Bridging gaps in the design and implementation of socially assistive technologies for dementia care: the role of occupational therapy

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Table 1. Recommendations to enhance the design and implementation of socially assistive technologies.

A) Designing socially assistive technology
Gaps	Considerations for bridging the gaps
1. Not considering (and anticipating) the current and evolving needs, preferences, abilities, and occupational preferences of PLWD and their caregivers Dementia is progressive; this means that the abilities of PLWD to engage in their day-to-day routines can change over time. Correspondingly, their needs and ability of PLWD and their caregivers to interact with and use the technology can also evolve rapidly. 2. Not aligning the function of socially assistive technology with the occupational needs of PLWD and their caregivers Each individual and their caregiver may have different needs and preferences. Therefore, a tailored approach to technology development is needed. 3. Not aligning socially assistive technology with the daily (and familiar) routines of PLWD and their caregivers Familiar routines are important for PLWD (and their caregivers), as such considerations about how technology can be designed to align with the routine of PLWD and their caregivers have to be made explicit.	Technology developers and occupational therapists (researchers, educators, and/or clinicians) could reach out to each other to collaborate in the (iterative) process of designing technology. The outreach may be done through clinical services or national representative organisations for the occupational therapy profession. Technology developers and researchers could consider the disease trajectory of different dementias, and understand the implications on the functional abilities and needs of PLWD and their caregivers. Technology developers and researchers could consult with occupational therapists who have knowledge of holistic and occupation-based models to enhance the comprehensiveness of considerations for technology design in relation to PLWD and their occupations. Examples include the Person-Environment-Occupation (PEO) model and the Human Activity Assistive Technology (HAAT) model. Occupational therapists could engage in professional development and further education to keep up to date with emerging technology and advocate for active occupational therapy involvement. Educators could consider educating about socially assistive technology within the occupational therapy educational and professional development curriculum.
B) Implementing socially assistive technology
Gaps	Considerations for bridging the gaps
4. Not facilitating PLWD and their caregivers to choose the “right” socially assistive technology Different socially assistive technology may suit different PLWD and their caregivers, depending on their unique preferences and needs. For example, a socially assistive technology with medication reminder functions may not as relevant or appropriate for PLWD in residential facilities, or for caregivers who are keen to support PLWD in medications without technology. 5. Not facilitating and training to support PLWD and their caregivers to integrate socially assistive technology into their daily routines Routines are important for PLWD. There is an insufficient focus on how the technology can be integrated into the daily lives of PLWD and their caregivers. 6. Not facilitating the use of socially assistive technology in dementia care facilities In dementia care facilities, the use of technology may occur in a group setting.	Technology developers and researchers could consider establishing a relationship with national assistive technology clinics and services to inform clinicians about emerging technologies, to support the uptake of these technologies by PLWD and their caregivers. Occupational therapists could consider: (i) collaborating with technology developers and researchers to design comprehensive assessments to match and to tailor the socially assistive technology to PLWD and their caregivers, and (ii) developing a clear intervention plan to train and equip them with the skills and confidence to use the technology in their daily lives. Occupational therapists and service providers (e.g., assistive technology clinics and providers) could factor in regular re-assessments of the changing needs and diminishing abilities of PLWD and their caregivers to determine the suitability of the socially assistive technology over time. Service providers (e.g., healthcare providers, dementia care facilities) could work with occupational therapists to design and facilitate the use of socially assistive technology in shared/group-based settings. An example includes group-facilitation techniques.