Towards personalized dementia care through meaningful activities supported by technology: A multisite qualitative study with care professionals

Abstract

Background Person-centred care is widely recognised as important for helping people with dementia maintain a sense of self and purpose in life – especially for those living in care facilities. Despite this, most care practices still adopt a medical approach in which physical needs are prioritized over psychosocial well-being. Addressing the need to find ways of promoting person-centred approaches in care, this study explored care professionals’ reflections on a novel, technological intervention (SENSE-GARDEN) that combines multisensory stimuli and digital media to create personalized environments for people with dementia. The aim of this study was to explore the experiences of care professionals who had used SENSE-GARDEN for approximately 1 year. Methods Three care homes in Norway, Belgium, and Portugal and 1 hospital in Romania used the SENSE-GARDEN with residents/patients with moderate to severe dementia over the course of 1 year. Qualitative data - including observations and interviews with 2 care professionals - were collected at the beginning of the study period from the Norwegian care home to explore initial impressions of the new SENSE-GARDEN room. At the end of the study period, 8 care professionals across the 4 facilities were interviewed for an in-depth exploration of their experiences. The two sets of data were analysed separately through reflexive thematic analysis. Results At the beginning of the study period, the staffs’ focus was mainly on the novelty of the new SENSE-GARDEN room and how it provided opportunities for meaningful experiences. Post-intervention, the care professionals provided reflective accounts on how care could be delivered in alternative ways to standard practice. The themes generated from the post-intervention interviews were: “shifting focus onto personalized care”, “building and fostering relationships”, and “continuous discoveries”. Through delivering person-centred care, the professionals reported a sense of purpose and achievement in their work. Conclusions Professionals from care facilities across 4 different countries highlighted the value of interventions such as SENSE-GARDEN as a way of creating opportunities to better know people with dementia. Thus, they experienced improved relationships and greater job satisfaction. However, delivering person-centred interventions is time-consuming, and future research should evaluate the feasibility of sustaining them on a long-term basis.

Enrichment of dementia caregiving relationships through psychosocial interventions: A scoping review

“…Other studies were conducted in Australia ( n = 4), Canada ( n = 3), Hong Kong ( n = 1), and the US ( n = 7). Two articles included multi-national studies ( 56 , 57 ). Three research approaches were employed, including 12 quantitative, 11 qualitative, and 11 multi- or mixed-methods.…”

“…Most studies reported interventions ( n = 22) which involved supporting caregiving dyads to participate in social activities (either supported by objects for shared attention or structured social sessions), cognitive and multisensory stimulation and self-management. Carer-provided stimuli for PLWD was a central means to support social participation, either through cognitive stimulation therapy (CST) ( 66 , 67 ) or in dedicated rooms, the latter including multisensory stimulation to improve caregiving in institutional settings through meaningful social interactions in the caregiving dyads ( 57 , 68 ). Bemelmans et al ( 60 ) reported on an intervention involving the social pet robot, PARO, to elicit social engagement and facilitate interactions between dyads.…”

“…Common platform for activity engagement: Several interventions provided a common platform for social interaction between dyad members. By providing a point of joint attention between the dyad members ( 59 , 60 , 72 , 79 ), the interventions created a framework within which they could engage in meaningful activities together ( 56 , 57 , 69 , 76 ). Regardless of whether the interventions aimed to stimulate positive social interactions ( 59 – 61 , 66 ) or empowerment ( 56 , 87 ), the fact that the focus was on the social aspects themselves and not on regular caregiving duties ( 63 , 68 , 75 ) provided structure to the social interactions.…”

“…Dementia-friendly activities: Most interventions engaged both dyad members in dementia-friendly activities, and as Figure 2 shows, this category was the most-represented category of all intervention components across all three core elements. These intervention components involved individualized social and physical stimulation for PLWD ( 57 , 59 , 61 , 62 , 66 , 67 , 72 , 77 ) to engage both dyad members in social interactions. Enhancing dementia caregiving: Interventions which, in one way or another, could facilitate caregiving activities ( 60 , 63 , 70 , 76 , 86 ).…”

“…When analyzing the interventions included in this review, elements contributing to this enrichment core element were categorized into four categories: (i) core focus on the dyadic relationship; (ii) supporting communication; (iii) common platform for activity engagement; and (iv) socially oriented caregiving. Core focus on the dyadic relationship: Nine studies they could engage in meaningful activities together (56,57,69,76). Regardless of whether the interventions aimed to stimulate positive social interactions (59)(60)(61)66) or empowerment (56,87), the fact that the focus was on the social aspects themselves and not on regular caregiving duties (63,68,75) provided structure to the social interactions.…”