Table 2

Themes and subthemes with illustrative quotes

Theme	Subtheme	Example quote 1	Example quote 2	Example quote 3
Providing care for a person with dementia while using AT	Caring role	when you are dealing with anything like dementia, for example, it doesn’t actually impact one person; it impacts the whole family (participant 20, son, living with person with dementia).	I needed the agency (private care provider), social services and the incontinence nurses to just kind of back me up that I'm doing the right thing. Because to take over someone's life it's not easy (participant 10, daughter, not living with person with dementia).	It means that every day I have to sort of… I can't really go out anywhere or do anything for the whole day because I have to be here some time of the day to call on my mum and check that she's OK (participant 12, daughter, not living with person with dementia).
	Financial considerations in using AT	…most of the equipment that we had has been supplied by the Red Cross and so it hasn’t cost a fortune to be able to, you know, keep them at home (participant 13, daughter, live-in carer).	so, I thought, well we need to get these automatic stop taps in. I knew they existed; it was just a case of getting the right sort of… the right price (participant 17, husband, living with person with dementia).	My sister, my other sister paid for that (participant 19, daughter, not living with person with dementia).
	Unanticipated issues from using AT	sometimes it (automatic medication dispenser) doesn’t work very well because he's doing something when it rings so he just turns it off and then he doesn’t get up and get his pills straight away, so then he forgets because he knows he's heard the alarm, so he assumes he's taken his pill (participant 14, wife, living with person with dementia).	And it was that device (three rings adaptor plug with kettle plugged in) which alerted us to the fact that she'd had her stroke (participant 23, son, not living with person with dementia).	So, he couldn’t ring for help. And he was there for a couple of hours. And for some reason the sensors didn’t alert the care link (participant 9, niece, not living with person with dementia).
Motivation for using AT	Freedom and autonomy	If he didn’t have a satnav I would just have to go with him more; it would really reduce his independence and make it harder for me (participant 14, wife, living with person with dementia).	I think it's brilliant because what I didn’t mention with the falls pendant is, say for example, I just go right now to the shops to go and grab some groceries (participant 20, son, living with person with dementia).	She watched TV and we got a very simple remote. She was able to use that (participant 4, daughter, not living with person with dementia).
	Quality of life and well-being	I think, any form of video communication is very helpful…The conversation…the quality of the conversation is very different when she's seen me on the video chat (participant 3, son, not living with person with dementia).	Well, you know, you get interrupted on what you're doing. It's very waring; draining I mean, to have to keep stopping and answering all these questions. So, yeh, it's just… it's (calendar clock) made things easier because somebody else can do it for themselves (participant 8, husband, living with person with dementia).	So all those bits of technology(falls alarm, mattress sensor, calendar clock)were very helpful. Well, it's… you know, it's solving a problem. Without it, it would be impossible (participant 13, daughter, live-in carer).
	Ease of use	And…even though I drew a note and I drew those two symbols and wrote against them pause and play, she no longer had the cognitive capacity to follow the instructions to use the assistive technology (simple button remote control) (participant 1, husband, person with dementia temporarily in hospital).	she does have difficulty remembering to… how to switch it off. So, you know, the commands, like you say, 'Alexa, stop', and stuff like that. So, she will forget, or panic and she'll unplug it because it's easier for her to… rather than say, 'Alexa, stop' (participant 19, daughter, not living with person with dementia).	of course voice calls are always available, but when we started finding that the iPad was easy for her to operate than the phone, we just moved from voice to video (participant 3, son, not living with person with dementia).
	Reassurance	So, from a reassurance point of view of not living in the same town or not… even if I was in the same town I wouldn’t know she's had a fall; it’s (falls monitor and alarm) been absolutely fantastic (participant 16, granddaughter, not living with person with dementia).	…so I didn’t have to ring mum up every morning to make sure she was up. I could look when she has used it (three rings plug attached to a kettle) and think oh yeah, she had a cup of tea at 9 o'clock and put the kettle on at 11, so she is ok (participant 4, daughter, not living with person with dementia).	Confidence, that she's safe and well looked after because we've got the equipment (falls alarm, key safe) that we've got (participant 13, daughter, live-in carer).
Changes to roles and routines in using AT	Additional tasks and responsibilities	I have to remember…I must and I do forget sometimes of course. So, if I go to the gym or something like that, I always have to remember to take the phone in my pocket (participant 2, husband, living with person with dementia).	…and it's something we're working on as a family to sort of build a schedule (using whatsApp groups) so that we know who's available to help (participant 5, daughter, not living with person with dementia).	The remote control (simple button remote control) means I don’t get those phone calls saying the TV's broken and I don’t have to respond to that (participant 7, son, not living with person with dementia).
	Active and passive devices	I suppose it's been a consideration around message… you know, voice messaging back and forth, that it's difficult for her to do anything active that’s got any level of complexity to it. Yeh, that’s definitely a consideration (participant 7, son, not living with person with dementia)	my mother, wears this on her wrist, so should she fall this triggers an automatic response straight to a medical services, and the phone rings and we can physically speak to somebody through the gadget, the box in the hallway, and they can actually call out an ambulance or the relevant emergency services if required (participant 20, son, living with person with dementia).	What we're going to do is monitor your habits and when there's a change from that we can send people a message to say, you know, look in on this person because it's ten o'clock and they still haven't been to their medicine cabinet, or whatever it might be…So, it's kind of like what can you do that doesn’t require an action from the person (participant 5, daughter, not living with person with dementia).
	Considering technology for use in the future	things where people get out of bed… a little mat tells you when someone's got out of bed and things like that, I think would be very useful. And I'm sure I will be using things like that, yes (participant 11, wife, living with person with dementia).	And therefore, as we all get older we'll perhaps be better at using modern technology, but the older generation are struggling with that I would say (participant 13, daughter, live-in carer).	I think there could be improved apps that could be designed around use for people with dementia, and their families (participant 19, daughter, not living with person with dementia).
Knowledge and skills for using AT	Sources of information for AT	The Alzheimer's Society sent me a load of stuff about… because it's about things asking advice for Mum for Alzheimer's (participant 10, daughter, not living with person with dementia).	But basically, we're quite good at finding information on the… you know, Googling things (participant 14, wife, living with person with dementia).	I am very familiar with digital technology. I just went online and found the appropriate devices there. So, yeah, I mean there are… there's at least one company that focuses on supplying those kinds of things to people with dementia (participant 8, husband, living with person with dementia).
	Support from public services and others	As far as the pendant stuff (pendant alarm) goes, that was actually provided to us by social services (participant 20, son, living with person with dementia).	So, I found it so the social services side was pretty useless, really down to me to research what I needed (participant 4, daughter, not living with person with dementia).	if you’ve got over a certain amount of money they're not interested in you. They just send you a leaflet, you know, a booklet telling you, 'Ere are, here's all the services', and they call it Help Yourself (participant 10, daughter, not living with person with dementia).
	Adapting AT for use	so it’s like you have to make big icons that say family pictures, just have the picture on the icon itself (modifying app styles on an iPad) (participant 3, son, not living with person with dementia).	So, then I've got to try to explain to her I'm on my mobile, so I call it my work phone now. So, I say, 'That’s my work phone if you need me; I'm always on that phone' (participant 10, daughter, not living with person with dementia).	Initially when I used it, they didn't have the emergency bypass on your phone setup because they used a third-party phone company but when I fed back to them that it would be really useful to be able to do that, because I often have to turn my phone off but I want to know if there's a problem, you know, so we managed to set up so that it would come through to my phone in an emergency (participant 4, daughter, not living with person with dementia).
	Use of AT over time	But he can't really use that now (GPS navigator); he doesn’t remember how to use it (participant 14, wife, living with person with dementia).	Basically, it's too complicated for her to use (pendant alarm), so despite it having a single SOS button that… she could do that, but what she couldn’t do was understand the next step, which is don’t do anything else (participant 8, husband, living with person with dementia).	So, she won't use the electricity one (electric bath left) or the one that’s with the battery power, which of course is nothing to do with electricity but she doesn’t realise that…So, that was a bit difficult. So, we've got a stool which she doesn’t use because it doesn’t let her into the bath because she likes to sit in the bath to have a proper wash (participant 10, daughter, not living with person with dementia).
Social, environmental and ethical considerations in using AT	Social pressure to use AT	I mean, I tried really hard with a mobile phone to show how that works. It's just a plain simple one. No, she never got it round, she just could not understand that at all (participant 10, daughter, not living with person with dementia).	I think it's because she doesn’t have a method for way of looking for things anymore. So, she would just be like running around the house wondering where buzzers are going off from. I think anything that’s sounding an alert and alarming, it's more of a problem (using a motion sensor alarm) (participant 5, daughter, not living with person with dementia).	It cuts out the…like the nuisance calls (call monitoring system). But it's been good in that it's stopped Mum giving out details, bank details and things, to these cold callers that have been calling. That’s been excellent (participant 12, daughter, not living with person with dementia).
	Integrated AT	so, it's (automatic medication dispenser) just a light now which also saves on the battery, because the battery died because it's not… it's not a mains connector; it's on batteries (participant 21, daughter, living with person with dementia).	sometimes it's difficult to get all three things to synchronise together (calendar app) but, you know, we don’t have too much of a problem (participant 15, husband, living with person with dementia).	she's also got an alarm round her neck, which she can press if she falls. That’s been one of the hardest things to get her to understand because it's a range… it works within a range of her telephone (participant 10, daughter, not living with person with dementia).
	Comorbidities	We're in the process of getting a room ready to accommodate a profiling bed; hospital bed (post fall and fracture of hip of person with dementia) (participant 17, husband, living with person with dementia).	So, you just press a button and the head comes up or we can raise the legs as well(4part profiling bed), yes, it's definitely been better for my well-being because I haven't had to worry about heavy lifting (participant 18, daughter, live-in carer).	It (automatic medication dispenser) was also really useful when she had the carers in because you'd know if they'd given her her tablets or not. And that for me just, you know, because you know just to know that you’ve given her the right dose (for epilepsy); she's not given two lots or anything like that (participant 21, daughter, living with person with dementia).
	Ethical considerations	…a baby alarm, which was something I had to buy. I suppose… I think that’s because of confidentiality and that the carers could be feel they were being spied on. It's almost like putting in a camera, isn't it? (participant 13, daughter, live-in carer).	(About Alexa) and there's no password or lock on the account, so you know, anyone can access it and do what they like to it (participant 19, daughter, not living with person with dementia).	it's giving more ability to the carer to do stuff remotely, but it might also be reducing the control that the person with dementia has because they don’t understand how it all works (participant 5, daughter, not living with person with dementia).

AT, assistive technology.