Background There is a lack of guidance for hospice and care home managers to help them decide what and how to use digital technology in care settings. The opportunity to apply for a one-year digital fellowship enabled this research question to be explored. This paper discusses the human-centred design approach (Wadhawan, Nguyen, Linden, et al. Digital apps and reducing ethnic health inequalities. NHS Race and Health Observatory; 2023) used to develop the tool.

Aim To co-design a decision-making tool with people with experience of living with dementia or complex nursing needs such as late-stage motor neurone disease, to inform the use of digital in a redesigned hospice and new nursing home.

Method Following a literature review a series of seven interactive workshops were held with people with experience of living with dementia or chronic diseases, their carers, and staff. The terms digital and artificial intelligence were explained and then people’s views were explored in what they thought was important in considering the use of digital (Lenfant, Ravaud, Montori, et al. BMJ; 2023; 383:2960; NHS. Digital service manual. [Internet] 2024) and how digital might support them to be independent in their activities and within the care environment.

Results What patients, carers and bereaved carers thought was important were used to develop a set of questions that made up the decision-making tool. The tool was refined through a series of testing together, considering for example, the use of acoustic monitoring, geofencing and Alexa. Guidance and additional questions to support people using the tool were also developed.

Conclusion The decision-making tool for digital technology will be used by the hospice in making decisions about what digital to use in its future developments. The current draft tool is open for use by care home providers across the county via a collaborative care home website, where staff are invited to provide feedback to further refine the tool before wider dissemination.