Exploring the views of GPs, people with dementia and their carers on assistive technology: a qualitative study

Abstract

ObjectivesTo explore the views and experiences of people with dementia, their family carers and general practitioners (GPs) on their knowledge and experience of accessing information about, and use of, assistive technology (AT) in dementia care.DesignQualitative methods with semistructured interviews and thematic analysis.Participants56 participants comprising 17 GPs, 13 people with dementia and 26 family carers.SettingCommunity care settings in the North East of England.Results4 main themes emerged: awareness and experience of AT; accessing information on AT; roles and responsibilities in the current care system and the future commissioning of AT services. All participants had practical experience of witnessing AT being used in practice. For people with dementia and their families, knowledge was usually gained from personal experience rather than from health and social care professionals. For GPs, knowledge was largely gained through experiential, patient-led learning. All groups acknowledged the important role of the voluntary sector but agreed a need for clear information pathways for AT; such pathways were perceived to be essential to both service providers and service commissioners.ConclusionsPeople with dementia and their family carers appear to be mainly responsible for driving a gradual increase in both awareness and the use of AT in dementia care. GPs should be equipped with the relevant knowledge to ensure families living with dementia receive appropriate information and support to enable them to live independently for as long as possible. There is an urgent need to simplify current complex community care pathways; as demonstrated in other chronic health conditions, a single point of access and a named lead professional may improve future care.

Personalisation, customisation and bricolage: how people with dementia and their families make assistive technology work for them

“…Despite attempts in public policy to promote the mainstreaming of telecare, there is currently little evidence to demonstrate that these technologies are being widely adopted, that they lead to significant improvements in care or that they are cost-effective (Bowes, Dawson and Greasley-Adams 2013;Fleming and Sum 2014;Greenhalgh et al 2013;Hirani et al 2014;Knapp et al 2015;Roberts and Mort 2009;Steventon et al 2013). Roberts and Mort (2009) argued that a mismatch exists between the promise of telecare and its material realisations, a claim which is also supported in more recent AT implementation research (Gibson et al 2015;Newton et al 2016). This suggests that despite the growing rhetoric supporting the role of technology in the care of people with dementia, there remain significant challenges to its mainstreaming.…”

Managing diabetes in people with dementia: a realist review

“…142 This is particularly important for people living with dementia for whom the dementia may progress in an uneven pattern of decline, 92 and for whom the transition from autonomy to delegation or caregiver-led management may be particularly difficult. 39,79,118 Regular contact may have particular advantages for people living with dementia, as illustrated by this quotation from a stakeholder interview:…”

“…98,102,118,125,157 For example, in a qualitative study of older adults with diabetes (aged ≥ 65 years), participants reported a variety of motivators for maintaining SM once a routine had been established. HCPs needed to understand what these motivators were and work with patients towards their SM goals.…”

“…105 Health and social care services appear to provide inadequate support because they have limited provision of appropriate technology and/or they do not have the requisite knowledge base. 91,118 Moreover, provision may be variable:…”

“…Feedback from participants included the observation that HCPs did not listen to, or were dismissive of, their concerns and, as a result, this reduced the trust that they had in their HCP. 118 A Cochrane review 137 looked at SM interventions for people with diabetes and severe mental illness. Searches, which were conducted in 2016, identified only one RCT that met the inclusion criteria.…”