Stated simply, Assistive Technology (AT) refers to any practical intervention available to support and promote the functional needs of people experiencing age-related or disability-related difficulties. As dementia is one of the major causes of disability and dependency among older people worldwide (WHO, 2015), AT has the potential to greatly benefit people living with a dementia, provided it is used ethically and provided the choice of product is based on the assessment of individual needs and dementia. It should also be remembered that in the context of dementia care, AT should never replace human interventions underpinned by person-centered principles. AT should always only be used in a supportive capacity to enable people living with dementia to undertake tasks they might otherwise be unable to complete successfully.
The first five country cross-national trial of AT for people with dementia, led by Norway but involving the DSIDC in Ireland took place during 2000-2004. This project titled ENABLE, tested out five different AT prototypes for people living with dementia. Its findings demonstrated the important role AT had in promoting more independent living and improving quality of life for these people and their family caregivers. The products evaluated by the DSIDC through the ENABLE project were (i) a night and day calendar, (ii) a bedtime light (iii) a cooker switch off device and (iv) an item locator. Since the time of ENABLE, the AT field has expanded rapidly and significantly, however we would contend that AT to date has not been put to optimum use in dementia care, particularly in home care.
AT comes in all shapes and sizes; it can be simple or complicated; can be low tech or high tech; inexpensive or cost thousands and it can be used in a wide variety of dementia care settings including day care, residential care and in normal domestic dwellings. AT is different conceptually from ambient assisted living (AAL) the goal of which is to enhance the quality of life of older people through the use of information and communication technologies.
Assistive technology can promote safety and well-being and help people with dementia to maintain their independence in a number of different ways. Here are some examples. AT can help to :
• Locate missing necessary objects such as a purse, pension book or a bunch of keys
• Find one’s way from A to B
• Tell the time of day and the date
• Alert the individual or caregiver to dangerous situations
• Maintain contact with friends, neighbours and family
• Take medications at the right time
• Find people who become lost
AT can never solve all the difficulties that a person with dementia may encounter, nor will it be applicable at all stages during the individual’s journey through dementia but it is well worthwhile to consider it as an option at different stages in the illness trajectory.
Firstly, you need to reflect over the situation and define the problem or identify the issue that is posing greatest difficulty. It may be that the issue you are trying to resolve does not require AT, perhaps a change in a person’s daily schedule or the slight alteration in home care hours will suffice. It is always worth exploring other ways to manage a situation before turning to technology.
After consideration, if you feel that AT can help with a particular issue you need to then ask yourself three important questions:
1. What is the simplest technological solution to the problem?
2. What is the cheapest technological solution to the problem?
3. What technological solution is least intrusive to the person with dementia?
Remember when it comes to AT, the simplest solution is nearly always the best option. Why buy a tablet computer if a diary will do? Why buy an item locator, if a neck strap for your glasses will work just as well?
If you have decided on a particular type of AT you should always check to see where the cheapest version of that product can be purchased. For example, many companies sell expensive types of ‘dementia calendar clocks’ but very similar products can be found in local high street stores for a fraction of the cost.
Also try and purchase a device that is discreet and that does not serve to stigmatise the person with dementia. For example a large tag on a pair of glasses may make someone with dementia feel very different from others and embarrassed.
Detailed below are some examples of AT, from the simple to the complex and the cheap to the expensive. There are also links to websites that deal with Assistive Technology.
Doro PhoneEasy 331ph (DP331). Big button phone with three ‘picture buttons’. Simply push the picture (or name) to dial the number. Available from the NCBI. Cost approx. €23
Doro Secure 580 mobile (DPM580). Simple, easy-to-use mobile phone. Four pre-programmed buttons with space for names alongside.
Includes an assistance button and a safety timer that will automatically alert preset numbers.
Cost approx. €134 www.ncbi.ie/shop/phones-and-mobiles
This is a communication tool designed to ascertain people’s feelings about various topics. Designed by speech and language therapists,
Talking Mats comes as either a physical product or a digital version. Cost: prices start at approx. €170. www.talkingmats.com/
Day/night calendar flip clock. Tells the time, date, day and also whether it is day or night.
Cost: approx. €145
Day Clock. Tells the day of the week and whether it is morning, afternoon or night.
Cost: approx. €100 www.day-clock.com
Habitat Flap Small Analogue Wall Clock. Display can be changed to read ‘Dublin’.
Cost: approx. €70 www.argos.ie
Day/Night Simple Dry-Wipe Personal Orientation Board. This board will tell the time but the other information requires manual adjustment.
Cost: approx. €100 www.findsignage.co.uk
Calendars & diaries. The original time and date orientation aids.
Cost: varies. Widely available.
Attach small fobs to items such as handbags, purses and keys. The handheld Loc8tor will help you find them.
Cost: approx. €60 www.lo8tor.com
Attach to keys, handbags, purses, etc. Whistle or clap and the key ring will beep and/or flash to help you to find it.
Cost: varies with product
Purchase from various retailers e.g. Gadget Shops
Retractable Key Fob
Put keys onto the key ring, attach key fob to a handbag or to your clothes and never leave your keys in the front door again!
Most smartphones have a tracking app built in to them or versions that you can download from an app store.
For example, ‘Find my iPhone’ or ‘Find my Android phone’.
So as long as a person has their phone and it is switched on then you should be able to locate them.
There are many different models on the market at different prices. Some use a monthly tariff, similar to a bill pay mobile phone.
This will afford you access to a ‘tracking call centre’ who will help you locate the tracker.
Other trackers you can buy outright and use an internet mapping site such as Google Maps to help you track movements.
Telecare refers to the continuous automatic and remote monitoring of real time emergencies and lifestyle changes over time to manage risks associated with independent living.
Telecare used to be little more than a pendant alarm button that could be used by the wearer in times of emergency. Technology has moved on however and now
Telecare systems can trigger alerts for a number of incidents. These include fall detectors, property exit sensors, bed and chair occupancy, flood monitors, smoke alarms and natural gas detectors amongst other things.
The Alzheimer Society of Ireland has over recent years been active through its Telecare project and has installed 70 packages of Telecare equipment in the homes of people living with dementia across the country.
Care packages installed include flood detectors, property exit sensors, smoke detectors, temperature sensors and pendant alarms. Contact the ASI for more information www.alzheimer.ie
Grant funding may be available for the system. Phone Age Action on Lo-call 1890 369369 or see https://www.ageaction.ie/sites/default/files/pdf/Personal%20Alarms%20
This refers to the electronic exchange of personal health data from a person at home to medical staff at a hospital or similar site to assist in diagnosis and ongoing monitoring of the person’s health condition.
An Enuresis Sensor (used to detect bed wetting) is a good example of how telehealth might be used to support a person with dementia experiencing incontinence continue to live at home.
The Sensor detects moisture and alerts the telehealth service, which records events and reports findings to the appropriate health care worker. http://contactcare.ie/telehealth/