Everyday technology is hard for dementia patients to use

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Not being able to use a mobile phone or forgetting how to withdraw money from an ATM can make life very difficult. Scientists at Karolinska Institutet are currently looking into what it is like to live with dementia in a society that requires a certain degree of technological competence.

Online baking and buying bus tickets on the mobile phone makes life easy - if, that is, you know how to do it. Many of our everyday activities involve more or less advanced technology, and it is not always for the best.

"Even well-known and very familiar technology can cause problems if you have a dementia disease," says Dr Louise Nygård, occupational therapist and researcher at the Department of Neurobiology, Care Sciences and Society. "Many people go to great and inconvenient lengths to avoid problems, such as going in person to the hairdresser's to book instead of calling them."

In their research, Dr Nygård and her colleagues asked elderly people to rate the difficulties they have using around ninety different types of everyday object, from domestic appliances, such as the phone and coffee machine, to more advanced forms of technology, such as the automatic check-in at Arlanda airport.

Their results show that people with dementia are more likely to have difficulties using everyday technologies than their healthy coevals, as do people with mild cognitive impairment, a possible transitional stage of dementia. The scientists believe that changes in technology use can be an early indication of dementia, which can otherwise be difficult for sufferers or their family and friends to detect.

"By looking at technology use, we can detect subtle yet very significant difficulties when using things like washing machines or mobile phones," says Dr Nygård.

Many people find it hard to use technology that requires a certain sequence of operations, such as entering a PIN code before turning on a mobile, while problems using automatic telephone services requiring callers to follow instructions and make selections are common.

Dr Nygård hopes that the results can be of use in the development of future assistive technologies. She also sees them as providing basic knowledge needed by those supporting people with dementia or other forms of cognitive impairment. According to her, the younger generation often turns to technology to solve the problems faced by the elderly - perhaps a kettle to make their lives a little easier, or a mobile phone for emergencies. But if there is dementia involved, Dr Nygård believes that alternative solutions ought to be given consideration before relying on technology.

"Even if someone knows how to use a mobile phone in the peace and quiet of their home, there's no saying that they'll be able to do so when they really need to, since the situation affects this ability so much," she says.

An ongoing research project is looking into how well people with dementia are able to function in public spaces, with all the demands that the road environment, door codes, and different payment systems place on the individual. According to Dr Nygård, despite the efforts made to render society as user-friendly as possible for people with physical disabilities, there are no such ambitions when it comes to people with cognitive disabilities.

Earlier research into dementia and technology has focused mainly on trying out different assistive technologies to compensate for cognitive impairment. Dr Nygård's team has studied a range of implements, including a cooker monitor, a device designed to improve safety by automatically switching off a hob after use. From her own and other peoples research, she draws the conclusion that optimism outstrips knowledge when it comes to assistive technologies.

"Even the most rudimentary tool requires the user to learn a new technique, but learning new things is generally very hard for people with dementia," says Dr Nygård. "You have to assume that they have to get help from others."

However, their research also shows that in some situations people with dementia have a surprising capacity to accept and use new technologies. Dr Nygård also finds it remarkable how important and relevant the technology can be for many of them.

"There was a lady with dementia, for example, who started to research into her family tree on the computer, something that she considered very meaningful - despite that fact that it should have been too difficult for her. This shows that the potential is there and that it's worth exploring the conditions under which technology use actually works."

Cognitive faculties, such as memory and reasoning, form just a part of the factors that determine how well people cope with everyday activities, whether it be brewing coffee or conducting genealogy research on the computer.

"Something that goes a long way to deciding what you end up being able to do is motivation, what you like doing and what you think is worthwhile," says Dr Nygård.

Text: Ola Danielsson. Published in Medical Science, issue no. 3, 2009.

Care SciencesDementiaNeurobiology