Service user experiences of using Assistive Technology for cognition after brain injury: a qualitative evaluation

Purpose
Cognitive impairments, such as difficulties with memory, planning, organisation and information processing, are common after brain injury. Assistive Technology for Cognition (ATC) can provide support to improve independence in everyday tasks and reduce reliance on caregiver support. Recommendation and support needs to be tailored to individual factors and therefore understanding individual experiences and preferences is essential. The aim of this study was to understand the lived experience of people using ATC after brain injury.

Materials and Methods
Semi-structured interviews were conducted with seven people (six people with brain injury and one caregiver) who were involved with both a Community Acquired Brain Injury Service and an Assistive Technology Service. Interviews were recorded and transcribed and analysed using principles of Framework Analysis.

Findings
We identified five themes: 1) Motivations and decisions to use ATC, 2) The anticipated and unanticipated impact of ATC, 3) ATC becoming part of everyday life, 4) Support and education from professionals (although I don’t know who from) and 5) Family and friends as back-up and trouble-shooters.

Conclusion
We use the themes to illustrate factors which can help professionals to match technology to individuals and their situations and therefore potentially optimise acceptability and use for this population. Findings emphasise the importance of support from family and friends and a lack of clarity about longer-term support.

IMPLICATIONS FOR REHABILITATION
People living with brain injury who use Assistive Technology for Cognition (ATC) perceive it to improve memory, reduce fatigue and stress, improve function in everyday tasks and increase feelings of self-efficacy and mastery.

To be useful, ATC needs to be matched to individual preferences, capabilities, goals and environments. Services and practitioners who assess, recommend and provide continuing support for ATC use need to consider this holistic context.

Familiarity with everyday technologies such as smartphones and personal assistant devices can be an important strength to build on for people and their family members. However, this should not be assumed with digital literacy and pre-morbid technology use likely to vary greatly.

ATC often does not replace human support, with caregivers continuing to help with back up reminders and troubleshooting problems. Support and education for these caregivers is therefore an essential part of services.

People may be unsure how to access longer term follow-up and support. Professionals and services should clarify this support in their local areas and clarify this for people accessing services.