Home Testing of a Digital Prompter for People with Dementia

This technology evaluation study assessed a personalised digital prompter designed for people with dementia, by trialling its use in the home by people with dementia and their carers. Technology based prompting may be used to support people with dementia to complete multi-step tasks in the home, provided that suitable tasks can be chosen and that a carer is able to load appropriate task steps onto the prompter. A prompter was developed specifically for this purpose, along with a detailed guidance manual. Twelve participants with mild or moderate dementia carried out cognitive tests and their carers completed carer burden and carer competence scales. Each pair attended a training session with a researcher and were provided with the prompter and instruction manual. The prompter was trialled at home for four weeks after a one-week familiarisation period, for use with a simple set task and one or two tasks chosen by the participants. Semi-structured interviews were used to capture the views of the participants at the start and end of the home testing, and to set and evaluate goals. Chosen tasks included preparing simple food and drinks, and using home appliances including coffee machines and television remote controls. There was a weak correlation between greater goal success for the participants and the carer goal success, number letter switching within the D-KEFS and ACE-III score. A thematic analysis of the interviews revealed three core themes relating to familiarity with technology, utility of the prompter and the cost versus benefit in terms of the effort required to set up the prompter. Factors influencing success could be grouped into: participants' motivation and capability; the design of the prompter; and the details of the task being carried out. Barriers to success included the difficulty of choosing a suitable task and the effort required to break down a task in to appropriate steps. All of the participants with dementia could follow the steps on the prompter, and all of the carers were able to choose, breakdown and load at least one task onto the prompter during the training session, but successful use in the home was varied because of the increased complexity of the home context. Changes to the hardware, software and manual were made in response to the data gathered during the study, in readiness for the planned further testing.