Co-designing an Adaption of a Mobile Application to Enhance Communication, Safety, and Well-being Among People Living at Home with Mild Dementia

Problem

People with dementia progressively suffer physical and psychological problems that require health and social care support. Digital interventions are increasingly being developed to meet needs such as issues in communication, safety and general wellbeing. A mobile app called Hear Me Now (HMN) was identified as having potential to meet some needs of people with mild dementia and their carers. This study aimed to: (1) evaluate the usability, usefulness, and relevance of HMN among community-dwelling people living with mild dementia; (2) examine the benefits and challenges of using HMN to enhance the management of health, safety, and well-being; and (3) determine if adaptions are required in HMN and how these should be designed.

Approach

Participatory qualitative methods were adopted over 3 phases with co-designers (people with mild dementia and their carers). Phase 1: a need analysis adopting a case study approach. 13 cases (dyads of person with dementia and their carer) were recruited and in-depth, dyadic interviews were conducted and analysed using thematic analysis. Phase 2: participants were trained on the app and post-training interviews were conducted capturing impressions of the app and its alignment to needs identified in phase 1. Participants then tried out the app over several months. Data on individual and group usage was collected and analysed and triangulated with phase 1 data. Phase 3: data was collected regarding HMN’s acceptability and to co-design an amended form including support needs for adoption. Normalisation Process Theory was used as an overarching sensitising tool.

Findings

People living with mild dementia and their carers described a range of challenges. Cognitive impairments resulted in issues for maintaining everyday life, valued activities and health-related challenges for those living with, and caring for, people with dementia. Participants described current strategies to aid their ability to manage their needs including the use of other technologies. HMN was felt to have potential relevance to some participants and was variously adopted alongside existing strategies by a minority, with others preferring existing strategies. Re-design issues concerned issues around touch as well as interoperability between app features (perceived to have potential) and to other existing technologies. Support needs for the successful use and adoption of HMN and digital interventions for this user group were also highlighted.

Consequences

Digital interventions have potential to meet some of the needs of people with mild dementia and their carers, however researcher and designers must also consider the design and roll out of technology with multi-factorial and contextual challenges in mind. Finally, designing appropriate support/training to aid potential users, should be as much of a priority as the technology itself.