JMIR Publications

ABSTRACT

Background:

The increasing number of community-dwelling people with dementia worldwide underscores the need for innovative eHealth technologies that aim to provide support to both patients and their informal caregivers in the home setting. Sustainable implementation of eHealth technologies within this target group can, however, be difficult.

Objective:

The goal of this study was to gain a more complete understanding of why, although numerous eHealth technologies are designed to support people with dementia and their informal caregivers at home, it is often found difficult to implement them in practice. In particular, our study aimed to (1) provide an overview of technologies that have been used and studied in the context of informal dementia care and (2) explore factors influencing the implementation of these technologies.

Methods:

Following an umbrella review design, 5 different databases were searched (PubMed, PsycINFO, Medline, Scopus, and Cochrane) for (systematic) reviews, resulting in 3109 hits. After removing 904 duplicates and 2061 irrelevant papers, 144 results were considered for full-text screening. Finally, 21 papers were included for this review. A combination of deductive and inductive thematic analysis was performed, using the NASSS framework for organizing the findings.

Results:

We mostly identified technologies designed to be used “by informal caregivers”, followed by technologies used “by people with dementia” and technologies used “with people with dementia”. Within those user groups, most represented technologies included, respectively: (i) devices for in-home monitoring of lifestyle, health and safety, (ii) technologies for supporting memory, orientation and day structure, and (iii) technologies to facilitate communication between the informal caregiver and person with dementia. Most identified factors influencing sustainable implementation related to the condition of dementia, characteristics of the technology, the expected or perceived value of users, and characteristics of the informal caregiver. Considerably less has been reported on factors related to the implementing organization and technology supplier, the wider institutional and sociocultural context of policy and regulations, and the continued adaptation of technology over time.

Conclusions:

Our study created a comprehensive overview of eHealth technologies studied in the context of informal dementia care and contributes to a better understanding of a broad range of factors influencing their implementation. Our results uncovered a knowledge gap regarding success factors for implementation related to the organizational and broader context and the continuous adaptation on the long term. Although future research is needed, the current findings can help researchers and stakeholders improving the development and implementation of eHealth technologies to support informal dementia care.