Using digital technologies to facilitate social inclusion during the COVID-19 pandemic: Experiences of co-resident and non-co-resident family carers of people with dementia from DETERMIND-C19.

BACKGROUND: The COVID-19 pandemic triggered rapid and unprecedented changes in the use of digital technologies to support people's social inclusion. We examined whether and how co-resident and non-co-resident family carers of people with dementia engaged with digital technologies during this period. METHODS: Throughout November 2020-February 2021, we interviewed 42 family carers of people with dementia from our DETERMIND-C19 cohort. Preliminary analysis was conducted through Framework analysis, followed by an inductive thematic analysis. FINDINGS: Digital technologies served as a Facilitator for social inclusion by enabling carers to counter the effects of the differing restrictions imposed on them so they could remain socially connected and form a sense of solidarity, access resources and information, engage in social and cultural activities and provide support and independence in their caring role. However, these experiences were not universal as carers discussed some Challenges for tech inclusion, which included preferences for face-to-face contact, lack of technological literacy and issues associated with the accessibility of the technology. CONCLUSION: Many of the carers engaged with Information and Communication Technologies, and to a lesser extent Assistive Technologies, during the pandemic. Whilst carers experienced different challenges due to where they lived, broadly the use of these devices helped them realise important facets of social inclusion as well as facilitated the support they provided to the person with dementia. However, to reduce the 'digital divide' and support the social inclusion of all dementia carers, our findings suggest it is essential that services are attuned to their preferences, needs and technological abilities.

Usability and acceptability of wearable technology in the early detection of dementia.

BACKGROUND: The Early Detection of Neurodegeneration (EDoN) is a global initiative that aims to explore the potential of wearable technologies and smartphone applications to detect preclinical dementia, with aspirations to validate a digital toolkit for clinical practice. To enhance the development of an inclusive digital toolkit, we conducted a study to assess the usability and acceptability of different digital devices in people with cognitive impairments and their carers. METHOD: Recruitment was conducted across various UK networks such as Join Dementia Research. Participants received the EDoN toolkit, which includes a smartwatch (Fitbit Charge 4), EEG headband (Dreem 3) and two smartphone applications (Longevity and Mezurio). Guides were provided to support the setup process. Initial interviews were conducted approximately three days after the participant received the devices, to explore initial perspectives regarding the toolkit and experiences of the setup process. Follow-up interviews were conducted two weeks later to explore the acceptability and usability of the toolkit. NVivo was used to thematically analyse the interview transcripts. Emerging themes were discussed and refined by the research group. RESULT: Sixteen semi-structured interviews were conducted with nine participants, at two-time points. Four participants had mild cognitive impairment, two had frontotemporal dementia, one had Alzheimer's and two were carers. We identified three key themes, which centred around usability, acceptability and inequity. Participants expressed the wearable devices were comfortable but individuals with physical disabilities or cognitive impairments struggled to use some devices. Participants valued the feedback the devices provided such as information on sleep and heart rate, although some information was not fully understood. Participants also shared their concerns around detecting preclinical dementia and the increased anxiety around the consequences of this such as "being put in a home". Various inequities of the toolkit were uncovered such as digital exclusion relating to a lack of access to strong WiFi connection, compatible smartphones and poor digital literacy. CONCLUSION: These results are informative for the further development of user-friendly digital tools for the early detection of dementia. Further work is required to ensure a digital toolkit is inclusive and provides information that can be understood by the user.