Impact of assistive technologies in supporting people with dementia.

Abstract

In recent decades, many Assistive Technologies (ATs) have been developed to promote independence among people with dementia (PWD). Although there is a high rate of AT abandonment, only a handful of studies have focused on AT usability evaluation from the user point of view. The aim of this thesis is to empirically investigate the usability of ATs from the PWD and to measure its impacts on their lives. Following the Multi-methods research approach, the first part of the thesis uses secondary research methods including literature review and systematic mapping studies. The second part uses primary research methods including interviews (N=20) and questionnaire (N=327) based surveys for data collection and requirements elicitation. The third part is based on the design, development, and testing of an assistive software application through case studies (N=8). The first mapping study categorised existing general ATs into five major categories: robotics, monitoring, reminders, communication, and software. The second mapping study categorised software-based ATs into nine categories: cognitive help, reminders, health/activity monitoring, socialization, leisure, travel help, dementia detection, dementia prevention, and rehabilitation. The qualitative results showed that most of the PWD use ATs for socialization, and highlighted user interface efficacy, tailoring individual needs, and simplified functions as the major limitations of existing ATs. The quantitative results identified eleven factors for ATs usage: operational support, physical support, psychological support, social support, cultural match, reduced external help, affordability, travel help, compatibility, effectiveness, and retention. The statistical analysis showed that improved (social, psychological and travel) support and reduced need of external help for operating ATs, greatly impact AT effectiveness and retention. Based on PWD requirements, an assistive software application named E-Community for Dementia (ECD) was developed and tested through case studies involving 8 PWD and 40 volunteers. The participants were able to get their daily needed items in less time and with a friendlier manner through the help of their neighbours. The involvement of the caregivers for medication, meals, prayers etc. reduced significantly. The painting function helped evoke their memories, and encouraged them to perform activities from their youth. The news and weather functions kept them updated about the world around them. The travel tutor guided them in safe travel outside home and made sure that they got back home independently. The enhanced interaction between the PWD and their neighbours significantly reduced their social isolation. The results support the idea to create dementia-friendly communities at street levels, which is a cost-effective and reliable solution. The major outcomes from this thesis are AT categorization, evaluation of user experiences, factor identification and ranking, user requirements elicitation, assistive software application development, and case studies. This thesis helps considerably towards empirical investigation of the impact of ATs in supporting the PWD. The implementation of the ECD contributes towards the wellbeing of the PWD and saves costs spent on caregivers and carer companies. In future, the same study could be conducted in other settings to analyse the role of culture in AT acceptance.