Implementing monitoring technologies in care homes for people with dementia: A qualitative exploration using Normalization Process Theory.
Alex Hall, Christine Brown Wilson, Emma Stanmore and 1 others
PMID 28494333WHAT IT FOUND
Staff and relatives in care homes saw monitoring sensors mainly as safety nets, not freedom or privacy tools.
Alarms were frequent, some staff wanted more training, and residents were not always involved in decisions about technology.
Key findings
01Staff and relatives most commonly justified monitoring technologies as safety measures. Privacy and freedom of movement were treated as less important than physical safety.
02Frequent alarms were perceived as overburden, but staff used knowledge of residents to decide when to respond. The location-based system generated false alarms that became unmanageable.
03Senior management made the final decision to use monitoring technologies with specific residents. Relatives and residents appeared more involved in discussions at Conifer Gardens than at the other homes, and some staff wanted more formal training.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This was a qualitative case study in three urban homes, so it cannot show how common these experiences are or whether the technologies work. Most participants were female and White British, so views from more diverse settings may differ. Only three residents were interviewed, although nine residents were recruited, because many lacked cognitive capacity to discuss the technologies. The homes mostly used older nurse-call systems with bed sensors or pressure mats, so there was little information about newer monitoring technologies. All data were collected by the first author, who had social care experience but not dementia care experience.
Declared interests
No conflicts of interest were declared. The work was funded by a UK Medical Research Council Doctoral Training Grant, and the funder had no role in design or conduct of the research.
The easy way to misread this
Do not read the use of bed sensors and pressure mats as proof that monitoring technologies prevent falls or improve safety. This was a qualitative study of experiences, not an outcome trial, and staff reported that residents still fell while alarms could create extra work.