The UK welfare landscape is increasingly challenging due to ongoing austerity involving public sector cuts, service retrenchment, and withdrawal of statutory responsibilities. This article shows that as the welfare state contracts, precarity increases and responsibility for service provision is progressively devolved to front-line individuals and service users. To illustrate, the article examines the use of assistive and everyday technologies to improve social housing residents’ quality of life based on a longitudinal mixed methods study conducted between 2020 and 2022. The findings highlight how housing providers can support person-led technology interventions for older residents, where minor improvements positively impact day-to-day living. However, interventions are often limited by practicalities, capacity, and cost. This article connects technological engagement in housing to the ongoing ‘responsibilisation’ of many areas of housing provision to social landlords and tenants. This suggests an extension of responsibility where social housing providers are papering over the cracks in the welfare state.

Assistive technology for older people promises much, but the research evidence suggests that it delivers little. One hypothesis to explain the lack of positive impact is that assistive technology is often implemented with little involvement of older people or other stakeholders, such as family members or care staff. The suggestion is that co-production may ensure that assistive technology solutions are better tailored to people's needs, capacities and living situations. In this article, we review existing studies to examine what works in co-production in relation to processes of design and implementation of assistive technology for older people. Our results show a growing interest in co-production as an approach in this field, with a wide range of approaches being employed. We highlight a number of key lessons from the research, including key issues around who needs to be engaged in the co-production, as well as essential elements of the process itself. Our review suggests that there is considerable potential in using co-production to improve effectiveness of technological solutions to the challenges of age-related impairments. However, we also emphasise the need for more longitudinal research in this area, to examine whether such collaborative approaches can truly deliver the promise of assistive technology for older people.

The environment, and assistive technologies as part of this, can play an important role in supporting the participation and wellbeing of people living with dementia. If not considered, environments can be overwhelming and disempowering. Disability approaches including environmental considerations and assistive technology were often not offered routinely with people living with dementia. Concerned by this, dementia advocates aimed to create change in this area. The Environmental Design-Special Interest Group (ED-SiG) of Dementia Alliance International was developed as an international consumer-driven community of practice bringing together people with different relevant expertise including living experience (people living with dementia, care partners), architecture and design, occupational therapy, rehabilitation and care provision. This practice opinion piece provides an overview of dementia, the need for collaborative practices within practice with people living with dementia, and the considerations of assistive technology, environmental design and the global context. The reflection provides insights into this international community of practice, with personal reflections of members with living experience of dementia, and benefits and opportunities in considering environmental design and assistive technology from the perspectives of members. This work demonstrates and advocates collaborations that centre the perspectives and expertise of people living with dementia.

This paper presents a soft, tendon-driven, robotic glove designed to augment grasp capability and provide rehabilitation assistance for postspinal cord injury patients. The basis of the design is an underactuation approach utilizing postural synergies of the hand to support a large variety of grasps with a single actuator. The glove is lightweight, easy to don, and generates sufficient hand closing force to assist with activities of daily living. Device efficiency was examined through a characterization of the power transmission elements, and output force production was observed to be linear in both cylindrical and pinch grasp configurations. We further show that, as a result of the synergy-inspired actuation strategy, the glove only slightly alters the distribution of forces across the fingers, compared to a natural, unassisted grasping pattern. Finally, a preliminary case study was conducted using a participant suffering from an incomplete spinal cord injury (C7). It was found that through the use of the glove, the participant was able to achieve a 50% performance improvement (from four to six blocks) in a standard Box and Block test.

There are currently limited guidelines on how to design complex assistive technologies (ATs), which necessitates expertise beyond that possessed by designers, occupational therapists (OTs), or end-users. To address this issue, we conducted a series of four participatory workshops to study various configurations of OT-designer-user collaboration in co-designing do-it-yourself (DIY) ATs for an older adult with mobility impairment. We then proposed a specific co-design framework for such OT-designer-user collaboration.

Interdisciplinary research using qualitative methods was employed to investigate the barriers to and facilitators of cultural participation for First Nations Elders who use wheeled mobility and live on reserve in Ontario, Canada. Themes were extracted into three broad categories: (1) impact of Elder participation in cultural activities, (2) usefulness of wheeled mobility devices, and (3) barriers to participating in cultural events. Barriers included lack of transportation, inability to access the outdoors safely and independently, challenging reserve terrain, stigma of being “disabled”, and feeling like a burden. Findings suggest that wheeled mobility can increase the active participation of Elders in cultural events, but demonstrate a need to facilitate the use of wheeled mobility on reserves in Ontario, Canada.

The aim of this study was to explore the experiences of family carers supporting a relative living with dementia during and after the move to technology-enriched supported accommodation (TESA). The paper explores the informal carers (ICs) roles, the factors prompting the move to TESA, alongside their perceptions of their relatives’ experience of the move and of life in a technology-enriched environment. Within a qualitative study 25 semi-structured interviews were conducted with ICs and data were analysed following a thematic approach. Four themes were identified, reflecting the shift in roles and identity of both ICs and persons living with dementia. The move to TESA was linked to a perceived reduction in care-giving pressures, with positive outcomes reported for both the ICs and the people living with dementia. Smart home technologies in the facilities did not appear to impact on the decision-making during transition, however, they were valued as part of the lived experience for the people living with dementia within the TESA facilities. These findings are relevant to policy makers, commissioners and providers of services to highlight the engagement of all stakeholders in the provision of care for people living with dementia and their families early from diagnosis in order to facilitate person-centred practices in community settings.

This paper presents the experiences of formal carers working in technology-enriched supported accommodation for people living with dementia, examining their care-giving role from a person-centred care perspective. Within a qualitative study, 21 semi-structured interviews were conducted with formal carers and data were analysed following a thematic approach. Four main themes were identified that mapped to the attributes of the person-centred practice framework (PCPF): promoting choice and autonomy, staffing model, using assistive technology and feeling that ‘you're doing a good job’. Central to person-centred practice in these settings was the promotion of choice, autonomy and independence. The dichotomy between safety and independence was evident, curtailing the opportunities within the environmental enablers and associated embedded assistive technologies. Formal carers reported considerable job satisfaction working in these settings. The small-scale, home-like facilities seemed to have a positive effect on job satisfaction. These findings are relevant to policy makers, commissioners and service providers, highlighting the facilitators of person-centred care in community dwellings for people living with dementia and the role of formal carers in promoting this approach.

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.

Background: The University College of Southeast Norway has an on-going project to develop a smart house welfare system to allow older adults and people with disabilities to remain in their homes for as long as they wish in safe, dignified, living conditions.

Objectives: This article reviews reported ethical challenges to implementing smart houses for older adults.

Methods: A systematic literature review identified twenty-four articles in English, French, Spanish, and Norwegian, which were analyzed and synthesized using Hofmann's question list to investigate the reported ethical challenges.

Results: Smart houses offer a promising way to improve access to home care for older adults and people with disabilities. However, important ethical challenges arise when implementing smart houses, including cost-effectiveness, privacy, autonomy, informed consent, dignity, safety, and trust.

Conclusions: The identified ethical challenges are important to consider when developing smart house systems. Due to the limitations of smart house technology, designers and users should be mindful that smart houses can achieve a safer and more dignified life-style but cannot solve all the challenges related to ageing, disabilities, and disease. At some point, smart houses can no longer help persons as they develop needs that smart houses cannot meet.

Brain–computer interfaces (BCIs) can enable communication for persons in severe paralysis including locked-in syndrome (LIS); that is, being unable to move or speak while aware. In cases of complete loss of muscle control, termed “complete locked-in syndrome,” a BCI may be the only viable solution to restore communication. However, a widespread ignorance regarding quality of life in LIS, current BCIs, and their potential as an assistive technology for persons in LIS, needlessly causes a harmful situation for this cohort. In addition to their medical condition, these persons also face social barriers often perceived as more impairing than their physical condition. Through social exclusion, stigmatization, and frequently being underestimated in their abilities, these persons are being locked out in addition to being locked-in. In this article, we (1) show how persons in LIS are being locked out, including how key issues addressed in the existing literature on ethics, LIS, and BCIs for communication, such as autonomy, quality of life, and advance directives, may reinforce these confinements; (2) show how these practices violate the United Nations Convention on the Rights of Persons with Disabilities, and suggest that we have a moral responsibility to prevent and stop this exclusion; and (3) discuss the role of BCIs for communication as one means to this end and suggest that a novel approach to BCI research is necessary to acknowledge the moral responsibility toward the end users and avoid violating the human rights of persons in LIS.