This study primary objective of this study is to identify promoting and hindering factors that affect the implementation of a smart robot in a care home setting.

People living with dementia represents a vulnerable group with a high need for person centred care to maintain a high quality of life. Loneliness and social isolation is already a common problem in care homes and has become a global challenge during the pandemic because of its negative effect on health. As a response to missing social interactions, technology with the intent to enhance communication and encourage activities have been introduced in care homes. However, there is a lack of knowledge about the introduction and use of technology. To gain insight into this, Centre for Age-Related Medicine at Stavanger University Hospital SESAM has carried out a pilot project made possible by DAM Foundation, where the smart robot Berntsen (hereinafter referred to as Berntsen) was used for video communication. The pilot project show that the use requires organizational leadership, motivated care staff and a well-organized introduction, and that there is a great need for more knowledge about these factors in order to develop a good implementation strategy.

Hence, SESAM has started the ground breaking project "RoboCare - Effectiveness, efficiency, uptake and use of a smart robot in care homes: A cluster randomized trial and implementation study" to investigate if Berntsen can reduce loneliness and social isolation, increase residents' quality of life and increase staff job satisfaction. Berntsen is an iPad on a stand with wheels or a tripod suitable for tabled tops, with content that can be customized to the user. It can promote person centred activities, tailored schedules and facilitate video communication. Berntsen can also act as a personal trainer with customized exercise videos in collaboration with a physical therapist.

This study will be part of the cluster RCT to explore which factors are important for implementation from the micro-level (person with dementia, family member and staff) perspective, and what must be set for optimal use of Berntsen in a care home.

It is of vital importance that all stakeholders are involved in an implementation process to integrate technology. These aspects are however less described in research concerning development of technological interventions in care homes. Consequently, knowledge concerning care staff, residents and informal carers is scarce.

Design: An explorative qualitative study consisting of 3 sub studies:

1. A qualitative study to investigate the resident, family member and care staff perspective on implementation and use of technology in a care home setting
2. A qualitative study to investigate the resident, family member and care staff experience using Berntsen as part of daily practice and for communication.
3. A qualitative observational study to investigate the dynamic between people living with dementia and family member during communication through Berntsen.

Care staff:

• Any care staff in the included care homes will be invited to participate

Residents

Inclusion Criteria:

• Dementia diagnosis at the time of inclusion equivalent with stage 5 (Moderately severe cognitive decline) on the Functional Assessment Staging Tool (FAST)

Exclusion Criteria:

• Any participants who are not able to give informed consent themselves or through a consultee will not be included in the project.

Family member

• All family members of included residents will be invited to participate in the project

The study population will be recruited from two care homes also included in the cluster RCT. For diversity purposes, we seek to include both large and smaller care homes from larger cities and rural areas and purposely include two different units from each care to reflect the variety of experiences.