This project aims to use technology to support the cognitive and emotional needs of people with dementia and their carers living in Bath and North East Somerset.

People living with dementia experience a diverse range of individual challenges in their daily lives. However, we know that there are a number of recurrent problems which many people experience, these are:

• Problems with personal, time or place orientation i.e. what day of the week is it, day or night time? Where am I?
• Task initiation or prompting i.e. preparing food or drink at tea time
• Anxiety i.e. when separated from a carer, unfamiliar environment

Any one of these can have a major impact on the quality of life for the person with a memory loss, affecting the safety of the carer or cared for person and the availability of staff time and interaction, which may result in the individual concerned having to go into care or being referred to an alternative service.

Low technology products can be used to address these problems and maintain independence of the person with dementia. These products are based on simple low cost voice recorders or displays, which are widely available. There are a number of reasons why they are not more widely used, these include: lack of awareness of the technology, uncertainty about the suitability or how to apply them for a particular individual or care environment and limited awareness of their effectiveness. These factors combine to limit adoption and diffusion of this technology, which could significantly improve the care of people with dementia. This proposal seeks to address these issues.

The project will utilise a standard framework based on a Discover – Define – Develop – Deliver model (www.designcouncil.org.uk/designprocess), together with evaluation and feedback.

1. Discover – define the scale and nature of these problems in a number of settings. These will be: Care homes, Extra care, Supported living services, Community wards and in people’s own homes in the Community. This will be informed by focus groups with formal and informal carers. We know that these problems are expressed in a number of different ways, depending on the setting. There will also be different needs around staff requirements, for example.
2. Define – establish the key requirements for each potential technology or product. These will include: small digital displays providing personal messages at home (www.day-clock.com), computer and TV systems with customized web based software, solid state voice recorders providing short audio messages (www.talkingproducts.com), low cost computer tablets providing text messages in a sequence or at a set time, and ‘greetings card’ voice messages to deliver a personal message. New products are becoming available all the time, but work is needed to define the key features that would make a device accessible to a person living with dementia or their carer. This includes: ease of use, size of text message, volume or length of the voice recording, timing or method of triggering the message and finally, power or battery requirements.
3. Develop – we will put together packages that will include the technology product, operating instructions, training materials and methods to assess the outcome or benefit of using the intervention. There will also be a need to refine or adapt some of the existing commercial products, to improve usability, for example to increase volume, or text size of messages.
4. Deliver – dementia community project leads will be employed to work with people living with dementia and their carers in each of the settings. They will recruit technology champions, who will work with other members of their team or community to support the introduction and evaluation of the interventions, from a central ‘product library’. This will provide people at each level to provide a chain of support and ensure communication and delivery of the interventions.
5. Evaluate and feedback – care staff and users will feed back their experiences and outcomes to the dementia community project leads. They will collate and share the information across the team. This will include potential barriers to deployment. The project team will use these outcomes as part of an iterative process, to redefine the requirements for the technology and the development of new packages. We will include research teams and commercial partners in this process as part of an innovation pathway.

Objectives

To use technology to improve the care and wellbeing of people living with dementia

1. Engage with carers and people living with dementia across the community: two wards, residential care homes, extra care and social housing and people living independently in the community.
2. Establish a package of simple technology that can be used to support the cognitive and emotional needs of people living with a diagnosis of dementia or memory problems and their carers through libraries in the various settings.
3. Provide support and advice around the deployment and establish processes for recording the outcomes.
4. Collate the results and share best practice across these settings.
5. Work with commercial providers to establish sustainable routes for users to access this technology.

Anticipated outcomes

People living with dementia

• Easy access to equipment that will give Greater personal independence
• Delay admission to residential care
• Avoidance of unnecessary hospital admission;
• Increase confidence
• Improve Wellbeing
• Increase Motivation
• Create an Heightened sense of orientation
• Increase Competence in task completion
• Reduce anxiety and the need for medication, especially anti-psychotics

Carers

• Tools to support them in their role, especially in terms of managing anxiety; increased communication/understanding
• reduction in ‘carer guilt’ when needing to be away; Increased quality of relationships.

Care homes and hospitals

• Facilitating person-centred understanding and communication.
• Fostering personhood through shared reminiscence and life histories.
• Supporting independence in task accomplishment
• Providing reassurance and reducing anxiety / agitation – reducing staff time and medication
• Re-orientating and maintaining safety at night to minimize falls and wandering

Community

• Promoting independence and independent living by providing tools which assist individuals to manage daily tasks.
• Maintaining activity and sustaining routines e.g. attendance at day centres, managing medication
• Avoiding emergency admissions and helping people stay in their own homes
• Re-orientating and maintaining safety at night to minimise falls and wandering