Together, at a distance: experiences with a novel technology for social contact among older people and their relatives in Norway during the COVID-19 pandemic.

BACKGROUND: The recognition that people are social beings is fundamental for person-centered care. During the COVID-19 pandemic, the lives of older people were restricted in ways that dramatically reduced their opportunities for face-to-face contact. Limited contact with family members due to social distancing raised concerns about the well-being of older people. In Norway, interactive technologies were therefore introduced to older people to help them maintain social contact while practicing physical distancing. OBJECTIVES: This study was designed to examine how older people and their relatives experienced the use of technology-mediated communication through KOMP, a tablet-like device for supporting social contact in care facilities and homes during the pandemic. METHODS: We adopted an open phenomenological approach inspired by Kvale and Brinkmann (2009) to explore how the use of KOMP became meaningful during the pandemic. The study was based on individual interviews with 4 residents in care facilities and 13 relatives. RESULTS: The lived experiences of using KOMP among older people and their relatives revealed that adopting digital communication helped older people, and their families mitigate social distancing and maintain relationships with each other, despite the restrictions imposed by the government. Virtual involvement through KOMP afforded meaningful interconnections in the social lives of the users and their distant family members, thereby supporting their roles as parents and grandparents despite the distance, and promoting cross-generational connections among family members. Digital meetings also provided opportunities for older people and their relatives to enjoy each other's presence in favored places, by conveying a homely atmosphere, for instance. These virtual encounters did not rely exclusively on talk as the only means of communication. CONCLUSION: This study suggests that communicating via KOMP was a meaningful activity for the participants. Technologies for social contact can, to some extent, facilitate person-centered care for older people in care facilities and their private homes, despite circumstances requiring social distancing.

Normalization of technology for social contact in a Norwegian care facility during COVID-19.

BACKGROUND: The COVID-19 pandemic has seen unprecedented growth in the use of interactive technologies in care facilities for social contact between residents and their close contacts due to the need for social distancing. As the pandemic is transitioning into a new phase, there is a need to critically examine the new practices associated with technology usage. OBJECTIVE: Our analysis is based on a case study of how a care facility in western Norway adopted a novel technology called KOMP. We empirically investigate the stability of practices with KOMP for maintaining social communication between residents and their relatives and consider whether these practices are likely to last beyond the pandemic. We draw on normalization process theory (NPT) to interpret our findings and critically examine how stable embedding of new technologies for social communication occurs under extraordinary circumstances. METHODS: We conducted a case study based on participant observation and interviews, and the data were analyzed through inductive thematic analysis. Participants are health care professionals from a public care facility in western Norway. RESULTS: Four major themes emerged from the data. The first revolved around the pressing need for communications between residents and relatives with a suitable tool. Second, staff showed engagement through motivation to learn and adapt the technology in their practices. A third theme centered on how staff and the organization could work effectively to embed KOMP in daily practice. Our fourth theme suggested that the professionals continuously assessed their own use of the technology. CONCLUSION: From the perspective of NPT, practices with KOMP have been partially embedded by developing a shared understanding, engaging through cognitive participation, working collectively with staff and the organization, and reflexively monitoring the benefits of using KOMP. However, staff engagement with the technology was continuously threatened by factors related to diverging staff preferences, the burden of facilitating KOMP for residents with impaired cognitive and physical abilities, issues of privacy and ethics, and the technical skills of the residents' relatives. Our analysis suggests that caring practices via KOMP have become relatively stable despite barriers to engagement and are therefore likely to persist beyond the pandemic.

Improvised use of a digital tool for social interaction in a Norwegian care facility during the COVID-19 pandemic: an exploratory study.

BACKGROUND: Digital tools for social communication have been deployed in care facilities during the COVID-19 pandemic to facilitate social connectedness between older people and their next of kin in a safe manner. This study explores how and why health care professionals facilitate the ad hoc and prompt use of a technology for social communication, known as KOMP, in care facilities in western Norway to promote communication and social engagement among residents and their next of kin during the crisis. METHODS: To investigate the perspectives and practices of health care professionals, we conducted focus groups, individual interviews, and participant observation in public short- and long-term care facilities in western Norway. An explorative investigation with inductive content analysis was applied to analyse interview transcripts and fieldnotes from participant observation. RESULTS: The resulting qualitative data reveal that prompt implementation of interactive technology to cope with social distancing during the pandemic added new routines to the staff workload. Using this interactive technology entailed new forms of collaborative work among residents, next of kin, health care professionals and technology facilitators. Additionally, the staff articulated a sense of responsibility towards using KOMP as a meaningful and practical tool for social communication in an extraordinary period of reduced social contact. CONCLUSIONS: Improvised implementation of KOMP as an interactive technology shapes work routines, introduces new tasks and creates additional responsibilities. Despite creative efforts by health care staff, however, using KOMP remains constrained by the physical and cognitive abilities of its users. We suggest that health care managers ask a deceptively simple question when introducing novel technologies in health care contexts, namely: what kind of invisible work do these devices entail?