this study to account for the relevance and use of EICT devices and functions as perceived by older adults including those living with dementia. This may better contribute towards a more inclusive society where older people are supported in daily life by the most enabling aspects of our technological landscape.

P19.3. From Research to Clinical Practice in technologies for people with dementia

FRANCO-MARTIN Manuel1, van der ROEST Henriette2, IRAZOKI Eider3, MATEOS Raimundo4

1Universitary Rio Hortega Hospital and Zamora Hospital, University of Salamanca, Salamanca, Spain, 2VU University Medical Centre, Amsterdam, Netherlands, 3Intras Foundation, Zamora, Spain, 4Santiago de Compostela University, Santiago de Compostela, Spain

Background: Many projects, papers and research have been dedicated on technologies developed for people with dementia with the aim to allay the symptomatology and improve the functioning of people with dementia and their carers. However, not all evaluated technology reaches people with dementia, mainly because many technologies are abandoned due to lack of evidence of efficacy, or were not marketed after having been developed due to a lack of a business plan.

Up to now, there is no systematic review of studies that focuses on the use of technologies in clinical settings that provide insight into the transference of new developed technology from research to clinical settings and community care.

Objectives: The primary objective of this study is to inventory which technological applications for psychosocial approaches in dementia that have been scientifically evaluated, are currently being used in clinical practice and community care. The research question is: Are the technologies developed for psychosocial approaches in dementia used in clinical or community settings?

Method: First, a systematic search of relevant databases (PubMED, PsycINFO, Cochrane), including grey literature and database projects of the European Commission was conducted, adapting the search strategy according to the database. Two authors independently screened all titles and abstracts of studies for meeting the inclusion criteria. Eligibility criteria are:

  1. Studies using new technological solutions for people with dementia used for psychosocial approaches after 2010.
  2. Studies done in clinical or community settings.

After identifying new technological developments for people of dementia, we have searched them on the internet using Google in order to identify their marketing and accessibility for being obtained. The results were screened by two independent researchers for feasibility.  Evidence based technological applications used in practice were categorised according to their aim, availability (country, language), type of use (clinical use or daily practice), price, and evidence.

Results: This review gives an overview of technological applications that have been developed in the last 8 years and have scientific evidence that are in use in daily practice. Most of them (over 50%) are not accessible to people with dementia. There are three main reasons of them: lack of business plan for marketing; difficulties for updating the new technologies; and abandon of the research. There are many parallel researches but difficulties for maintaining the research lines and going on with the new developments after 5 years.  

Conclusions: There are many technological developments well-proved in research. However, few of them reach to people with dementia. It´s necessary to develop new strategies for making sustainable and promote new advances of them.

P19.4. INTERDEM Taskforce Assistive Technology: follow-up on the position paper on assistive technologies

MEILAND Franka1, FRANCO Manuel2

1VU University Medical Centre Amsterdam, APH Research Institute, Amsterdam, Netherlands, 2Universitary Rio Hortega Hospital and Zamora Hospital, University of Salamanca, Salamanca, Spain

Background: In 2017, a position paper was published by the INTERDEM Taskforce on Assistive Technology, discussing issues regarding development, usability, (cost-) effectiveness, deployment and ethics (Meiland et al., 2017). Based on literature reviews and expert knowledge it was concluded that in all areas there were promising developments, but that challenges remained. One of these challenges was to improve large-scale deployment of technologies in dementia care and it was advised to have better knowledge about existing technologies and its usage, and to collaborate in preparing strategies for the implementation of assistive technologies in different care settings.

Method: Based on the results of the position paper, a next paper will be drafted on existing assistive technologies for people with dementia. This will be defined as ‘any item, piece of equipment, product or system driven by electronics, whether acquired commercially, off-the-shelf, modified or customized, that is used to help persons with dementia in dealing with the consequences of dementia’ (based on Marshall, 1997). A survey will be developed that will be distributed among INTERDEM members, who can forward this to relevant stakeholders in their country. At this presentation, the survey will be presented and discussed.

Results: The survey will include topics on various categories of technologies, various settings (a.o. at home, outside the home, at day care centres), known effects (studies), costs and implementation strategies.

Conclusion: Providing an overview of successful assistive technologies for community dwelling people with dementia and carers, and in the strategies that were used in implementing them in various European countries may inspire stakeholders to speed up implementation. This may help next generations of people with dementia to more easily use appropriate technologies and to benefit from them. 

 

 
 

Last Updated: Tuesday 13 November 2018

 

 
  • Acknowledgements

    The 28th AE Conference in Barcelona received funding under an operating grant from the European Union’s Health Programme (2014-2020). Alzheimer Europe, CEAFA and Fundación Alzheimer España gratefully acknowledge the support of all conference sponsors.
  • European Union
  • Roche
 
 

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