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Health and Wellbeing Promotion for People Living with Dementia through Human-Centred Technologies

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Digital Health".

Deadline for manuscript submissions: closed (30 November 2022) | Viewed by 27005

Special Issue Editors


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Guest Editor
Department of Communication Design and Digital Media Design, Swinburne University of Technology, Hawthorn VIC 3122, Melbourne, Australia
Interests: design for aging; aged care; ergonomics and aesthetics design: cognitive models; interaction design; user-centred design; human computer interaction
Centre for Design Innovation, Swinburne University of Technology, Hawthorn VIC 3122, Melbourne, Australia
Interests: aged care; computing education; human computer interactions; product innovation design; service design; education; design for aging; co-design; interaction design; gerontology; dementia; human interest and motivation

Special Issue Information

Dear Colleagues,

Human–computer interaction (HCI) plays an increasingly important role in supporting the wellbeing and health of people living with dementia through everyday interactive products. Research has shown that feelings of independence, confidence, and social relatedness can increase wellbeing. These concepts have yet to be explored in depth in regard to their longer-term impact for people living with dementia supported by technology. We are interested in how people living with dementia engage with technologies to gain more independence, foster equal participation, and maintain positive social interactions facilitated by technology. Person-centred care and Kitwood’s concept of personhood demands that technologies used in care enable interactions that are flexible and can be tailored to individual needs, interests, and life goals through carers and increasingly lifestyle staff. We invite articles promoting technologies that are striving for normality and holistic health without stigmatising people with dementia further and excluding them from participating in daily activities and social interactions. The key aim of this issue is to show evidence of how technologies can facilitate engagement with meaningful activities, increasing health and wellbeing for people with dementia and their relationships beyond the principles of clinical or medical care. We advocate participatory methods in designing, developing, and evaluating these technologies. While focussing on the individual living with dementia, we also emphasise the need to consider the wider sociotechnical system during technology implementation. We encourage contributions of any type of technologies targeting the range of dementia conditions from early diagnosis to late-stage dementia.

Dr. Sonja Pedell
Dr. Jeanie Beh
Guest Editors

Manuscript Submission Information

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Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • human–computer interaction
  • dementia
  • wellbeing technology
  • sociotechnical systems
  • health
  • human-centred design
  • participatory design
  • social integration
  • engagement
  • technology evaluation

Published Papers (9 papers)

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Research

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15 pages, 4137 KiB  
Article
HUG: A Compassionate Approach to Designing for Wellbeing in Dementia Care
by Cathy Treadaway, Abdul Seckam, Jac Fennell and Aidan Taylor
Int. J. Environ. Res. Public Health 2023, 20(5), 4410; https://doi.org/10.3390/ijerph20054410 - 1 Mar 2023
Cited by 2 | Viewed by 2649
Abstract
Design can improve the quality of life of people living with dementia but creating successful design solutions is not simple, due to the complexity of the medical condition, and the ethical considerations of including those affected in design research and evaluation. This article [...] Read more.
Design can improve the quality of life of people living with dementia but creating successful design solutions is not simple, due to the complexity of the medical condition, and the ethical considerations of including those affected in design research and evaluation. This article describes research involving an interactive product, ‘HUG’, developed from academic research, to support the wellbeing of people living with advanced dementia, which is now commercially available. People affected by dementia were included at every stage in the design research process. The evaluation of HUG took place in both hospital and care home contexts with 40 participants living with dementia. In this paper, a qualitative hospital study is described, in which patients received a HUG on prescription. Findings reveal that although HUG was rejected by some, those patients who did accept it benefitted significantly. Not only did the device reduce distress, anxiety and agitation but it also helped with patient compliance in medical procedures, aspects of daily care and enhanced communication and socialisation. The Alzheimer’s Society’s accelerator partnership funding has enabled this product to be manufactured and made commercially available so that the benefits of this academic design research can be made more widely available to people living with dementia. Full article
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15 pages, 2313 KiB  
Article
Affective Out-World Experience via Virtual Reality for Older Adults Living with Mild Cognitive Impairments or Mild Dementia
by Maria Matsangidou, Theodoros Solomou, Fotos Frangoudes, Konstantinos Ioannou, Panagiotis Theofanous, Ersi Papayianni and Constantinos S. Pattichis
Int. J. Environ. Res. Public Health 2023, 20(4), 2919; https://doi.org/10.3390/ijerph20042919 - 7 Feb 2023
Cited by 6 | Viewed by 2448
Abstract
Older adults with cognitive impairments may face barriers to accessing experiences beyond their physical premises. Previous research has suggested that missing out on emotional experiences may affect mental health and impact cognitive abilities. In recent years, there has been growing research interest in [...] Read more.
Older adults with cognitive impairments may face barriers to accessing experiences beyond their physical premises. Previous research has suggested that missing out on emotional experiences may affect mental health and impact cognitive abilities. In recent years, there has been growing research interest in designing non-pharmacological interventions to improve the health-related quality of life of older adults. With virtual reality offering endless opportunities for health support, we must consider how virtual reality can be sensitively designed to provide comfortable, enriching out-world experiences to older adults to enhance their emotional regulation. Thirty older adults living with mild cognitive impairment or mild dementia participated in the study. Affect and emotional behavior were measured. The usability and the sense of presence were also assessed. Finally, we assessed the virtual reality experiences based on physiological responses and eye-tracking data. The results indicated that virtual reality can positively enhance the mental health of this population by eliciting a positive affective state and enhancing their emotional regulation. Overall, this paper raises awareness of the role of virtual reality in emotion elicitation, regulation, and expression and enhances our understanding of the use of virtual reality by older adults living with mild cognitive impairments or mild dementia. Full article
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15 pages, 568 KiB  
Article
Reflecting on Living Labs as Multi-Stakeholder Collaborative Networks to Evaluate Technological Products for People Living with Dementia
by Francesca Toso, Rens Brankaert, Niels Hendriks, Lieke Lenaerts and Andrea Wilkinson
Int. J. Environ. Res. Public Health 2023, 20(3), 1673; https://doi.org/10.3390/ijerph20031673 - 17 Jan 2023
Viewed by 1867
Abstract
Dementia is a growing societal challenge putting pressure on care systems across Europe. Providing supporting technology for people living with dementia, referring to both people with dementia and their caregivers, is an important strategy to alleviate pressure. In this paper, we present lessons [...] Read more.
Dementia is a growing societal challenge putting pressure on care systems across Europe. Providing supporting technology for people living with dementia, referring to both people with dementia and their caregivers, is an important strategy to alleviate pressure. In this paper, we present lessons learned from the Interreg NWE Project Certification-D, in which we evaluated technological products with people living with dementia, using a Living Lab approach. Living Labs were set up in five different countries to conduct field evaluations at the homes of people living with dementia. Via an open call products from small to medium enterprises across northwestern Europe were selected to be evaluated in the Living Labs. In this paper, we describe the setup of and reflection on Living Labs as multi-stakeholder collaboration networks to evaluate technological products in the context of dementia. We reflect on the experiences and insights from the Living Lab researchers to execute and operate the Living Labs in such a sensitive setting. Our findings show that Living Labs can be used to conduct field evaluations of products, that flexibility is required to adopt a Living Lab in various care settings with different stakeholder compositions and expertise, and that Living Lab researchers serve as both a linking pin and buffer between people living with dementia and companies and thereby support the adoption of technological products. We close the paper with a proposal of best practices to encourage inclusivity in, and scalability of, Living Labs in the context of dementia. Full article
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22 pages, 5377 KiB  
Article
Introducing and Familiarising Older Adults Living with Dementia and Their Caregivers to Virtual Reality
by Aisling Flynn, Marguerite Barry, Wei Qi Koh, Gearóid Reilly, Attracta Brennan, Sam Redfern and Dympna Casey
Int. J. Environ. Res. Public Health 2022, 19(23), 16343; https://doi.org/10.3390/ijerph192316343 - 6 Dec 2022
Cited by 5 | Viewed by 2760
Abstract
Virtual Reality (VR) is increasingly being applied in dementia care across a range of applications and domains including health and wellbeing. Despite the commercial availability of VR, informants of design are not always aware of its functionality and capabilities, to meaningfully contribute to [...] Read more.
Virtual Reality (VR) is increasingly being applied in dementia care across a range of applications and domains including health and wellbeing. Despite the commercial availability of VR, informants of design are not always aware of its functionality and capabilities, to meaningfully contribute to VR design. In designing VR applications for people living with dementia, it is recommended that older adults living with dementia and their support persons be involved in the design process using participatory approaches, thereby giving them a voice on the design of technology from the outset. A VR technology probe is a useful means of familiarising older adults living with dementia and their informal caregivers with the knowledge and understanding of interactive VR to employ technology that supports them to maintain their social health. This paper charts the implementation and evaluation of a VR technology probe, VR FOUNDations. To explore their experiences, nine older adults living with dementia and their nine informal caregivers trialled VR FOUNDations and completed semi-structured interviews after its use. Overall, older adults living with dementia and their informal caregivers perceived VR FOUNDations to achieve its aim of increasing understanding and inspiring future design decisions. The findings also identified promising positive experiences using a VR technology probe which may be indicative of its applicability to social health and wellbeing domains. This paper advocates for the structured design and implementation of VR technology probes as a pre-requisite to the participatory design of VR applications for the health and wellbeing of people living with dementia. The use of such technology probes may afford older adults living with dementia and their informal caregivers the best opportunity to contribute to design decisions and participate in technology design to support their health and wellbeing. Full article
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9 pages, 338 KiB  
Article
How Do We Know Co-Created Solutions Work Effectively within the Real World of People Living with Dementia? Learning Methodological Lessons from a Co-Creation-to-Evaluation Case Study
by Grahame Smith, Chloe Dixon, Rafaela Neiva Ganga and Daz Greenop
Int. J. Environ. Res. Public Health 2022, 19(21), 14317; https://doi.org/10.3390/ijerph192114317 - 2 Nov 2022
Cited by 1 | Viewed by 1807
Abstract
Living Labs (LL) are a novel and potentially robust way of addressing real-life health challenges, especially within the dementia field. Generally, LLs focus on co-creating through implementing the quadruple helix partnership as a user-centric approach to co-creating. In the context of this paper, [...] Read more.
Living Labs (LL) are a novel and potentially robust way of addressing real-life health challenges, especially within the dementia field. Generally, LLs focus on co-creating through implementing the quadruple helix partnership as a user-centric approach to co-creating. In the context of this paper, the users were people with dementia and their informal carers. LL are not necessarily environments that evaluate these co-created innovations within the real world. Considering this disconnect between co-creation and real-world evaluation, this paper, as a critical commentary, will reflect on the methodological lessons learnt during the development of an LL model aimed at addressing this discrepancy. The LL at Liverpool John Moores University (LJMU) was commissioned to co-create and then evaluate a new Dementia Reablement Service. The case study findings revealed that the Dementia Reablement Service had a positive impact on the quality of life of people with dementia, suggesting that the service is a catalyst for positive change. In addition, the critical learning from this case study highlights the potential role of LLs in seamlessly co-creating and then evaluating the co-created solution within the real world. A benefit of this way of working is that it provides opportunities for LLs to secure access to traditional research funding. Full article
18 pages, 1865 KiB  
Article
Toward the Integration of Technology-Based Interventions in the Care Pathway for People with Dementia: A Cross-National Study
by Vera Stara, Benjamin Vera, Daniel Bolliger, Susy Paolini, Michiel de Jong, Elisa Felici, Stephanie Koenderink, Lorena Rossi, Viviane Von Doellen and Mirko di Rosa
Int. J. Environ. Res. Public Health 2021, 18(19), 10405; https://doi.org/10.3390/ijerph181910405 - 2 Oct 2021
Cited by 4 | Viewed by 4270
Abstract
Background: The integration of technology-based interventions into health and care provision in our aging society is still a challenge especially in the care pathway for people with dementia. Objective: The study aims to: (1) identify which socio-demographic characteristics are independently associated with the [...] Read more.
Background: The integration of technology-based interventions into health and care provision in our aging society is still a challenge especially in the care pathway for people with dementia. Objective: The study aims to: (1) identify which socio-demographic characteristics are independently associated with the use of the embodied conversational agent among subjects with dementia, (2) uncover patient cluster profiles based on these characteristics, and (3) discuss technology-based interventions challenges. Methods: A virtual agent was used for four weeks by 55 persons with dementia living in their home environment. Results: Participants evaluated the agent as easy-to-use and quickly learnable. They felt confident while using the system and expressed the willingness to use it frequently. Moreover, 21/55 of the patients perceived the virtual agent as a friend and assistant who they could feel close to and who would remind them of important things. Conclusions: Technology-based interventions require a significant effort, such as personalized features and patient-centered care pathways, to be effective. Therefore, this study enriches the open discussion on how such virtual agents must be evidence-based related and designed by multidisciplinary teams, following patient-centered care as well as user-centered design approaches. Full article
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9 pages, 303 KiB  
Article
Volunteers’ Support of Carers of Rural People Living with Dementia to Use a Custom-Built Application
by Clare Wilding, Hilary Davis, Tshepo Rasekaba, Mohammad Hamiduzzaman, Kayla Royals, Jennene Greenhill, Megan E. O’Connell, David Perkins, Michael Bauer, Debra Morgan and Irene Blackberry
Int. J. Environ. Res. Public Health 2021, 18(18), 9909; https://doi.org/10.3390/ijerph18189909 - 20 Sep 2021
Cited by 4 | Viewed by 2984
Abstract
There is great potential for human-centred technologies to enhance wellbeing for people living with dementia and their carers. The Virtual Dementia Friendly Rural Communities (Verily Connect) project aimed to increase access to information, support, and connection for carers of rural people living with [...] Read more.
There is great potential for human-centred technologies to enhance wellbeing for people living with dementia and their carers. The Virtual Dementia Friendly Rural Communities (Verily Connect) project aimed to increase access to information, support, and connection for carers of rural people living with dementia, via a co-designed, integrated website/mobile application (app) and Zoom videoconferencing. Volunteers were recruited and trained to assist the carers to use the Verily Connect app and videoconferencing. The overall research design was a stepped wedge open cohort randomized cluster trial involving 12 rural communities, spanning three states of Australia, with three types of participants: carers of people living with dementia, volunteers, and health/aged services staff. Data collected from volunteers (n = 39) included eight interviews and five focus groups with volunteers, and 75 process memos written by research team members. The data were analyzed using a descriptive evaluation framework and building themes through open coding, inductive reasoning, and code categorization. The volunteers reported that the Verily Connect app was easy to use and they felt they derived benefit from volunteering. The volunteers had less volunteering work than they desired due to low numbers of carer participants; they reported that older rural carers were partly reluctant to join the trial because they eschewed using online technologies, which was the reason for involving volunteers from each local community. Full article

Review

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16 pages, 2929 KiB  
Review
Designing Work with People Living with Dementia: Reflecting on a Decade of Research
by Paul A. Rodgers
Int. J. Environ. Res. Public Health 2021, 18(22), 11742; https://doi.org/10.3390/ijerph182211742 - 9 Nov 2021
Cited by 5 | Viewed by 2109
Abstract
The United Nations Universal Declaration of Human Rights is widely acknowledged as a landmark document in the history of human rights. Drafted by representatives from all over the world, the declaration was proclaimed by the United Nations General Assembly in Paris on 10 [...] Read more.
The United Nations Universal Declaration of Human Rights is widely acknowledged as a landmark document in the history of human rights. Drafted by representatives from all over the world, the declaration was proclaimed by the United Nations General Assembly in Paris on 10 December 1948 (General Assembly resolution 217 A) as a common standard for all peoples and all nations. The declaration sets out a series of articles that articulate a number of fundamental human rights to be universally protected. Article 23 of the declaration relates to the right to work and states that people have a human right to work, or engage in productive employment, and may not be prevented from doing so. The right to work is enshrined in international human rights law through its inclusion in the International Covenant on Economic, Social and Cultural Rights, where the right to work emphasizes economic, social and cultural development. This paper presents ongoing research that highlights how a disruptive co-design approach contributes to upholding UN Article 23 through the creation of a series of innovative working practices developed with people living with dementia. The research, undertaken in collaboration with several voluntary and third sector organizations in the UK, looks to break the cycle of prevailing opinions, traditional mindsets, and ways-of-doing that tend to remain uncontested in the health and social care of people living with dementia. As a result, this research has produced a series of innovative work opportunities for people living with dementia and their formal and informal carers that change the perception of dementia by showing that people living with dementia are capable of designing and making desirable products and offering much to UK society after diagnosis. In this ongoing research, the right to continue to work for people living with dementia post-diagnosis in creative and innovative ways has clearly helped to reconnect them to other people, helped build their self-esteem, identity and dignity and helped keep the person with dementia connected to their community, thus delaying the need for crisis interventions. This paper reports on a series of future work initiatives for people living with dementia where we have used design as a disruptive force for good to ensure that anyone diagnosed with dementia can exercise their right to work and engage in productive and rewarding employment. Full article
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Other

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14 pages, 467 KiB  
Systematic Review
Gait Assessment Using Wearable Sensor-Based Devices in People Living with Dementia: A Systematic Review
by Yehuda Weizman, Oren Tirosh, Jeanie Beh, Franz Konstantin Fuss and Sonja Pedell
Int. J. Environ. Res. Public Health 2021, 18(23), 12735; https://doi.org/10.3390/ijerph182312735 - 2 Dec 2021
Cited by 10 | Viewed by 3450
Abstract
The ability of people living with dementia to walk independently is a key contributor to their overall well-being and autonomy. For this reason, understanding the relationship between dementia and gait is significant. With rapidly emerging developments in technology, wearable devices offer a portable [...] Read more.
The ability of people living with dementia to walk independently is a key contributor to their overall well-being and autonomy. For this reason, understanding the relationship between dementia and gait is significant. With rapidly emerging developments in technology, wearable devices offer a portable and affordable alternative for healthcare experts to objectively estimate kinematic parameters with great accuracy. This systematic review aims to provide an updated overview and explore the opportunities in the current research on wearable sensors for gait analysis in adults over 60 living with dementia. A systematic search was conducted in the following scientific databases: PubMed, Cochrane Library, and IEEE Xplore. The targeted search identified 1992 articles that were potentially eligible for inclusion, but, following title, abstract, and full-text review, only 6 articles were deemed to meet the inclusion criteria. Most studies performed adequately on measures of reporting, in and out of a laboratory environment, and found that sensor-derived data are successful in their respective objectives and goals. Nevertheless, we believe that additional studies utilizing standardized protocols should be conducted in the future to explore the impact and usefulness of wearable devices in gait-related characteristics such as fall prognosis and early diagnosis in people living with dementia. Full article
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