Dementia Centred

By Henriette Laidlaw

June 7th, 2016

Support for people with dementia living in remote areas

The University of Stirling conducted the evaluation of the RemoDem project, a project aimed to develop, test and evaluate new service models for people with dementia in remote and rural areas including Faroe Islands, Greenland, Sweden and Scotland. Many of these models involved the use of technology.

Supporting people living with dementia in remote areas introduces some particular challenges relating to distance, such as

  • Longer travel distance for people with dementia, their family and care staff
  • Difficulty in accessing specialist health and social care
  • Family carers living at significant distances from those they care for

Most of us desire to stay at home or close to home for as long as possible and while remote locations can present challenges they often consist of close-knit and mutually supportive communities, making them potentially positive locations in which to age.

Public awareness

Across all sites it was shown that it is important to raise public awareness in the local population, both to combat stigma and improve early diagnosis of dementia.

It is also important to consider how the implementation of new technology might be viewed by the wider population. For example, it was noted that external views on the use of technology could be a negative issue, such as the press coverage of the trial of robots in the Western Isles, Scotland and the use of night-time monitoring services in Sweden.

Use of technology

A variety of technological aids were tried across the locations and the evaluation suggests that the most popular technology use related to:

  • Timekeeping
  • Orientation
  • Communication over distance
  • Risk reduction
  • Enjoyment

Sometimes, the technology use was not as anticipated; for example, an iPad intended for listening to music was used more for communication and in another case, the iPads were used by staff for mutual support, rather than by the service users as had been originally intended.

Families were crucial to the success of technology use. They were widely reported as important for initiating the technology request and use; they frequently helped to keep it working; in many cases, they were the ‘first responders’ if alarms suggested problems. A key outcome for the family caregivers was respite and reduced stress, emphasising the importance for them of knowing what was happening to their relative, without having to make ‘just in case’ visits.

Care staff will resist change, however, this was generally changed to enthusiasm once it was clear that technology was not there to replace their jobs, but as an aid to ensure service delivery can continue as the population of service users increases.

Sometimes when introducing technology staff and local decision makers might be more nervous than they need to be. Examples from this project are the use of monitoring devices that observed night time activity and the use of GPS devices. In the former, those using the service preferred not to be interrupted during the night and appreciated that the night camera could detect if they needed a visit or not, and in the case of the latter research has demonstrated that people with dementia and their carers are content to use the GPS devices as they value how this enables them to get out and about.

When introducing technology, ensure the technological solution is working well as the user is potentially vulnerable. The mainstream technology used presented fewer problems.

This blog by Grant Gibson discusses the use of use of technology to improve care for people with dementia.

RemoDem

The RemoDem project adopted a conceptual model of dementia support which placed the self of the person with dementia at the centre of a series of intersecting ‘circles of support’ bounded by the community in which they live. This model draws on approaches to dementia care which emphasises personhood and person-centredness. You can find more information about RemoDem and details of the research and findings on the project website.

The evaluation

RemoDem: Delivering support for people with dementia in remote areas
by: Alison Bowes, Alison Dawson and Louise McCabe
Faculty of Social Sciences, University of Stirling Scotland

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