BackgroundExisting everyday technology as well as potential future technology may offer both challenges and possibilities in the everyday occupations of persons with cognitive decline. To meet their wishes and needs, the perspective of the persons themselves is an important starting point in intervention planning involving technology. The aim of this study was to explore how persons with mild cognitive impairment relate to technology as a part of and as potential support in everyday life – both present and future.MethodsQualitative in-depth interviews with six participants aged 61–86 were conducted and analyzed, using a grounded theory approach.ResultsThe findings describe the participants’ different ways of relating to existing and potential future technology in everyday occupations as a continuum of downsizing, retaining, and updating. Multiple conditions in different combinations affected both their actions taken and assumptions made towards technology in this continuum. Both when downsizing doing and technology use to achieve simplicity in everyday life and when striving for or struggling with updating, trade-offs between desired and adverse outcomes were made, challenging take-off runs were endured, and negotiations of the price worth paying took place.ConclusionsOur findings suggest that persons with mild cognitive impairment may relate to technology in various ways to meet needs of downsized doing, but are reluctant to adopt video-based monitoring technology intended to support valued occupations. Feasibility testing of using already-incorporated everyday technologies such as smartphones and tablets as platforms for future technology support in everyday occupations is suggested.

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Objective:To compare five-year outcomes and changes over time of a client-centred activities of daily living (ADL) intervention versus usual ADL interventions for people with stroke and their significant others.Design:Five-year follow-up of a cluster-randomized controlled trial where a client-centred ADL intervention (n = 129) or usual ADL interventions (n = 151) were delivered to people with stroke.Setting:Multicentre study including 16 inpatient or home-based rehabilitation units.Participants:People with stroke and significant others.Intervention:The client-centred ADL intervention aimed at enabling agency in daily activities and participation in everyday life and at reducing caregiver burden.Main measures:For people with stroke, perceived participation (Stroke Impact Scale), independence in ADL, life satisfaction, and use of formal/informal care were measured. For significant others, caregiver burden, life satisfaction, and mood (Hospital Anxiety and Depression Scale) were assessed.Results:Five years post-intervention, data were collected from 145 people with stroke (intervention group: n = 71/control group: n = 74) and 75 significant others (intervention group: n = 36/control group: n = 39). For those with stroke, the Participation domain of the Stroke Impact Scale showed no group differences at year five (68.9 vs 75.4, P = 0.062) or in changes over time. At year five, the control group had better outcomes regarding Other help/supervision. Significant others in the control group were more likely to show signs of depression at year five (odds ratio = 22.3; P < 0.001).Conclusion:The client-centred ADL intervention appears to render similar long-term effects as usual ADL interventions for people with stroke, but for significant others signs of depression might be reduced.

When monitoring activity involvement in clients with cognitive decline, health care professionals should take into account clients' ability to use everyday technologies and the amount of everyday technologies they use.

Over time, a decreasing use of ET was shown in this sample with MCI. This process was influenced by several aspects important to consider in occupational therapy intervention planning.

Background:In clinical practice, efficient and valid functional markers are needed to detect subtle cognitive and functional decline in mild cognitive impairment (MCI). This prospective study explored whether changes in perceived challenge of certain everyday technologies (ETs) can be used to detect signs of functional change in MCI.

A network-based approach for evaluating ambient assisted living (AAL) technologies. Abstract.Ambient assisted living (AAL) technologies could support people experiencing physical or cognitive challenges, to and maintain social identities and complex activities of daily living.Although there has been substantial investment in developing AAL innovation, less effort has been devoted to understanding how to evaluate the impact of AAL on physical and mental health. Taking a theory-based evaluation approach, we suggest that AAL technologies rely on networks of people and organisations to function, and analysing the changing structure of networks can bridge the gap between socio-technological change and individual-level capabilities. We present conceptual arguments for taking a network perspective in AAL evaluations, illustrated with examples from our own group's work on technology use among older people with cognitive impairments. We then discuss the different evaluation questions that could be addressed by 'ego-centred' and 'global' network analysis. Finally, recognising the creative ways people mobilise technology for themselves, and the unanticipated effects of technology, we underline the importance of qualitative, observational, and ethnographic approaches in unpicking the processes of change brought about when new technologies are introduced.

As the need for support is individual and likely to alter over time, repeated evaluations of activity involvement and difficulty in ET use are suggested to target timely interventions for persons with MCI.