Bridging gaps in the design and implementation of socially assistive technologies for dementia care: the role of occupational therapy

Dementia is a global health challenge, and people living with dementia (PLWD) are especially susceptible to reduced engagement in meaningful occupations, including social participation. In the past few decades, socially assistive technologies continue to be developed amidst a rapidly evolving technological landscape to support the social health of PLWD and their caregivers. Examples include social robots, virtual reality, smart home technology, and various digital technologies, such as mobile applications for tablets and smartphones. Despite an increasing body of research and interest in this field, several gaps relating to the design and implementation process of socially assistive technologies continue to undermine their relevance for PLWD in daily life. In this paper, some of these gaps are highlighted and the role of occupational therapy in the design and implementation of socially assistive technology is presented. In the design process, occupational therapists are uniquely skilled to advise and advocate for the tailoring and personalisation of technology to address the occupational needs of PLWD. In the implementation of socially assistive technologies, occupational therapists are skilled to educate, train, and conduct ongoing evaluations with PLWD and their caregivers, to incorporate socially assistive technologies into their routine and daily lives. We recommend that occupational therapists should continue to be acquainted with such technologies through continuous professional development and educational curricula. Moreover, we highlight the necessary collaboration between occupational therapists, technology developers, and researchers to enhance the process of designing and implementing socially assistive technology, so that their relevance for PLWD and their caregivers can be maximised.Implications for rehabilitationDevelopers and designers of socially assistive technology should consider the disease trajectory of different types of dementia, as well as the different needs, abilities, preferences, occupations and routines of people living with dementia (PLWD) and/or their caregivers.Collaborations between technology developers, researchers, and occupational therapists should take place iteratively throughout the process of designing and implementing socially assistive technology to maximise their relevance and applicability for people living with dementia and their caregivers.To continue enhancing the current role of occupational therapy in socially assistive technology provision, occupational therapists should keep up to date with socially assistive technology that are being developed to support the social health of PLWD.

Supporting early-career dementia researchers: Identifying support needs and ways forward via a European study

INTRODUCTION

Early-career researchers contribute significantly to dementia research and clinical practice. However, a growing group of early-career dementia researchers (ECDRs) lack appropriate support throughout their careers. Thus, we aim to (i) explore support needs, (ii) determine recommendations, and (iii) set the agenda for organizations to better support ECDRs.

METHODS

An iterative, explanatory sequential mixed-methods design was applied. First ECDRs' needs were identified using an online survey informed by the Vitae Researcher Development Framework. Next, priority areas were selected and explored qualitatively with ECDRs in two workshops, utilizing the World Café methodology.

RESULTS

Sixty-five ECDRs throughout Europe completed the survey, with the majority reporting that greater support is needed in terms of funding and career opportunities, social support and well-being, and "wide-reaching" dissemination.

DISCUSSION

Based on the findings, six recommendations for support organizations, funding bodies, and universities to better support ECDRs are formulated, each intended for specific target audiences.

HIGHLIGHTS

This article reports on focal points of career-related support needed in doctoral education and postdoctoral employment to foster a healthier academic environment, including finance, work-life balance, dissemination of research findings, and supervision, both in general and in dementia fields specifically. Funding and resources were identified as a significant challenge, and there was a call for more long-term positions and transition funding for postdoctoral researchers. Early-career dementia researchers addressed the need for support in producing outputs for non-academic audiences, including people living with dementia. The importance of disseminating research to diverse audiences has long been recognized; thus, it is critical that early-career dementia researchers be supported in this effort. Recommendations were formulated for researcher support (organizations), funding bodies, and universities. These recommendations include providing support for disseminating research to non-academic audiences, offering training in supervision skills, and promoting peer-to-peer mentoring and social activities for early-career dementia researchers.

The Usability and Impact of a Low-Cost Pet Robot for Older Adults and People With Dementia: Qualitative Content Analysis of User Experiences and Perceptions on Consumer Websites

Background

Worldwide, populations are aging exponentially. Older adults and people with dementia are especially at risk of social isolation and loneliness. Social robots, including robotic pets, have had positive impacts on older adults and people with dementia by providing companionship, improving mood, reducing agitation, and facilitating social interaction. Nevertheless, the issue of affordability can hinder technology access. The Joy for All (JfA) robotic pets have showed promise as examples of low-cost alternatives. However, there has been no research that investigated the usability and impact of such low-cost robotic pets based on perceptions and experiences of its use with older adults and people with dementia.

Objective

The aim of our study was to explore the usability and impact of the JfA robotic cat, as an example of a low-cost robot, based on perceptions and experiences of using the JfA cat for older adults and people with dementia.

Methods

We used a novel methodology of analyzing a large volume of information that was uploaded by reviewers of the JfA cat onto online consumer review sites. Data were collected from 15 consumer websites. This provided a total of 2445 reviews. Next, all reviews were screened. A total of 1327 reviews that contained information about use of the JfA cat for older adults or people with dementia were included for analysis. These were reviews that contained terms relating to “older adults,” “dementia,” and “institutional care” and were published in the English language. Descriptive statistics was used to characterize available demographic information, and textual data were qualitatively analyzed using inductive content analysis.

Results

Most reviews were derived from consumer sites in the United States, and most reviewers were family members of users (ie, older adults and people with dementia). Based on the qualitative content analysis, 5 key themes were generated: prior expectations, perceptions, meaningful activities, impacts, and practicalities. Reviewers had prior expectations of the JfA cat, which included circumstantial reasons that prompted them to purchase this technology. Their perceptions evolved after using the technology, where most reported positive perceptions about their appearance and interactivity. The use of the robot provided opportunities for users to care for it and incorporate it into their routine. Finally, reviewers also shared information about the impacts of device and practicalities related to its use.

Conclusions

This study provides useful knowledge about the usability and impact of a low-cost pet robot, based on experiences and perceptions of its use. These findings can help researchers, robot developers, and clinicians understand the viability of using low-cost robotic pets to benefit older adults and people with dementia. Future research should consider evaluating design preferences for robotic pets, and compare the effects of low-cost robotic pets with other more technologically advanced robotic pets.

Technological Interventions and Social Participation in Community-Dwelling Older Adults With or Without Dementia

Social isolation is a growing health issue in community-dwelling older adults with and without dementia as it can negatively affect their health and well-being. Consequently, psychosocial interventions targeting their social participation are increasingly gaining importance. So far, however, little is known about the potential of technological interventions in this population. Therefore, this systematic review explored the effectiveness of technological interventions in improving social participation of community-dwelling older adults with and without dementia. Records identified through five scientific databases were independently screened by two reviewers. A total of 36 studies published between 2005 and 2020 were included in a narrative synthesis. Studies differed widely in study design, type of technology, used outcome measures, and methodological quality. However, the findings highlight the potential role of technological interventions in improving different dimensions of social participation. At the same time, barriers and facilitators of these interventions to social participation were identified.

Experiences and perceptions of using a low-cost pet robot for older adults and people with dementia

Pet robots are a practicable substitute for animal-assisted therapy. They have been shown to have positive impacts on older adults, including people with dementia, such as providing companionship and facilitating social interaction. However, the issue of affordability can hinder equal access to such technology. The purpose of our study was to understand the perceptions and experiences of using a low-cost, commercially available pet robot with older adults and people with dementia. We used a novel methodology of analysing a large volume of user reviews that were collected from 15 consumer websites. A total of 1,327 user reviews that met our pre-specified inclusion criteria were included. Descriptive statistics was applied to characterise demographic data, and inductive qualitative content analysis was used to identify themes in the textual data. Most reviews were obtained from consumer sites in the United States, and most reviewers were family members of the users (i.e., older adults and people with dementia). We found that circumstantial reasons, such the inability to own live animals, prompted reviewers to purchase the pet robot. Most reviewers had positive perceptions of the pet robot, and described various activities that users engaged in with it. Impacts of using the pet robot, such as positive emotions, were also described. Finally, experiences about practical aspects of its use, such as durability and hygiene, were discussed. Overall, this study provides useful knowledge that can help researchers, robot developers and clinicians understand the viability of using low-cost pet robots to benefit older adults, including people with dementia.

The Effects of Technological Interventions on Social Participation of Community-Dwelling Older Adults with and without Dementia: A Systematic Review

Social isolation in community-dwelling older adults with dementia is a growing health issue that can negatively affect health and well-being. To date, little attention has been paid to the role of technology in improving their social participation. This systematic review aims to provide a systematic overview of the effects of technological interventions that target social participation in community-dwelling older adults with and without dementia. The scientific databases Medline (PubMed), PsycINFO, CINAHL, Web of Science, and the Cochrane Library were systematically searched and independently screened by two reviewers. Results were synthesized narratively. The methodological quality of included studies was independently assessed by two reviewers. In total, 36 studies of varying methodological quality were identified. Most studies evaluated social networking technology and ICT training programs. Three studies focused on people with dementia. Quantitative findings showed limited effects on loneliness, social isolation, and social support. Nevertheless, several benefits related to social participation were reported qualitatively. Social interaction, face-to-face contact, and intergenerational engagement were suggested to be successful elements of technological interventions in improving the social participation of community-dwelling older adults. Rigorous studies with larger sample sizes are highly needed to evaluate the long-term effects of technology on the multidimensional concept of social participation.

An evaluation of intraoral lidocaine patches in reducing needle-insertion pain

Intraoral lidocaine patches have recently been approved by the US Food and Drug Administration for the production of topical anesthesia before superficial dental procedures and for the reduction of pain associated with local anesthetic injections. The results of this 5-center clinical study showed that lidocaine patches were significantly more efficacious than matching placebo patches in reducing the pain associated with 25-gauge needle insertions to the level of bone in the maxillary premolar region. Anesthetic onset occurred within 5 minutes and was present for the entire 15-minute period that the patches were in contact with the oral mucosa. In addition, the patches were safe and well tolerated by study participants. Other potential clinical applications of this novel delivery system are also discussed in this article.

One-wall proximal defects: pretreatment characteristics and bone response following flap curettage

Several characteristics of 53 infrabony defects were compared with changes in bone height, following treatment by flap-curettage and regular maintenance. The mean post-surgical interval was 11.4 years. Proximal angular defects from mandibular posterior teeth comprised the study population. Changes in bone height following therapy were compared with the pre-treatment bone loss, tooth-bone angle, and inter-radicular width. The influence of the post-surgical duration on these factors was also evaluated. Bone height was examined at both the deep and shallow sides of each proximal defect. Data were collected from enlarged tracings of pre- and post-treatment radiographs. Gain or loss of bone was established at greater than 2 SD of the measurement error as determined by replicate calibration trials. Deep-side sites which gained bone exhibited the most pretreatment bone loss at a mean of 57.1%. These sites also exhibited a mean tooth-bone angle of 31.9 degrees and a mean inter-radicular width of 3.1 mm. Gaining sites were those with longer post-surgical durations. Deep-side sites that lost bone following therapy had a mean pre-treatment bone loss of 43.6%, a mean tooth-bone angle of 50.3 degrees, and a mean interradicular width of 2.9 mm. Losing sites were those with shorter post-surgical durations. The majority of deep-side sites with less than 55% pretreatment bone loss remained unchanged. Shallow-side sites which gained bone following treatment had a greater mean pretreatment bone loss and a smaller tooth-bone angle than losing sites.

Relative stability of deep- versus shallow-side bone levels in angular proximal infrabony defects

The relative changes with time, in the position of the coronal margin of the mesial and distal bone of proximal, angular infrabony defects, were investigated. Tracings of the radiographs of 51 mandibular posterior sites, treated by flap curettage, with a mean post-surgical duration of 11.8 years, were measured using a digitizer pad. The group consisting of shallow-side sites (N = 51), exhibited no significant change in the bone height with time; however, there was a significant decrease in bone height in the deep-side group (N = 51). The mean area of proximal bone decreased significantly with time. The defects were divided into early (N = 25) and advanced (N = 26) angular groups, and then into deep- and shallow-side subgroups. In the early defect group, there was a significant decrease in the mean bone height of the deep-side subgroup. There were no differences in the changes of mean bone level of the remaining 3 subgroups with time. There was no correlation between changes in bone levels of adjacent mesial and distal sides of angular defects with time (r = 0.27). There was no difference between the deep- and shallow-side groups in the number of sites which gained, lost or evidenced no change in bone height. In the study population, the bone height of 73% of the deep-side, and 84% of the shallow-side sites was either unchanged or in a more coronal position.(ABSTRACT TRUNCATED AT 250 WORDS)

The relative effects of therapy and periodontal disease on loss of probing attachment after root debridement

This study investigated the immediate effects, and the effects during 12 months, of a single episode of root debridement in 1248 sites in 9 periodontitis patients. Single recordings for probing depths and probing attachment levels were made at baseline, and at 3, 6, 9 and 12 months. In addition, triplicate recordings of attachment levels were made for all sites by 3 independent examiners immediately prior to debridement, immediately post debridement, and at 3 and 12 months. It was found that a mean loss of probing attachment of 0.5 to 0.6 mm occurred as a result of instrumentation, irrespective of initial probing depth. Individual sites were identified as having lost probing attachment using a site-specific standard deviation for measurement variability and a greater than or equal to 1.0 mm change. 5% of all sites lost probing attachment from pre-instrumentation to 12 months. Approximately half of these had probing attachment loss inflicted during instrumentation. 23 sites (2% of all sites) were identified as having lost probing attachment from the post-instrumentation time point to 12 months. The majority of these sites seemed to undergo this probing attachment loss as a result of a remodelling process during the healing phase. Over the observation period used in this study, the majority of the attachment loss identified seems to be either directly attributable to instrumentation or to a remodelling process as a result of the therapy rather than to progressive periodontitis.

Response of the rat submaxillary gland to pilocarpine: a quantitative analysis of gross and microscopic changes

The gross weight, gross volume, and the relative volume of certain microscopic components were determined for the submaxillary glands of rats given injections of pilocarpine. On comparison with control rats, there were significant differences in the weight and volume of the whole glands and in the relative volume of the microscopic components.