Evaluating the use of Touch Screen Technology for Engaging People with Dementia in Meaningful Activity that Promotes Wellbeing- UKDC2012

June 23, 2013 by Alison Watson-Shields

Background

  • 12 month project led by Clevearc Alzheimer’s Residential Centre Ltd (Clevearc) with Tees, Esk and Wear Valleys NHS Foundation Trust and Hand in Hand Care as participants.
  • Project not formal research, rather an evaluation of the potential benefits that touch screen technology can offer to people with dementia and their carers, also the challenges involved
  • Device used as recreational resource, as might be a book, DVD, painting materials etc.
  • Evaluations commenced February 2012 in various environments e.g. care homes, clients’ homes, day centre – groups and 1-to-1’s.

Restrictions

  • No storage permitted of any information or photographs relating to patients or service users directly on the iPad. Thus could not use the iPad to facilitate the creation of a life story book.
  • iPad could not be connected to Trust computers or access Internet through Trust wi-fi connections. Bought 3G capable iPad with a data sim package; computer had to be set up at Clevearc in case ever necessary to connect the iPad to a computer.
  • No access to any personal email and social media accounts.
  • No use of Internet to access any explicit materials. Opted to use a subscription based safe browser and enable existing iPad restrictions. Access to the App Store, YouTube app, email facilities and in-app purchases all disabled.
  • Once all governance concerns addressed, steering group was set up with Clevearc as the lead agency, Hand In Hand Care and TEWV as participants.
  • Clevearc set up an Apple ID account in order to make purchases and agreed the environments that the iPad would be used in with the participants.
  • A Licence Agreement was drawn up that would be signed by all key practitioners and outlined what the iPad could be used for and the individual responsibilities of being involved in the evaluation.
  • An evaluation tool was identified and agreed by the steering group and a training package was developed which outlined how the iPad worked, how the evaluation tool should be completed and participants responsibilities.
  • Once the training had been delivered and the Licence Agreement signed, key practitioners were ready to use the iPads and evaluate its use

 

Key Project Findings based on 34 evaluations

Benefits:

  • Wide range of apps offers recreational interest for people with dementia whatever their existing abilities and can promote skill maintenance e.g. identifying colours.
  • All but one of the experiences evaluated to date promoted a sense of well-being. In the contrary instance, staff felt external influences had led to negative feedback, rather than the activity itself.
  • Findings suggest the technology is able to lift a person’s mood, evidenced in e.g. laughter and displays of affection towards others.
  • The technology can act as an aide memoire to encourage discussion and spontaneity as ideas are shared within a group.
  • Day centre report increase in alertness, concentration, communication and language that appears to last longer than the actual activity.
  • Social interaction is encouraged and a sense of community can be experienced at times as people try to help each other complete tasks e.g. making pots for sale at auction.
  • The more “soothing” apps (e.g. “Swirlicity”) can provide a diversion for people feeling agitated and distressed
  • A sense of empowerment can be gained by people regaining lost skills, e.g. replacing paintbrush with finger art.
  • People can experience increased confidence and self esteem, when able to demonstrate their existing skills.
  • The technology can help build up knowledge of a person’s life history and interests that can be built into their everyday care. This is particularly important for bridging the generational knowledge gap between support staff and clients.
  • The learning from the project is being cascaded to other care staff, environments and family carers, who are keen to take forward the benefits of the technology when working with people with dementia both at home or in day care settings.

Challenges:

  • Helpful to have some background knowledge of client as starting point to encourage interest, allay anxiety and connect with person’s sense of identity and spirituality.
  • Small screen and volume level makes it difficult to work with groups without being amplified – use of Bluetooth speakers/projectors is an asset as well as adequate lighting and seating arrangements.
  • The benefits of the technology for people with dementia needs to demonstrated through staff training and time allocated to try out the apps before actual sessions. Even apps produced for this user group are not always intuitive.
  • Frustration and negative emotions can arise if apps are not chosen, or presented, in ways appropriate to the skill level of the client or group, For example, a slide show of images may be set to run too quickly, or the tasks set by the app too demanding – good hand/eye co-ordination may be needed.
  • Managing a group activity calls for alertness and good facilitation skills on the part of staff, e.g. if a client loses interest if it isn’t their turn to hold the device. Some clients become anxious and tetchy in a group situation.
  • Having enough staff available to support activity, offer reassurance and encouragement.
  • Tension in groups needs to be managed well to stop misunderstanding escalating e.g. where people perceive others are being confrontational.
  • Periods of disinterest need to be addressed – participation needs to be voluntary and alternative activity/environment should be available.
  • Enough is enough – end activity if sense of tiredness or predominantly negative emotions are being observed.

View the Presentation

Download the Information Leaflet

Project Team

  • Richard Bradshaw – Chaplain,Tees, Esk and Wear Valleys NHS Trust,
  • Gayle Tweed – Chief Executive, Clevearc
  • Corinne Walsh – Service Development Worker, Stockton Integrated Mental Health Services for Older People
  • Alison Watson – Support Worker, Hand In Hand Care
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