Nancy Brown is a PhD candidate at University of Edinburgh in dementia care. She has 16 years experience as a Senior Coordinator in MELABEV (Community Clubs for Eldercare, Jerusalem, Israel) with a special interest in utilizing interactive technology to support both carers and clients and in designing programs to engage persons with moderate to advanced cognitive impairment. With the onset of COVID-19, Ms. Brown presented webinars to families, professional staff and the community on building communication skills and relationship-centered activities whether in-person or online. As a practitioner-researcher, she now focuses on moving the ‘built environment’ of the memory care day center to an online platform developing effective programming using interactive technology for persons affected by dementia, particularly in a group environment. Through culturally appropriate intervention, persons with all levels of cognitive impairment can engage, interact, and communicate with one another expressing their self-identity, remaining emotive capacity and social connectivity, thus mitigating the negative effects of social isolation for themselves and their families, despite the stigma and ageism they experience with the general population. Innovative home services and access to digital technology may be helpful in building more inclusive resilient communities for more highly vulnerable populations.
Narrowing the digital divide during the corona pandemic: Creating a zoom virtual community from home
Nancy Brown, University of Edinburgh, United Kingdom and MELABEV Community Clubs for the Elderly, Israel
COVID-19 pandemic and subsequent lockdowns created a global public health crisis generating mental health problems including social isolation, stress, and anxiety especially for persons with dementia and their carers. This study utilized digital technology to maintain social connectivity via a virtual group session that focused on the topic of ‘what is home.’ Participants in this session included 16 day-care center clients representing an immigrant community identified with mild to moderate cognitive impairment. Our hypothesis is that by using technology that enabled facial recognition and communication and by focusing on the meaning of home, these persons and their carers expressed positive emotional feelings, and remained engaged with their social world despite what was going on around them.
Online psychodrama sessions were conducted for 7 weeks, 1 hour each week during the COVID-19 lockdown. A trained psychodrama therapist conducted the virtual group meeting based on five key techniques: spectrogram, role reversal, doubling, mirroring, and soliloquy. Carers were instructed on the use of the tablet and preparations needed for the Zoom sessions. The session ‘What is Home’ was video recorded following the ethics guidelines of the day care center MELABEV and then manually transcribed. NVivo software was used for the qualitative analysis of the transcribed video recording to identify key themes based on grounded theory methodology.
Zooming from home, clients engaged in significant social interaction. Results of the NVivo analysis identified the following themes of ‘what is home’: Emotions and home, Home is family, Home is community, and Reminiscence (with objects and traditions). Results suggest that digital interactive technologies, like Zoom, enhance social connectivity thus mitigating the negative impact of social isolation for persons with dementia especially during pandemic lockdowns. Our pilot results based on virtual group meetings from home demonstrate that participants can express significant emotive capacity and enhanced connectivity with one another in very personal ways despite a diagnosis of mild to moderate dementia. In contrast to recent literature, neither our clients nor their caregivers exhibited anxiety, stress, or depression despite their social isolation.
Results support the notion that technology like Zoom offers not only an option for preventing social isolation and mitigating the negative impact of supporting someone with dementia during pandemic lockdowns but also as an addition to other community and home care services. While larger studies are needed to confirm these findings, we suggest that this methodology may be used to support persons with dementia not only in times of pandemics but other crises as well. From a societal perspective, particularly during COVID-19, the importance of making available technology to persons with dementia and to see them social connect and engage through a medium that is not part of their generation has far-reaching implications not only for future research but also for policy considerations, mitigating social isolation and caregiver burden. Changes in reimbursement policies to include these innovative home services may be helpful in building more resilient communities for the more highly vulnerable populations.