Assistive technologies for elderly patients with dementia: perspectives from the bioethics of health care

https://doi.org/10.18294/sc.2023.4488

Published 3 October 2023 Open Access


Isis Laynne de Oliveira Machado Cunha Doctor in Bioethics. Postdoctoral fellow, Pontifícia Universidade Católica do Paraná, Brazil. image/svg+xml



Abstract views
396
Metrics Loading ...

Crossref
Scopus
Google Scholar
Europe PMC

Funding data

Keywords:

Aged, Dementia, Self-Help Devices, Bioethics, Empathy

Abstract


Dementia is currently one of the most common diseases affecting elderly people, ranking seventh among leading causes of death. As it causes memory loss, difficulties in reasoning, and resulting difficulties in making and executing decisions, assistive technologies and cognitive stimulation are valuable resources in the care process. Based on a theoretical inquiry into the bioethics of health care, and drawing on the work of Aline Albuquerque and Victor Montori, this article focuses on three main issues: first, the concept of bioethics in health care, patient-centered care, and the idea of clinical empathy. Second, it looks at the use of assistive technologies in caring for elderly patients with dementia. Lastly, we offer a discussion of whether the care process could be considered a health technology.


References


1. World Health Organization. Global Health Estimates: Life expectancy and leading causes of death and disability [Internet]. 2019 [cited 3 abr 2023]. Disponible en: https://tinyurl.com/2a9kkbx8.

2. World Health Organization. Demência [Internet]. 2021 [cited 3 mar 2022]. Disponible en: https://tinyurl.com/4emj333u.

3. Machado ILO, Garrafa V. Bioética, o envelhecimento no Brasil e o dever do Estado em garantir o respeito aos direitos fundamentais das pessoas idosas. Revista de Direitos e Garantias Fundamentais. 2020;21(1):79–106. DOI: https://doi.org/10.18759/rdgf.v21i1.1804

4. Machado ILO. Curatela e tomada de decisão apoiada (TDA) com relação a pessoas idosas no Brasil: uma análise bioética. [Tesis de doctorado]. Brasilia: Universidade de Brasília; 2022.

5. Ash EL. What is Dementia? In: Foster C, Herring J, Doron I, eds. The law and ethics of dementia. London: Hart; 2014. p. 3–14.

6. Donnelly M. Healthcare decision-making and the law. Cambridge: Cambridge University Press; 2010. DOI: https://doi.org/10.1017/CBO9780511760679

7. Donnelly M. Deciding in dementia: The possibilities and limits of supported decision-making. International Journal of Law and Psychiatry. 2019;66:101466. DOI: https://doi.org/10.1016/j.ijlp.2019.101466

8. Baldwin C. Technology, dementia, and ethics: Rethinking the issues. Disability Studies Quarterly. 2005;25(3). DOI: https://doi.org/10.18061/dsq.v25i3.583

9. Carmo EG, Zazzetta MS, Fuzaro Junior G, Micali PN, Moraes PF, Costa JLR. A utilização de tecnologias assistivas por idosos com Doença de Alzheimer. Kairós. 2015;4(18):311-336.

10. Nunes C, Melo FC, Bonini JS. Prospecção tecnológica de estimulação cognitiva para idosos com doença de Alzheimer. Cadernos de Prospecção. 2023;16(1):278-294. DOI: https://doi.org/10.9771/cp.v16i1.49634

11. Andorno R. Bioética y dignidad de la persona. 2a ed. Madrid: Tecnos; 2012.

12. Albuquerque A. Empatia nos cuidados em saúde: comunicação e ética na prática clínica. Santana de Parnaíba: Manole; 2023.

13. Albuquerque A, Tanure C. The necessity of new bioethics to clinical practice. Nursing & Care Open Access Journal. 2023;9(2):38-39. DOI: https://doi.org/10.15406/ncoaj.2023.09.00257

14. Richards T, Montori VM, Godlee F, Lapsley P, Paul D. Let the patient revolution begin. BMJ. 2013;346:f2614. DOI: https://doi.org/10.1136/bmj.f2614

15. Montori V. Why we revolt: a patient revolution for careful and kind care. 2nd ed. Rochester: Mayo Clinic Press; 2020.

16. Adom D, Hussein EK, Adu-Agyem J. Theoretical and conceptual framework: mandatory ingredients of a quality research citations see profile theoretical and conceptual framework: mandatory ingredients of a quality research. International Journal of Scientific Research. 2018;7(1):438-441.

17. Albuquerque A. Direitos humanos dos pacientes. Curitiba: Juruá; 2016.

18. Albuquerque A. Manual de direito do paciente. Belo Horizonte: CEI; 2020.

19. Howick J, Bizzari V, Dambha-Miller H. Therapeutic empathy: what it is and what it isn’t. Journal of the Royal Society of Medicine. 2018;111(7):233-236. DOI: https://doi.org/10.1177/0141076818781403

20. van Dijke J, van Nistelrooij I, Bos P, Duyndam J. Towards a relational conceptualization of empathy. Nursing Philosophy. 2020;21(3):e12297. DOI: https://doi.org/10.1111/nup.12297

21. Hardman D, Howick J. The friendly relationship between therapeutic empathy and person-centred care. European Journal for Person Centered Healthcare. 2019;7(2):351-357.

22. Paranhos DGAM, Albuquerque A. Direitos humanos dos pacientes como instrumentos bioéticos de proteção das pessoas idosas. Cadernos Ibero-Americanos de Direito Sanitário. 2019;8(1):53–64. DOI: https://doi.org/10.17566/ciads.v8i1.507

23. Albuquerque A, Paranhos DG de AM. Direitos humanos dos pacientes e vulnerabilidade: o paciente idoso à luz da jurisprudência da corte europeia de direitos humanos. Revista Quaestio Iuris. 2017;10(4):2844-2462. DOI: https://doi.org/10.12957/rqi.2017.27401

24. Paranhos DGAM, Albuquerque A, Garrafa V. Vulnerabilidade do paciente idoso à luz do princípio do cuidado centrado no paciente. Saúde e Sociedade. 2017;26(4):932-942. DOI: https://doi.org/10.1590/s0104-12902017170187

25. Machado I, Garrafa V. Capacidades jurídica e decisional e os importantes aportes bioéticos para promoção da autonomia de pessoas idosas. Redbioética. 2021;2(24):95-102.

26. Cohen J, Ezer T. Human rights in patient care: a Theoretical and practical framework. Health and Human Rights. 2013;15(2):7-19.

27. Albuquerque A, Barroso A. Curso de direitos humanos. Rio de Janeiro: Lumen Juris; 2018.

28. Ferreira EV, Medeiros de Mello J, Leiny de Lima L, De Mello D, Sant’ana G. Plasticidade neural em indivíduos da terceira idade. Arquivos do Mudi. 2019;23:120-129. DOI: https://doi.org/10.4025/arqmudi.v23i3.51518

29. Dos Santos CS, de Bessa TA, Xavier AJ. Factors associated with dementia in elderly. Ciência & Saúde Coletiva. 2020;25(2):603-611. DOI: https://doi.org/10.1590/1413-81232020252.02042018

30. Palmdorf S, Stark AL, Nadolny S, Eliaß G, Karlheim C, Kreisel SH, et al. Technology-assisted home care for people with dementia and their relatives: Scoping review. JMIR Aging. 2021;4(1):e25307. DOI: https://doi.org/10.2196/25307

31. Lee-Cheong S, Amanullah S, Jardine M. New assistive technologies in dementia and mild cognitive impairment care. Asian Journal of Psychiatry. 2022;73:103135. DOI: https://doi.org/10.1016/j.ajp.2022.103135

32. Battineni G, Chintalapudi N, Hossain MA, Losco G, Ruocco C, Sagaro GG, et al. Artificial intelligence models in the diagnosis of adult-onset dementia disorders: A review. Bioengineering. 2022;9(8):370. DOI: https://doi.org/10.3390/bioengineering9080370

33. Costa BR. A memória em tela: os grupos de estimulação cognitiva online para pessoas com a Doença de Alzheimer. Anais da ReACT. 2021;1(1):2293-2309.

34. Bernardo LD. Revisão integrativa sobre o engajamento em ocupações de idosos com Alzheimer. Revista Interinstitucional Brasileira de Terapia Ocupacional. 2017;1(3):386-407. DOI: https://doi.org/10.47222/2526-3544.rbto5484

35. Franco TB, Merhy EE. Produção imaginária da demanda e o processo de trabalho em saúde. In: Pinheiro R, Mattos RA, orgs. Construção social da demanda: direito à saúde, trabalho em equipe, participação e espaços públicos. Rio de Janeiro: IMS/UERJ; 2005. p. 181-193.

36. Shippee ND, Shah ND, May CR, Mair FS, Montori VM. Cumulative complexity: A functional, patient-centered model of patient complexity can improve research and practice. Journal of Clinical Epidemiology. 2012;65(10):1041-1051. DOI: https://doi.org/10.1016/j.jclinepi.2012.05.005

37. Ahmed SM, Drph M, Lemkau JP, Nealeigh N, Mann B. Barriers to healthcare access in a non-elderly urban poor American population. Health & Social Care in the Community. 2001 Nov;9(6):445-453. DOI: https://doi.org/10.1046/j.1365-2524.2001.00318.x

38. Joseph AE, Hallman BC. Over the hill and far away: distance as a barrier to the provision of assistance to elderly relatives. Social Science & Medicine. 1998;46(6):631–639. DOI: https://doi.org/10.1016/S0277-9536(97)00181-0

39. Mackenzie CS, Gekoski WL, Knox VJ. Age, gender, and the underutilization of mental health services: The influence of help-seeking attitudes. Aging & Mental Health. 2006;10(6):574-582. DOI: https://doi.org/10.1080/13607860600641200

40. Santos Koerich M, Stein Backes D, De Moura Scortegagna H, Loewen Wall M, Veronese AM, Zeferino MT, et al. Tecnologias de cuidado em saúde e enfermagem e suas perspecti-vas filosóficas. Texto & Contexto-Enfermagem. 2006;15:178-185. DOI: https://doi.org/10.1590/S0104-07072006000500022

41. Merhy EE, Franco TB. Por uma composição técnica do trabalho em saúde centrada no campo relacional e nas tecnologias leves: Apontando mudanças para os modelos tecno-assistenciais. Saúde em Debate. 2003;27(65):316-323.