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Personalisation, customisation and bricolage: how people with dementia and their families make assistive technology work for them

Published online by Cambridge University Press:  27 June 2018

Grant Gibson Open the ORCID record for Grant Gibson [Opens in a new window] ,
Claire Dickinson ,
Katie Brittain  and
Louise Robinson
Grant Gibson*
Affiliation:
Faculty of Social Sciences, University of Stirling, UK
Claire Dickinson
Affiliation:
Tees, Esk and Wear Valley NHS Trust, UK
Katie Brittain
Affiliation:
Department of Nursing, Midwifery and Health, Northumbria University, Newcastle upon Tyne, UK
Louise Robinson
Affiliation:
Newcastle University Institute for Ageing, Newcastle University, Newcastle upon Tyne, UK
*
*Corresponding author. Email: [email protected]
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Abstract

Assistive technologies (ATs) are being ‘mainstreamed’ within dementia care, where they are promoted as enabling people with dementia to age in place alongside delivering greater efficiencies in care. AT provision focuses upon standardised solutions, with little known about how ATs are used by people with dementia and their carers within everyday practice. This paper explores how people with dementia and carers use technologies in order to manage care. Findings are reported from qualitative semi-structured interviews with 13 people with dementia and 26 family carers. Readily available household technologies were used in conjunction with and instead of AT to address diverse needs, replicating AT functions when doing so. Successful technology use was characterised by ‘bricolage’ or the non-conventional use of tools or methods to address local needs. Carers drove AT use by engaging creatively with both assistive and everyday technologies, however, carers were not routinely supported in their creative engagements with technology by statutory health or social care services, making bricolage a potentially frustrating and wasteful process. Bricolage provides a useful framework to understand how technologies are used in the everyday practice of dementia care, and how technology use can be supported within care. Rather than implementing standardised AT solutions, AT services and AT design in future should focus on how technologies can support more personalised, adaptive forms of care.

Keywords

assistive technologytelecaredementiacarersbricolagebricoleur
Type
Article
Information
Ageing & Society , Volume 39 , Issue 11 , November 2019 , pp. 2502 - 2519
Copyright
Copyright © Cambridge University Press 2018 

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References

Astell, A, Malone, B, Williams, G, Hwang, F and Ellis, M (2014) Leveraging everyday technology for people living with dementia: a case study. Journal of Assistive Technologies 8, 4, 164–176.Google Scholar
Barken, R (2017) ‘Independence’ among older people receiving support at home: the meaning of daily care practices. Ageing & Society 39, 3, 518–540.Google Scholar
Berridge, C (2015) Breathing room in monitored space: the impact of passive monitoring technology on privacy in independent living. The Gerontologist 56, 5, 807–816.Google Scholar
Bjørneby, S, Topo, P and Holthe, T (eds) (1999) TED. Technology, Ethics and Dementia. A Guidebook on How to Apply Technology in Dementia Care. INFO-banken, Oslo: Norwegian Centre for Dementia Care.Google Scholar
Bowes, A, Dawson, A and Greasley-Adams, C (2013) Literature Review: The Cost Effectiveness of Assistive Technology in Supporting People with Dementia: Report to the Dementia Services Development Trust. Available online at https://www.stir.ac.uk/research/hub/publication/14830 (accessed 14 June 2018).Google Scholar
Bowes, A and McColgan, G (2006) Smart Technology and Community Care for Older People: Innovation in West Lothian, Scotland. Edinburgh: Age Concern.Google Scholar
Braun, V and Clarke, V (2006) Using thematic analysis in psychology. Qualitative Research in Psychology 3, 2, 77–101.Google Scholar
Brittain, K, Corner, L, Robinson, L and Bond, J (2010) Ageing in place and technologies of place: the lived experience of people with dementia in changing social, physical and technological environments. Sociology of Health and Illness 3, 2, 272–287.Google Scholar
Brittain, K, Degnen, C, Gibson, G, Dickinson, C and Robinson, L (2017) When walking becomes wandering: representing the fear of the fourth age. Sociology of Health and Illness 39, 2, 270–284.Google Scholar
Burrow, S and Brooks, D (2012) AT Dementia: an information resource on assistive technologies that support the independence of people with dementia. Dementia 11, 4, 553–557.Google Scholar
Buse, C (2010) E-scaping the ageing body? Computer technologies and embodiment in later life. Ageing & Society 30, 6, 987–1009.Google Scholar
Chan, M, Campo, E, Esteve, D and Forniols, J (2009) Smart homes – current features and future perspectives. Maturitas 64, 2, 90–97.Google Scholar
Department of Health (2015) Prime Minister's Challenge on Dementia 2020. Department of Health, London.Google Scholar
Dewing, J (2007) Participatory research: a method for process consent with persons who have dementia. Dementia 6, 1, 11–25.Google Scholar
Doyle, J, Bailey, C, Scanaill, C and Van Den, Berg F (2014) Lessons learned in deploying independent living technologies to older adults’ homes. Universal Access in the Information Society 13, 2, 191–204.Google Scholar
Fleming, R and Sum, S (2014) Empirical studies on the effectiveness of assistive technology in the care of people with dementia: a systematic review. Journal of Assistive Technologies 8, 1, 14–34.Google Scholar
Gibson, G, Dickinson, C, Brittain, K and Robinson, L (2015) The everyday use of assistive technology by people with dementia and their family carers: a qualitative study. BMC Geriatrics 15, 89.Google Scholar
Gibson, G, Newton, L, Pritchard, G, Finch, T, Brittain, K and Robinson, L (2016) The provision of assistive technology products and services for people with dementia in the United Kingdom. Dementia 15, 4, 681–701.Google Scholar
Glaser, B (1965) The Constant Comparative method of qualitative analysis. Social Problems 12, 4, 436–445.Google Scholar
Greenhalgh, T, Procter, R, Wherton, J, Sugarhood, P and Shaw, S (2012) The organising vision for telehealth and telecare: discourse analysis. BMJ Open 2, 4, e001574.Google Scholar
Greenhalgh, T, Procter, R, Wherton, J, Sugarhood, P, Hinder, S and Rouncefield, M (2015) What is quality in assisted living technology? The ARCHIE framework for effective telehealth and telecare service. BMC Medicine 13, 1, 91.Google Scholar
Greenhalgh, T, Shaw, S, Wherton, J, Hughes, G, Lynch, J, A'Court, C, Hinder, S, Fahy, N, Byrne, E, Finlayson, A, Sorell, T, Procter, R and Stones, R (2016) SCALS: a fourth generation study of assisted living technologies in their organisational, social, political and policy context. BMJ Open 6, 2, e010208.Google Scholar
Greenhalgh, T, Wherton, J, Sugarhood, P, Hinder, S, Procter, R and Stones, R (2013) What matters to older people with assisted living needs? A phenomenological analysis of the use and non-use of telehealth and telecare. Social Science and Medicine 93, 1, 86–94.Google Scholar
Hirani, S, Beynon, M, Cartwright, M, Rixon, L, Doll, H, Henderson, C, Bardsley, M, Steventon, A, Knapp, M, Rogers, A, Bower, P, Sanders, C, Fitzpatrick, R, Hendy, J and Newman, S (2014) The effect of telecare on the quality of life and psychological well-being of elderly recipients of social care over a 12 month period: the whole systems demonstrator cluster randomised trial. Age and Ageing 43, 3, 334–341.Google Scholar
Kirkpatrick, H, Boblin, S, Ireland, S and Robertson, K (2014) The nurse as bricoleur in falls prevention: learning from a case study of the implementation of fall prevention best practices. Worldviews on Evidence Based Nursing 11, 2, 118–125.Google Scholar
Knapp, M, Barlow, J, Comas-Herrera, A, Damant, J, Freddolino, P, Hamblin, K, Hu, B, Lorenz, K, Perkins, M, Rehill, A, Wittenberg, R and Woolham, J (2015) The Case for Investment in Technology to Manage the Global Costs of Dementia. Policy Innovation Research Unit, London. Available online at http://eprints.lse.ac.uk/66482/1/__lse.ac.uk_storage_LIBRARY_Secondary_libfile_shared_repository_Content_LSEE_The%20case%20for%20investment%20in%20technology.pdf (accessed 14 June 2018).Google Scholar
Langstrup, H (2013) Chronic care infrastructure and the home. Sociology of Health and Illness 35, 7, 1008–1022.Google Scholar
Lindqvist, E, Nygard, L and Borell, L (2013) Significant junctures on the way towards becoming a user of assistive technology in Alzheimer's disease. Scandinavian Journal of Occupational Therapy 20, 5, 386–396.Google Scholar
Lopez, D (2015) Little arrangements that matter. Rethinking autonomy-enabling innovations for later life. Technological Forecasting and Social Change 93, 91–101.Google Scholar
Lorenz, K, Freddolino, P, Coma-Herrera, Knapp M, Damant, J (2017) Technology based tools and services for people with dementia and carers: mapping technology onto the dementia care pathway. Dementia. Published online 08 February 2017, doi:10.1177/1471301217691617.Google Scholar
May, C, Finch, T, Cornford, J, Exley, C, Gately, C, Kirk, S, Jenkings, K, Osbourne, J, Robinson, L, Rogers, A, Wilson, R and Mair, F (2011) Integrating telecare for chronic disease management in the community: what more needs to be done. BMC Health Services Research 11, 131.Google Scholar
Meiland, F, Innes, A, Robinson, L, van der Roest, H, Garcia-Casal, J, Gove, D, Thyrian, J, Evans, S, Droes, R-M, Kelly, F, Kurz, A, Casey, D, Szczesniak, D, Dening, T, Craven, M, Span, M, Felzmann, H, Tsolaki, M and Franco-Martin, M (2017) Technologies to support community-dwelling persons with dementia: a position paper on issues regarding development, usability, effectiveness and cost-effectiveness, deployment, and ethics. JIMR Rehabilitation and Assistive Technologies 1, e1, doi:10.2196/rehab.6376.Google Scholar
Milligan, C, Roberts, C and Mort, M (2011) Telecare and older people: who cares where? Social Science and Medicine 72, 3, 347–354.Google Scholar
Milne, H, van der Pol, M, McCloughan, L, Hanley, J, Mead, G, Starr, J, Sheikh, A and McKinstry, B (2014) The use of global positional satellite location in dementia: a feasibility study for a randomised controlled trial. BMC Psychiatry 14, 1, 160.Google Scholar
Mort, M, Roberts, C and Callen, B (2012) Ageing with telecare: care or coercion in austerity. Sociology of Health and Illness 35, 6, 799–812.Google Scholar
Moyle, W, Jones, C, Murfield, J, Thalib, L, Beattie, E, Shum, D, O'Dwyer, S, Mervin, M and Draper, B (2017) Use of a robotic seal as a therapeutic tool to improve dementia symptoms: a cluster-randomized controlled trial. Journal of the American Medical Directors Association 9, 1, 766–773.Google Scholar
Newton, L, Dickinson, C, Gibson, G, Brittain, K and Robinson, L (2016) Exploring the views of GPs, people with dementia and their carers on assistive technology: a qualitative study. BMJ Open 6, 5, e011132.Google Scholar
Nygard, L (2008) The meaning of everyday technology as experienced by people with dementia who live alone. Dementia 7, 4, 481–502.Google Scholar
Nygard, L and Starkhammar, S (2007) The use of everyday technology by people with dementia living alone: mapping out the difficulties. Aging and Mental Health 11, 2, 144–155.Google Scholar
Oldman, C (2003) Deceiving, theorizing and self-justification: a critique of independent living. Critical Social Policy 23, 1, 44–62.Google Scholar
Orpwood, R, Bjorneby, S, Hagen, I, Maki, O, Faulkner, R and Topo, P (2004) User involvement in dementia product development. Dementia 3, 3, 263–279.Google Scholar
Orpwood, R, Sixsmith, A, Torrington, J, Chadd, J, Gibson, G and Chalfont, G (2007) Designing technology to support quality of life of people with dementia. Technology and Disability 19, 2, 103–112.Google Scholar
Peek, S, Luijkx, K, Rijnaard, M, Nieboer, M, Van Der Voort, C, Aarts, S, Van Hoof, J, Vrijhoef, H and Wouters, E (2015) Older adults’ reasons for using technology while aging in place. Gerontology.Google Scholar
Pickard, S and Rogers, A (2012) Knowing as practice: self-care in the case of chronic multi-morbidities. Social Theory and Health 10, 2, 101–120.Google Scholar
Pols, J (2012) Care at a Distance: On the Closeness of Technology. Amsterdam University Press, Amsterdam.Google Scholar
Pols, J and Willems, D (2011) Innovation and evaluation: taming and unleashing telecare technology. Sociology of Health and Illness 33, 3, 484–498.Google Scholar
Procter, R, Greenhalgh, T, Wherton, J, Sugarhood, P, Rouncefield, M and Hinder, S (2014) The day-to-day co-production of ageing in place. Computer Supported Co-operative Work 23, 3, 245–267.Google Scholar
Roberts, C and Mort, M (2009) Reshaping what counts as care: older people, work and new technologies. ALTER: European Journal of Disability Research 3, 2, 138–158.Google Scholar
Rosenberg, L, Kottorp, A and Nygard, L (2012) Readiness for technology use with people with dementia: the perspectives of significant others. Journal of Applied Gerontology 31, 4, 510–530.Google Scholar
Rosenberg, L and Nygard, L (2011) Persons with dementia become users of assistive technology: a study of the process. Dementia 11, 23, 135–154.Google Scholar
Scottish Government (2017) Scotland's National Dementia Strategy 2017–2020. Edinburgh: Scottish Government.Google Scholar
Secker, J, Hill, R, Villeneau, L and Parkman, S (2003) Promoting independence, but promoting what and how? Ageing & Society 23, 3, 375–391.Google Scholar
Sixsmith, A and Sixsmith, J (2008) Ageing in place in the United Kingdom. Aging International 32, 3, 219–235.Google Scholar
Steventon, A, Bardsley, M, Billings, J, Dixon, J, Doll, H, Beynon, M, Hirani, S, Cartwright, M, Rixon, L, Knapp, M, Henderson, C, Rogers, A, Hendy, J, Fitzpatrick, R and Newman, S (2013) Effect of telecare on use of health and social care services: findings from the Whole Systems Demonstrator Cluster randomised trial. Age and Ageing 42, 4, 501–508.Google Scholar
Stinchfield, B, Nelson, R and Wood, M (2013) Learning from Levi-Strauss’ legacy: art, craft, engineering, bricolage and brokerage in entrepreneurship. Entrepreneurship Theory and Practice 37, 4, 889–921.Google Scholar