Assessment of need and practice for assistive technology and telecare for people with dementia – the ATTILA (Assistive Technology and Telecare to maintain Independent Living at Home for people with dementia) Trial

INTRODUCTION: To define current assistive technology and telecare (ATT) practice for people with dementia living at home. METHODS: Randomised controlled trial (N=495) of ATT assessment and ATT installation intervention, compared to control (restricted ATT package). ATT assessment and installation data were collected. Qualitative work identified value networks delivering ATT; established an ATT assessment standard. RESULTS: ATT was delivered by public and not-for-profit telecare networks. ATT assessments showed 52% fidelity to the ATT assessment standard. Areas of assessment most frequently leading to identifying ATT need were daily activities (93%), memory (89%) and problem solving (83%). ATT needs and recommendations were weakly correlated (τ = 0.242; p<0.000), with ATT recommendations and installations moderately correlated (τ=-0.470; p<0.000). Half (53%) of recommended technology was not installed. Safety concerns motivated 38% of installations. DISCUSSION: Assessment recommendations were routinely disregarded at the point of installation. ATT was commonly recommended for safety and seldom for supporting leisure.