Applying Technology in a Hybrid-Fashion to Create Dementia-Inclusive Community Spaces
Elaine Czech · 2022 · Proceedings of the 24th International ACM SIGACCESS Conference on Computers and Accessibility (ASSETS '22) · doi:10.1145/3517428.3550412
Summary
This doctoral consortium paper presents PhD research exploring how technology can improve accessibility to community spaces and social programs for people living with dementia (PLWD) and their informal carers. The work is grounded in the growing practice of social prescribing — linking clinical care with community activities to enhance wellbeing — and addresses the significant barriers PLWD face in accessing such programs, including location constraints, awareness gaps, scheduling difficulties, and the digital divide exposed by COVID-19. The research comprises three studies. Study 1 investigated how technology used for social programs changed during the pandemic through semi-structured interviews with 15 program coordinators across the US and UK, plus focus groups with six people living with early-to-mid-stage dementia and three carers recruited through an Alzheimer's Social Club. Using a critical realist approach and constructivist grounded theory, Czech identified themes of Reliance and Support, which she analysed through Bennett et al.'s interdependency framework. Study 2, in progress at the time of writing, uses research-through-design workshops in five public spaces around Bristol (a history museum, art museum, community farm, church, and community centre) to discover what makes spaces feel accessible and inclusive for PLWD. Study 3 will implement a hybrid design in one or two locations through participatory design with community members.
Key findings
Study 1 expanded Bennett et al.'s interdependency framework by identifying two distinct types of interdependencies in social programs for PLWD: social interdependencies (between individuals) and organizational interdependencies (which determine whether programs exist and their nature). Technology was found to be a bridge that can cause these two types to overlap and influence one another. The research produced two design checklists — one for blended programs and one for virtual spaces. Key design principles include: virtual programming should complement rather than replace in-person activities; in-person settings should prioritize sensory experiences and social engagement; virtual settings should personalize and localize content; programs should not constrain participants by mobility, distance, or lack of technology access; and repetition should be celebrated within program narratives. Critically, the research found that assuming a one-to-one adaptation of in-person programs to online platforms limits social interaction for PLWD, because readily available platforms are designed for a "hyper-cognitive society" that does not account for the needs of people with cognitive impairments.
Relevance
This research is valuable for accessibility practitioners and community organizations working to include people with cognitive disabilities in social programs and public spaces. The hybrid approach — combining in-person and virtual elements as complementary rather than equivalent experiences — offers a practical framework for organizations that adopted online programming during COVID-19 and are now determining how to move forward. The design checklists provide actionable guidance for technologists developing platforms for PLWD, highlighting that mainstream tools like Zoom were not designed with cognitive accessibility in mind. The interdependency framework challenges the dominant independence narrative in assistive technology, arguing instead for designs that support mutual dependence between PLWD, carers, coordinators, and technology. While the later studies were still in progress at publication, the community-based participatory design methodology itself is a contribution, demonstrating how to conduct meaningful design research with people in early stages of dementia.
Tags: dementia · cognitive accessibility · social prescribing · community-based design · hybrid spaces · inclusive design · participatory design · social programs · interdependence · older adults