Practical thinking about technology for people with dementia

Nurses are increasingly using assistive technology to care for people with dementia, either at home or in a care setting.  It is important not to be overwhelmed by or to be overly enthusiastic about the “kit”. It’s also vital to find out how each individual piece of technology works. Ask the following questions:

  • What does the technology do and is that helpful?
  • How simple is it to operate?
  • How much does it cost to purchase and to maintain?
  • Does the technology require regular upkeep – for example, changing the batteries?
  • Will a carer need to take responsibility to ensure that the technology achieves its goal?
  • What information is being gathered by this equipment, who is storing it and for what purpose?

Assistive technology should directly or indirectly benefit the patient or client or gather helpful information. There are many simple devices that can help.

Flood alerts

Some people with dementia forget to turn off taps, and therefore preventing a flood can become a critical issue. If a flood causes a temporary move, disrupting the person’s routine, they may never be able to return home.

Flood alert devices range from alarms fitted to the bath that make a noise when the water reaches a certain height, to a plug that automatically lets out water when the bath is too full. The setting off of an alarm can startle or confuse the person with dementia, so a plug might be the better option. It might also be cheaper, and as it looks a lot like an ordinary bath plug, it is easy to use.

Detectors, ovens and other devices

Detectors for smoke and carbon monoxide are essential safety devices and are now cheaper to purchase than ever before. A microwave oven that turns itself off if metal is accidentally placed in it is useful. A telephone with large, transparent pre-programmable buttons, behind which friends’ or carers’ photos can be placed, can compensate for forgetting familiar numbers.

What helps depends on the problem. For instance, a device can be placed on the cold water supply to alert carers if the person has not flushed the toilet or used the cold water tap for the kettle by a certain time of day. It might mean that they have a problem.

Passive infrared monitors

Passive infrared (PIR) monitors can also be fitted that send out an invisible harmless beam that, just like a home alarm system, triggers an alert when disrupted by movement. You can fix it temporarily to a wall in a ward or in the person’s home or a care home, using simple Velcro fixings, or can be used only when there is a specific problem.

Staff should be alerted by a vibrating pager, rather than a bell. For relatives, offer a vibrating pad that will fit under their pillow so that they can sleep soundly, safe in the knowledge that they don’t have to keep one eye open in case their relative takes a walk in the night. The pad will surely wake them up, but only if they are needed.

Leaving the bathroom light on and its door open may cue the person with dementia to use the toilet and then go back to bed if they wake in the night. Another way of doing this is for the bathroom light to be triggered to go on when a PIR beam is broken by the person leaving their bedroom. This can be important as, by the time they get to the hallway, they may have forgotten they need the toilet and go on to leave the house. The technology for triggering lights this way is becoming cheaper but does require an electrician. 

A light box operated by PIR can help if someone tries to leave their home inappropriately. This device should be fitted next to an exit door and be set to operate only at night. When it is triggered, a message in black letters is backlit – for example, “Don’t go out, Mary. It’s dark.” This can prompt the person to go back to bed. The messages need to be individualised to their needs and should be routinely changed.

Learning more

Technological developments happen very quickly, and new and exciting opportunities present themselves constantly. However, the technology must be appropriate to the individual with dementia, and before any device is installed, every effort should be made to inform and seek consent from them. Nurses need to know what is available, and understand the practical and ethical issues.

The Dementia Services Development Centre at the University of Stirling has a standing exhibition of assistive technology. In the Iris Murdoch Building, we have a mock-up of a home with kit you can handle and test yourself, backed up by a staffed library and resource centre.

You can visit these during any of our events or conferences, or you can arrange a special visit. Contact us via our website, where you can also see some of our design ideas that aim to increase the independence of people with dementia and provide practical support to their nurses and carers.

Professor June Andrews and Mr Colm Cunningham