Welfare technologies for people with dementia - challenges within the service delivery process: occupational therapist's perspectives

The rising prevalence of dementia, combined with workforce shortages in eldercare, has intensified interest in welfare technologies (WTs) as a means to enhance safety, independence, and efficiency in Swedish municipal care. Occupational therapists (OTs) play a central role in assessing needs, prescribing devices, implementing support, and conducting follow-up. However, research shows that WT implementation is often inconsistent, delayed, or underutilised. This study explores the challenges OTs encounter across the service delivery process for people with dementia.

A qualitative study was conducted using one focus group interview (five participants) and four individual semi-structured interviews with experienced OTs. Data were transcribed verbatim, translated from Swedish, and analysed thematically using the four stages of the service delivery process: assessment, selection, implementation, and follow-up.

Across all stages, OTs reported significant barriers. Assessments were hindered by a lack of dementia-specific tools, time constraints, and difficulty linking identified needs to appropriate WTs. Selection was shaped by regional disparities, limited municipal assortments, economic constraints, ethical considerations, and the crucial - yet sometimes challenging - involvement of relatives. Implementation required extensive communication, patient-centred adaptation, and organisational support, while inadequate training and rapidly changing needs complicated long-term use. Follow-up was often inconsistent due to workload pressures, reliance on relatives for feedback, and the absence of structured follow-up routines.

WT service delivery for people with dementia is constrained by structural, organisational, and cognitive complexities. Improving standardised assessment tools, promoting equitable access, enhancing OT training, and establishing clear follow-up protocols are essential to strengthen WT integration in dementia care.