Its not often that i find an article that I would report on my own Blog, however I came across this factsheet on the http://alzheimers.org.uk website. Dementia makes day-to-day life more difficult. Little things like mislaying keys, forgetting to turn off the taps or leaving the gas unlit can prove frustrating or even create hazards. This factsheet looks at technological developments that can help make life easier for people with dementia and their carers in certain situations. It also suggests the steps to take if you think that you, or someone you are caring for, could benefit from some of these devices.
What is assistive technology?
The term ‘assistive technology’ refers to ‘any device or system that allows an individual to perform a task that they would otherwise be unable to do, or increases the ease and safety with which the task can be performed’ (Royal Commission on Long Term Care, 1999). This includes equipment and devices to help people who have problems with:
- moving about
- getting out and about
- cognition (thought processes and understanding)
- daily living activities, such as dressing and preparing meals
Assistive technology ranges from very simple tools, such as calendar clocks and touch lamps, to high-tech solutions such as satellite navigation systems to help find someone who has gone missing.
What are the benefits?
Assistive technology can:
- promote independence and autonomy, both for the person with dementia and those around them
- help manage potential risks in and around the home
- reduce early entry into care homes and hospitals
- facilitate memory and recall
- reduce the stress on carers, improving their quality of life, and that of the person with dementia.
What technology is available?
There are many different technologies that can be adapted to the needs of someone with dementia. This factsheet mostly focuses on electronic devices but simpler equipment, such as tap turners, are also assistive technology devices.
- Reminder messages − when a person enters or leaves their home, a personal voice prompt recording can remind them to pick up their keys or lock the front door, for example. The messages can be recorded so that the voice is of someone they know, such as a family member. Messages can also be recorded to remind the person of their daily appointments, to tell them not to go out at night, or to provide reassurance, such as ‘Go back to bed, Mum − it’s night time.’ Door reminders can remind people not to trust bogus callers. This can be useful as people with dementia can be vulnerable to burglary.
- Clocks and calendars − automatic calendar clocks can be helpful for people who forget which day it is. Try to find one that shows the date and day of the week too. Clocks that show whether it is evening or morning can help prevent disorientation, particularly in the light summer evenings.
- Medication aids − Dossette boxes are simple boxes for pills, with compartments for particular days of the week and times of day. They help people remember to take their medication at the right time. Simple versions are available from the local chemist. Automatic pill dispensers are also available. When the medication needs to be taken, the dispenser beeps and a small opening allows access to the particular pill at the right time.
- Locator devices − these devices can be attached with a key ring or Velcro to items that are often mislaid. If a person wants to find a particular item, they press a colour-coded button on a radio transmitter and the device with the corresponding colour will beep until the item is picked up. (The only snag is that the transmitter itself may be mislaid, however fixing it to the wall or keeping it in a particular place should help to prevent this from happening.)
- Aids for reminiscence and leisure − multimedia software is available to evoke memories and stimulate conversation, by showing photographs or films about how life used to be, and playing music that is familiar to the person. Talking photo albums (where a message can be recorded for each photograph) can also be useful reminiscence aids.
The name ‘telecare’ refers to devices that continuously, automatically and remotely monitor real-time emergencies and lifestyle changes over time to manage the risks associated with living alone. Sensors around the home can be linked via a telephone line to a nominated person or call centre. The system monitors a person’s activities and, if a problem occurs, triggers an alarm to a relative, keyholder or call centre. Sensors can be used to detect a range of situations that could indicate a potential hazard, including:
- Floods − sensors can be fitted on skirting boards or floors in the kitchen or bathroom. If the taps have been left running and cause a flood, the system will shut off the water and raise the alarm. Specially designed plugs can also be used to prevent floods from taps that have been left running.
- Extreme temperatures − sensors will send a warning signal if the temperature is very low, very high, or if there is a rapid rise in temperature. This can be useful in the kitchen, for example to detect a pan that has boiled dry, and can also detect if the temperature in a room is low enough to pose a risk of hypothermia.
- Gas − sensors detect if someone forgets to turn the gas off, and a device will automatically shut off the gas and raise the alarm.
- Falls − sensors worn on the hip can detect the impact of a person falling.
- Absence from a bed or chair − if a person gets up and doesn’t return within a pre-set time, or if they don’t get up in the morning, a bed or chair occupancy system can raise an alarm.
- Getting up in the night − bed occupancy sensors or pressure-mat sensors placed by the bed can be used to activate an alarm when the person gets up in the night, to alert someone to help them get to the toilet. Similarly, lights with movement sensors can be fitted to switch on if a person gets out of bed or enters a room.
- Leaving the home − the system may be set up to trigger a response if the front door is opened, perhaps during specified times − for example, at night, or if a person does not return within a specified time. Door systems such as these use passive infra-red (PIR) or door contacts, and can help to reduce risk and retain the person’s independence.
AT Dementia is an organisation that provides information about telecare support and also produces a self-assessment guide that can help people identify which assistive technologies may be of use to them (see ‘Useful organisations’ section below).
Devices to enable safer walking
Tracking devices use satellite technology to help trace someone who has gone missing. A person’s location can be viewed on a computer or mobile phone. Most devices have the facility for the person carrying the device to press a panic button if they get lost. A mobile phone with location finder technology could also be considered instead of a stand-alone tracking device. When purchasing a device to enable safer walking it is important to consider how reliable it is, for example whether it works when the person is indoors, and how often the device will need charging.
Research suggests that tracking devices give both people with dementia and carers an enhanced sense of independence and help carers feel more reassured.
As with other technologies, there are ethical issues to consider if a person is unable to give their informed consent to carrying (or wearing) this sort of device. For more discussion of these issues, see Alzheimer’s Society’s position statement on Safer walking technology.
Other things to consider are what items the person should carry with them in case they get lost − for example, personal information and contact details of someone who can help them.
Devices to oversee daily activity
It is possible to install sensors to monitor a person’s activity in their own home over a period of time. This can sometimes help relatives or community services get a better idea of a person’s activity during the day and night. A system such as this can allay fears that the person with dementia is not coping well, and may help those around them to step back and not take over unless it is absolutely necessary.
Other problems associated with dementia include mobility problems, incontinence and difficulties with sight or hearing. For information about mobility aids, continence devices and pressure relief mattresses, see our factsheet on Equipment to help with disability (429).
Finding the right solution
People react differently to different products. For example, one person might find it helpful to have a recorded message that plays when they open the front door, reminding them to take their keys, while another person might find this confusing. Some people may also be wary of trying new things or find it difficult to learn new skills. Choosing the right device is therefore not always an easy task. If an assessment is carried out it must be detailed and person-centred so that the solution will suit the individual and their situation. It is also important to emphasise that assistive technology can be effective only when combined with good care.
Many devices can be bought independently, but before doing so it is advisable to contact the person’s occupational therapist or GP, or the local authority social services department. Even if they can’t offer the products, the person with dementia may be eligible for a proper assessment, help in finding the best product or financial assistance.
Alzheimer’s Society sells a range of assistive technology products through our online shop at alzheimers.org.uk/shop
- Aim to find solutions that can be integrated into the person’s normal routine with minimum disruption.
- Involve the person in decisions about which product or solution to use, and take their opinions on board.
- There is a higher chance of success if you can introduce assistive technology when the dementia is still at an early stage, so that the person can gradually get used to the new way of doing things.
- Simple ideas such as a diary or noticeboard can provide a reminder of appointments, important phone numbers and things to do.
- Deciding on a permanent place to keep important items such as keys and labelling cupboards or rooms may help the person with dementia to remember where things are.
Technologies should enhance and enable independence but they do have the potential to produce less positive outcomes. For example, if a device is misused it may replace human contact with the person with dementia, or restrict rather than enhance their freedom of movement. Some people might even find that the very presence of the equipment reminds them about their memory problems, which can cause distress.
Importantly, no one should be forced into using technology if it is not right for them. The person with dementia must be involved in the decision making and their consent sought and given, where possible.
Where this is not possible, it is vital that people making the decisions have the person’s best interests at heart. The Mental Capacity Act (2005) provides a legal framework to support decision-making in cases where a person does not have the capacity to make their own informed decisions (see factsheet 460, Mental Capacity Act 2005).
Provides a network of centres throughout the UK that aim to improve disabled and older people’s access, reliable information and advice about products, and equipment for easier living.
A web-based information resource on assistive technologies (including telecare) for people with dementia. In addition to general information the website contains a database of products that may be appropriate for people with dementia.
Disabled Living Foundation
Charity that provides information about finding simple solutions, such as mobility aids.
Foundation for Assistive Technology (FAST)
Charity that works with the assistive technology community to get well-designed, useful inventions on to the market faster. Provides an online database of assistive technology research, events and contacts.
US-based website with extensive advice on home safety and technology used to support people living with dementia at home.
Royal Commission on Long Term Care (1999) With respect to old age: long term care − rights and responsibilities. London: The Stationery Office.
Last reviewed: August 2011
Next review due: August 2013
Reviewed by: Professor Gail Mountain, Professor of Health Services Research, University of Sheffield, Sheffield and Mr Stephen Wey, Senior Lecturer, York St John University, York.
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