Author: Asha Carpenter, Research assistant, RAND Europe
According to the Alzheimer’s Society 850,000 people in the UK have dementia, with this figure predicted to rise and reach more than 1 million by 2025 and 2 million by 2051. One person every three minutes will develop dementia in the UK and a new dementia diagnosis is made every 4 seconds worldwide. Dementia is a broad term to describe a variety of brain disorders with the Alzheimer’s Society describing symptoms including “memory loss, confusion and problems with speech and understanding”.
The most common type of dementia is Alzheimer’s disease which affects 62% of people diagnosed. The risk of developing dementia increases significantly as individuals get older and with an ageing population this is therefore becoming a significant challenge for society.
What is it like to have dementia?
For those who have dementia it is often difficult to explain how it feels to live with the condition. Alzheimer’s Research UK therefore developed an app for Android and iOS smartphones, A Walk Through Dementia, that aims to allow people to see life through the lens of someone living with the disease. This app uses virtual reality to enable the user to walk through three everyday scenarios: going to the supermarket, being on the road and being at home. It highlights how an everyday task that appears to be simple can be a real challenge for someone with dementia.
Dementia is a progressive condition that reduces a person’s capacity for independence and at the same time increases the anxiety and worries for their family about their wellbeing and safety. Assistive technologies have been developed to help address these challenges with the aim to support people in keeping control of their lives for longer, while at the same time providing reassurance to their carers.
A home system for reminders
The online device, myhomehelper, is intended for people with dementia and the people that care for them. The technology allows family members or others to support the person with dementia remotely, with reminders provided on a display screen in the person’s home with there being minimal requirements for them to interact with the screen other than to occasionally look at it. The myhomehelper requires access to the internet and family members can regulate what is shown on the display whether they are at work, home or on holiday. The display has six optional modes: calendar clock, diary, reminders, photos, news and messages.
The most prominent features are the diary display which gives the user context for the coming day or week with visits, appointments and birthdays being visible. A carer can set reminders for specific times of the day or randomly during the day and can specify when the reminder is shown, how long it is visible for and whether it is repeated throughout the day. An example could be to remind the person with dementia to drink water, and an image can also be displayed on the screen with a sound played to attract the attention of the user to the screen. It is possible to set the text to be automatically spoken and if the user touches the screen whatever is currently displayed will also be spoken.
Another component of this function of myhomehelper is an option to request a response after a reminder. The carer receives an email when a response has been provided which can reduce anxiety about the wellbeing of the person with dementia. Messages can be sent from a mobile phone, Facebook or the myhomehelper website with the sender’s photo appearing on the screen alongside their message. VSee is integrated into the myhomehelper display and has an auto-answer function. This means video calls can be made to the display without the person with dementia needing to answer.
It is possible to have multiple users for a single myhomehelper account so many family members can be involved with supporting the person with dementia.
As dementia reduces memory function it can be difficult if someone with dementia has to take medication regularly. Online programming of a pill dispenser connected to an app allows medication to be dispensed at pre-set times with an alarm sounding to notify the user.
Access to the medication only occurs at the alarm time and alert messages including if the dose of medication has not been taken can be sent to three separate mobile numbers and one email address. This means that family members can take steps to prevent a possible adverse event from arising.
Sensors can be used in the home, for example on doors, to inform carers if their family member leaves the house during pre-set times. Devices can be also used for specific cases where a person with dementia is prone to getting lost or there is a risk they may go missing. Such devices include watches, apps or pendants that include a GPS tracker. Family members can then identify the location of the individual which can be viewed on a computer, tablet or phone.
The considerations and benefits of using assistive technologies
The types of assistive technologies implemented should be carefully considered and based on an individual’s best interests, needs and capabilities and should not be used to replace human interaction. There are also ethical considerations, especially for devices that can track the person with dementia, as they may not have the capacity to consent and this will impose on their right for privacy. An independent evaluation of myhomehelper, although small in scale, provided support for the use of the home system in the future.
Other home systems, such as Canary Care and Just Checking, use wireless sensors to monitor the movements of the person with dementia within their home. Assistive technologies such as medical aids and home systems could benefit the user by enabling independence and self-care, providing memory stimulation and reducing anxiety, whilst also offering reassurance to carers and reducing some of the burden of having to check on the individual.