Ethical Use of Simulative Technologies for Dementia Care in Long-Term Residential Facilities – A Qualitative Study Protocol

In long-term dementia care, simulative technology such as robotic pets and virtual reality is increasingly used to support psychosocial well-being. While their ethical use has been debated in the literature, the voices of stakeholders, including people living with dementia, family members and care staff have not been meaningfully represented. This protocol paper describes a two-phase qualitative study that aims to identify stakeholders’ perceptions of ethical issues relating to simulative technology use and ways to navigate these issues in long-term care contexts. In Phase 1, a constructivist grounded theory approach will be used to explore stakeholders’ perceptions of ethical issues; in-depth interviews or focus group discussions will be conducted with people living with dementia, their family members, long-term care staff, and managers. Discussions will be audio-recorded, transcribed verbatim, and analyzed. In Phase 2, a virtual Nominal Group Technique will be used to explore means in which ethical dilemmas can be navigated. Participants will include stakeholders as described in Phase 1, along with ethics experts and decision-makers. Participants will review the ethical issues and ways to navigate dilemmas as identified in Phase 1, suggest additional issues and strategies to navigate dilemmas, and a mixed-methods analysis will be applied to prioritize strategies, and a qualitative content analysis will be used to analyze free-text comments to identify rationales behind prioritization. The findings will inform the development of a resource guide that integrates the lived experiences and expert knowledge to support ethically informed technology use in long-term dementia care.