Perspectives on technology use in the context of caregiving for persons with dementia: qualitative interview study

Abstract

Background: Examining ways to support persons with dementia and their caregivers to help minimize the disease’s impact on individuals, families, and society is critical. One emerging avenue for support is technology (eg, smartphones and smart homes).

Objective: Given the increasing presence of technology in caregiving, it is pertinent to appreciate whether and how technology can be most useful to a care partner’s everyday life. This study aims to further understand care partner technology use, attitudes, and the potential role of off-the-shelf technologies (eg, smartphones and smart homes) in supporting caregiving from the perspective of care partners for persons with dementia.

Methods: We conducted a telephone cross-sectional survey using random digit dialing with 67 self-identified care partners of persons with dementia across one Canadian province. Participants were asked about attitudes toward technology, barriers to and facilitators for technology use, technology use with caregiving, and demographic information. Eight open-ended questions were analyzed using content analysis; 2 closed-ended questions about comfort with and helpfulness of technology (rated on a scale of 1 to 10) were analyzed with frequencies. From these data, an in-depth semistructured interview was created, and 10 (15%) randomly sampled care partners from the initial collection of 67 care partners were interviewed approximately 1year later, with responses analyzed using content analysis.

Results: Frequency analysis rated on a scale of 1 to 10 suggested that care partners were comfortable with technology (wearable technology mean 7.94, SD 2.02; smart home technology mean 6.94, SD 2.09), although they rated the helpfulness of technology less strongly (mean 5.02, SD 2.85). Qualitatively, care partners described using technology for functional tasks and some caregiving. Barriers to technology use included cost, lack of knowledge, security or privacy concerns, and undesirable features of technology. Facilitators included access to support and the presence of desirable features. Some care partners described merging technology with caregiving and reported subsequent benefits. Others stated that technology could not be adopted for caregiving due to the degree of impairment, fear of negative consequences for the person living with dementia, or due to incongruity with the caregiving philosophy. Furthermore, care partners noted that their technology use either increased or was unchanged as they moved through the COVID-19 pandemic.

Conclusions: The 2 analyses were conducted separately, but there was notable overlap in the data, suggesting temporal stability of identified content. Both analyses suggested care partners’ relative comfort with technology and its use, but other care partners noted concerns about integrating technology and caregiving. Care partners’ reports of increased technology use throughout the COVID-19 pandemic may also suggest that the pandemic impacted their perceptions of the usefulness of technology, being influenced by the requirements of their reality. Future investigations should examine how to support care partners in adopting relevant technology.

Plain Language Summary

It is critical to support persons with dementia and their care partners to have a good quality of life. One new way for support is technology (for example, smartphones or smart homes like Amazon’s Echo system). We wanted to understand the perspective of care partners on using technology to help them. We also wanted to know what they thought and felt about using technology to help them with caregiving. We conducted a survey with care partners of persons with dementia across Saskatchewan. Afterwards, we selected a random group of 10 care partners to participate in an in-depth 1-on-1 conversation approximately one year later. We found that care partners were relatively comfortable with technology, using it for functional tasks (e.g., looking things up) and some caregiving (e.g., carrying a loved one’s health information. Difficulties with technology included cost, lack of knowledge, security/privacy concerns, and undesirable features (e.g., small text/picture size). Positive aspects of using technology included access to support, and presence of desirable features (like ‘dropping in’ virtually). Some care partners were merging technology with caregiving and seeing benefit. Others were concerned about technology and caregiving. They were concerned that technology would not be usable for caregiving due to their loved one’s impairment, their views on caregiving, or fear of negative consequences for the person living with dementia. COVID-19 increased technology use and may have changed people’s opinion about it. These findings are useful for two reasons. First, they support our understanding of how care partners feel about and use technology so we can plan ways to best support the. Secondly, our telephone survey may have reached care partners that would not have normally participated in this type of research.