Background: There is lack of knowledge on how occupational therapists (OTs) assess daily time management (DTM) for persons with dementia (PwDs) and on which aspects affect prescription of time assistive technology (AT). Aim: To explore OTs’ experiences of assessing the need for and prescribing time AT for PwDs. Material and methods: Focus group interviews with OTs that prescribe time AT for PwDs analyzed via qualitative content analysis. Results: A main category and four categories were identified. The categories illustrated a complex and time-consuming prescription process, which was facilitated if the PwD was supported by a significant other (SO). Support from a SO was especially important during implementation and follow-up. OTs had to take individual responsibility for staying informed about time AT. Organizational limitations and time constraints were barriers for OTs striving to work according to national prescription guidelines. Conclusions and significance: High demands are made on SO’s participation during the prescription process. PwDs with no support from SOs are at risk not receiving or fully benefitting from time AT. To avoid inequalities, specific forms of support need to be developed and targeted at PwDs without SOs to ensure that they have sufficient opportunities to access and use time AT.
Background: Persons with dementia encounter time-related problems and significant others often need to provide support in daily time management and use of time assistive technology (AT). Further research has been requested on how time AT for persons with dementia affects the situation of significant others. Moreover, there are a few previous qualitative studies on the experiences of time AT by persons with dementia. This study explores the experiences of persons with dementia and significant others in daily time management and their perceptions on how time AT affects everyday life. Method: Semi-structured interviews with persons with mild to moderate dementia (n = 6) and significant others (n = 9) were conducted three months after receiving prescribed time AT. Interviews were analysed using qualitative content analysis. Results: A main category “Support by significant others is always part of daily time management”, and three categories “Facing new challenges”, “Using strategies to handle changes”, and “Time assistive technology in daily life” illustrated that significant others provided support for daily time management in all phases of dementia. This support was often embedded in other kinds of support for emerging challenges. Support in time management was needed from an early stage in dementia, and responsibility for time management was gradually transferred to significant others. Time AT could support time orientation and were important for sharing the time management conducted by others but did not enable independent time management. Conclusions: Time-related assessments and interventions should be offered at an early stage of dementia to increase the possibility of maintaining daily time management skills. Using time AT to communicate time might increase agency and participation in daily occupations for persons with dementia. Given the central role of significant others for daily time management, the society needs to adequately support persons with dementia lacking support from significant others.
This study investigated associations between time processing ability (TPA), daily time management (DTM), and dementia severity. Persons with dementia (PwDs) (n = 53) and their significant others (n = 49) participated in this cross-sectional study. Bivariate analyses were used to investigate associations between TPA and DTM and the dementia severity. Linear regression models were used to further predict the contribution of the subtests in the Mini Mental State Examination (MMSE) for TPA results. The results showed significant correlations between TPA and dementia severity, where visuospatial functions were the most highly correlated. TPA also showed a significant correlation to proxy-rated DTM. In addition, proxy-rated DTM was significantly correlated with dementia severity and PwDs’ own self-ratings of their DTM. Knowledge of the association between TPA, dementia severity, and visuospatial functions can enable early detection of TPA impairments. For a comprehensive assessment of TPA and DTM, objective measures should be used in combination with self-ratings and proxy-ratings. The findings can be used in clinical research and healthcare settings to develop methods to compensate for impaired TPA and support DTM in PwDs.
29 June 2022 in Australian Occupational Therapy Journal
The aim of this study was to investigate the effect of time-assistive products in supporting persons with mild to moderate dementia to achieve their time-related activity goals given their time processing ability. A multicentre single-blinded randomised controlled intervention study. A total of 73 persons with mild to moderate dementia aged ≥60 years were recruited through memory clinics across Sweden, of which 57 completed the three-month follow-up (intervention group n = 26, waiting list control group n = 31). The intervention group received individually prescribed time-assistive products. The primary outcome measure was the Canadian Occupational Performance Measure (COPM). Comparative analyses were done of the differences in COPM ratings at baseline and after three months within and between groups. KaTid-Senior was used to measure time processing ability. After three months, COPM ratings, adjusted for time processing ability, had significantly improved in the intervention group regarding satisfaction with performance (p = .028, = 0.09) but not for performance (p = .053, = 0.07). The change from the ratings at baseline to the ratings at 3 months was clinically significant in the intervention group as their improvement exceeded 2 points on a 10-point scale both for performance (mean 2.8, CI 1.8-3.7) and satisfaction with performance (mean 3.4, CI 2.3-4.6). Prescription of time-assistive products can support persons with mild to moderate dementia in their daily time management in relation to individual time-related goals. However, given the weak evidence base, further research is needed on the effectiveness of time-based assistive products for persons with dementia.