Objectives Technology-based prompting has the potential to support people with dementia to complete multistep tasks in the home. However, these devices can be complex to use. This paper reports a feasibility trial of a personalised touchscreen digital prompter designed for home use. Methodology: A tablet-based prompter suitable for people living with dementia was developed, along with a detailed guidance manual. Carers loaded instructions for completing the task onto the prompter, and the person with dementia then used the tablet independently to complete a task. Eleven couples used the prompter 'out-of-the-box' with no support other than a guidance manual. Results The majority of participants with dementia could follow the steps on the prompter, and carers were able to breakdown and load tasks onto the prompter. Eight couples used the prompter successfully to complete goals that they had identified in advance. These included preparing simple snacks and using a TV remote control. Successfully achieving goals was associated with more frequent use of the prompting screen on more days, but not higher levels of editing or previewing of tasks. Conclusion The study provides the preliminary evidence that family caregivers can use a touchscreen tablet, software and manual package to identify specific tasks and break these down into steps and that people living with dementia can then follow the prompts to complete the tasks. This potentially represents an important advance in dementia care. Further testing is required to establish efficacy and to identify any factors that impact on outcomes.

Objectives To investigate the relative effectiveness of different prompts for people with dementia during multistep tasks in the home, to inform prompting technology design. Methods Nine pairs of participants (one with dementia and a partner or relative) participated at home. The participants with mild to moderate dementia (5M/4F, aged 73–86 years) functioned at the Planned or Exploratory levels of the Pool Activity Level instrument. A touchscreen computer displayed different prompts during two set tasks: “card-and-envelope” and “CD player.” The trials were scored to establish the relative effectiveness of the prompts. Individual tasks were also explored. Results Text and audio prompts were each more effective than video or picture prompts for a card-and-envelope task, but this was not seen in a CD player task. The differences may be related to the type of actions within the tasks; the card-and-envelope actions were easier to convey verbally; the CD player actions lent themselves to visual prompts. Conclusions Designers of technology-based prompts for people with dementia should consider that the effectiveness of different prompts is likely to be task dependent. Familiar, unambiguous language can increase the success of tailored prompts. There are significant practical challenges associated with choosing and deconstructing everyday tasks at home.

People with dementia and family carers often use calendars to support time orientation to maintain routine. However, little is known about the use of calendars as a compensatory strategy. This study examines the experience and practicalities of using calendar reminders from the perspective of people with dementia and family carers. Six dyads were recruited and interviewed at home. Interpretative Phenomenological Analysis was used to develop a narrative interpreted from an occupational therapy perspective. The themes were reflected on during two subsequent focus groups. Findings suggested that calendars are used either intensively as external memory records or more casually and randomly for reassurance. The familiarity and location of the calendar and its utility to the person with dementia and carer, all contribute to its efficacy. For carers the experience of supporting calendar reminders encompasses practical, cognitive and emotional effort. There was little awareness amongst participants of electronic assistive technology.

This technology evaluation study assessed a personalised digital prompter designed for people with dementia, by trialling its use in the home by people with dementia and their carers. Technology based prompting may be used to support people with dementia to complete multi-step tasks in the home, provided that suitable tasks can be chosen and that a carer is able to load appropriate task steps onto the prompter. A prompter was developed specifically for this purpose, along with a detailed guidance manual. Twelve participants with mild or moderate dementia carried out cognitive tests and their carers completed carer burden and carer competence scales. Each pair attended a training session with a researcher and were provided with the prompter and instruction manual. The prompter was trialled at home for four weeks after a one-week familiarisation period, for use with a simple set task and one or two tasks chosen by the participants. Semi-structured interviews were used to capture the views of the participants at the start and end of the home testing, and to set and evaluate goals. Chosen tasks included preparing simple food and drinks, and using home appliances including coffee machines and television remote controls. There was a weak correlation between greater goal success for the participants and the carer goal success, number letter switching within the D-KEFS and ACE-III score. A thematic analysis of the interviews revealed three core themes relating to familiarity with technology, utility of the prompter and the cost versus benefit in terms of the effort required to set up the prompter. Factors influencing success could be grouped into: participants' motivation and capability; the design of the prompter; and the details of the task being carried out. Barriers to success included the difficulty of choosing a suitable task and the effort required to break down a task in to appropriate steps. All of the participants with dementia could follow the steps on the prompter, and all of the carers were able to choose, breakdown and load at least one task onto the prompter during the training session, but successful use in the home was varied because of the increased complexity of the home context. Changes to the hardware, software and manual were made in response to the data gathered during the study, in readiness for the planned further testing.

Purpose The purpose of this paper is to explore a large data set compiled by a UK charity loan scheme to identify trends and paint a practice-based picture of how young children use early years powered mobility (EYPM). Design/methodology/approach Statistical analysis was used to investigate a database of 90 children, ranging in age from 15 to 72 months who completed use of an EYPM device (the Wizzybug, or WB) between April 2011 and December 2015. Goals were set and reviewed, and thematic analysis was used to understand families’ insights into their children’s use of EYPM, using a free-text review form. Findings Children’s mean age when joining this free loan scheme was 39.6 months. The later the child started using a Wizzybug, the less likely they were to achieve their goals. A theme of happiness and enjoyment emerged as important for both child and family. The child’s independence translated to independence for the whole family. Research limitations/implications The database was operational and incomplete. Lack of a standardised outcome measure was disadvantageous. Practical implications Challenges of translating research knowledge into practice are highlighted, supporting the need for more rigorous and standardised outcome measures. Earlier identification of children’s readiness for EYPM is required alongside research and recognition of the holistic benefits of EYPM for all the family. Originality/value This research profited from a large data set of young children with long-term access to powered mobility at home.

Time disorientation is common in dementia, and can cause difficulty in knowing what day or time it is, or whether it is day or night. Some time orientation products exist to mitigate this, but the need for a simpler product was highlighted by relatives of people with dementia. The Day Clock was developed to meet this need, displaying only the day of the week and part of the day, by working in consultation with people with dementia, carers and healthcare professionals. Questionnaires and user trials were used to fully understand the product requirements. The design was further developed with a commercial partner and supplied as a market product. The Day Clock was evaluated with 123 people with dementia or memory problems as part of a local memory technology lending library, and the majority of goals set using Goal Attainment Scaling by people with dementia and their carers were met as a result of using the Day Clock. There was good acceptability and evidence of efficacy of the Day Clock, in what was one of the largest formal evaluations to date of assistive technology for people with dementia. Understanding the requirements of people living with dementia and their carers, and carrying out iterative design, has underpinned the development of this product and justifies the final design of the Day Clock which gives the day of the week and part of the day but does not tell the time.

Simulated presence therapy is a technique which utilises a familiar recorded voice to calm and reassure people with dementia who are agitated or anxious. Although simulated presence therapy has shown potential benefits in small-scale studies, practical limitations in making and playing the recordings have restricted its use. An alternative method of delivering a message from an attachment figure is through a personal message card. This was one of seven products used within the Bath Memory Technology Library which was made available free of charge to people affected by dementia and their carers. This paper provides an evaluation of the personal message cards. Although feedback was received on only 10 of the 24 cards that were distributed, for nine people there was evidence that the cards met the goals that had been set either fully or in part, and that people affected by even quite severe levels of dementia could benefit from them.

Enabling smart technology uses a system of pre-recorded prompts or messages to support people with dementia to live independently. The aim is to use an integrated messaging system to support an individual's independence. Bath Institute of Medical Engineering evaluated this technology over a 12-month period in a Housing 21, very sheltered housing, flat with a single tenant who had moderate dementia. This practice experience has highlighted the importance of a therapeutic approach to ensure that the use of technology is optimised for the benefit of vulnerable adults and their families.

This two-year project aims to investigate in detail how prompting can help to guide people with dementia through tasks independently in a domestic setting. Four formats of prompt (text, audio, video and picture) are being compared with each other during domestic user-testing visits, to establish the relative strengths and weaknesses of each format. The importance of providing overall task context at each step, and ways of manual or automatic forwarding to the next instruction, will also be explored. Early findings from user testing have shown that comparable text or audio prompts are more effective means of prompting than picture or video prompts, and that there is strong potential for people with dementia to be able to control the timing of the prompts to work through the task at their own pace. These findings will be combined and the prompts will be developed iteratively so that prototype pieces of prompting technology can be created to enable a person with dementia to successfully carry out a task independently.

Background: Technology plays an increasing role in our everyday lives, but we have yet to explore its full potential for supporting independent living.Content: This article gives an overview of the range of new telecare technology that is available and looks at some of the current challenges and future opportunities this presents. The evidence base for the effectiveness still needs to be established and more work is needed to quantify the benefits for carers. There are opportunities around the application of the technology to support independent living for people with dementia. We discuss our experiences and the potential for assistive technology.Conclusion: Although technology has great potential for supporting independent living, we are currently utilizing a fraction of this capacity. To fully realize its benefits, a systematic and cohesive approach across various sectors needs to be adopted.

This chapter is about the application of behaviour monitoring technology in the context of a smart home for people with dementia. It is not about the design of technology, but about the application and configuration of existing technology in a specific context: in this case, smart flats for people with dementia in London and Bristol. Technology was installed and evaluated in a year long evaluation in London by a resident tenant. He was assessed throughout his tenancy using standardized outcome measures, by clinical professionals; and through the analysis of data collected by sensors installed in his flat. It was demonstrated that the technology had a positive impact on his life, improving his sleep in particular. This improvement had a positive effect on many other aspects of his life in the extra care setting where he lived. The Bristol evaluation is in progress. It is also an evaluation of smart home technology embedded in a person's own home.This chapter also describes two technologies being developed at the University of Toronto, in Canada. The first is COACH, a system used for the guidance of activities of daily living, and the second is HELPER, a fall detection and personal emergency response system (PERS). These technologies operate autonomously with little or no explicit input from the person using them, making them extremely intuitive and effortless to use. Practical experience and clinical results gained from the latest efficacy trials with COACH are presented and discussed. From the data collected through these trials, it seems that COACH has a positive effect on peoples' ability to independently complete the activity of handwashing. It is hoped that monitoring technologies such as these will improve the independence and quality of life for people with dementia.

This paper presents the results of a study evaluating a complete autonomous smart home installation in an apartment in a care home, and the impact it had on the behaviour and independence of someone with quite severe dementia (Mini Mental State Examination, or MMSE, of 10). It describes the technology that has been evolved for this purpose, and how the apartment was configured. The evaluation compared the behaviour of the resident before and after the switching on of a wide range of autonomous support technology, by analysing the logged sensor data, through a questionnaire‐based outcome measure, and through transcribed interviews. The technology enabled the client to retain a lot of independence. It helped him to regain urinary continence, improved his sleep from around 3.5 hours per night to 5.5, and halved the number of night‐time wanderings. The paper concludes with a series of recommendations for future work in this area.

This paper describes work in progress evaluating a smart flat for people with dementia that is part of an Extra-Care development in London. The flat has been let to a permanent tenant who has dementia. They are fitted with a KNX (EIB) based integrated smart house system providing local intervention and monitoring in the event of a problem being detected by the built in distributed sensor network. Close cooperation between the system designers, housing manager, social services, evaluation team, users and carers has proved to be important to successful and efficient completion of the design and installation of this technology and its subsequent evaluation. It is expected that much data will be collected using outcome measures and data logging that will facilitate the configuration and evaluation of smart systems for people with dementia

Robotic technology is now being developed as a tool for assisting everyday activity. The Weston robot is a prototype robotic arm developed by the Bath Institute of Medical Engineering. This article describes how volunteers evaluated the robotic arm in their own homes and how their practical experiences and views are refining and guiding this project.