Developing an implementation guide for robotic pets in continuing care settings for older adults living with dementia in Canada: findings from a modified Delphi

While live animal therapy has been demonstrated to improve the well-being of persons living with dementia, no-pet policies frequently exclude live pets in continuing care settings due to the potential for biting, scratching, and allergies to occur. Robotic pets as an alternative tool for supporting the well-being of persons living with dementia in continuing care is increasing in prevalence due to its therapeutic value. While there are benefits to using robotic pets, implementation challenges and unintended consequences exist. An evidence-based implementation guide is needed to support care providers implementing robotic pets in continuing care to maximize the therapeutic benefits while mitigating implementation challenges. A RAND/UCLA Modified Delphi method (a consensus-building approach) was used to inform guide development. To develop the Delphi questionnaire, we conducted a scoping review and ethnographic participant observations to identify potential barriers and facilitators to implementing robotic pets in continuing care for persons living with dementia. We then asked Canadian care providers (researchers, healthcare providers, and family and friend caregivers) to complete a two-round Delphi questionnaire, with round 1 feedback from participants integrated into round 2. In round 1, 12 participants reviewed 143 statements on a 7-point Likert scale of agreement. In round 2, 8 participants reviewed 52 revised statements based on feedback from round 1. In total, 135 statements reached consensus for inclusion, and 8 reached consensus for exclusion. The included statements reflected the importance of allowing residents to lead interactions with robotic pets and having resources to support purchasing and maintaining robotic pets. The included statements were used to create two implementation guides, one for health care providers, and one for organizational leaders. The implementation guides reflecting statements that were agreed upon for inclusion by Delphi participants will support care providers implementing robotic pets in continuing care. An evidence-based approach to implementing robotic pets within continuing care will help improve the mental well-being and quality of life of persons living with dementia.