Future bathroom: A study of user-centred design principles affecting usability, safety and satisfaction in bathrooms for people living with disabilities

Research and development work relating to assistive technology 2010-11 (Department of Health) Presented to Parliament pursuant to Section 22 of the Chronically Sick and Disabled Persons Act 197

Exploring museum-based programmes for people living with a mild-to-moderate dementia

Museum-based programmes are recognised as having the potential to engage people with dementia (PWD) in the community and to positively impact wellbeing. However, there is a recognised lack of methodological rigour limiting the quality of the evidence-base. A systematic review is presented to better understand the psychological and social impacts of museum-based programmes specific to heritage settings for people with mild-to-moderate dementia. Themes relating to psychological outcomes comprised mood and enjoyment, subjective wellbeing, quality of life, and personhood; other key themes were cognition, engagement, and social outcomes. Quantitative measures tended to yield mixed results. There was much overlap in qualitative outcomes across studies. To expand the evidence-base of meaningful activities for PWD in line with dementia care guidance, a mixed-methods study investigated the subjective wellbeing of PWD following small group object handling (OH) sessions in a museum. Building on previous research, the processes within sessions that may have promoted wellbeing were also explored. Wellbeing scores tentatively suggested an overall increase following OH sessions. Qualitative themes identified were scaffolding, exploring objects, agency, and group collaboration. Tentative interpretations are made around the dynamic interaction of themes and subthemes. The limitations of the study are considered, and clinical and research implications discussed

When technology cares for people with dementia:A critical review using neuropsychological rehabilitation as a conceptual framework

Clinicians and researchers have become increasingly interested in the potential of technology in assisting persons with dementia (PwD). However, several issues have emerged in relation to how studies have conceptualized who the main technology user is (PwD/carer), how technology is used (as compensatory, environment modification, monitoring or retraining tool), why it is used (i.e., what impairments and/or disabilities are supported) and what variables have been considered as relevant to support engagement with technology. In this review we adopted a Neuropsychological Rehabilitation perspective to analyse 253 studies reporting on technological solutions for PwD. We analysed purposes/uses, supported impairments and disabilities and how engagement was considered. Findings showed that the most frequent purposes of technology use were compensation and monitoring, supporting orientation, sequencing complex actions and memory impairments in a wide range of activities. The few studies that addressed the issue of engagement with technology considered how the ease of use, social appropriateness, level of personalization, dynamic adaptation and carers' mediation allowed technology to adapt to PWD's and carers' preferences and performance. Conceptual and methodological tools emerged as outcomes of the analytical process, representing an important contribution to understanding the role of technologies to increase PwD's wellbeing and orient future research.University of Huddersfield, under grants URF301-01 and URF506-01

The Photostroller: supporting diverse care home residents in engaging with the world

The Photostroller is a device designed for use by residents of a care home for older people. It shows a continuous slideshow of photographs retrieved from the FlickrTM image website using a set of six predefined categories modified by a tuneable degree of ‘semantic drift’. In this paper, we describe the design process that led to the Photostroller, and summarise observations made during a deployment in the care home that has lasted over two months at the time of writing. We suggest that the Photostroller balances constraint with openness, and control with drift, to provide an effective resource for the ludic engagement of a diverse group of older people with each other and the world outside their home

Using Adaptive Interaction to simplify caregiver's communication with people with dementia who cannot speak

Caregivers find it difficult to interact with people with dementia who have lost the capacity for speech. Adaptive Interaction is a simplified approach that uses the nonverbal fundamentals of communication to connect with people who can no longer speak. Here we present Adaptive Interaction as a method for equipping caregivers with these nonverbal skills to increase communication with the people they care for. Six caregivers were each paired with one individual with dementia and trained in Adaptive Interaction. After receiving training in Adaptive Interaction, caregivers identified more communicative behaviours in their interactions partners and engaged in more frequent positive social behaviours and meaningful actions during interactions. These findings suggest that it is possible to equip staff to use simplified communication based on nonverbal fundamentals to connect with people with dementia who can no longer speak.Publisher PDFPeer reviewe

A critical evaluation of the implementation process of a person-centred model of care in a new dementia specific care home

This thesis addresses the challenges associated with the implementation of models of person-centred care in newly operational care homes in an English context. This study critically evaluates a model of care produced in house, with academic support named in this thesis as EMBRACELIFE. The implementation of person-centred care in newly opened care settings is yet to be explored. Data collection took place between September and November 2015. An ethnographic approach was taken to fieldwork. Semi-structured interviews and/or unstructured observations were conducted with 20 care workers and 10 people with dementia. Document analysis was also undertaken on 6 personal care plans. A letter from the care provider completed the data set. A thematic approach to data collection was undertaken, informed by principles of discourse analysis. The finding revealed a culture of care organised around task. Overarching themes indicative of task-based practice were the care planning, activity, outdoor space, care worker perceptions, the mealtime experience, leadership and a lack of choice. The model of care was therefore not fully implemented. The research indicated the implementation process was hindered by organisational issues. These were inadequate staff training, unmet staff expectations, low staff satisfaction, a lack of a team ethos, a high agency staff presence, a lack of flexible care delivery. The newly operational status of the home had a uniquely mediating influence on these findings due to the challenge of assembling a new staff team, having a domino effect on the organisational issues described. This thesis concludes by suggesting care providers are in need of more support if they are to overcome organisational barriers, accentuated by the challenges of opening a new care home, to achieve person-centred cultures of care in such settings

Experiences with everyday technology and wellbeing in dementia

This portfolio thesis consists of three parts: a systematic literature review, an empirical paper and a set of appendices. The thesis as a whole explores the use of everyday technologies in dementia and how everyday technology is experienced by individuals living with dementia and their care partners.Part one is a systematic literature review that explores how people living with dementia and their care partners experience and view using technologies to enhance wellbeing through social engagement, participation and leisure. The review additionally aimed to understand what views and experiences people with dementia and their care partners have in relation to the usability of everyday technology. Ten papers were reviewed, and the data were synthesised from a narrative approach. The findings indicate that everyday technology has the potential to have a positive impact of different areas of wellbeing for people living with dementia. The overall findings are discussed within the context of wider literature, with consideration of areas for further research and clinical implications.Part two of the portfolio is an empirical study that aimed to understand how couples, where one person is living with dementia, experience co-creating a digital life story book together. The study aimed to understand whether co-creating a digital life book supports couples’ wellbeing and, if so, how does it support their wellbeing. Four married couples (n=8) completed the 6 week study of creating their digital life story book and participated in an interview following the 6 weeks. The research used a qualitative method, gathering data using a Constructivist Grounded Theory approach. Because full data saturation was not met, the final data were analysed using Thematic Analysis. Four superordinate and eight subordinate themes emerged from the data. The findings are discussed around the wider context of literature exploring life story work and couples’ wellbeing in dementia, with the implications for clinical practice and further research discussed.Part three consists of a set of appendices relating to both the systematic literature review and the empirical paper. Included in these appendices are a reflective statement and an epistemological statement which explores the researcher’s journey throughout the research process, and the philosophical position including the underlying assumptions of the research

Qualitatively exploring the suitability of tablet computers to encourage participation with activities by people with moderate stage dementia

INTRODUCTION: Opportunities to participate with enjoyable activities is one of the most frequently reported unmet needs by the person living with dementia. Enabling and intuitive technologies may offer accessible ways to engage with such activities. OBJECTIVES: To explore how tablet computers might encourage participation in enjoyable activities by people with moderate levels of dementia and to consider how such technologies might be incorporated into the repertoire of activities currently provided through day care settings. METHODS: A focused visual ethnographic approach was developed specifically to meet the research objectives. Twelve participants attending a community day care centre and nine supporters (both volunteers and paid staff) consented to take part in the research. Technology facilitated group activity sessions took place twice a week for a period of four weeks and all were video recorded. Findings: Video analysis demonstrated that the majority of people with dementia found the technology an effective means of participating in enjoyable activities. Analysis also revealed the extent to which participation relies on the existence of effective support. It showed how maintaining focus on retained strengths and abilities enabled the group overall to meet and often exceed their own and others perceived capacity to participate. Finally, analysis confirmed the importance of enjoyment of activities 'in the moment' and the need for those supporting people in the moderate stages of dementia to acknowledge and work with this. CONCLUSION: The use of tablet computers to enhance participation in sociable and enjoyable activities in day care settings is realistic and achievable if supported appropriately