Using PARO, a robotic seal, to support people living with dementia: ‘what works’ in inpatient dementia care settings?

Abstract

Abstract Introduction: The robotic seal PARO has received increased attention as a new technology to support people living with dementia in terms of emotional and physiological outcomes. However, little research has been conducted to improve understanding of how and why PARO may work within inpatient dementia care. We investigate for whom PARO works best in this setting, and why PARO may work. Methods: Informed by principles from realist methodology, qualitative interviews were conducted with healthcare professionals, participants with dementia and their relatives to explore experiences related to the delivery and receipt of an intervention using PARO in an inpatient dementia ward in the United Kingdom (UK). Observations of PARO intervention sessions were conducted to gain further insight into provision and implementation of sessions using PARO in ‘real time’. Data were analysed using thematic analysis, and using the process of configuration mapping, we constructed a visualisation of our findings framed within the Intervention-Context-Actor-Mechanisms-Outcomes (ICAMO) model. Results: The visualisation of our findings framed within the ICAMO model suggests that PARO may result in positive outcomes within inpatient dementia care due to a range of potential mechanisms, including enhancement of social interactions, developing a sense of attachment, evoking emotive memories, physical interaction, and perceiving the robotic animal as a live being. For these mechanisms to be activated, the sessions should be structured but participant-led, and be delivered as needed in a one-to-one setting by a skilled facilitator. Conclusion: Using PARO in an inpatient dementia care context appeared promising and well-received in this small observational study. This study explicitly considers the context and mechanisms of using PARO within inpatient dementia care settings, presenting findings in a structured visualisation framed within the ICAMO model and offering a theoretical basis for future intervention research.