Familiar Routines and Symbolic Anchors Support Digital Engagement in Dementia Care.

Digital technology offers promising tools for supporting older adults living with dementia, but successful engagement requires careful consideration of how memory and cognition change with age. Jeongone Seo from Rutgers University, Kyung-zoon Hong from Sungkyunkwan University, and Sol Baik from the University of Virginia investigate how ingrained habits and meaningful cues can sustain digital interaction for individuals experiencing cognitive decline. Their research reveals that familiar digital routines, rooted in procedural memory – the ability to perform tasks without conscious thought – continue even as other memories fade. Importantly, the team demonstrates that symbolic anchors, such as family photos or personalised content, powerfully reinforce this engagement. At the same time, unfamiliar designs can inadvertently create resistance or fear, highlighting the need for culturally sensitive and cognitively accessible technology in dementia care.

As populations age globally, the need for effective dementia care continues to grow. In South Korea, a nation with a rapidly increasing older population and strong technological infrastructure, digital tools are increasingly seen as a way to expand care services and combat social isolation. However, simply introducing technology to individuals with cognitive decline is not enough; cognitive impairments can create significant barriers to use. This research investigates how procedural memory – the ability to perform learned routines – and the use of symbolic anchors, like familiar photos or icons, can support continued digital engagement for people living with dementia. Researchers focused on understanding how to cising that familiar routines can persist even as other cognitive functions decline. To explore these ideas, Jeongone Seo, Kyung-zoon Hong, and Sol Baik conducted in-depth interviews with eleven professional caregivers working with older adults experiencing cognitive decline in South Korea.

These caregivers, working in community-based adult day care centers, were chosen for their expertise in understanding the behavioral and functional changes of their clients. The researchers employed a grounded theory approach, allowing themes to emerge directly from the caregivers’ experiences rather than imposing pre-defined expectations. This method allowed for a nuanced understanding of how caregivers support digital engagement and address the anxieties their clients might experience. The findings reveal a dual role for procedural memory and symbolic anchors in sustaining digital interaction. Caregivers consistently reported that familiar digital routines, like taking and viewing photos, could be maintained through procedural memory. Furthermore, the use of symbolic anchors – personalized content like family photos or recognizable icons – significantly enhanced interaction and emotional engagement. However, unfamiliar or overly complex technologies, particularly those with human-like features, often triggered fear or resistance.

This highlights the importance of designing technologies that are not only cognitively accessible but also culturally sensitive and emotionally reassuring, recognizing that a sense of familiarity and personal connection can be key to successful engagement for individuals living with dementia. This study contributes a nuanced, culturally-situated model for understanding technology engagement among people with cognitive decline, highlighting that technology is not merely a tool, but a critical site where autonomy, identity, and connection are negotiated. By centering memory, meaning, and mediated relationships, researchers reimagine digital inclusion not as a binary goal, but as a dynamic and contextually grounded process. Jeongone Seo received research funding from the Korea Health Industry Development Institute (KHIDI) for the period 2023–. The other authors declare no relationships, activities, or interests related to the content of this manuscript. Part of the data analysed in this article was originally collected as part of the author’s doctoral dissertation at Sungkyunkwan University, approved by the university’s IRB. Portions of this manuscript were supported using generative AI tools, under the direction of the first author, who assumes sole responsibility for their use. All participants provided informed consent prior to participation, and the study was approved by the Institutional Review Board of Sungkyunkwan University, complying with the ethical standards outlined in the Declaration of Helsinki.