# A mixed methods evaluation of time management products for persons with dementia in India: what works, what does not, and what may

## TL;DR

This study explores how time management products help people with dementia and their caregivers in India, finding mixed results and suggesting improvements for local use.

## Contribution

The study provides novel insights into the effectiveness and acceptance of time management products in the Indian context.

## Key findings

- TMPs showed minimal impact on DTM scores but improved confidence and independence in some users.
- Caregivers reported increased involvement in supporting device use and noted contextual barriers to adoption.
- Themes highlighted the need for culturally appropriate design and person-centered approaches in assistive technology.

## Abstract

Persons with dementia (PwD) experience difficulties in daily time management (DTM), which restricts their participation in valued activities. Time management products (TMPs) are assistive devices that support DTM and functional independence. Most previous research on TMP has been based on developed regions of the world. Given the limited research in low- and middle-income countries, the present study aimed to explore the use of TMP by PwD and caregivers in India.

We conducted a mixed-methods, explanatory sequential study. We first undertook a single-group, prospective, prepost, interventional study involving 38 dyads of persons with mild to moderate dementia and their caregivers. We assessed the self-reported and caregiver-reported DTM, performance and satisfaction in valued daily activities, time processing abilities, and well-being of the PwD and the caregivers’ well-being and ability to cope. The participants were then encouraged to use the TMP provided as an intervention. We reassessed the participants after three months and conducted semistructured interviews with three PwD and 12 caregivers to understand their experience of using the TMP.

Within-group analysis revealed minimal but statistically insignificant changes in the scores of the PwD and caregiver on all the assessments. These findings suggest that TMP may help maintain the ability of PwD, especially those with mild dementia, and support caregivers to some extent. Thematic analysis revealed benefits to PwD, including reduced annoyance with caregivers’ prompts, improved confidence in knowing the time and doing valued activities more independently, increased caregiver involvement in supporting device use, complex operation of some products, and suggestions to make the products more suitable for use in India. The study also identified salient factors that may influence the use of TMPs, including PwD and caregivers’ need and priority for DTM; personal characteristics; and contextual factors, especially living arrangements and prevalent sociocultural attitudes towards time, devices, and elders. An increased demand for such products in the future is also anticipated.

This study provides encouraging evidence on the usefulness and acceptance of TMP by PwD and caregivers in India, although DTM may not be a priority for most individuals. The adoption of such products would entail a person-centred, context-specific approach to the development and provision of assistive technology.

The trial was registered with the Clinical Trail Registry - India (CTRI/2017/06/008916) on 27 June 2017.