Alzheimer's Society

Dementia can make day-to-day life more difficult. Little things like mislaying items in the house, 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:

• speaking
• hearing
• eyesight
• moving about
• memory
• cognition (thought processes and understanding).

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 got lost.

What are the benefits?

Assistive technology can help by:

• increasing independence and choice, both for the person with dementia and those around them
• reducing the risk of accidents in and around the home
• reducing avoidable entry into residential and hospital care
• reducing the stress on carers, improving their quality of life, and that of the person with dementia.

Finding the right solution

Selecting the right device is not always easy. Sometimes it may be that a non-technological solution is more appropriate. Different people react differently to different products. One person might find a simple recorded message that plays when they open the front door, reminding them to take their keys helpful, while another person might find this confusing. Before you make a decision, seek as much advice as possible. Whenever you can, involve social services and the person's occupational therapist or GP in your decision, to ensure a tailored solution. If the assistive technology does not meet the individual needs and preferences of the person with dementia, it may be ineffective or even cause distress.

Tips: keep it simple

• Solutions don't need to be high-tech. Simple ideas such as a diary, notebook or noticeboard can provide a reminder of appointments, important phone numbers and things to do.
• Decide on a permanent place to keep important items such as keys.
• Label cupboards or rooms to help you remember where things are.

Ethical considerations

Technologies should enhance and enable independence but they do have the potential to produce less positive outcomes. For example, a device may confuse the person with dementia or, if misused, may be used to replace any human contact they have, or to restrict rather than enhance their freedom of movement.

As with any form of support or care, there are a number of considerations to make when thinking about how a technology may help a person in a particular situation. No one should be coerced 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 those making the decision have the person's best interests at heart. The Mental Capacity Act (2005) now 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).

What technology is available?

There are many different technologies that can be adapted to the needs of someone with dementia. You can buy many of these devices independently, but before you do, it is advisable to contact your local authority social services or Supporting People departments (see 'Useful organisations'), or your occupational therapist or GP. Even if they can't offer you the products, you may be eligible for a proper assessment, help in finding the best product, or financial assistance.

Telecare

Telecare is the continuous, automatic and remote monitoring of real-time emergencies and lifestyle changes over time in order to manage the risks associated with independent living. Sensors around the home are linked via a telephone line to a 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.
• 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 to detect a pan that has boiled dry, for example.
• Scalding baths − A temperature-responsive plug replaces the standard bath plug and changes colour from blue to bright pink at high temperatures.
• Gas − If someone forgets to turn the gas off, this device will automatically shut off the gas and raise the alarm.
• Falls − Sensors worn on the wrist can detect the impact of a person falling.
• Absence from a bed or chair − If a person gets up and doesn't return within 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 − A pressure-mat sensor is placed by the bed and a sensor activates 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 in a specified time. The system uses passive infra-red (PIR) and door contacts, and can help to reduce risk and retain the person's independence.

ATdementia can provide more information about telecare, see 'Useful organisations', below.

Memory aids

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 are often 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 − Dosset 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!)

Aids for reminiscence and leisure − Multimedia software is available to evoke memories and stimulate conversation, by showing photographs or films, and playing music that is familiar to the person, and videos about how life used to be.

Devices to enable safer walking

Tracking devices use satellite technology to help trace someone who has got lost. A person's location can be viewed on a computer or perhaps on a mobile phone. Most devices have the facility for the person carrying the device to press a panic button if they get lost. They have some limitations, but are generally accurate within 50m depending on the location of the user and the geographical area. At the time of writing there are none available on the market, but it is expected that one will be launched soon. There is currently no research available to demonstrate the benefits of these devices to people with dementia.

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 the Alzheimer's Society position statement.

Other things to consider are what items the person should carry with them in case they get lost − for example, personal information. There are schemes whereby a person can carry a card with a phone number of a call centre and an ID number. When contacted, the call centre will match the ID with a next of kin, who will be contacted.

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 managing well, and may help those around them to step back and not take over unless it is absolutely necessary.

Mobility aids

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 and cushions, see Factsheet 429, Equipment to help with disability, and 428, Adaptations, improvements and repairs to the home.

Is assistive technology for you?

Assistive technology can make a huge difference to the lives of people with dementia and their carers. But it is not always the answer. Some people might find that the very presence of the equipment reminds them about their memory problems, which can cause distress. Some technological solutions may be unnecessarily complex or expensive, and small changes in daily activities may be enough to overcome a problem. Finally, it goes without saying that assistive technology can only be effective when combined with good care.

Tips: is the product fit for the job?

Dementia can sometimes make people wary of trying new things, adapting to changing situations or learning new skills, so it's important to find a product that really suits their situation, and their likes and dislikes. To overcome this difficulty, you may find it helpful to do the following:

• Aim to find solutions that can be integrated into the person's normal routine without being noticed, or with the 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.

Your local Alzheimer's Society branch will always be willing to talk to you and offer advice and information to support your needs.

For more information, Dementia Catalogue, our specialist dementia information resource, is available on the website at alzheimers.org.uk/dementiacatalogue

Reference

Royal Commission on Long Term Care (1999) With respect to old age: long term care − rights and responsibilities. London: The Stationery Office

Useful organisations

Before ordering anything, contact your local social services to see if they can source the items on your behalf. Please note that the Alzheimer's Society cannot recommend any specific suppliers or products.

Alzheimer's Society

Devon House
58 St Katharine's Way
London E1W 1JX
T 020 7423 3500
   0845 300 0336 (helpline open 8.30am-6.30pm weekdays)
E info@alzheimers.org.uk (general information)
   helpline@alzheimer.org.uk (helpline)
W alzheimers.org.uk

The UK's leading care and research charity for people with dementia and those who care for them. The helpline provides information, support, guidance and referrals to other appropriate organisations.

Assist UK

Redbank House
4 St Chad's Street
Manchester M8 8QA
T 0870 770 2866
E general.info@assist-uk.org
W http://www.assist-uk.org/

Provides a network of centres throughout the UK that aim to improve disabled and older people's access to accurate, reliable and impartial information and advice about products and equipment for easier living.

AT Dementia (Assistive Technologies for People with Dementia)

Trent Dementia Services Development Centre
9 Newarke Street
Leicester LE1 5SN
T 0116 257 5017
E info@trentdsdc.org.uk
W http://www.atdementia.org.uk/

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 available technologies that may be appropriate for people with dementia.

AZTEC Centre

Croydon Community Equipment Service
Access Ability Centre
Boulogne Road
Croydon CRO 2QT
T 020 8664 8860

Run by Croydon Social Services, this centre is open to the public on certain days and displays a full range of assistive technology and telecare products.

Disabled Living Foundation

380-384 Harrow Road
London W9 2HU
T 0845 130 9177 (10am-4pm weekdays)
E advice@dlf.org.uk
W www.dlf.org.uk/links/suppliers.html

Charity that provides information about finding some simple solutions, such as mobility aids.

Excite online shopping

The following online shopping website has a section on assistive technology: www.excite.co.uk/directory/shopping/health/disabilities/assistive_technology

Foundation for Assistive Technology (FAST)

12 City Forum
250 City Road
London EC1 8AF
T 020 7253 3303
E info@fastuk.org
W http://www.fastuk.org/

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.

Help the Aged (England)

207-221 Pentonville Road
London N1 9UZ
T 020 7278 1114
   0808 800 6565 (seniorline freephone, weekdays 9am-4pm)
E info@helptheaged.org.uk
W http://www.helptheaged.org.uk/

Provides advice and reliable information for older people and their carers, including a catalogue of items aimed at older people, including some assistive technology devices.

Help the Aged (Wales)

12 Cathedral Road
Cardiff CF11 9LJ
T 02920 346 550
E infocymru@helptheaged.org.uk
W http://www.helptheaged.org.uk/

Leicestershire Social Services Adaptations and Building Services Team

Rothley House
Coalville
Leicester LE67 3NR
T 01530 513781

Leicestershire Social Services has produced a very useful catalogue of assistive technology products, called Signal. (Contact Ann Boam.)

Supporting People

T 020 7944 2556
E supporting.people@communities.gsi.gov.uk
W http://www.spkweb.org.uk/

A government programme that offers vulnerable people the opportunity to improve their quality of life by providing a stable environment that enables greater independence. May be able to offer funding.

Factsheet 437

Last updated: June 2008
Last reviewed: June 2008

Reviewed by: Clive Evers, Director of Knowledge Management, Alzheimer's Society, with Simon Burrow, Director, Trent Dementia Services Development Centre; Keren Down, Director, Foundation for Assistive Technology; Louise Lakey, Senior Policy Officer, Alzheimer's Society; and Brian Longman, Project Co-ordinator, AZTEC Centre.