title: The everyday use of assistive technology by people with dementia and their family carers: a qualitative study.
abstract: BACKGROUND
  Assistive Technology (AT) has been suggested as a means by which people with dementia can be helped to live independently, while also leading to greater efficiencies in care. However little is known about how AT is being used by people with dementia and their carers in their daily routines. This paper reports on a qualitative study exploring the everyday use of AT by people with dementia and their families.
  
  
  METHODS
  The research employed a qualitative methodology. Semi structured interviews took place with 39 participants, 13 people with dementia and 26 carers. Key themes were identified using thematic analysis and the constant comparative method.
  
  
  RESULTS
  Three categories of AT use in everyday settings were identified; formal AT, accessed via social care services, 'off the shelf AT' purchased privately, and 'do it yourself' AT, everyday household products adapted by families to fulfil individual need in the absence of specific devices. Access to AT was driven by carers, with the majority of benefits being experienced by carers. Barriers to use included perceptions about AT cost; dilemmas about the best time to use AT; and a lack of information and support from formal health and social care services about how to access AT, where to source it and when and how it can be used.
  
  
  CONCLUSIONS
  It has been argued that the 'mixed economy' landscape, with private AT provision supplementing state provision of AT, is a key feature for the mainstreaming of AT services. Our data suggests that such a mixed economy is indeed taking place, with more participants using 'off the shelf' and 'DIY' AT purchased privately rather than via health and social care services. However this system has largely arisen due to an inability of formal care services to meet client needs. Such findings therefore raise questions about just who AT in its current provision is working for and whether a mixed market approach is the most appropriate provider model. Everyday technologies play an important role in supporting families with dementia to continue caring; further research is needed however to determine the most effective and person-centred models for future AT provision.
authors.affiliation: School of Applied Social Sciences, Colin Bell Building, University of Stirling, Stirling, FK9 4LA, Scotland, UK. grant.gibson@stir.ac.uk.
authors.forename: Grant
authors.initials: G
authors.lastname: Gibson
authors.affiliation: Institute of Health & Society, Newcastle Biomedical Research Building, Newcastle University, Campus for Ageing and Vitality, Newcastle upon Tyne, NE4 5PL, UK. claire.dickinson@ncl.ac.uk.
authors.forename: Claire
authors.initials: C
authors.lastname: Dickinson
authors.affiliation: Institute of Health & Society, Newcastle Biomedical Research Building, Newcastle University, Campus for Ageing and Vitality, Newcastle upon Tyne, NE4 5PL, UK. katie.brittain@ncl.ac.uk.
authors.forename: Katie
authors.initials: K
authors.lastname: Brittain
authors.affiliation: Institute of Health & Society, Newcastle Biomedical Research Building, Newcastle University, Campus for Ageing and Vitality, Newcastle upon Tyne, NE4 5PL, UK. a.l.robinson@ncl.ac.uk.
authors.forename: Louise
authors.initials: L
authors.lastname: Robinson
mesh_terms: D000328:Adult; D000368:Aged; D017028:Caregivers / Q000523:psychology*; D003704:Dementia / Q000523:psychology / Q000628:therapy; D005260:Female; D006701:Home Nursing / Q000191:economics / Q000379:methods; D006801:Humans; D057187:Independent Living / Q000706:statistics & numerical data; D008297:Male; D020380:Needs Assessment; D036301:Qualitative Research; D012656:Self-Help Devices / Q000191:economics / Q000706:statistics & numerical data; D012944:Social Support; D006113:United Kingdom