Understanding the impact of assistive technology on the lives of people who draw on care and support

A study examining the impacts of assistive technology using a capability-based framework, focusing on person-centred outcomes beyond device provision.

Key messages

  • assistive technology benefits extend beyond functional support to autonomy, safety, social participation and wellbeing
  • capability-based outcomes provide a broader understanding of how assistive technology supports people’s lives
  • person-centred evaluation moves beyond counting devices or hours of use
  • access barriers persist, including affordability, usability and lack of training
  • routine evaluation rarely captures the outcomes that matter most to users.

Policy implications

  • evaluation of assistive technology should incorporate capability-based outcome measures
  • commissioning approaches may need to prioritise user-defined outcomes rather than device provision
  • training and usability support are critical to realising the benefits of assistive technology
  • funding and access policies should address affordability to reduce exclusion.

Gaps

  • lack of standardised capability-based metrics in routine assistive technology evaluation
  • limited evidence on how capability outcomes vary across population groups
  • need for integration of capability measures into health and social care data systems.

Commentary

This paper reframes the use of technology in care by focusing on what assistive technology enables people to do and be, rather than on the devices themselves. By applying a capability-based approach, it highlights outcomes such as independence, safety and social participation that are often overlooked in standard evaluations.

From a care equity perspective, this shift is important. Measuring success through device provision alone risks masking unequal experiences, where some users are unable to benefit due to affordability, usability or lack of training.

The findings suggest that person-centred evaluation could support more equitable commissioning and service design. Understanding which capabilities are enhanced, and for whom, may help identify where assistive technology is failing to meet needs.

However, the study also highlights systemic limitations. Without standardised capability measures embedded in routine practice, these outcomes remain difficult to track or compare. Addressing this gap is essential if assistive technology is to contribute meaningfully to equitable care rather than reinforcing existing barriers.

Carers’ experiences of assistive technology in dementia care at home

A qualitative study exploring how carers of people with dementia use assistive technology at home, focusing on awareness, burden and changing needs.

Key messages

  • carers often use multiple assistive technologies to support people with dementia at home
  • reported benefits include improved safety and reduced stress for carers
  • carers experience significant information gaps about available technologies
  • affordability limits access and contributes to unequal use
  • technologies are frequently abandoned as needs change over time.

Policy implications

  • centralised information and advice services could improve awareness and appropriate use
  • loan stores may support trialling technology before purchase
  • assistive technology provision should anticipate changing needs rather than one-off solutions
  • better integration with formal care services may support sustained use.

Gaps

  • limited evidence on how assistive technology use affects formal care demand
  • lack of research on incremental addition of technologies as dementia progresses
  • insufficient understanding of long-term patterns of use and technological abandonment.

Commentary
This study highlights the complex role of assistive technology in home-based dementia care. Carers often assemble multiple technologies to manage safety and daily support, reflecting both the potential value and the burden of technology use.

From a care equity perspective, information and affordability barriers are central. Carers with less access to advice or financial resources may struggle to identify suitable technologies or sustain their use as needs evolve.

The frequent abandonment of technologies underscores the importance of adaptability. Static solutions are poorly suited to the progressive nature of dementia, placing additional emotional and practical strain on carers.

Overall, the findings reinforce that the use of technology in care must be supported by clear information, ongoing advice and flexible provision. Without this, assistive technology risks increasing burden rather than supporting carers and the people they care for.

Effectiveness of assistive technology and telecare for people with dementia

A randomised controlled trial evaluating whether a comprehensive telecare package improves outcomes for people with dementia compared with a basic telecare offer.

Key messages

  • a comprehensive telecare package did not improve time living at home compared with a basic offer
  • no reduction in ‘caregiver burden’ was observed with more intensive telecare provision
  • outcomes suggest limited benefit from technology-first approaches
  • effectiveness is strongly influenced by how well technology fits individual needs and context
  • implementation and personalisation appear central to whether telecare adds value.

Policy implications

  • telecare should not be assumed to deliver benefits simply through increased provision
  • matching technology to individual capabilities, routines and environments is essential
  • commissioning should prioritise assessment, tailoring and ongoing support
  • evidence cautions against large-scale roll-out of standardised telecare packages without personalisation.

Gaps

  • limited understanding of how different implementation models affect outcomes
  • need for research on personalised and adaptive telecare approaches
  • uncertainty about longer-term impacts beyond the trial period.

Commentary
This NIHR trial provides some of the strongest evidence on the limits of telecare effectiveness in dementia care. By comparing a comprehensive telecare package with a basic offer, it challenges assumptions that more technology necessarily leads to better outcomes.

From a care equity standpoint, the findings highlight risks in technology-led approaches that do not account for individual context. Standardised packages may fail to support people with dementia whose needs, capabilities and environments vary widely.

The results align with qualitative evidence showing that personalisation, support and fit with daily life are critical to successful technology use. Without these elements, telecare may add complexity without delivering meaningful benefit.

Overall, the study highlights that the use of technology in care must be grounded in person-centred assessment and ongoing support. Technology alone is insufficient to improve outcomes, and poorly matched interventions risk diverting resources from more effective forms of care.

Everyday use and personalisation of assistive technology in dementia

A study examining how people with dementia and their family carers use, adapt and abandon assistive technology and technology-enabled care in everyday life.

Key messages

  • people with dementia and carers actively adapt and repurpose assistive technologies to fit daily routines
  • technologies are often abandoned when they do not align with lived experience or changing needs
  • unintended consequences of assistive technology use are common
  • successful use depends on contextual tailoring at home and routine level
  • many assistive technology products lack flexibility to accommodate progression of dementia.

Policy implications

  • assistive technology provision should prioritise personalisation and adaptability
  • ongoing, longitudinal support is needed rather than one-off installation
  • service models should recognise carers’ role in adapting and maintaining technology
  • procurement should consider how technologies evolve alongside changing needs.

Gaps

  • limited longitudinal evidence on sustained assistive technology use
  • lack of flexible product design that supports progression of dementia
  • insufficient integration of ethnographic insights into commissioning and practice.

Commentary
This study provides rich insight into how assistive technology is used in real-world dementia care. Rather than being passively adopted, technologies are actively adapted, modified or abandoned depending on how well they fit with everyday routines and relationships.

From a care equity viewpoint, the findings challenge assumptions that technology alone can provide support. Without tailoring, ongoing support and responsiveness to changing needs, assistive technologies may fail to deliver intended benefits and can even create new burdens.

The concept of ‘bricolage’ highlights the work done by carers to make technologies usable. This ‘invisible work’ is rarely recognised in service design or commissioning, yet it is central to whether technology supports or disrupts care.

Overall, the study stresses that the use of technology in care must be grounded in lived experience. Personalisation, flexibility and longitudinal support are essential if assistive technology is to support people with dementia and their carers equitably and sustainably.

Technology use and digital access among unpaid carers

Survey analysis from the State of Caring 2025 report examining how unpaid carers use digital technology and online resources to access information, support services and manage caring responsibilities.

Key messages

  • the report is based on an online survey of 10,539 carers conducted between June and August 2025.
  • many carers rely on online information and digital tools to understand benefits, services and support available to them.
  • digital access is an important route through which carers seek guidance on managing caring responsibilities and navigating health and social care systems.
  • carers report using the internet to access information about caring, financial support and services, demonstrating the growing importance of digital channels for support.
  • however, digital access does not replace the need for clear, accessible information and practical support from services and professionals.

Policy implications

  • digital information and online services should be designed so carers can easily access guidance on support, benefits and services.
  • government and health and social care organisations should recognise digital channels as a key mechanism through which carers seek support.
  • digital services should complement, rather than replace, other routes to support such as advice services and direct engagement with professionals.

Gaps

  • the report does not evaluate the effectiveness of digital tools or technologies used by carers.
  • there is limited analysis of how digital exclusion affects different groups of carers.
  • the report does not examine outcomes associated with technology use, such as impacts on wellbeing, care coordination or service access.

Commentary
The State of Caring 2025 report highlights the increasing importance of digital information and technology in supporting unpaid carers. Online platforms are widely used to access guidance on benefits, services and caring responsibilities. This reflects broader shifts in health and social care systems, where information and service navigation increasingly take place through digital channels.

However, the report also suggests that digital access alone cannot address the practical and emotional challenges carers face. Technology may support information access, but carers continue to rely on professional advice, community services and peer support to manage complex caring responsibilities.

The findings also raise important issues relating to care equity. When support systems rely heavily on digital access, carers who lack reliable internet access, digital skills or confidence may struggle to obtain the information and assistance they need. This can create uneven access to support, particularly for older carers or those experiencing financial disadvantage.

Overall, the report reinforces the role of digital information as an important component of support for carers, while highlighting the need for inclusive design and multiple routes to assistance to ensure carers are not excluded from essential services.

Technology use in supported living for people with dementia

A qualitative study exploring experiences of living and caring in technology-rich supported living environments for people living with dementia.

Key messages

  • wearable devices and mobile phones were commonly used in supported living settings
  • technology was associated with increased feelings of safety and reassurance for tenants
  • residents and carers actively sought support to improve digital skills
  • carers identified factors that enabled or hindered effective technology use
  • concerns were raised around privacy, consent and autonomy.

Policy implications

  • supported living models should integrate technology with clear consent and privacy safeguards
  • ongoing digital skills support benefits both tenants and carers
  • technology adoption should be embedded within care models rather than added informally
  • guidance is needed to support ethical use of monitoring technologies in dementia care.

Gaps

  • findings are limited to supported living environments
  • other housing and care settings were not included
  • low survey response rates may limit representativeness
  • further longitudinal ethnographic research is recommended.

Commentary
This study provides insight into how technology is woven into everyday life within supported living environments for people with dementia. Rather than being experienced as purely clinical tools, technologies such as wearables and mobile phones were often described as contributing to reassurance and a sense of security.

The findings also show that technology use is relational. Tenants’ ability to benefit depended on the support of both informal and formal carers, alongside opportunities to build digital confidence. Where this support was available, technology was more likely to be used in ways that aligned with residents’ preferences.

At the same time, the study highlights ethical tensions. Monitoring and assistive technologies raised questions about privacy, consent and autonomy, particularly as cognitive capacity changes over time. These concerns highlight the importance of clear governance and ongoing dialogue with tenants and carers.

Overall, the research suggests that technology can enhance supported living when it is thoughtfully integrated into care models. Ensuring that use remains person-centred, ethically grounded and supported over time is central to avoiding harm and enabling technology to contribute positively to dementia care.

Value and sustainability of technology-enabled care services

A case study examining the value, commissioning and sustainability of technology-enabled care services within health and social care systems in north-east England.

Key messages

  • technology-enabled care services (TECS) are positioned as tools for prevention and early intervention
  • TECS can support people to live at home for longer, potentially reducing reliance on institutional care
  • local authority budget cuts have constrained innovation and service development
  • infrastructure limitations within care systems hinder effective deployment of TECS
  • TECS are not always well aligned with integrated health and social care planning

Policy implications

  • sustainable funding models are needed to support long-term delivery of TECS
  • commissioning approaches should integrate TECS into wider health and social care pathways
  • investment in digital infrastructure is required to support implementation in care settings
  • clearer frameworks for assessing value may help systems evaluate TECS more consistently

Gaps

  • limited evidence on the effectiveness of TECS within integrated care pathways
  • lack of long-term outcome data linking TECS to prevention or cost savings
  • uncertainty about how value is defined and measured across health, social care and local government stakeholders

Commentary
This case study examines how technology-enabled care services are commissioned and implemented within a regional health and social care system. While TECS are frequently promoted as tools that support prevention and independence, the study highlights how their effectiveness depends heavily on local financial and organisational conditions.

Local authority funding pressures emerge as a major constraint. Budget reductions limit the ability of councils and care systems to invest in new technologies, redesign services or scale promising initiatives. As a result, the potential benefits of TECS are often difficult to realise in practice.

The research also highlights structural challenges around infrastructure and system integration. Where digital systems, care pathways or organisational responsibilities are poorly aligned, technology-enabled services may remain peripheral rather than embedded within everyday care delivery.

From a care equity perspective, these findings raise questions about how technological innovation is distributed across the care system. If the implementation of TECS depends heavily on local financial capacity, areas facing greater fiscal pressure may have fewer opportunities to develop or sustain technology-enabled services. This could contribute to uneven access to preventative tools that help people remain independent at home.

The study therefore suggests that the benefits of technology-enabled care cannot be separated from wider system conditions. Ensuring that TECS support equitable access to care may require stable funding, coordinated commissioning across health and social care, and clearer evaluation of how these services improve outcomes for different populations.