A systematic review of digital access to post-diagnostic health and social care services for dementia

ObjectivesFor many people with dementia and unpaid carers, using technology for care and support has become essential. Rapid proliferation of technology highlights the need to understand digital access to health and social care services for dementia. This mixed-methods systematic review aims to explore digital access to health and social care services for dementia, from the perspective of people with dementia and unpaid carers.MethodsNine electronic databases were searched in May 2023 for qualitative, quantitative, or mixed-method studies, published in English or German, focused on experiences of using technology-delivered health and social care services for people with dementia and unpaid carers. After removal of duplicates and screening, 44 empirical papers were included.ResultsFrom the 44 studies, findings were grouped into five categories, highlighting experiences for people with dementia and unpaid carers: (1) Adapting to technology, (2) Inequalities and variations in outcomes, (3) Impact on caring, (4) Impact on health, and (5) Impact on relationships. Proliferation of technology in care access emphasised the need for quick adaptation to technology and examination of its impact. The impact of such service delivery has evidenced mixed findings. There were improvements in the health and wellbeing of people with dementia and unpaid carers, and benefits for their dyadic relationship. However, using technology for health and social care access is not always possible and is often reliant on unpaid carers for support. Lower tech-literacy, lack of equipment or money to buy equipment and poor internet connection can impact the potential for positive outcomes.ConclusionsTechnology can bring great benefits: social inclusion, improved service access and care. However, using technology in service delivery in dementia needs careful thought. Professionals and service providers need to be cognizant of the complex nature of dementia, and the benefits and challenges of hybrid service delivery. Evidence emphasises benefits and challenges to the availability, implementation, use, of technology in health and social care access in dementia. Though there are issues, technology can help improve quality of life for people with dementia, can support carers to care, and facilitate positive relationships between unpaid carers and people with dementia. Proliferation of technology for care access was expedited during COVID-19, but has not been equally rolled out, making remote and disadvantaged groups less well-served. A hybrid delivery of services in which people are given choice of delivery method, and are supported in accessing and using technology, will better serve people with dementia and unpaid carers.