Background: Owing to no cure for dementia currently, there is an urgent need to look for alternative ways to support these people and their informal caregivers. Carefully designed interventions can answer the unmet needs of both people with dementia and their informal caregivers in the community. However, existing products, systems, and services are often too complex or unsuitable. Objective: This study aims to identify, longitudinally, the changing needs (as dementia progresses) of people with dementia living at home and their informal caregivers. By developing co-creation-based innovations, these changing needs will hopefully be met. Methods: A user-driven Living Lab design is used to structurally explore the needs over time of people with dementia (and their informal caregivers) living in the community in the North Brabant region of the Netherlands. In addition, co-creation-based innovations will be developed, tested, and evaluated by these people and their caregivers at home. All participants will complete complaints-oriented questionnaires at 3 time-points—at the baseline, 1 year, and 2 years after they start participating. Home interviews are scheduled to explore if and how these complaints translate into participants’ specific needs or wishes. Focus groups meet on a monthly basis to further identify the needs of people with dementia and their informal caregivers and provide feedback to the stakeholders. In the context field, participants have an opportunity to actually test the products at home and provide feedback. Quantitative outcome measurements include neuropsychiatric symptoms, cognitive decline, independence in activities of daily living, safety, and caregiver burden. Qualitative outcome measurements include feedback to the stakeholders regarding the needs of people with dementia and their informal caregivers and how these needs change over time, as well as user experiences about the specific innovations. Results: Participant recruitment will start in September 2018 and is ongoing. The first results of data analyses are expected in the spring of 2019. Conclusions: The overall aim of Innovate Dementia 2.0 is to facilitate person-centered innovations developed for people with dementia and their informal caregivers at all stages as dementia progresses. This should lead to newly designed concepts and innovations, which are better able to answer the needs of people with dementia and their caregivers in the community. International Registered Report Identifier (IRRID): PRR1-10.2196/10952

A variety of technologies classified as lifestyle monitoring (LM) allows, by unobtrusive monitoring, for supporting of living alone at home of vulnerable older adults, especially persons with neurocognitive disorders such as dementia. It can detect health deterioration, facilitate early intervention, and possibly help people avoid hospital admission. However, for LM to redeem its intended effects, it is important to be adopted by involved stakeholders such as informal and formal caregivers and care managers. Therefore, the aim of this qualitative study is to understand factors that drive or impede successful implementation of LM for vulnerable older adults, specifically using infrared sensors to record movements, studied from a multiple stakeholder perspective. An open coding process was used to identify key themes of the implementation process. Data were arranged according to a thematic framework based on the normalization process theory (NPT). All stakeholders agreed that LM could lead to various health benefits for older adults using LM. However, some did not perceive the LM system to be cost-efficient and expressed a need for more flexible health care structures for LM to be successfully implemented. All stakeholders acknowledged the fact that LM requires a transition of care and responsibilities, a clear eligibility strategy for clients, and a clear ambassador strategy for health care professionals, as well as reliable technology. This study highlights the complex nature of implementing LM and suggests the need for alignment within constructs of the NPT among stakeholders about new ways of collaboration in supporting living alone at home.

Most people with dementia live at home supported by informal caregivers, but disturbed sleep patterns may induce a heavy burden of care. The beneficial effects of bright light on their sleep, health, and well-being have been demonstrated in clinical settings, but not in a home situation. We evaluated a dynamic lighting system in a real-life longitudinal single-case experimental design (SCED) with people with dementia living at home. Eleven people with dementia and their informal caregivers were included in this study with four 4-week periods of alternating exposure and nonexposure in an introduction–withdrawal setup (ABAB). Objective light exposure data were collected and analyzed. The used study design seems applicable for this population and suitable for home use. Participant dropout did occur, but was due to health conditions rather than participant burden. The lighting system led to more light in the homes of the participants, as well as to higher actual individual light exposures, although the latter increased only moderately and not consistently across all participants, seasons, and times of day. The participants appreciated the lighting system even after 6 months. We reflect on individual differences, seasonal and daypart influences, and differential light effects. Recommendations and lessons learned are discussed.

Despite the potential value of assistive technology to support people with dementia and their informal caregivers (=PlwD) to age in place, use of these innovations is still limited. To ensure that innovations better address specific needs of PlwD, it is important to actively involve them into the innovation process. A Living Lab (LL) is a user-centred research design in which multiple stakeholders, develop, test and validate innovative solutions in real-life environment together with end-users (i.e. PlwD). Although user involvement activities in LLs are seen as their main goal, little literature is available on how different stakeholders, including users, experience their collaboration in LLs. This case study (Playtime) investigates the experiences of various stakeholders, including PlwD, when developing a serious game in a LL. 18 semi-structured interviews were conducted with PlwD, healthcare professionals, developers and researchers about their experiences following the key-principles of a successful User Centred Design project. Results shows that the stakeholders of the Playtime LL are most positive with regard to the key-principles active user participation, continuous iteration of design solutions and multidisciplinary networks. Some lessons learned are selected to inspire other LLs when collaborating with PlwD in the development of assistive technology for dementia.

Dementia is related to disturbances in the sleep-wake pattern, behavioural and psychological symptoms of dementia (BPSD). These phenomena are the main reason for institutionalization. Assistive light technology is relevant to study, as mitigation of BPSD may allow for the improvement of quality of life for both people with dementia and their caregivers. Studies of dynamic light exposure in home-dwelling populations are scarce. In this single-case experimental design study, we evaluated the effects of exposure to dynamic light on the sleep-wake pattern and symptoms of depression, agitation, and anxiety in 11 home-dwelling people with dementia. A four-phase light-exposure therapy oscillating between the control and intervention waves was offered. Objective and questionnaire data were analysed and discussed. The results show that the used dynamic light system did not significantly affect the sleep variables. The severity of BPSD fluctuated in the expected pattern, reducing in intensity with increased light exposure. This pattern was significant for depression and agitation. This longitudinal study included an exploration of a low-cost assistive light intervention within a hard-to-study home-dwelling dementia population. The lessons learned are discussed and recommendations are made for future studies, as this design seems suitable for studying lifestyle interventions to support home-dwelling people with dementia.

BACKGROUND Despite the potential value of assistive technology to support people with dementia (PWD) in everyday activities, use of these technologies is still limited. To ensure that assistive technologies better address the specific needs and daily context of PWD and their informal caregivers, it is particularly important to involve them in all different phases of assistive technology development. The literature rarely describes the involvement of PWD throughout the development process of assistive technologies, which makes it difficult to further reflect on and improve active involvement of PWD. OBJECTIVE This two-part study aimed to gather insights on the user-centered design (UCD) applied in the development process of the alpha prototype of the serious game PLAYTIME by describing the methods and procedures of the UCD as well as evaluating the UCD from the perspective of all involved stakeholders. METHODS The first three phases of the user-driven Living Lab of Innovate Dementia 2.0 were applied to directly involve PWD and their informal caregivers through qualitative research methods, including focus groups and a context-field study, in the development of the alpha prototype of PLAYTIME from exploration to design to testing. After the testing phase, a total number of 18 semi-structured interviews were conducted with PWD, their informal caregivers and the project members of PLAYTIME to evaluate the applied UCD from the perspective of all involved stakeholders. The interviews addressed five of the principles for successful UCD and the appropriateness of the different methods used in the focus groups and context-field study. RESULTS Results of the interviews focused, amongst others, on the level of involvement of PWD and their informal caregivers in the development process, the input provided by PWD and their informal caregivers, the value of early prototyping, continuous iterations of design solutions and in-context testing, the role of dementia care professionals in the multidisciplinary project team, and the appropriateness of open- and closed-ended questions for obtaining input from PWD and their informal caregivers. CONCLUSIONS The description and evaluation of the UCD applied in the development process of the alpha prototype of PLAYTIME resulted in several insights on the relevance of UCD for all involved stakeholders as well as how PWD can be involved in the subsequent phases of usable and meaningful assistive technology development.