Abstract
BackgroundAs life expectancy grows, so do the challenges of caring for an aging population. Older adults, including people with dementia, want to live independently and feel in control of their lives for as long as possible. Assistive technologies powered by artificial intelligence and internet of things devices are being proposed to provide living environments that support the users’ safety, psychological, and medical needs through remote monitoring and interventions.ObjectiveThis study investigates the functional, psychosocial, and environmental needs of people living with dementia, their caregivers, clinicians, and health and social care service providers toward the design and implementation of smart home systems.MethodsWe used an iterative user-centered design approach comprising 9 substudies. First, semistructured interviews (9 people with dementia, 9 caregivers, and 10 academic and clinical staff) and workshops (35 pairs of people with dementia and caregivers, and 12 health and social care clinicians) were conducted to define the needs of people with dementia, home caregivers, and professional stakeholders in both daily activities and technology-specific interactions. Then, the spectrum of needs identified was represented via patient–caregiver personas and discussed with stakeholders in a workshop (14 occupational therapists; 4 National Health Service pathway directors; and 6 researchers in occupational therapy, neuropsychiatry, and engineering) and 2 focus groups with managers of health care services (n=8), eliciting opportunities for innovative care technologies and public health strategies. Finally, these design opportunities were discussed in semistructured interviews with participants of a smart home trial involving environmental sensors, physiological measurement devices, smartwatches, and tablet-based chatbots and cognitive assessment puzzles (10 caregivers and 2 people with dementia). A thematic analysis revealed factors that motivate household members to use these technologies.ResultsOutcomes of these activities include a qualitative and quantitative analysis of patient, caregiver, and clinician needs and the identification of challenges and opportunities for the design and implementation of remote monitoring systems in public health pathways.ConclusionsParticipatory design methods supported the triangulation of stakeholder perspectives to aid the development of more patient-centered interventions and their translation to clinical practice and public health strategy. We discuss the implications and limitations of our findings, the value and the applicability of our methodology, and directions for future research.
Highlights
BackgroundDementia is a syndrome that accounts for the ongoing decline of brain functioning including problems such as memory loss, thinking speed, mental sharpness, language, understanding, judgment, mood, movement, and difficulty in carrying out daily activities [1]
Participatory design methods supported the triangulation of stakeholder perspectives to aid the development of more patient-centered interventions and their translation to clinical practice and public health strategy
The interactions that were observed between users and the monitoring team pointed to many of the design and usability issues within the current configuration of the UK Dementia Research Institute (UK DRI) CR&T’s smart home system
Summary
BackgroundDementia is a syndrome that accounts for the ongoing decline of brain functioning including problems such as memory loss, thinking speed, mental sharpness, language, understanding, judgment, mood, movement, and difficulty in carrying out daily activities [1]. Because of the wide-ranging consequences of the illness, interventions need to address health, safety, and psychological concerns. Understanding the needs of people living with dementia is critical and finding ways to support patient and caregiver autonomy and well-being is an ethical imperative. During the early stages of the illness most people with dementia want to remain living in their own home as independently as possible. Patients may suffer significant personality changes, hallucinations, paranoid ideas, aggression, wandering, and incontinence, so care is often provided in special facilities. Older adults, including people with dementia, want to live independently and feel in control of their lives for as long as possible. Assistive technologies powered by artificial intelligence and internet of things devices are being proposed to provide living environments that support the users’ safety, psychological, and medical needs through remote monitoring and interventions
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