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The extent to which technology may be able to support people with dementia and their carers along the care pathway and in different care settings is of interest to policy makers and governments. In this paper we provide an overview of the role of technology in dementia care, treatment and support by mapping existing technologies - by function, target user and disease progression. Technologies identified are classified into seven functions: memory support, treatment, safety and security, training, care delivery, social interaction and other. Different groups of potential users are distinguished: people with mild cognitive impairment and early stages of dementia, people with moderate to severe dementia and unpaid carers and health- and social care professionals. We also identified the care settings, in which the technologies are used (or for which the technologies are developed): at home in the community and in institutional care settings. The evidence has been drawn from a rapid review of the literature, expert interviews and web and social media searches. The largest number of technologies identified aim to enhance the safety and security of people with dementia living in the community. These devices are often passive monitors, such as smoke detectors. Other safety interventions, such as panic buttons, require active intervention. The second largest number of interventions aims to enhance people's memory and includes global positioning systems devices and voice prompts. These technologies mostly target people in the early stages of dementia. A third group focusing on treatment and care delivery emerged from the literature. These interventions focus on technology-aided reminiscence or therapeutic aspects of care for people with dementia and their carers. While the review found a range of technologies available for people with dementia and carers there is very little evidence of widespread practical application. Instead, it appears that stakeholders frequently rely on everyday technologies re-purposed to meet their needs.

What is known about this topic• Some research indicates that older people's use of email and Skype positively affects their quality of life (QOL) by enabling them to keep in touch with friends and relatives.• Research suggests mobile phone ownership can have a positive effect on older people's sense of safety and security. What this paper adds• The empirical evidence demonstrates that the effects of older people's use of ICT, for both mainstream and remote care purposes, on different domains of AbstractIt is often asserted that older people's quality of life (QOL) is improved when they adopt information and communication technology (ICT) such as the Internet, mobile phones and computers. Similar assumptions are made about older people's use of ICT-based care such as telecare and telehealth. To examine the evidence around these claims, we conducted a scoping review of the academic and grey literature, coving the period between January 2007 and August 2014. A framework analysis approach, based on six domains of QOL derived from the ASCOT and WHOQOL models, was adopted to deductively code and analyse relevant literature. The review revealed mixed results. Older people's use of ICT in both mainstream and care contexts has been shown to have both positive and negative impacts on several aspects of QOL. Studies which have rigorously assessed the impact of older people's use of ICT on their QOL mostly demonstrate little effect. A number of qualitative studies have reported on the positive effects for older people who use ICT such as email or Skype to keep in touch with family and friends. Overall, the review unearthed several inconsistencies around the effects of older people's ICT use on their QOL, suggesting that implicit agreement is needed on the best research methods and instrumentation to adequately describe older people's experiences in today's digital age. Moreover, the available evidence does not consider the large number of older people who do not use ICT and how non-use affects QOL.

This study examined whether training provided to adults age 60+ would increase the use of information and communication technologies (ICTs), such as email and the Internet, and influence participants' social support and mental health. Participants were randomly assigned to an experimental (n=45) or a control group (n=38). The experimental group participated in a six-month training program. Data were collected before, during, and after training on outcomes related to computer use, social support, and mental health. Mixed regression models were used for multivariate analyses. Compared to the control group, the experimental group reported greater self-efficacy in executing computer-related tasks and used more ICTs, perceived greater social support from friends, and reported significantly higher quality of life. Computer self-efficacy had both a direct and indirect effect on ICT use, but not on other variables. With appropriate training, older adults want to and can learn the skills needed to use ICTs. Older adults with ICT skills can access online sources of information regarding Medicare Part D options and utilize patient portals associated with electronic medical records. Agencies may develop services that build upon this technology sophistication, but policies also will need to address issues of access to equipment and high-speed Internet service.

Background: To test whether access to home-based social worker–led case management (SWCM) program or SWCM program combined with a website providing stroke-related information improves patient-reported outcomes in patients with stroke, relative to usual care. Methods and Results: The MISTT (Michigan Stroke Transitions Trial), an open (unblinded) 3-group parallel-design clinical trial, randomized 265 acute patients with stroke to 3 treatment groups: Usual Care (group-1), SWCM (group-2), and SWCM+MISTT website (group-3). Patients were discharged directly home or returned home within 4 weeks of discharge to a rehabilitation facility. The SWCM program provided in-home and phone-based case management services. The website provided patient-orientated information covering stroke education, prevention, recovery, and community resources. Both interventions were provided for up to 90 days. Outcomes data were collected by telephone at 7 and 90 days. Primary patient-reported outcomes included Patient-Reported Outcomes Measurement Information System Global-10 Quality-of-Life (Physical and Mental Health subscales) and the Patient Activation Measure. Treatment efficacy was determined by comparing the change in mean response (90 days minus 7 days) between the 3 treatment groups using a group-by-time interaction. Subjects were aged 66 years on average, 49% were female, 21% nonwhite, and 86% had ischemic stroke. There were statistically significant changes in Patient-Reported Outcomes Measurement Information System Physical Health ( P =0.003) and Patient Activation Measure ( P =0.042), but not Patient-Reported Outcomes Measurement Information System Mental Health ( P =0.56). The mean change in Patient-Reported Outcomes Measurement Information System Physical Health scores for group-3 (SWCM+MISTT Website) was significantly higher than both group-2 (SWCM; difference, +2.4; 95% CI, 0.46–4.34; P =0.02) and group-1 (usual care; difference, +3.4; 95% CI, 1.41–5.33; P <0.001). The mean change in Patient Activation Measure scores for group-3 was significantly higher than group-2 (+6.7; 95% CI, 1.26–12.08; P =0.02) and marginally higher than group-1 (+5.0; 95% CI, −0.47 to 10.52; P =0.07). Conclusions: An intervention that combined SWCM with access to online stroke-related information produced greater gains in patient-reported physical health and activation compared with usual care or case management alone. There was no intervention effect on mental health. Clinical Trial Registration: URL: https://www.clinicaltrials.gov . Unique identifier: NCT02653170.

A key component of social work ethics is social justice and equitable access to resources. Increasingly, this includes access to technology. This study addresses issues related to the 'digital divide' by testing a peer tutor model (Technology and Aging Project, TAP) to teach adults aged  and older how to use information and communication technologies (ICTs) such as email, the internet, online chat rooms and discussion groups, internet-based support groups, and voice technology and webcams. Participants from the control group of a previous programme, TAP (N = ) participated in a six-month computer training programme. Six participants who had successfully completed the TAP training were selected to be peer tutors. Data were collected from tutors and learners at baseline, three months, six months and nine months (three months after the end of training). The current study reports on learner outcomes only. Measures include computer, social support, and mental health-related outcomes. Learners reported a significant and consistent increase over time in their confidence completing certain computer-related tasks and their overall use of ICTs. Mental health and social support outcomes did not change. Overall, the peer tutor model appeared to be at least as effective as the previous staff-directed model.KEY WORDSinformation and communication technologies, older adults, computer training, volunteer. Standards for Technology and Social Work Practice (NASW and ASWB ). Although the Standards provide a much needed guide for using technology in assisting clients, they do not provide a framework for working with specific groups of clients, such as older adults. Of the ten Standards, three are clearly applicable to working with older adults: (a) bridging the 'digital divides' that limit accessibility for some individuals, (b) understanding the strengths and limitations of technologies in meeting the needs of members of vulnerable populations, and (c) using technology to advocate for clients and educate clients to advocate for themselves (NASW and ASWB ). This study addresses issues related to the 'digital divide' by testing a peer tutor model to teach older adults how to use information and communication technologies (ICTs). Literature reviewICTs include computer-based applications that provide access to information anytime, anywhere, as well as those that enhance communication between two or more people, regardless of physical distance. These include web pages, email, the internet, online chat rooms and discussion groups, internet-based support groups, and voice technology and webcams (Blaschke, Freddolino and Mullen ). ICTs in general offer increasingly affordable, convenient, portable, and less intrusive ways of communicating with family and friends (Beckenhauser and Armstrong ; Gatto and Tak ). For older adults specifically, ICTs have the potential to positively impact quality of life by improving social support and psycho-social wellbeing (Carpenter and Bunday ; Eastman and Iyer ; Pfeil, Zap...

BackgroundFor some stroke patients and caregivers, navigating the transition between hospital discharge and returning home is associated with substantial psychosocial and health-related challenges. Currently, no evidence-based standard of care exists that addresses the concerns of stroke patients and caregivers during the transition period. Objectives of the Michigan Stroke Transitions Trial (MISTT) are to test the impact of a social worker home-based case management program, as well as an online information and support resource, on patient and caregiver outcomes after returning home.MethodsThe Michigan Stroke Transitions Trial is a randomized, pragmatic, open (un-blinded), 3-group parallel designed superiority trial conducted in 3 Michigan hospitals. Eligible participants are adult acute stroke patients discharged home directly or within 4 weeks of being discharged to a rehabilitation facility. The patient’s primary caregiver is also invited to participate. Patients are randomized on the day they return home using a randomized block design. Consented patients discharged to a rehabilitation facility who do not go home within 4 weeks are dropped from the study.The 2 study interventions begin within a week of returning home and conclude 3 months later. The 3-group design compares usual care to either a home-based social worker stroke case management (SWSCM) program, or a combination of the SWSCM program plus access to an online information and support resource (MISTT website). Outcomes data are collected at 7-days and 90-days by trained telephone interviewers. Primary patient outcomes include the PROMIS global 10 score (a generic Quality of Life scale), and the Patient Activation Measure (PAM). Caregiver outcomes include the Bakas Caregiving Outcomes Scale. Final analysis will be based on 214 randomized acute stroke patients. To accommodate subjects excluded due to prolonged rehabilitation stays, as well as those lost-to-follow-up, up to 315 patients will be consented.DiscussionThe MISTT study will determine if a home-based case management program designed around the needs and preferences of stroke patients and caregivers, alone or in combination with a patient-centered online information and support resource can improve stroke survivor and caregiver outcomes 3 months after returning home.Trial registrationClinicalTrials.gov: NCT02653170 (Protocol ID: 135457). Registered April 9, 2015.

To conduct comprehensive treatment effectiveness studies, evaluators must frequently track, locate and interview service recipients long after program participation has ended. For some populations, this is an arduous task. But, despite wide variations in retention rates, the published literature from follow-up studies rarely provides information on their tracking, locating, or interviewing techniques. The present report concerns a 12-month follow-up study of individuals who were homeless and mentally ill, which achieved a remarkably high retention rate—over 70%. Quantitative information is presented on client characteristics related to locatability and agreement to be interviewed, as well as qualitative information on successful techniques, from a focus group session with research interviewers.Wealth of research studies has been carried out in the last 10 years to describe the everincreasing problem of homelessness in this country. Investigators agree that what are now needed are demonstrations of innovative services to individuals who are homeless, especially those with alcohol, drug, and mental health (ADM) problems, with rigorous research components (Dennis et al. 1991). Desirable outcomes of interventions should include stabilization of functioning, acquisition of permanent housing, and linkage to ongoing, community-based services to maintain positive gains.