The Challenge of Coming to Terms with the Use of a New Digital Assistive Device: A Case Study of Two Persons with Mild Dementia

There is an increased interest in supporting persons with dementia with technical services in daily life. The aim of this case study was to explore the complex issues involved in the process from a user driven development to the acceptance and usage of a new digital assistive device for persons with mild dementia. Even though it was developed in a user driven process and personalized to meet their individual needs they rarely used it. To deepening the understanding of this disparity between actual usage and perceived usefulness, the participants were studied whilst performing daily life activities through participant observations and interviews. Their partners were interviewed two years after the first observations to clarify the change in needs over time. The results show that the participant needs encompassed occupation, safety, social interaction, and memory support together with the receipt of general support. The overriding requirement for both participants was a need to maintain their self-image. When the digital assistive device did not correspond with the participants’ expectations or view of themselves, their interest in using it faded, since the digital assistive device failed to support their self-image. The acceptance of a digital assistive device by a person with dementia is a process that begins with identifying and personalizing the functions of the device according to individual needs, and then supporting the usage and the gradual integration of the device into daily life. During this process, the person’s self-image must be taken into consideration and supported

The Impact of Using Measurements of Electrodermal Activity in the Assessment of Problematic Behaviour in Dementia

Background: A major and complex challenge when trying to support individuals with dementia is meeting the needs of those who experience changes in behaviour and mood. Aim: To explore how a sensor measuring electrodermal activity (EDA) impacts assistant nurses’ structured assessments of problematic behaviours amongst people with dementia and their choices of care interventions. Methods: Fourteen individuals with dementia wore a sensor that measured EDA. The information from the sensor was presented to assistant nurses during structured assessments of problematic behaviours. The evaluation process included scorings with the instrument NPI-NH (Neuropsychiatric Inventory-Nursing Home version), the care interventions suggested by assistant nurses to decrease problematic behaviours, and the assistant nurses’ experiences obtained by focus group interviews. Results: The information from the sensor measuring EDA was perceived to make behavioural patterns more visual and clear, which enhanced assistant nurses’ understanding of time-related patterns of behaviours. In turn, this enhancement facilitated timely care interventions to prevent the patterns and decrease the levels of problematic behaviour. Conclusion: With the addition of information from the sensor, nursing staff could target causes and triggers in a better way, making care interventions more specific and directed towards certain times throughout the day to prevent patterns of problematic behaviours

Aktivitet: Hur kan eHälsa bidra till en personcentrerad vård av personer med demens?

Startdatum: 16/10/2012; Slutdatum: 16/10/2012; Roll: Föreläsare; Typ: Föreläsning / muntligt bidra

Aktivitet: Dubbelheten i synen på informations- och kommunikationsteknologi i vården av äldre

Startdatum: 21/09/2005; Slutdatum: 22/09/2005; Roll: Föreläsare; Typ: Föreläsning / muntligt bidra

Telecare of frail elderly : reflections and experiences among health personnel and family members

Telecare has been an approach to care that, internationally, has experienced a generally rapid development during the last ten years. There are many examples of successful pilot projects where ICT applications have been used in the care of elderly: for improved remote consultation with health professionals, to improve the communication and support of the elderly person’s social network, and as intelligent sensors intended to improve the safety of the elderly person. Despite these successes, implementation has been slow. This research project was set up to provide additional knowledge on some of the important questions regarding quality and implementation aspects of the use of ICT application on the care of frail elderly persons. The overall aim of the research project is to illuminate reasoning and experiences of using applications of telecare for frail elderly persons. The research project comprised five studies that were conducted using qualitative research methods. Four of them were carried out within the framework of three telecare projects. Different qualitative research approaches such as content analysis, phenomenological hermeneutics and conversational and discourse analysis were used, in accordance with the research questions of each study. The experiences revealed in the findings of the studies indicate that it is possible to have communication of good quality via videoconferencing with frail elderly persons, even those that have mild or mid-level dementia, provided the conditions are right. Technical limitations of the videoconferencing media in transferring communication cues and the limitations on what the camera can expose place special demands on those communicating with the frail elderly and on the general setting. On the other hand, these limitations on the context of interaction in some situations also seem to be an advantage for demented elderly persons and contribute to increased attention. One example of meaningful remote communication with frail elderly persons was family members’ videophone conversations with their demented relatives when they were placed in nursing homes or homes for respite services. This communication gave new possibilities of being involved in caring for, and of maintaining a relationship with, their demented relative. An introduction of teleconsultations in the care of frail elderly persons will, according to the experiences recorded, affect the professional role and the practical spheres of involved health professionals. The perceptions and experiences of participating health personnel indicate that in order for ICT applications to become valuable assets in the care of frail elderly persons they have to be part of a care alternative that is viewed by all concerned as the best alternative, as a whole, for all affected parties. Further research is needed in order to confirm or refute the findings of this thesis and in order to further broaden our understanding of the use of ICT applications in the care of frail elderly persons. This could facilitate a development of ICT applications suitable for the care of frail elderly persons and their introduction into regular care activities, to the benefit of both the frail elderly persons and their carers

Aging in place of persons with dementia with support of e-health services

Godkänd; 2011; 20120419 (andbra

Caring relationships in home-based nursing care : registered nurse's experiences

The caring relationship between the nurse and the person in need of nursing care has been described as a key concept in nursing and could facilitate health and healing by involving the person's genuine needs. The aim of this study was to explore registered nurses' experiences of their relationships with persons in need of home-based nursing care. Individual interviews with nurses (n=13 registered nurses and 11 district nurses) working in home-based nursing care were performed. A thematic content analysis was used to analyze the transcribed interviews and resulted in the main theme Good nursing care is built on trusting relationship and five sub-themes, Establishing the relationship in home-based nursing care, Conscious efforts maintains the relationship, Reciprocity is a requirement in the relationship, Working in different levels of relationships and Limitations and boundaries in the relationship. A trusting relationship between the nurse and the person in need of healthcare is a prerequisite for good home-based nursing care whether it is based on face-to-face encounters or remote encounters through distance-spanning technology. A trusting relationship could reduce the asymmetry of the caring relationship which could strengthen the person's position. The relationship requires conscious efforts from the nurse and a choice of level of the relationship. The trusting relationship was reciprocal and meant that the nurse had to communicate something about themself as the person needs to know who is entering the home and who is communicating through distance-spanning technology.Godkänd; 2013; 20121213 (andbra);License fulltext: CC BY-NC</p

Measuring the impact of cognitive prosthetics on the daily life of people with dementia and their carers

Assistive technologies to support persons with dementia and their carers are used increasingly often. However, little is known about the effectiveness of most assistive devices. Much technology is put on the market without having been properly tested with potential end-users. To increase the chance that an assistive device is well accepted and useful for the target group, it is important, especially in the case of disabled persons, to involve potential users in the development process and to evaluate the impact of using the device on them before implementing it in the daily care and support. When evaluating the impact, decisions have to be made regarding the selection of measuring instruments. Important considerations in the selection process are the underlying domains to be addressed by the assistive technology, the target group and the availability of standardized instruments with good psychometric properties. In this chapter the COGKNOW project is used as a case example to explain how the impact of cognitive prosthetics on the daily lives of people with dementia and their carers can be measured. In COGKNOW a cognitive prosthetic device is being developed to improve the quality of life and autonomy of persons with dementia and to help them to remember and remind, to have social contact, to perform daily activities and to enhance feelings of safety. For all these areas, potential measuring instruments are described. Besides (standardized) measuring instruments, other data collection methods are used as well, such as semi-structured interviews and observations, diaries and in situ measurement. Within the COGKNOW project a first uncontrolled small-scale impact measurement takes place during the development process of the assistive device. However, it is recommended to perform a larger randomized controlled study as soon as the final product is ready to evaluate the impact of the device on persons with dementia and carers before it is released on the market