Supporting Memory Services to enable people with dementia and their families’ timely access to assistive technology.

Abstract

Background: Assistive Technology (AT) could help people with dementia (PwD) to live independently. In England, Memory Services (MS) are usually the first post dementia diagnostic service for information provision. This study aimed to determine current MS practice with regard to giving information on AT and supporting PwD, and their families, to access AT. Methods: This mixed-methods, sequential study involved: 1) two national, cross-sectional surveys exploring current MS provision and individual professional practice regarding AT, and 2) a qualitative study comprising focus groups (n=2) and semi-structured interviews (n=10) to explore professional practice in depth. Surveys were distributed to 117 MS in England. Results: Although MS described a typical ‘AT care pathway’, there was considerable variation in the knowledge/resources they had available. Professionals highlighted an inequality of provision on many levels, with considerable professional unease around knowledge of AT and the associated costs to PwD. Despite being positive about AT, professionals were driven by patient safety and risk, which shaped the discussions they had with PwD. The term AT was confusing; professionals found introducing AT challenging, especially the timing of such discussions, and often deferred to an ‘in house expert’, usually an occupational therapist. They described a poorly developed ‘AT ecosystem’ and identified the need for system wide improvements around information, implementation and monitoring. Notwithstanding these issues, professionals suggested a range of improvements, including: a national AT database, specific training, and access to demonstration resources. Organisations with more advanced services described clear leadership, structures, processes for change and people with drive. Conclusions: This thesis highlights the challenges of implementing a complex intervention, in a complex setting, with a complex group of patients. Despite working in a poorly developed AT ecosystem, professionals are positive about this aspect of dementia care and provided sensible solutions to embed AT into MS everyday practice.