The idea of using tablet devices as an intervention for older adults, including those with severe dementia, was partially born at a restaurant dinner table, according to Ipsit Vahia, M.D..
He observed that his friends’ boisterous four-year-old, when handed an iPhone, was able to calm down enough so that everyone could enjoy their meals.
Vahia, the medical director of Geriatric Psychiatry Outpatient Services at McLean Hospital, led a pilot study that built upon previous research showing how art, music and other therapies are viable non-pharmaceutical options for reducing dementia symptoms.
The study involved using a wide range of free apps available on iTunes with varying degrees of complexity – everything from cute pictures of dogs and cats to Sudoku and crossword puzzles.
He explained that researchers tried to offer patients apps that matched as closely as possible with hobbies that they once enjoyed. For example, an individual that did not like music would not be subjected to listening to drum kits or piano apps.
Researchers found that patients with milder forms of dementia engaged longer and used a larger number of apps than those with more severe cases. However, with proper supervision and training, the engagement rate with the devices was nearly at 100 percent.
Vahia said that it was somewhat surprising that people with severe dementia experienced a decrease in agitation by interacting with the device.
“Even those (people) with superficial communication, if shown simple apps that are mostly images, were able to swipe the screen and move from one image to another,” he said.
Another revelation to him was that no damage was done to the equipment.
“I think it is a novel program. We don’t know of anywhere else that uses tablets in this manner,” Vahia said. “The principal we applied is a known one which is non-pharmaceutical approaches work in controlling agitation.”
The biggest advantage is versatility, he said. “The tablet gives you the option of switching from one app to another easily and the technology makes it possible to personalize and customize apps to suit a wide range of interests.
The device allows you to engage a person with multiple forms of therapy at the same time and move effectively between the forms. So, it really almost turbo charges how you can implement the non-pharmaceutical interventions.”
He noted that using cell phones or laptops was ruled out as the first would be too small and the other too bulky.
“The tablet hits the sweet spot size-wise and is easy to move around.”
Vahia said he would like to expand the use of tablet devices to include not only McLean’s inpatient dementia population but also individuals residing in dementia care units at assistant living facilities or in community settings.
The next step is to conduct a full, randomized control trial to see how tablets work compared to other activities as a means to possible medication reduction.
He said the tablets are easy to use and contrary to stereotypes, elderly people are typically proficient and willing to learn how to access the tools.
“I’ve met a lot of people in their 80s and 90s who have actually made it a goal to learn how to use these devices,” Vahia added.
The research, “Use of Tablet Devices in the Management of Agitation Among Inpatients with Dementia: An Open-Label Study” was recently published in the online version of The American Journal of Geriatric Psychiatry.
By Susan Gonsalves