Open Access. © 2020 Sarah Palmdorf, Christoph Dockweiler, published by De Gruyter. This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License. https://doi.org/10.1515/9783110677485-008 8 Challenges arising from the use of assistive technologies by people with dementia in home care arrangements Sarah Palmdorf, Christoph Dockweiler Abstract People with dementia living at home are potential users of assistive technologies, as are their informal or professional carers. However, the development of these technol- ogies is oriented more towards what is technically possible as towards the needs of the subsequent users. This is due to the fact that including this group of patients in the development is subject to particular challenges because of their vulnerability and the symptom changes. In addition, weighing the use and the actual application of technology raises both ethical and legal challenges. This implies the formulation and articulation of an informed consent, the emergence of ethical problems depending on the actual system and its application, equal resources and equal opportunities. These ethical problems will be discussed in the following and lead to considerations of the challenges arising from the participation of users and the demands made on technologies and users. So far, the ethical and legal challenges of using the technolo- gies have not been discussed adequately with the user group. There are also no estab- lished concepts supporting people with dementia and their relatives when making a decision about using a system, helping them reflect on the possible consequences or finding an alternative that would facilitate self-determined care. Another issue, which has yet to be dealt with, is how decisions made at the onset of the disease should be implemented in the homecare setting during the further course of the illness. 8.1 Introduction In Germany, 1.7 million people suffer from dementia (German Alzheimer’s Associa- tion 2018). Dementia is an umbrella term identifying a syndrome usually of a chronic nature in which there is a disturbance of multiple higher cortical functions: memory, thinking, orientation, language, judgement and learning (Robinson et al. 2015). The sense of self steadily deteriorates, distancing the people with dementia (PwD) from their former selves and, in turn, their relationship with friends and family (Quinn et al. 2009; Wadham et al. 2016). Further to this, the prevalence of challenging behavior such as anxiety, hallucinations, delusion or disinhibition is high (Savva et al. 2009; van der Linde et al. 2016). Due to the disease, PwD are restricted in their activities of daily living and rely on support from other people. These can be informal carers like family members or professional carers. This potentially leads to a stressful situation for the family and professional carers alike (Gilhooly et al. 2016), but PwD want to stay