eHealth interventions are health services delivered or enhanced through technology or the internet. This includes electronic records, video consultations with medical professionals, and assessment tools. However, it is not known whether these interventions are acceptable to residents, families and staff to manage care for people with dementia, or how effective they are at improving outcomes of care such as appropriate prescribing of medications or reduction of restraint.

Elderly black man using laptop photo by Tolu Bamwo

As dementia progresses and needs increase, many people living with dementia move into care homes to be cared for until their death. It is estimated that 70% of people who live in care homes in England have dementia. It is further estimated 58% of those living with dementia will die in a care home. Care home staff get to know residents extremely well and are likely well placed to assess and identify changes in care needs. eHealth interventions can support them to assess and monitor needs and to access timely health care.

To carry out the research, the team analysed 26 papers which had met the eligibility criteria. eHealth interventions were grouped into six categories: video consultations, electronic health records, multi-component interventions, digital decision support tools, digital assessment tools and personal devices. All studies were conducted in high income, and mostly western, countries.

The research team found:

  • interventions favoured by staff provided them with supportive and practical learning through integration with external professionals
  • eHealth interventions also gave them the language to communicate their intrinsic knowledge of resident’s needs
  • residents were willing to use video consultations as they reduced time spent going to appointments, however families preferred face-to-face appointments, but evidence was limited
  • eHealth interventions were showed to be effective at improving resident outcomes around appropriate prescribing and advance care planning, as well as improving staff knowledge, confidence, and well-being.
  • interventions that included a video consultation component were effective at reducing hospitalisations for residents.

Overall, eHealth interventions are acceptable to staff to manage care for people with dementia. More work is required to understand the acceptability of eHealth to residents and families. The research also found very limited evidence on how eHealth interventions can improve family outcomes.

With the increased uptake of eHealth since the Covid-19 pandemic, it is important that we understand the best ways that eHealth might support care. Future research should further examine how acceptable eHealth is to people living with dementia in care homes, its effect on family outcomes and how effective and acceptable it is in non-Western cultures and in low-middle income countries

India Tunnard

India Tunnard, research project and coordination assistant and NIHR pre-doctoral Fellow at the Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation says:

This review of literature was undertaken as a part of a larger programme of work to develop new ways of improving care for people dying with or from dementia and their carers. The Empowering Better End of Life Dementia Care (EMBED-Care) programme is a five year programme of work between University College London and King’s College London, funded by the UK Economic and Social Research Council and the National Institute of Health and Care Research. EMBED-Care is supported by the NIHR ARC South London.

Find out more 

Read the paper: The acceptability and effectiveness of eHealth interventions to support assessment and decision-making for people with dementia living in care homes: A systematic review 

Read more about our palliative and end life care research