People with disabilities can utilize assistive technology to live healthier, more active, productive, and respected lives, as well as participate in education, the labor market, and civic engagement. Assistive technology reduces the demand for traditional healthcare and social services, as well as long-term care and caregiver jobs. Individuals are frequently alienated, alone, and imprisoned in poverty with the lack of assistive technology, aggravating the impact of illness and disability on individuals, families, and the population. Looking after somebody with dementia can have a substantial influence on the caregiver's well-being. It is regarded as one of the most demanding and challenging kinds of care, as carers may be required to manage unpleasant symptoms and make critical considerations for several years. Assistive technologies (ATs) have recently emerged as one of the most important cornerstones of healthcare initiatives. Technology, on the other hand, opens up new opportunities for persons suffering from Alzheimer's disease and their carers. It can increase autonomy, security, and standard of living, as well as minimize neuropsychological disorders and attendant strain.
Assistive technology (AT) refers to any item, piece of kit, software program, or combination of processes intended to enhance, preserve, or develop the functional capacities of people with impairments. The primary purpose of assistive devices is to maintain or improve a person's productivity and autonomy, hence enhancing their well-being. They help people to live healthier, more efficient, self-sufficient, and respectful lives, as well as participate in community activities in education, the employment market, and public participation (Hopwood et al. 2018). People who have trouble talking, reading, typing, recalling, gesturing, thinking, having a hearing, studying, moving, and other activities might benefit from assistive technology. Various infirmities need the use of different assistive devices. Assistive technology facilitates and encourages inclusion and involvement, particularly for those with disabilities, the elderly, and those suffering from non-communicable conditions. The primary purpose of assistive devices is to maintain or enhance a person's productivity and autonomy, hence improving their well-being. Today, one billion individuals require assistive devices, and by 2030, more than 2 billion individuals worldwide are estimated to use at least one assistive device (who.int 2022). Despite the international demand for the acknowledged advantages of assistive goods, accessibility to them continues restricted.
Figure 1: Assistive Technology
Source: (caregiverdave.com 2019)
Dementia is a term used to characterize the indications that arise when the brain is impacted by diseases or disorders that cause the slow loss of brain cells. As a result, cognitive deterioration progresses. More than 920,000 population in the UK have dementia, and the number is expected to rise from over a million by 2024. (Wittenberg et al. 2019). In the case of dementia, ATs can improve motor independence and lower the dangers related to mobility.
Research and Development of Assistive Technology
Hardware and software advancements are examples of recent advancements in technological mechanics. Network communication advancements have traditionally centered on better exploiting the user's right to maneuver the technology and enabling more natural gadget control. Technical growth and training initiatives in assistive technology must be based on a continuous, well-defined, sequenced, and complete approach (Dam et al. 2016). The primary objective of assistive technology assets and advancement is to continue increasing educators' expertise and abilities in a range of aspects such as, but not restricted to, effective collaboration; a wide spectrum of techniques, methods, and assistance; resources; legal problems; strategic planning; and data compilation and assessment. Engaging in events beyond the home is still crucial for those suffering from dementia. Orientation and route-finding, on the other hand, can be difficult, and several technology solutions have been created to help with these operations and permit safe walking. Mobile phones with GPS and map features can help you find your way around (Li et al. 2016). The possibility of online environments for brain training or to lower dementia risk has piqued the public's interest. Nevertheless, while there is a continuous indication of improvements in the training element of brain performance (e.g., cognitive power), there is no strong support for dementia protection or postponing decline at this time (Butler et al. 2018). Encouraging casual caregiving and providing treatment remotely are key difficulties that dementia technologies can help to solve, at least to some extent.
Challenges and Barriers of Assistive Technology in Dementia Care
Its usage is influenced by the design process, which can operate as a barrier or a facilitator. In terms of the devices' outward appearance, too large or noticeable gadgets might lead to the innovation being discarded (Guisado-Fernández et al. 2019). Dementia's character might lead to an aggressive refusal of technologies. Assistive technology refers to items or tools that are meant to make life easier for people with impairments. Such technologies, for instance, serve to compensate for learning impairments. The usage of these technologies, particularly in rural places, has proven tricky. The majority of these places lack power and even network access. When it pertains to such places, most assistive aids, such as mobile voice features, might be difficult to use. Daily issues become more challenging for older people with mental disabilities owing to impairments in memory, reasoning, direction, language, understanding, action, and reasoning (Vollmer Dahlke and Ory 2020).
Assistive technology for persons with dementia poses significant ethical concerns. Ethical considerations such as guaranteeing equitable access to technologies (relational fairness) and safeguarding end-user and information confidentiality by layout seem to be undervalued (Wangmo et al. 2019).
Influence of Assistive Technology
Assistive technology is a wide phrase that encompasses the infrastructure and applications used to offer assistive products and solutions. Assistive technology devices preserve or increase an individual's functionality and independence, boosting their well-being and, as a result, decreasing the need for more official healthcare. Individuals are often alienated, isolated, and in the lack of assistive technology, people are detained in poverty, exacerbating the impact of illness and disability on themselves, their families, and the population overall (Daly Lynn et al. 2019).
Assistive technology may improve an individual's and their family's wellness and well-being. Here are several instances:
- Assistive technology can supervise a fragile person's health in their own home 24/7 offering comfort both for the individual and their families. This is especially useful when getting specialized caregivers available 24 hours a day, 7 days a week is neither desired nor economical (Dove and Astell 2017).
- Assistive technology can help senior adults spend more time at home for a longer period. and postpone or eliminate the requirement for long-term treatment.
- Program consumers will have more options, safety, freedom, and a feeling of power.
- Living conditions have enhanced.
- Personalized monitoring and telehealth can assist to provide a faster reaction if a significant emergency arises. A faster reaction to occurrences such as an accident or a medical problem such as a stroke can assist to decrease the long-term negative impact of the incident.
- Caregivers are relieved of some of their responsibilities.
- Assistance for those with long-term health issues has been enhanced.
- Injuries and mishaps in the house have been decreased (Christie et al. 2018).
Improvements in Assistive Technology
Numerous cooperative dementia care approaches have been established by innovators to serve the biopsychosocial requirements of persons suffering from Alzheimer's disease while reducing the pressure and load on their underpaid carers (Välimäki et al. 2016). Multiple clinical studies and project implementation have demonstrated that new models of care incorporating education and counseling, healthcare administration and collaboration, and tailored treatment plans that are evaluated and adjusted as required can enhance the care of persons with Alzheimer's disease (As Association 2017). Several treatments needed by evidence-based models, such as counseling and problem-solving training for unregistered carers, may be uncertain to be provided by practitioners. The suggested framework tries to strengthen this critical relationship and assist patients and unpaid carers in navigating it; links between medical systems and community-based services are frequently informal and unstable. Furthermore, by introducing a mechanism to recompense them for delivering regionally accessible and culturally suited resources, this approach would stimulate the formation and usage of self-contained community-based organizations (Jennings et al. 2016). Interventions focused on mental and physiological exercise for carers support healthy lives and future healthy aging. Mental activity often focuses on decision-making and problem-solving skills. Furthermore, particular mobile Apps may be used to self-assess cognitive performance and physiological wellness (Brims and Oliver 2019).
Impacts of Assistive Technology
Implementing devices to control the dangers of staying at home is what assistive technology entails. Certain AT systems screen for real-time crises and lifestyle modifications constantly, autonomously, and virtually (Jütten, Mark, and Sitskoorn 2019). While they are aimed at the service user, they may also influence caregiver performance by enhancing sleep and lowering concern and anxiety by sending alerts to significant occurrences such as slips, cooking mishaps, or wandering, allowing for suitable and prompt responses. Telephone-based initiatives to assist caregivers in communicating with patients and healthcare systems tend to be beneficial in enhancing results (Lucero et al. 2019).
Provision of Assistive Technology
People with disabilities can use assistive technology to lead healthier lifestyles, successful, autonomous, and respectful lives, as well as engage in school, the employment market, and public participation. Assistive technology decreases the demand for official healthcare and social services, long-term treatment, and caregivers' duties (Federici, Meloni, and Borsci 2016). Because of the multiplicity of customer categories and the large choice of assistive devices and associated activities, AT delivery is a complicated subject. Many nations have had public AT supply systems in existence for several years as components of their federal or local healthcare and social programs. The phrase "Assistive Technology provision" refers to anything required to ensure that someone with a handicap who may advantage from AT receives it and receives the best suitable AT service for that client. The delivering services procedure, which is the procedure through which a person obtains an AT solution that fulfills his or her requirements, is an important component. Nevertheless, many additional factors are required for successful AT supply (de Witte et al. 2018). These aspects encompass high performance AT products at inexpensive costs; people–end clients and specialists implicated–knowing that definite alternatives exist; business services supplying assistance and recommendations; regulations and processes determining suitability for such solutions and financing processes; mentoring on use; follow-up facilities; and infrastructural facilities. All of these aspects can be grouped or arranged in many ways, but they must be present for AT delivery to be successful (Federici and Scherer 2018).
Assistive Technology reduces Inequalities
In recent years, digital technology has demonstrated a remarkable ability to tackle real-world problems. In the pursuit of equality, artificial intelligence is a terrific instrument for combating inequities. In aspects of machine learning, integration policy must pursue a dual goal: help ensure that the advancement of these technology solutions does not relate to the expansion of social and economic inequalities, and then use machine learning to efficiently decrease these (Sherry, Ravneberg, and Söderström 2017). It specifically mentions the development of a computer-controlled concise description organizational support framework to enhance equivalent entry to general populace services, as well as AI-based technologies that allow for better consideration of the necessities of individuals with special needs and the improvement of their living standards. Aside from that, AI can greatly improve digital usage and thereby close the digital gap. Humans are acquiring and achieving new talents with the help of artificial intelligence technologies and sophisticated human interactions, finding answers to the issues of those most necessary (Tebbutt et al. 2016).
To conclude, mainstream gadgets can enable persons with dementia in a wide range of interests and pastimes; yet, adoption levels drop significantly, owing in addition to the absence of understanding or barriers to access (particularly monetary) and assistance. Implementing technology-enabled preventative and care interventions necessitates addressing a variety of ethical problems, including confidentiality, data governance, exchange, and utilization, hazard, entitlements, obligations, and connections (particularly information sharing) among private enterprises and governmental organizations. For those afflicted with dementia, humans can supervise the advancement of their situation, recognize arising issues, give proper diagnosis and treatment, and evade needless urgent admissions and hospitalization by supplying people with advanced technologies (e.g., applications, smartwatches, home automation devices) from the spot of diagnostic testing. These technologies can also give cues and recalls both inside and outside the house to aid in the preservation of intellectual, social, and physiological performance, as well as the fulfillment of everyday tasks. Technology can also help with caring, both explicitly and implicitly, by lowering pressures on individuals and institutional organizations, both of which impact significantly the financial expenses of dementia.
As Association, 2017. Alzheimer’s disease facts and figures. Alzheimer’s & dementia, 13(4), pp.325-73.
Brims, L. and Oliver, K., 2019. Effectiveness of assistive technology in improving the safety of people with dementia: a systematic review and meta-analysis. Aging & mental health, 23(8), pp.942-951.
Butler, M., McCreedy, E., Nelson, V.A., Desai, P., Ratner, E., Fink, H.A., Hemmy, L.S., McCarten, J.R., Barclay, T.R., Brasure, M. and Davila, H., 2018. Does cognitive training prevent cognitive decline? A systematic review. Annals of internal medicine, 168(1), pp.63-68.
caregiverdave.com, 2019. List of 10 Assistive Technology Devices To Help Seniors. Caregiverdave.com.
Christie, H.L., Bartels, S.L., Boots, L.M., Tange, H.J., Verhey, F.R. and de Vugt, M.E., 2018. A systematic review on the implementation of eHealth interventions for informal caregivers of people with dementia. Internet interventions, 13, pp.51-59.
Daly Lynn, J., Rondón-Sulbarán, J., Quinn, E., Ryan, A., McCormack, B. and Martin, S., 2019. A systematic review of electronic assistive technology within supporting living environments for people with dementia. Dementia, 18(7-8), pp.2371-2435.
Dam, A.E., de Vugt, M.E., Klinkenberg, I.P., Verhey, F.R. and van Boxtel, M.P., 2016. A systematic review of social support interventions for caregivers of people with dementia: Are they doing what they promise?. Maturitas, 85, pp.117-130.
de Witte, L., Steel, E., Gupta, S., Ramos, V.D. and Roentgen, U., 2018. Assistive technology provision: towards an international framework for assuring availability and accessibility of affordable high-quality assistive technology. Disability and Rehabilitation: Assistive Technology, 13(5), pp.467-472.
Dove, E. and Astell, A.J., 2017. The use of motion-based technology for people living with dementia or mild cognitive impairment: a literature review. Journal of Medical Internet Research, 19(1), p.e6518.
Federici, S. and Scherer, M., 2018. The assistive technology assessment process model and basic definitions. Assistive Technology Assessment Handbook, pp.1-9.
Federici, S., Meloni, F. and Borsci, S., 2016. The abandonment of assistive technology in Italy: a survey of users of the national health service. European journal of physical and rehabilitation medicine, 52(4), pp.516-526.
Guisado-Fernández, E., Giunti, G., Mackey, L.M., Blake, C. and Caulfield, B.M., 2019. Factors influencing the adoption of smart health technologies for people with dementia and their informal caregivers: scoping review and design framework. JMIR aging, 2(1), p.e12192.
Hopwood, J., Walker, N., McDonagh, L., Rait, G., Walters, K., Iliffe, S., Ross, J. and Davies, N., 2018. Internet-based interventions aimed at supporting family caregivers of people with dementia: systematic review. Journal of medical Internet research, 20(6), p.e9548.
Jennings, L.A., Tan, Z., Wenger, N.S., Cook, E.A., Han, W., McCreath, H.E., Serrano, K.S., Roth, C.P. and Reuben, D.B., 2016. Quality of care provided by a comprehensive dementia care comanagement program. Journal of the American Geriatrics Society, 64(8), pp.1724-1730.
Jütten, L.H., Mark, R.E. and Sitskoorn, M.M., 2019. Empathy in informal dementia caregivers and its relationship with depression, anxiety, and burden. International journal of clinical and health psychology, 19(1), pp.12-21.
Li, D., Park, H.W., Piao, M. and Ryu, K.H., 2016. The design and partial implementation of the dementia-aid monitoring system based on sensor network and cloud computing platform. In Applied Computing & Information Technology (pp. 85-100). Springer, Cham.
Lucero, R.J., Fehlberg, E.A., Patel, A.G., Bjarnardottir, R.I., Williams, R., Lee, K., Ansell, M., Bakken, S., Luchsinger, J.A. and Mittelman, M., 2019. The effects of information and communication technologies on informal caregivers of persons living with dementia: a systematic review. Alzheimer's & Dementia: Translational Research & Clinical Interventions, 5, pp.1-12.
Sherry, M., Ravneberg, B. and Söderström, S., 2017. Disability, society and assistive technology. Routledge.
Tebbutt, E., Brodmann, R., Borg, J., MacLachlan, M., Khasnabis, C. and Horvath, R., 2016. Assistive products and the sustainable development goals (SDGs). Globalization and health, 12(1), pp.1-6.
Välimäki, T.H., Martikainen, J.A., Hongisto, K., Väätäinen, S., Sintonen, H. and Koivisto, A.M., 2016. Impact of Alzheimer’s disease on the family caregiver’s long-term quality of life: results from an ALSOVA follow-up study. Quality of Life Research, 25(3), pp.687-697.
Vollmer Dahlke, D. and Ory, M.G., 2020. Emerging issues of intelligent assistive technology use among people with dementia and their caregivers: A US Perspective. Frontiers in Public Health, 8, p.191.
Wangmo, T., Lipps, M., Kressig, R.W. and Ienca, M., 2019. Ethical concerns with the use of intelligent assistive technology: findings from a qualitative study with professional stakeholders. BMC medical ethics, 20(1), pp.1-11.
who.int, 2022. Assistive technology. Who.int.
Wittenberg, R., Hu, B., Barraza-Araiza, L. and Rehill, A., 2019. Projections of older people with dementia and costs of dementia care in the United Kingdom, 2019–2040. London: London School of Economics.