Alzheimer's Society's view on assistive technology
Find out what we think about assistive technology and how it relates to the needs of people affected by dementia.
Assistive Technology has the potential to offer benefits to people with dementia and their carers in specific circumstances. However, there are practical and ethical issues that must be addressed with respect to the provision of assistive technology. The overarching principle of assistive technology must ensure that it is in the individual's best interests.
What is assistive technology?
Assistive technology can be defined as "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". This includes a wide range of devices that can grouped according to their purpose.
Supportive technologies help the individual to complete tasks; responsive technologies help manage risk and raise alarms; and preventative technologies prevent harm and raise alarms. These technologies may include simple 'low tech' items such as basic mobility devices -walking sticks, walking frames, bath aids, calendar clocks through to more 'high tech' items such as automatic lighting and telecare.
The term 'telecare' is used to describe sensors or detectors (for example movement, flood, gas, smoke or fall detectors) that automatically send a signal via a base unit connected to a telephone line ('tele') to a carer, community alarm or monitoring service and which can call for assistance ('care') when it is needed.
Examples of assistive technology include:
Electronic location devices which let carers know if the people they care for have left the room or building. This includes GPS technology that can locate people who have left the home and become lost or disorientated.
Temperature, smoke and carbon monoxide detectors. These can be linked with a number of devices, enabling gas or electricity supplies to be shut off automatically, or power operated windows to be opened.
Memo minders - can help people who have difficulty in remembering to carry out tasks.
Medication dispensers - these devices can help people who have difficulty in remembering to take their medicine
How assistive technology can benefit people with dementia and their carers
Assistive technology has potential benefits for people with dementia providing it is introduced early on in the care of an individual with dementia and is tailored to each individual's needs. People considering using assistive technology should do so in consultation with their health or social care professional.
For example, it can enable people to live independently for longer, reduce stress on people with dementia and carers and can potentially enhance the quality of life for people with dementia and give them greater choices about their care. For carers, there is evidence to suggest that since the introduction of telecare in to their caring situation, they have benefited from more peace of mind, a better night's sleep, improved the relationship with the person(s) they cared for, the opportunity to continue with activities they might otherwise have to give up, the ability to remain in paid employment in some cases, and more confidence about the safety and comfort of the person they cared for.
Whilst assistive technology has potential benefits to offer people with dementia there are still a number general issues around the provision of assistive technology that need to be explored in more detail and addressed. These are:
- Improving access
- Personalised care
- Ethical considerations
- Future developments
Improving access to assistive technology for people with dementia
Too many people are diagnosed late meaning they often do not receive appropriate or timely access to assistive technology. Early intervention is necessary and offers an excellent opportunity to enhance the quality of life of both the individual with dementia and their carer. Getting the right support in place early may mean that an individual can continue to live in an environment of their choice with independence and dignity, and help to ensure that the appropriate assistive technology package is provided to them. However, access to assistive technology should not require a formal diagnosis.
Lack of public awareness and information
The lack of public awareness relating to assistive technology means that people with dementia and carers do not know what to ask for. There is also a lack of good quality information around assistive technology. This means that the right equipment at the right time is not provided to people with dementia. This is not just an issue for the provision of assistive technology, rather a lack of information more generally especially for people with dementia and, to a lesser extent, their carers.
The priority given to assistive technology by different local authorities is variable and there is no national guidance on how assistive technology should be provided. In some areas of the country people with dementia have much poorer access to assistive technology than others. Depending on where an individual with dementia lives, eligibility for assistive technology may vary, only a limited range of products might be available and there may be a considerable wait for assistive technology to be provided.
There is also a need for dementia advisers and other relevant staff within memory services to receive awareness training around assistive technology. This would allow them to better inform people with dementia and their carers of products that may assist their care and also signpost them to how they can access assessments for assistive technology. However, there is much work still to be done to raise awareness amongst health and social care professionals and this must be addressed to ensure the potential of assistive technology is recognised.
Assistive technology must be personalised
It is very important that assistive technology is personalised to the individual and not part of a 'set menu' or 'dementia package'. Assuming that every individual with dementia requires, or will benefit from, the same piece of assistive technology is unhelpful. People with dementia experience very different symptoms that require different responses. In addition the most appropriate assistive technology will depend on an individual's lifestyle and circumstances which changes over time. A thorough assessment of needs should always be carried out to ensure people are not in receipt of technology that is of no use to them, or are not in receipt of technology that they would find helpful.
Overcoming the potential limitations of assistive technology
Assistive technology should not be seen as a 'quick fix' for people with dementia, or used as a replacement for human interaction and care for people with dementia. Rather, assistive technology should be seen in the context of complementing an individual's care and support to enhance their quality of life. The development of assistive technology should include people with dementia in the design process to produce technological aids that are 'fit for purpose' without being to overly complex or requiring extensive training.
Key to some of the issues around assistive technology for people with dementia and carers is how reliable the technology is as a standardised or 'off the shelf' solution. For example, telecare is only of use to some people with dementia provided it is backed up with human care, support and training.
Quite often a simple modification to existing technology could improve the lives of people with dementia and their carers - without the need for expensive products, which may not be suitable in any case. For example, very simple things such as a wipe-board or well-placed "post-it" notes acting as prompts and reminders can be helpful 'aids' for a person with memory difficulties.
How useful assistive technology can be will depend strongly on the external environmental factors that are in place. For example, ensuring that there is adequate lighting could make a significant difference to a person with dementia being able to navigate around their home or environment.
Like many new ideas or inventions, assistive technology including telecare has the potential to benefit people, but there is also a chance it could be misused or have unintended effects. Although assistive technology can offer people greater independence and potentially free up carers' time, there are some aspects of its commissioning and provision that could compromise people's privacy, autonomy and wellbeing. Particular attention should be paid to aspects of care planning including assessment, installation and obtaining consent so that the beneficial effects of the technology are realised
Some people with dementia may feel stigmatised by assistive technology, it is important that they are consulted as to whether they are happy to use it.
There are opportunities for assistive technology to play an increased role following important policy developments.
For example, the increasing use of personal budgets may mean more people choose to spend their budget on assistive technology. This may be beneficial if it improves access to assistive technology and enables people with dementia and their carers the necessary freedom to make informed choices about assistive technology. However, it is vital that these choices are always informed by comprehensive assessments and ongoing support.
Self-funders may have particular difficulty in accessing reliable information about appropriate assistive technology. They may also miss out on a needs assessment and the necessary ongoing support. The risk is that they may be directed to costly products that do not match their needs.
In order to properly promote the benefits of assistive technology, there needs to be strong local and national leadership where advocates can explain ways in which assistive technology can bring about benefits to people with dementia and their carers. There is no national guidance in relation to assistive technology. Alzheimer's Society would like services in this area being brought up to the standard of the best.
Alzheimer's Society acknowledges the potential benefits which assistive technology may bring to people with dementia. However, assistive technology must be seen as only a part of the range of potential options that should be employed to support people with dementia. Assistive technology cannot be a replacement for person-centred care, nor is it something which can be rolled-out in a 'one-size-fits-all' approach to people with dementia.
The Society campaigns for:
People with dementia to be included in decisions, wherever possible, about assistive technology. People with dementia will not be able to benefit fully from assistive technology unless people are diagnosed earlier and able to access services. People with dementia should also be part of the research in to assistive technology.
The needs and views of carers to be taken in to account when looking at whether assistive technology would enable a person with dementia to benefit.
To improve health and social care professionals awareness of assistive technology for people with dementia. There are several local authorities which recognise the benefits assistive technology can have for people with dementia. More work should be done to lift overall levels of knowledge.
More research to develop assistive technology for people with dementia and to assess its efficacy in improving quality of life and maintaining independence
Last updated: April 2013 by Geraldine Green