Evaluating the ‘lessons learned’ in transitioning a digital health technology for dementia from lab to care home

The introduction of technologies and devices to support wellbeing in dementia are often evaluated using sensing technologies in a rather tech-heavy approach. With any research study involving such devices, there are unforeseen circumstances that emerge when operating this technology within a new site. This study considers the specific case of a lighting technology to support the synchronisation of the circadian rhythm for people living with dementia in care homes. Such a study requires an overlap in expertise between lighting design, networking, sensor processing, data analytics and dementia care. Therefore, this study makes use of a collaboration between industry (Chroma Lighting), academia (Ulster University) and the care sector in order to both support the wellbeing for people living with dementia and to support staff in maximising the benefits the technology can administer. Consequently, an integrated approach is used to design, develop, implement, test and evaluate the lighting and sensing solution. The technology is deployed in a local care home for 16 weeks with the aim to understand how dynamic lighting can support parameters of wellbeing such as sleep/wake cycles, rest-activity patterns, mood, and social interactions. This study therefore aims to categorise and address the main lessons learned during the trial using a retrospective approach. We review the following obstacles faced in deploying the technology; 1) Technical, 2) Ethical, 3) Logistical, 4) Coordination and Communication. 1)We identify issues with networking and gateway communications, highlighting the potential for obstruction to sensor signals caused by building composition and layout. The need for ‘repeater’ modules to allow lighting and sensing devices to communicate became a requirement due to the density of heavily-attenuating materials such as concrete within the care home. 2)Discussions arise surrounding the declaration of ‘medical device status’ and whether a lighting technology to support wellbeing would fall within this category and thus require extra testing/licensing. Combined with the ethical processes surrounding consent, we discuss the rigour involved in this stage alongside the importance of maintaining the perspectives of people living with dementia. 3)We find that the importance of a structured and ordered site survey cannot be understated. This requires liaising with site managers for access to the property, access to electrical cupboards and roof spaces in order to map out the deployment area and reduce the risk of technical issues in the next steps. 4)We find that implementing a technical research protocol requires aligning the needs of the residents and care staff in an approach that best suits them in their daily routines. As such, an open discussion between care manager, care staff and researchers is explored to ease the ‘burden’ associated with data collection and observation. To conclude, an informal evaluation of the entire system is conducted between researchers and the care home manager. The study closes with an approach to recommending a step-by-step process for designing future trials from the lab to care home environment.