1
|
Håkansson T, Svensson H, Karlsson S. Living with a person with young onset dementia - spousal experience. Int J Qual Stud Health Well-being 2024; 19:2330233. [PMID: 38493492 PMCID: PMC10946261 DOI: 10.1080/17482631.2024.2330233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 03/11/2024] [Indexed: 03/19/2024] Open
Abstract
PURPOSE Being of working age while at the same time needing to help a partner with young onset dementia has specific consequences for spouses. Research to date has been sparse concerning this particular group of spouses. The aim of the study was to explore spouses' everyday experiences when living with a person with young onset dementia. METHOD The study had a descriptive qualitative design with semi-structured interviews with nine spouses. The interviews were analysed using content analysis. RESULT The interviewed spouses experienced emotions that varied from feelings of loneliness, frustration, and worry to peace of mind. They said that they used coping strategies, which included adopting a positive mindset, adapting to inabilities, adopting an avoidant approach, and finding ways to recharge. Spouses also felt that they could use more support, both formal and informal. CONCLUSION The spouse of a person with young onset dementia has a range of emotional experiences and has resourceful ways of handling everyday life. Various types of support are offered to spouses, however, they seemed to desire more from health care services.
Collapse
Affiliation(s)
- Tania Håkansson
- School of Health and Welfare, Halmstad University, Halmstad, Sweden
| | - Hilda Svensson
- School of Health and Welfare, Halmstad University, Halmstad, Sweden
| | - Staffan Karlsson
- School of Health and Welfare, Halmstad University, Halmstad, Sweden
- Faculty of Health Science, Kristianstad University, Kristianstad, Sweden
| |
Collapse
|
2
|
Kim I, Yang Y, Cheon H, Kim J, Song JA. Non-pharmacological interventions for people living with young-onset dementia and their carers: A scoping review focussing on the support of participants' needs. J Psychiatr Ment Health Nurs 2024; 31:14-30. [PMID: 37465855 DOI: 10.1111/jpm.12954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 05/30/2023] [Accepted: 07/02/2023] [Indexed: 07/20/2023]
Abstract
WHAT IS KNOWN ON THE SUBJECT?: Young-onset dementia (YOD) refers to a phenomenon in which dementia symptoms appear under age 65. Diagnosing YOD is difficult and its progression is fast. Furthermore, it limits the socio-economic careers of people living with YOD, regardless of their needs. People living with YOD and their carers have unstable occupational status and their dependents also have to face a high burden of care. They claim that existing social support for dementia is limited to the elderly and is not suitable for them. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: The characteristics of non-pharmacological intervention studies for people living with YOD and/or their carers so far, and an analysis of the needs supported via the applied interventions. A theoretical basis and direction for the interventions to be studied in the future. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Research and intervention development should focus more on the needs of people living with YOD. In addition, it is necessary to understand and reflect on carers who directly care for people living with YOD. A multidisciplinary programme that supports wide area of the needs should be developed. ABSTRACT INTRODUCTION: Young-onset dementia (YOD) is a highly influential disease that exerts force on the normal life of those who still have to continue social life. Research has been lacking in spite of its seriousness, which accounts for about 9% of all dementia cases. AIM This study aimed to examine non-pharmacological interventions for people living with YOD and/or their carers, and to analyse how those interventions support their needs. METHOD A scoping review methodology was utilized to search the studies examining interventions for people living with YOD and/or their carers, and in English or Korean. The information was extracted, summarized and analysed in CANE categories. RESULTS Sixteen studies were included in the review. Five types of interventions were drawn. 'Memory' was the most covered part of the needs by the interventions. DISCUSSION This study found that interventions currently do not match the needs of people living with YOD and their carers. Multidisciplinary research would be eligible to cover the subjects' wide range of the needs as much as possible. IMPLICATIONS FOR PRACTICE We suggest the development of a specialized needs assessment tool and specialized interventions for people living with young-onset dementia and their carers.
Collapse
Affiliation(s)
- Iktae Kim
- Transdisciplinary Major in Learning Health Systems, College of Nursing & BK21 FOUR R&E Center for Learning Health Systems, Korea University, Seoul, Republic of Korea
| | - Yoosun Yang
- College of Nursing, Korea University, Seoul, Republic of Korea
| | - Hongjin Cheon
- College of Nursing, Korea University, Seoul, Republic of Korea
| | - Jiyeon Kim
- College of Nursing, Korea University, Seoul, Republic of Korea
| | - Jun-Ah Song
- College of Nursing & BK21 FOUR R&E Center for Learning Health Systems, Korea University, Seoul, Republic of Korea
| |
Collapse
|
3
|
Cui X, Wang J, Wu B, Zhao Q, Tang X, Wang J. Interventions for Persons with Young-Onset Dementia and Their Families: A Scoping Review. J Alzheimers Dis 2024; 97:1519-1531. [PMID: 38277297 DOI: 10.3233/jad-231006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2024]
Abstract
Background Dementia occurring before age 65 is known as young-onset dementia (YOD), with Alzheimer's disease being the most common type. YOD poses unique challenges for persons and families, impacting their working-age years and family responsibilities. Person-centered interventions and services are essential to improve their quality of life and social engagement. Objective This study aims to synthesize non-pharmacological interventions for persons with YOD and their families to inform future targeted interventions. Methods We conducted a systematic literature search across four databases: PubMed, PsycINFO, Scopus, and CINAHL. The included articles were carefully screened, categorized, and synthesized by following Arksey and O'Malley's five stages framework. Results We included 20 studies reported in 24 papers, with 11 studies (14 papers) on persons with YOD and nine studies (10 papers) on families. Quantitative intervention results vary, but qualitative interviews show positive feedback. Stakeholders provided positive evaluations, stating these interventions provided a sense of normalcy, facilitated communication among families, enhanced the independence of persons with YOD, and improved the families' caregiving self-efficacy, thereby reducing care burden and psychological distress. The heterogeneity among the studies posed integration challenges. Conclusions Interventions for YOD can improve the quality of life for both persons with YOD and their families. More extensive intervention studies are urgently needed, especially in developing countries, with a focus on family-centered and life course perspectives. In future intervention research design, a more extensive incorporation of stakeholder involvement is essential for successful implementation. Moreover, the integration of new technologies shows promise as a potential avenue for intervention advancement.
Collapse
Affiliation(s)
- Xiaoyan Cui
- Fudan University School of Nursing, Shanghai, China
| | - Junqiao Wang
- Fudan University School of Nursing, Shanghai, China
| | - Bei Wu
- Rory Meyers College of Nursing, New York University, NY, USA
| | - Qianhua Zhao
- Institute of Neurology, Huashan Hospital, Fudan University, Shanghai, China
- National Center for Neurological Disorders, Huashan Hospital, Fudan University, Shanghai, China
- National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Xueting Tang
- Fudan University School of Nursing, Shanghai, China
| | - Jing Wang
- University of New Hampshire, NH, USA
| |
Collapse
|
4
|
MacNeil M, Hirslund E, Baiocco-Romano L, Kuspinar A, Stolee P. A scoping review of the use of intelligent assistive technologies in rehabilitation practice with older adults. Disabil Rehabil Assist Technol 2023:1-32. [PMID: 37498115 DOI: 10.1080/17483107.2023.2239277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 05/30/2023] [Accepted: 07/17/2023] [Indexed: 07/28/2023]
Abstract
PURPOSE There is growing interest in intelligent assistive technologies (IATs) in the rehabilitation and support of older adults, however, the factors contributing to or preventing their use in practice are not well understood. This study aimed to develop an overview of current knowledge on barriers and facilitators to the use of smart technologies in rehabilitative practice with older adults. MATERIALS AND METHODS We undertook a scoping review following guidelines proposed by Arksey and O'Malley (2005) and Levac et al. (2010). A computerised literature search was conducted using the Scopus and Ovid databases, yielding 7995 citations. Of these, 94 studies met inclusion criteria. Analysis of extracted data identified themes which were explored in semi-structured interviews with a purposefully selected sample of seven clinical rehabilitation practitioners (three physical therapists, two occupational therapists, and two speech-language pathologists). RESULTS Barriers and facilitators to using these technologies were associated with accessibility, reported effectiveness, usability, patient-centred considerations, and staff considerations. CONCLUSIONS Collaborative efforts of policy-makers, researchers, manufacturers, rehabilitation professionals, and older persons are needed to improve the design of technologies, develop appropriate funding and reimbursement strategies, and minimise barriers to their appropriate use to support independence and quality of life. Any strategies to improve upon barriers to prescribing smart technologies for older people should leverage the expertise of rehabilitation professionals operating at the interface between older people; their health/mobility; their families; and technology-based solutions.Implications for rehabilitationThere is growing interest in intelligent assistive technologies (IATs) in the rehabilitation of older adults, as well as barriers to their use in practice.Rehabilitation professionals can play a key role in enabling access to IATs by recommending or prescribing their use to their older clients. Strategies to address barriers to the use of IATs for older people should leverage the expertise of rehabilitation professionals operating at the interface between older people, their families, and technology-based solutions.Older people and their families require technical support to initiate and continue to use IATs for rehabilitation. While rehabilitation providers may be well-placed to offer this support, they may require time and organizational support to build and maintain expertise in the fast-advancing field of smart technologies for rehabilitation.Cost and usability are universal challenges across the types of smart technologies considered in this review. Participatory approaches to involving older people in the design and development of smart assistive technologies contribute to better usability of these technologies. Devices and interventions that leverage more readily available devices and lower-cost components may overcome cost barriers to accessibility.
Collapse
Affiliation(s)
- Maggie MacNeil
- School of Nursing, McMaster University, Hamilton, Canada
| | - Emily Hirslund
- School of Public Health Sciences, University of Waterloo, Waterloo, Canada
| | | | - Ayse Kuspinar
- School of Rehabilitation Science, McMaster University, Hamilton, Canada
| | - Paul Stolee
- School of Public Health Sciences, University of Waterloo, Waterloo, Canada
| |
Collapse
|
5
|
Boyle LD, Husebo BS, Vislapuu M. Promotors and barriers to the implementation and adoption of assistive technology and telecare for people with dementia and their caregivers: a systematic review of the literature. BMC Health Serv Res 2022; 22:1573. [PMID: 36550456 PMCID: PMC9780101 DOI: 10.1186/s12913-022-08968-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 12/13/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND One of the most pressing issues in our society is the provision of proper care and treatment for the growing global health challenge of ageing. Assistive Technology and Telecare (ATT) is a key component in facilitation of safer, longer, and independent living for people with dementia (PwD) and has the potential to extend valuable care and support for caregivers globally. The objective of this study was to identify promotors and barriers to implementation and adoption of ATT for PwD and their informal (family and friends) and formal (healthcare professionals) caregivers. METHODS Five databases Medline (Ovid), CINAHL, Web of Science, APA PsycINFO and EMBASE were searched. PRISMA guidelines have been used to guide all processes and results. Retrieved studies were qualitative, mixed-method and quantitative, screened using Rayyan and overall quality assessed using Critical Appraisal Skills Programme (CASP) and Mixed Methods Assessment Tool (MMAT). Certainty of evidence was assessed using Grading of Recommendations Assessment, Development and Evaluation (GRADE) criteria and assigned within categories of high, moderate, or low. NVivo was used for synthesis and analysis of article content. A narrative synthesis combines the study findings. RESULTS Thirty studies (7 quantitative, 19 qualitative and 4 mixed methods) met the inclusion criteria. Identified primary promotors for the implementation and adoption of ATT were: personalized training and co-designed solutions, safety for the PwD, involvement of all relevant stakeholders, ease of use and support, and cultural relevance. Main barriers for the implementation and adoption of ATT included: unintended adverse consequences, timing and disease progress, technology anxiety, system failures, digital divide, and lack of access to or knowledge of available ATT. CONCLUSION The most crucial elements for the adoption of ATT in the future will be a focus on co-design, improved involvement of relevant stakeholders, and the adaptability (tailoring related to context) of ATT solutions over time (disease process).
Collapse
Affiliation(s)
- Lydia D. Boyle
- grid.7914.b0000 0004 1936 7443Department of Global Public Health and Primary Care, Centre for Elderly and Nursing Home Medicine, University of Bergen, Årstadveien 17, 5009 Bergen, Norway ,grid.7914.b0000 0004 1936 7443Department of Global Public Health and Primary Care, Centre for International Health, University of Bergen, Årstadveien 17, 5009 Bergen, Norway ,grid.7914.b0000 0004 1936 7443Neuro-SysMed Center, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norge
| | - Bettina S. Husebo
- grid.7914.b0000 0004 1936 7443Department of Global Public Health and Primary Care, Centre for International Health, University of Bergen, Årstadveien 17, 5009 Bergen, Norway ,grid.7914.b0000 0004 1936 7443Neuro-SysMed Center, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norge
| | - Maarja Vislapuu
- grid.7914.b0000 0004 1936 7443Department of Global Public Health and Primary Care, Centre for International Health, University of Bergen, Årstadveien 17, 5009 Bergen, Norway ,grid.7914.b0000 0004 1936 7443Neuro-SysMed Center, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norge
| |
Collapse
|
6
|
Miura C, Chen S, Saiki S, Nakamura M, Yasuda K. Assisting Personalized Healthcare of Elderly People: Developing a Rule-Based Virtual Caregiver System Using Mobile Chatbot. SENSORS (BASEL, SWITZERLAND) 2022; 22:3829. [PMID: 35632238 PMCID: PMC9146313 DOI: 10.3390/s22103829] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 05/14/2022] [Accepted: 05/17/2022] [Indexed: 12/24/2022]
Abstract
To assist personalized healthcare of elderly people, our interest is to develop a virtual caregiver system that retrieves the expression of mental and physical health states through human-computer interaction in the form of dialogue. The purpose of this paper is to implement and evaluate a virtual caregiver system using mobile chatbot. Unlike the conventional health monitoring approach, our key idea is to integrate a rule-based virtual caregiver system (called "Mind Monitoring" service) with the physical, mental, and social questionnaires into the mobile chat application. The elderly person receives one question from the mobile chatbot per day, and answers it by pushing the optional button or using a speech recognition technique. Furthermore, a novel method is implemented to quantify the answers, generate visual graphs, and send the corresponding summaries or advice to the specific elder. In the experimental evaluation, we applied it to eight elderly subjects and 19 younger subjects within 14 months. As main results, its effects were significantly improved by the proposed method, including the above 80% in the response rate, the accurate reflection of their real lives from the responses, and high usefulness of the feedback messages with software quality requirements and evaluation. We also conducted interviews with subjects for health analysis and improvement.
Collapse
Affiliation(s)
- Chisaki Miura
- Graduate School of System Informatics, Kobe University, 1-1 Rokkodai-cho, Nada, Kobe 657-8501, Japan; (C.M.); (M.N.)
| | - Sinan Chen
- Graduate School of System Informatics, Kobe University, 1-1 Rokkodai-cho, Nada, Kobe 657-8501, Japan; (C.M.); (M.N.)
| | - Sachio Saiki
- Department of Data & Innovation, Kochi University of Technology, 185 Miyanigutu, Tosayamada-cho, Kami-shi, Kochi 782-8502, Japan;
| | - Masahide Nakamura
- Graduate School of System Informatics, Kobe University, 1-1 Rokkodai-cho, Nada, Kobe 657-8501, Japan; (C.M.); (M.N.)
- RIKEN Center for Advanced Intelligence Project, 1-4-1 Nihonbashi, Chuo-ku, Tokyo 103-0027, Japan
| | - Kiyoshi Yasuda
- Osaka Institute of Technology, 5-16-1 Omiya, Asahi-ku, Osaka 535-8585, Japan;
| |
Collapse
|
7
|
Howard J, Fisher Z, Kemp AH, Lindsay S, Tasker LH, Tree JJ. Exploring the barriers to using assistive technology for individuals with chronic conditions: a meta-synthesis review. Disabil Rehabil Assist Technol 2022; 17:390-408. [PMID: 32663110 DOI: 10.1080/17483107.2020.1788181] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Accepted: 06/23/2020] [Indexed: 02/07/2023]
Abstract
PURPOSE Assistive technology can provide a key tool to enabling independence, greater inclusion and participation in society for individuals with chronic conditions. This potential is currently not always realized due to barriers to accessing and using assistive technology. This review aims to identify the common barriers to acquiring and using assistive technology for users with chronic conditions through a systematic meta-synthesis. This differs from other systematic reviews by applying a transdiagnostic approach to identify if barriers are common across chronic conditions. MATERIALS AND METHODS A systematic literature search of five scientific databases (PubMed, SCOPUS, PsycINFO, CINAHL and Medline) was conducted to identify relevant qualitative studies. The search was conducted in November 2019. For the identified articles, thematic content analysis was conducted and the methodological quality was evaluated using the Critical Appraisal Skills Programme (CASP) checklist for qualitative research. RESULTS Forty papers met the inclusion criteria and were included in the analysis. Fifty-one descriptive themes grouped into six overarching analytical themes were identified from the studies. The analytical themes identified were: the design and function of the assistive technology, service provision, information and awareness, psychological barriers, support network and societal barriers. CONCLUSIONS The barriers are interconnected and common across different health conditions. More involvement in personalized care for developing strategies, adaptation of home technologies and provision of assistive technology could overcome the service provision and design barriers to assistive technology. Accessible information and providing greater awareness will be important to overcoming information, psychological and societal barriers to assistive technology.Implications for rehabilitationIndividuals with chronic conditions face complex barriers to acquiring and using assistive technology as a result of the devices themselves, their individual context, the healthcare context where assistive technology is provided and wider societal barriers.The provision of assistive technology needs to change away from the traditional medical model of the "expert" clinician and instead focus on more user involvement to deliver personalised care that utilises the users lived knowledge and experiences.Assistive technology provision should be considered alongside how to adapt everyday mainstream technology to meet user needs; the provision of devices should encourage creative problem solving rather then relying on pre-defined prescription lists of assistive technology.
Collapse
Affiliation(s)
- Jonathan Howard
- Department of Psychology, College of Human and Health Sciences, Swansea University, Swansea, UK
- Rehabilitation Engineering Unit, Swansea Bay University Health Board, Morriston Hospital, Swansea, UK
| | - Zoe Fisher
- Health and Wellbeing Academy, College of Human and Health Sciences, Swansea University, Swansea, UK
- Traumatic Brain Injury Service, Swansea Bay University Health Board, Morriston Hospital, Swansea, UK
| | - Andrew H Kemp
- Department of Psychology, College of Human and Health Sciences, Swansea University, Swansea, UK
| | - Stephen Lindsay
- Department of Computer Science, College of Science, Swansea University, Swansea, UK
| | - Lorna H Tasker
- Rehabilitation Engineering Unit, Swansea Bay University Health Board, Morriston Hospital, Swansea, UK
| | - Jeremy J Tree
- Department of Psychology, College of Human and Health Sciences, Swansea University, Swansea, UK
| |
Collapse
|
8
|
Xiong C, D'Souza A, El-Khechen-Richandi G, Mihailidis A, Cameron JI, Astell A, Nalder E, Colantonio A. Perceptions of Digital Technology Experiences and Development Among Family Caregivers and Technology Researchers: Qualitative Study. JMIR Form Res 2022; 6:e19967. [PMID: 35089150 PMCID: PMC8838597 DOI: 10.2196/19967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 11/20/2020] [Accepted: 12/19/2020] [Indexed: 11/13/2022] Open
Abstract
Background Caregiving is highly stressful and is associated with poor mental and physical health. Various technologies, including mobile and eHealth apps, have been developed to address caregiver needs. However, there is still a paucity of research examining the technology perceptions of informal caregivers, especially from the perspectives of sex, gender, and diversity. Objective To address the research gap and inform the development of future caregiving technologies, this study aims to examine how family caregivers perceive using technology to assist with their caregiving routines; identify the sex, gender, and diversity factors that shape these perceptions; and understand how these perceptions and needs are reflected within the current technology development process. Methods Semistructured interviews were conducted with 16 informal caregivers of individuals with a range of chronic medical conditions and 8 technology researchers involved in caregiving technology projects. Results Three main themes with subthemes were developed. The first main theme is that caregivers see a need for technology in their lives, and it comprises the following 3 subthemes: caregiving is a challenging endeavor, technology is multifaceted, and caregiver preferences facilitate technology use. The second main theme is that relationships play a vital role in mediating technology uptake, and it comprises the following 2 subthemes: the caregiver-care recipient dynamic shapes technology perceptions and caregivers rely on external sources for technology information. Finally, the third main theme is that barriers are present in the use and adoption of technology, and it comprises the following 2 subthemes: technology may not be compatible with personal values and abilities and technology that is not tailored toward caregivers lacks adoption. Conclusions The findings highlight the multifaceted role that technology can play in aiding caregiving while drawing attention to the perceived drawbacks of these technologies among caregivers. The inclusion of technology researchers in this study provides a more holistic understanding of technologies in caregiving from their initial development to their eventual uptake by caregivers.
Collapse
Affiliation(s)
- Chen Xiong
- Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada.,Toronto Rehabilitation Institute-University Health Network, Toronto, ON, Canada.,Acquired Brain Injury Research Lab, University of Toronto, Toronto, ON, Canada
| | - Andrea D'Souza
- Toronto Rehabilitation Institute-University Health Network, Toronto, ON, Canada.,Acquired Brain Injury Research Lab, University of Toronto, Toronto, ON, Canada
| | - Graziella El-Khechen-Richandi
- Toronto Rehabilitation Institute-University Health Network, Toronto, ON, Canada.,Acquired Brain Injury Research Lab, University of Toronto, Toronto, ON, Canada
| | - Alex Mihailidis
- Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada.,Toronto Rehabilitation Institute-University Health Network, Toronto, ON, Canada.,Department of Occupational Science & Occupational Therapy, University of Toronto, Toronto, ON, Canada
| | - Jill I Cameron
- Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada.,Department of Occupational Science & Occupational Therapy, University of Toronto, Toronto, ON, Canada
| | - Arlene Astell
- Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada.,Department of Occupational Science & Occupational Therapy, University of Toronto, Toronto, ON, Canada
| | - Emily Nalder
- Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada.,Department of Occupational Science & Occupational Therapy, University of Toronto, Toronto, ON, Canada
| | - Angela Colantonio
- Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada.,Toronto Rehabilitation Institute-University Health Network, Toronto, ON, Canada.,Acquired Brain Injury Research Lab, University of Toronto, Toronto, ON, Canada.,Department of Occupational Science & Occupational Therapy, University of Toronto, Toronto, ON, Canada
| |
Collapse
|
9
|
Bannon SM, Reichman MR, Wang K, Uppal S, Grunberg VA, Vranceanu AM. A qualitative meta-synthesis of common and unique preferences for supportive services among persons with young onset dementia and their caregivers. DEMENTIA 2021; 21:519-539. [PMID: 34610764 DOI: 10.1177/14713012211048118] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND AND OBJECTIVES Young onset dementias (young onset dementia) produce a myriad of stressors for persons with young onset dementia and their caregivers, yet there is a critical shortage of supportive services that address their needs. To develop such services, it is necessary to first comprehensively understand persons' with young onset dementia and their caregivers' service preferences. Therefore, we conducted a meta-synthesis to integrate and summarize qualitative data on persons' with young onset dementia and caregivers' preferences for supportive services for young onset dementia, defined as support provided by medical providers, psychosocial interventions, and any other resources/services provided to promote positive adjustment in persons with young onset dementia and their caregivers. RESEARCH DESIGN AND METHODS We searched five electronic databases for qualitative articles from inception to January 2020. We extracted and synthesized data from eligible articles using thematic analysis. After removal of duplicates, we screened 219 articles identified through database and hand searches. FINDINGS Forty-three studies met our inclusion criteria. We extracted findings from these 43 studies on preferences within three a priori defined domains: 1) general characteristics of supportive services, 2) format and modality of supportive services, and 3) content for supportive services. Persons with young onset dementia and caregivers predominantly expressed common preferences, with some unique preferences based on their specific roles within the partnership. DISCUSSION AND IMPLICATIONS Persons with young onset dementia and their caregivers endorsed largely overlapping preferences, including having direct contact with providers and the ability to participate together in programs that have content and skills relevant to their specific needs and challenges. Findings can directly inform the format, content, and procedures of supportive services for persons with young onset dementia and their caregivers.
Collapse
Affiliation(s)
- Sarah M Bannon
- Integrated Brain Health Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, 2348Harvard Medical School, Boston, MA, USA
| | - Mira R Reichman
- Integrated Brain Health Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, 2348Harvard Medical School, Boston, MA, USA
| | - Katherine Wang
- Integrated Brain Health Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, 2348Harvard Medical School, Boston, MA, USA
| | - Simrit Uppal
- Integrated Brain Health Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, 2348Harvard Medical School, Boston, MA, USA
| | - Victoria A Grunberg
- Integrated Brain Health Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, 2348Harvard Medical School, Boston, MA, USA
| | - Ana-Maria Vranceanu
- Integrated Brain Health Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, 2348Harvard Medical School, Boston, MA, USA
| |
Collapse
|
10
|
Steenfeldt VØ, Aagerup LC, Jacobsen AH, Skjødt U. Becoming a Family Caregiver to a Person With Dementia: A Literature Review on the Needs of Family Caregivers. SAGE Open Nurs 2021; 7:23779608211029073. [PMID: 35155770 PMCID: PMC8832314 DOI: 10.1177/23779608211029073] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Accepted: 06/12/2021] [Indexed: 11/16/2022] Open
Abstract
Introduction The dementia disease affects both the family caregivers’ health and
social and psychological well-being. The aim of this review was
to identify and describe the needs of family caregivers living
with a person with dementia at home. Method The literature review, conducted using the matrix method, was also
inspired by Thomas and Harden’s thematic synthesis. Results Three themes were identified: (1) the family caregiver’s new roles
and relationships; (2) caregiver burdens; and (3) the
caregiver’s need for information and support. Conclusion When family caregivers gradually lose their reciprocal relationship
with the person with dementia, and sometimes also with family
and friends, the need for other kinds of social contact arises
e.g. with others in a similar situation. They also need to have
some respite to provide room to pursue their own interests and
take care of their own health. Also, a high level of
individually tailored information is needed.
Collapse
Affiliation(s)
| | | | | | - Ulla Skjødt
- Center for Nursing, University College Absalon, Roskilde, Denmark
| |
Collapse
|
11
|
Behera CK, Condell J, Dora S, Gibson DS, Leavey G. State-of-the-Art Sensors for Remote Care of People with Dementia during a Pandemic: A Systematic Review. SENSORS (BASEL, SWITZERLAND) 2021; 21:4688. [PMID: 34300428 PMCID: PMC8309480 DOI: 10.3390/s21144688] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 05/31/2021] [Accepted: 07/02/2021] [Indexed: 01/10/2023]
Abstract
In the last decade, there has been a significant increase in the number of people diagnosed with dementia. With diminishing public health and social care resources, there is substantial need for assistive technology-based devices that support independent living. However, existing devices may not fully meet these needs due to fears and uncertainties about their use, educational support, and finances. Further challenges have been created by COVID-19 and the need for improved safety and security. We have performed a systematic review by exploring several databases describing assistive technologies for dementia and identifying relevant publications for this review. We found there is significant need for appropriate user testing of such devices and have highlighted certifying bodies for this purpose. Given the safety measures imposed by the COVID-19 pandemic, this review identifies the benefits and challenges of existing assistive technologies for people living with dementia and their caregivers. It also provides suggestions for future research in these areas.
Collapse
Affiliation(s)
- Chandan Kumar Behera
- Intelligent Systems Research Centre, Faculty of Computing, Engineering and Built Environment, University of Ulster, Northland Road, Londonderry BT48 7JL, UK; (C.K.B.); (S.D.); (G.L.)
| | - Joan Condell
- Intelligent Systems Research Centre, Faculty of Computing, Engineering and Built Environment, University of Ulster, Northland Road, Londonderry BT48 7JL, UK; (C.K.B.); (S.D.); (G.L.)
| | - Shirin Dora
- Intelligent Systems Research Centre, Faculty of Computing, Engineering and Built Environment, University of Ulster, Northland Road, Londonderry BT48 7JL, UK; (C.K.B.); (S.D.); (G.L.)
| | - David S. Gibson
- Northern Ireland Centre for Stratified Medicine (NICSM), Biomedical Sciences Research Institute, University of Ulster, Altnagelvin Area Hospital, C-TRIC Building, Glenshane Road, Londonderry BT47 6SB, UK;
| | - Gerard Leavey
- Intelligent Systems Research Centre, Faculty of Computing, Engineering and Built Environment, University of Ulster, Northland Road, Londonderry BT48 7JL, UK; (C.K.B.); (S.D.); (G.L.)
| |
Collapse
|
12
|
Désormeaux-Moreau M, Michel CM, Vallières M, Racine M, Poulin-Paquet M, Lacasse D, Gionet P, Genereux M, Lachiheb W, Provencher V. Mobile Apps to Support Family Caregivers of People With Alzheimer Disease and Related Dementias in Managing Disruptive Behaviors: Qualitative Study With Users Embedded in a Scoping Review. JMIR Aging 2021; 4:e21808. [PMID: 33861207 PMCID: PMC8087965 DOI: 10.2196/21808] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 01/30/2021] [Accepted: 02/14/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND People with Alzheimer disease and related dementias often display disruptive behaviors (eg, aggression, wandering, and restlessness), which increase family caregivers' burden of care. However, there are few tools currently available to help these caregivers manage disruptive behaviors. Mobile apps could meet this need, but to date little is known about them. OBJECTIVE The aims of our study were to identify existing mobile apps designed to support family caregivers of people with Alzheimer disease and related dementias in managing disruptive behaviors; explore whether family caregivers view these mobile apps as relevant to meeting their needs and as useful in managing disruptive behaviors; and document the types of mobile apps that are of interest and appeal to most family caregivers (with regard to format, ergonomics, and clarity). METHODS A review of mobile apps initially conducted in February 2018 was updated in March 2019 with 2 platforms (App Store [Apple Inc.] and Google Play [Google]). The selected apps were first analyzed independently by 3 raters (2 students and 1 researcher) for each of the platforms. A focus group discussion was then held with 4 family caregivers to explore their perceptions of the apps according to their needs and interests. The content of the discussion was analyzed. RESULTS Initially, 7 of 118 apps identified met the inclusion criteria. An eighth app, recommended by one of the knowledge users, was added later. Four family caregivers (women aged between 58 and 78 years) participated in the discussion. Participants expressed a preference for easy-to-understand apps that provide concrete intervention strategies. They reported being most inclined to use two apps, Dementia Advisor and DTA Behaviours. CONCLUSIONS Few mobile apps on the market meet the needs of family caregivers in terms of content and usability. Our results could help to address this gap by identifying what family caregivers deem relevant in a mobile app to help them manage disruptive behaviors.
Collapse
Affiliation(s)
- Marjorie Désormeaux-Moreau
- School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada
- Institut universitaire de première ligne en santé et services sociaux, Centre intégré universitaire de santé et de services sociaux de l'Estrie, Centre hospitalier universitaire de Sherbrooke, Sherbrooke, QC, Canada
| | - Charlie-Maude Michel
- School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Mélanie Vallières
- School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Maryse Racine
- School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Myriame Poulin-Paquet
- School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Delphine Lacasse
- School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Pascale Gionet
- School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Melissa Genereux
- Department of Community Health Sciences, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada
- Public Health Directory, Centre intégré universitaire de santé et de services sociaux de l'Estrie, Centre hospitalier universitaire de Sherbrooke, Sherbrooke, QC, Canada
| | - Wael Lachiheb
- Research Center on Aging, Centre intégré universitaire de santé et de services sociaux de l'Estrie, Centre hospitalier universitaire de Sherbrooke, Sherbrooke, QC, Canada
| | - Véronique Provencher
- School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada
- Research Center on Aging, Centre intégré universitaire de santé et de services sociaux de l'Estrie, Centre hospitalier universitaire de Sherbrooke, Sherbrooke, QC, Canada
| |
Collapse
|
13
|
Gathercole R, Bradley R, Harper E, Davies L, Pank L, Lam N, Davies A, Talbot E, Hooper E, Winson R, Scutt B, Montano VO, Nunn S, Lavelle G, Lariviere M, Hirani S, Brini S, Bateman A, Bentham P, Burns A, Dunk B, Forsyth K, Fox C, Henderson C, Knapp M, Leroi I, Newman S, O'Brien J, Poland F, Woolham J, Gray R, Howard R. Assistive technology and telecare to maintain independent living at home for people with dementia: the ATTILA RCT. Health Technol Assess 2021; 25:1-156. [PMID: 33755548 DOI: 10.3310/hta25190] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Assistive technology and telecare have been promoted to manage the risks associated with independent living for people with dementia, but there is limited evidence of their effectiveness. OBJECTIVES This trial aimed to establish whether or not assistive technology and telecare assessments and interventions extend the time that people with dementia can continue to live independently at home and whether or not they are cost-effective. Caregiver burden, the quality of life of caregivers and of people with dementia and whether or not assistive technology and telecare reduce safety risks were also investigated. DESIGN This was a pragmatic, randomised controlled trial. Blinding was not undertaken as it was not feasible to do so. All consenting participants were included in an intention-to-treat analysis. SETTING This trial was set in 12 councils in England with adult social services responsibilities. PARTICIPANTS Participants were people with dementia living in the community who had an identified need that might benefit from assistive technology and telecare. INTERVENTIONS Participants were randomly assigned to receive either assistive technology and telecare recommended by a health or social care professional to meet their assessed needs (a full assistive technology and telecare package) or a pendant alarm, non-monitored smoke and carbon monoxide detectors and a key safe (a basic assistive technology and telecare package). MAIN OUTCOME MEASURES The primary outcomes were time to admission to care and cost-effectiveness. Secondary outcomes assessed caregivers using the 10-item Center for Epidemiological Studies Depression Scale, the State-Trait Anxiety Inventory 6-item scale and the Zarit Burden Interview. RESULTS Of 495 participants, 248 were randomised to receive full assistive technology and telecare and 247 received the limited control. Comparing the assistive technology and telecare group with the control group, the hazard ratio for institutionalisation was 0.76 (95% confidence interval 0.58 to 1.01; p = 0.054). After adjusting for an imbalance in the baseline activities of daily living score between trial arms, the hazard ratio was 0.84 (95% confidence interval 0.63 to 1.12; p = 0.20). At 104 weeks, there were no significant differences between groups in health and social care resource use costs (intervention group - control group difference: mean -£909, 95% confidence interval -£5336 to £3345) or in societal costs (intervention group - control group difference: mean -£3545; 95% confidence interval -£13,914 to £6581). At 104 weeks, based on quality-adjusted life-years derived from the participant-rated EuroQol-5 Dimensions questionnaire, the intervention group had 0.105 (95% confidence interval -0.204 to -0.007) fewer quality-adjusted life-years than the control group. The number of quality-adjusted life-years derived from the proxy-rated EuroQol-5 Dimensions questionnaire did not differ between groups. Caregiver outcomes did not differ between groups over 24 weeks. LIMITATIONS Compliance with the assigned trial arm was variable, as was the quality of assistive technology and telecare needs assessments. Attrition from assessments led to data loss additional to that attributable to care home admission and censoring events. CONCLUSIONS A full package of assistive technology and telecare did not increase the length of time that participants with dementia remained in the community, and nor did it decrease caregiver burden, depression or anxiety, relative to a basic package of assistive technology and telecare. Use of the full assistive technology and telecare package did not increase participants' health and social care or societal costs. Quality-adjusted life-years based on participants' EuroQol-5 Dimensions questionnaire responses were reduced in the intervention group compared with the control group; groups did not differ in the number of quality-adjusted life-years based on the proxy-rated EuroQol-5 Dimensions questionnaire. FUTURE WORK Future work could examine whether or not improved assessment that is more personalised to an individual is beneficial. TRIAL REGISTRATION Current Controlled Trials ISRCTN86537017. FUNDING This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 25, No. 19. See the NIHR Journals Library website for further project information.
Collapse
Affiliation(s)
| | - Rosie Bradley
- Medical Research Council Population Health Research Unit, University of Oxford, Oxford, UK
| | - Emma Harper
- Medical Research Council Population Health Research Unit, University of Oxford, Oxford, UK
| | - Lucy Davies
- Medical Research Council Population Health Research Unit, University of Oxford, Oxford, UK
| | - Lynn Pank
- Medical Research Council Population Health Research Unit, University of Oxford, Oxford, UK
| | - Natalie Lam
- Medical Research Council Population Health Research Unit, University of Oxford, Oxford, UK
| | - Anna Davies
- School of Health Sciences, City, University of London, London, UK.,Population Health Sciences, University of Bristol, Bristol, UK
| | - Emma Talbot
- Norfolk and Suffolk NHS Foundation Trust, Stowmarket, UK
| | - Emma Hooper
- Lancashire Care NHS Foundation Trust, Preston, UK.,Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Rachel Winson
- Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
| | - Bethany Scutt
- Department of Old Age Psychiatry, King's College London, London, UK
| | | | - Samantha Nunn
- Cambridgeshire Community Services NHS Trust, Cambridge, UK
| | - Grace Lavelle
- Department of Old Age Psychiatry, King's College London, London, UK
| | - Matthew Lariviere
- Centre for International Research on Care, Labour and Equalities, University of Sheffield, Sheffield, UK
| | | | - Stefano Brini
- School of Health Sciences, City, University of London, London, UK
| | - Andrew Bateman
- School of Health and Social Care, University of Essex, Colchester, UK
| | - Peter Bentham
- Birmingham and Solihull Mental Health NHS Foundation Trust, Birmingham, UK
| | - Alistair Burns
- Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Barbara Dunk
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Kirsty Forsyth
- School of Health Sciences, Queen Margaret University, Edinburgh, UK
| | - Chris Fox
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - Catherine Henderson
- Care Policy and Evaluation Centre, London School of Economics and Political Science, London, UK
| | - Martin Knapp
- Care Policy and Evaluation Centre, London School of Economics and Political Science, London, UK
| | - Iracema Leroi
- Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland
| | - Stanton Newman
- School of Health Sciences, City, University of London, London, UK
| | - John O'Brien
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Fiona Poland
- School of Health Sciences, University of East Anglia, Norwich, UK
| | - John Woolham
- National Institute for Health Research (NIHR) Health & Social Care Workforce Research Unit, King's College London, London, UK
| | - Richard Gray
- Medical Research Council Population Health Research Unit, University of Oxford, Oxford, UK
| | - Robert Howard
- Division of Psychiatry, University College London, London, UK
| |
Collapse
|
14
|
Vollmer Dahlke D, Lee S, Smith ML, Shubert T, Popovich S, Ory MG. Attitudes Toward Technology and Use of Fall Alert Wearables in Caregiving: Survey Study. JMIR Aging 2021; 4:e23381. [PMID: 33502320 PMCID: PMC8081189 DOI: 10.2196/23381] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 10/18/2020] [Accepted: 11/09/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Wearable technology for fall alerts among older adult care recipients is one of the more frequently studied areas of technology, given the concerning consequences of falls among this population. Falls are quite prevalent in later life. While there is a growing amount of literature on older adults' acceptance of technology, less is known about how caregivers' attitudes toward technology can impact care recipients' use of such technology. OBJECTIVE The objective of our study was to examine associations between caregivers' attitudes toward technology for caregiving and care recipients' use of fall alert wearables. METHODS This study examined data collected with an online survey from 626 caregivers for adults 50 years and older. Adapted from the technology acceptance model, a structural equation model tested the following prespecified hypotheses: (1) higher perceived usefulness of technologies for caregiving would predict higher perceived value of and greater interest in technologies for caregiving; (2) higher perceived value of technologies for caregiving would predict greater interest in technologies for caregiving; and (3) greater interest in technologies for caregiving would predict greater use of fall alert wearables among care recipients. Additionally, we included demographic factors (eg, caregivers' and care recipients' ages) and caregiving context (eg, caregiver type and caregiving situation) as important predictors of care recipients' use of fall alert wearables. RESULTS Of 626 total respondents, 548 (87.5%) with all valid responses were included in this study. Among care recipients, 28% used fall alert wearables. The final model had a good to fair model fit: a confirmatory factor index of 0.93, a standardized root mean square residual of 0.049, and root mean square error of approximation of 0.066. Caregivers' perceived usefulness of technology was positively associated with their attitudes toward using technology in caregiving (b=.70, P<.001) and interest in using technology for caregiving (b=.22, P=.003). Greater perceived value of using technology in caregiving predicted greater interest in using technology for caregiving (b=.65, P<.001). Greater interest in using technology for caregiving was associated with greater likelihood of care recipients using fall alert wearables (b=.27, P<.001). The caregiver type had the strongest inverse relationship with care recipients' use of fall alert wearables (unpaid vs paid caregiver) (b=-.33, P<.001). CONCLUSIONS This study underscores the importance of caregivers' attitudes in care recipients' technology use for falls management. Raising awareness and improving perception about technologies for caregiving may help caregivers and care recipients adopt and better utilize technologies that can promote independence and enhance safety.
Collapse
Affiliation(s)
- Deborah Vollmer Dahlke
- Texas A&M Center for Population Health and Aging, Texas A&M University, College Station, TX, United States.,DVD Associates, LLC, Austin, TX, United States
| | - Shinduk Lee
- Texas A&M Center for Population Health and Aging, Texas A&M University, College Station, TX, United States
| | - Matthew Lee Smith
- Texas A&M Center for Population Health and Aging, Texas A&M University, College Station, TX, United States
| | | | - Stephen Popovich
- Texas A&M Center for Population Health and Aging, Texas A&M University, College Station, TX, United States.,Clairvoyant Networks, Austin, TX, United States
| | - Marcia G Ory
- Texas A&M Center for Population Health and Aging, Texas A&M University, College Station, TX, United States
| |
Collapse
|
15
|
Bannon S, Reichman M, Popok P, Wagner J, Gates M, Uppal S, LeFeber L, Wong B, Dickerson BC, Vranceanu AM. In It Together: A Qualitative Meta-Synthesis of Common and Unique Psychosocial Stressors and Adaptive Coping Strategies of Persons With Young-Onset Dementia and Their Caregivers. THE GERONTOLOGIST 2020; 62:e123-e139. [PMID: 33125490 DOI: 10.1093/geront/gnaa169] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND AND OBJECTIVES The common and unique psychosocial stressors and adaptive coping strategies of people with young-onset dementia (PWDs) and their caregivers (CGs) are poorly understood. This meta-synthesis used the stress and coping framework to integrate and organize qualitative data on the common and unique psychosocial stressors and adaptive coping strategies employed by PWDs and CGs after a diagnosis of young-onset dementia (YOD). RESEARCH DESIGN AND METHODS Five electronic databases were searched for qualitative articles from inception to January 2020. Qualitative data were extracted from included articles and synthesized across articles using taxonomic analysis. RESULTS A total of 486 articles were obtained through the database and hand searches, and 322 articles were screened after the removal of duplicates. Sixty studies met eligibility criteria and are included in this meta-synthesis. Four themes emerged through meta-synthesis: 1) common psychosocial stressors experienced by both PWDs and CGs, 2) unique psychosocial stressors experienced by either PWDs or CGs, 3) common adaptive coping strategies employed by both PWDs and CGs, and 4) unique adaptive coping strategies employed by either PWDs or CGs. Within each meta-synthesis theme, subthemes pertaining to PWDs, CGs, and dyads (i.e., PWD and CG as a unit) emerged. DISCUSSION AND IMPLICATIONS The majority of stressors and adaptive coping strategies of PWDs and CGs were common, supporting the use of dyadic frameworks to understand the YOD experience. Findings directly inform the development of resiliency skills interventions to promote adaptive coping in the face of a YOD diagnosis for both PWDs and CGs.
Collapse
Affiliation(s)
- Sarah Bannon
- Integrated Brain Health Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Mira Reichman
- Integrated Brain Health Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Paula Popok
- Integrated Brain Health Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Juliana Wagner
- Integrated Brain Health Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Melissa Gates
- Integrated Brain Health Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Simrit Uppal
- Integrated Brain Health Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Lisa LeFeber
- Integrated Brain Health Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Bonnie Wong
- Frontotemporal Disorders Unit, Departments of Neurology and Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Bradford C Dickerson
- Frontotemporal Disorders Unit, Departments of Neurology and Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Ana Maria Vranceanu
- Integrated Brain Health Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| |
Collapse
|
16
|
Kruse CS, Fohn J, Umunnakwe G, Patel K, Patel S. Evaluating the Facilitators, Barriers, and Medical Outcomes Commensurate with the Use of Assistive Technology to Support People with Dementia: A Systematic Review Literature. Healthcare (Basel) 2020; 8:E278. [PMID: 32824711 PMCID: PMC7551699 DOI: 10.3390/healthcare8030278] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 08/04/2020] [Accepted: 08/14/2020] [Indexed: 12/01/2022] Open
Abstract
Background: Assistive technologies (AT) have been used to improve the daily living conditions of people living with dementia (PWD). Research supports the positive impact of the use of AT such as decreased burden on caregivers and behavioral support for people with dementia. Four reviews in the last six years have analyzed AT and PWD, but none have incorporated the dimension of medical outcomes. Objectives: The purpose of this review is to identify the facilitators, barriers, and medical outcomes commensurate with the use of AT with PWD. Method: This review queried The Cumulative Index of Nursing and Allied Health Literature (CINAHL), Web of Science, Science Direct, and PubMed databases for peer-reviewed publications in the last five years for facilitators, barriers, and medical outcomes commensurate with the use of AT with PWD. The study is reported and conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) and the Kruse Protocol for conducting a systematic review. Results: 48 studies were analyzed. Fourteen types of AT, 17 facilitators, 17 barriers, and 16 medical outcomes were identified in the literature. The two most frequently mentioned ATs were cognitive stimulators (9/48, 19%) and social robots (5/48, 10%). The two most frequently mentioned facilitators were caregivers want AT (8/68, 12%) and enables increased independence (7/68, 10%). The top two barriers were cost (8/75, 11%) and PWD reject AT (8/75, 11%). The top medical outcomes were improved cognitive abilities (6/69, 9%), increased activities of daily living (ADLs), and increased autonomy (each at 5/69, 7%): Zero negative outcomes were reported. Conclusion: The systematic review revealed the positive relations that occur when PWD and their caregivers use AT. Although many reservations surrounding the use of AT exist, a majority of the literature shows a positive effect of its use. Research supports a strong support for AT by caregivers due to many positive medical outcomes, but also a reticence to adopt by PWD. If ATs for PWD are a way to reduce stress on caregivers, barriers of cost and complexity need to be addressed through health policy or grants.
Collapse
Affiliation(s)
- Clemens Scott Kruse
- School of Health Administration, Texas State University, San Marcos, TX 78666, USA; (J.F.); (G.U.); (K.P.); (S.P.)
| | | | | | | | | |
Collapse
|
17
|
Xiong C, Ye B, Mihailidis A, Cameron JI, Astell A, Nalder E, Colantonio A. Sex and gender differences in technology needs and preferences among informal caregivers of persons with dementia. BMC Geriatr 2020; 20:176. [PMID: 32423406 PMCID: PMC7236350 DOI: 10.1186/s12877-020-01548-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Accepted: 04/02/2020] [Indexed: 11/23/2022] Open
Abstract
Background Dementia is a major public health concern associated with significant caregiver demands and there are technologies available to assist with caregiving. However, there is a paucity of information on caregiver needs and preferences for these technologies, particularly from a sex and gender perspective. To address this gap in research, the objectives of this study are to examine (1) the knowledge of technology, (2) perceived usefulness of technology, (3) feature preferences when installing and using technology and (4) sex and gender influences on technology needs and preferences among family caregivers of persons with dementia (PWD) across North America. Methods A secondary analysis was conducted on an existing cross-sectional survey with family caregivers of PWDs. Respondents were recruited through the Alzheimer Society of Canada, the Victorian Order of Nurses and Adult Day Programs and other Canadian health care provision institutes. Descriptive statistics, bivariate and multivariate analyses were used to describe the study sample, uncover differences between male and female caregivers and examine sex and gender influences on caregivers’ technology needs and preferences. Results A total of 381 eligible responses were received over a nine month data collection period. The majority of respondents did not know much about and never used any technologies to assist with caregiving. “Being easy to install”, “easy to learn how to use” and “cost” were identified as the most important features when purchasing and setting up technology, while “reliability” was identified as the most important feature when using technology. Most respondents were willing to pay up to $500 to acquire individual technologies. Controlling for other socio-demographic variables, female respondents were more likely to have some or more knowledge about technology for caregiving while male respondents were more willing to pay higher amounts for these technologies compared to their female counterparts. Conclusions As one of the first studies of its kind, our findings represent a step towards the incorporation of sex and gender considerations such as cost and reliability in technology design and promotion for caregivers. Future efforts are warranted to establish an in-depth understanding of sex and gender influences in relation to other social and environmental factors.
Collapse
Affiliation(s)
- Chen Xiong
- Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, 500 University Avenue, Suite 160, Toronto, Ontario, M5G 1V7, Canada. .,Toronto Rehabilitation Institute-University Health Network, 550 University Ave, Toronto, M5G 2A2, Ontario, Canada. .,Acquired Brain Injury Research Lab, University of Toronto, 500 University Ave, Room 260, Toronto, M5G 1V7, Ontario, Canada.
| | - Bing Ye
- Toronto Rehabilitation Institute-University Health Network, 550 University Ave, Toronto, M5G 2A2, Ontario, Canada.,Department of Occupational Science & Occupational Therapy, University of Toronto, 500 University Avenue, Suite 160, Toronto, Ontario, M5G 1V7, Canada
| | - Alex Mihailidis
- Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, 500 University Avenue, Suite 160, Toronto, Ontario, M5G 1V7, Canada.,Toronto Rehabilitation Institute-University Health Network, 550 University Ave, Toronto, M5G 2A2, Ontario, Canada.,Department of Occupational Science & Occupational Therapy, University of Toronto, 500 University Avenue, Suite 160, Toronto, Ontario, M5G 1V7, Canada
| | - Jill I Cameron
- Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, 500 University Avenue, Suite 160, Toronto, Ontario, M5G 1V7, Canada.,Department of Occupational Science & Occupational Therapy, University of Toronto, 500 University Avenue, Suite 160, Toronto, Ontario, M5G 1V7, Canada
| | - Arlene Astell
- Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, 500 University Avenue, Suite 160, Toronto, Ontario, M5G 1V7, Canada
| | - Emily Nalder
- Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, 500 University Avenue, Suite 160, Toronto, Ontario, M5G 1V7, Canada.,Department of Occupational Science & Occupational Therapy, University of Toronto, 500 University Avenue, Suite 160, Toronto, Ontario, M5G 1V7, Canada
| | - Angela Colantonio
- Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, 500 University Avenue, Suite 160, Toronto, Ontario, M5G 1V7, Canada.,Toronto Rehabilitation Institute-University Health Network, 550 University Ave, Toronto, M5G 2A2, Ontario, Canada.,Acquired Brain Injury Research Lab, University of Toronto, 500 University Ave, Room 260, Toronto, M5G 1V7, Ontario, Canada.,Department of Occupational Science & Occupational Therapy, University of Toronto, 500 University Avenue, Suite 160, Toronto, Ontario, M5G 1V7, Canada.,Dalla Lana School of Public Health, University of Toronto, 155 College St, Room 500, Toronto, M5T 3M7, Ontario, Canada
| |
Collapse
|
18
|
Persson AC, Boman IL, Dahlberg L, Janeslätt G, Möller MC, Löfgren M. Lack of time and dependence on significant others: Occupational therapists´ experiences of prescribing time assistive technology for persons with dementia. Scand J Occup Ther 2020; 27:614-624. [PMID: 32356475 DOI: 10.1080/11038128.2020.1751875] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Background: There is lack of knowledge on how occupational therapists (OTs) assess daily time management (DTM) for persons with dementia (PwDs) and on which aspects affect prescription of time assistive technology (AT).Aim: To explore OTs' experiences of assessing the need for and prescribing time AT for PwDs.Material and methods: Focus group interviews with OTs that prescribe time AT for PwDs analyzed via qualitative content analysis.Results: A main category and four categories were identified. The categories illustrated a complex and time-consuming prescription process, which was facilitated if the PwD was supported by a significant other (SO). Support from a SO was especially important during implementation and follow-up. OTs had to take individual responsibility for staying informed about time AT. Organizational limitations and time constraints were barriers for OTs striving to work according to national prescription guidelines.Conclusions and significance: High demands are made on SO's participation during the prescription process. PwDs with no support from SOs are at risk not receiving or fully benefitting from time AT. To avoid inequalities, specific forms of support need to be developed and targeted at PwDs without SOs to ensure that they have sufficient opportunities to access and use time AT.
Collapse
Affiliation(s)
- Ann-Christine Persson
- Department of Clinical Sciences, Karolinska Institutet, Stockholm, Sweden.,Department of Rehabilitation Medicine, Danderyd University Hospital, Stockholm, Sweden
| | - Inga-Lill Boman
- Department of Rehabilitation Medicine, Danderyd University Hospital, Stockholm, Sweden
| | - Lena Dahlberg
- School of Education, Health and Social Studies, Dalarna University, Falun, Sweden.,Aging Research Center, Karolinska Institutet, Stockholm University, Solna, Sweden
| | - Gunnel Janeslätt
- Department of Public Health and Caring Sciences, Disability and Habilitation, Uppsala University, Uppsala, Sweden.,Center for Clinical Research in Dalarna, Falun, Sweden
| | - Marika C Möller
- Department of Clinical Sciences, Karolinska Institutet, Stockholm, Sweden.,Department of Rehabilitation Medicine, Danderyd University Hospital, Stockholm, Sweden
| | - Monika Löfgren
- Department of Clinical Sciences, Karolinska Institutet, Stockholm, Sweden.,Department of Rehabilitation Medicine, Danderyd University Hospital, Stockholm, Sweden
| |
Collapse
|
19
|
Osam JA, Opoku MP, Dogbe JA, Nketsia W, Hammond C. The use of assistive technologies among children with disabilities: the perception of parents of children with disabilities in Ghana. Disabil Rehabil Assist Technol 2019; 16:301-308. [PMID: 31603354 DOI: 10.1080/17483107.2019.1673836] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
PURPOSE Assistive technologies (ATs) are fundamental to the successful educational and societal inclusion of all children with disabilities. In particular, the use of ATs has been found to increase levels of independence in daily living and promote greater access to learning opportunities for children with disabilities. However, the knowledge base and baseline information on the use of ATs is limited in developing countries such as Ghana. In this study, we sought to explore the experiences of parents regarding the use of ATs by their children with disabilities in Ghana. MATERIALS AND METHODS We used a survey questionnaire consisting of both open- and closed-ended questions to explore the perspectives of parents with children with disabilities (n = 35) who were attending the rehabilitation unit of a referral hospital. RESULTS Although participants acknowledged the benefits of ATs for the development and participation of their children in society, they noted barriers to the usage of ATs by their children. Among several barriers, parents mentioned that they lacked funds to purchase assistive devices. Some parents also mentioned the high cost of ATs and rehabilitation services. CONCLUSION The need for government to include rehabilitation services and ATs in the National Health Insurance Scheme to ease the burden on participants and other implications of the findings for policymaking are extensively discussed. Implications for rehabilitationIn an environment where there is negative attitude towards children and parents with disabilities, ATs are expected to encourage the participation and acceptance in society.Although many participants were aware of the benefits of ATs to their children, they reported barriers to usage among their children with disabilities.This study shows that poverty, limited health facilities, unfriendly environment and stigmatisation were barriers encountered by parents.We conclude that the government should expand health and rehabilitation facilities to encourage access and participation.
Collapse
Affiliation(s)
- Joshua Annor Osam
- Department of Community Health, School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | | | - Joslin Alexei Dogbe
- Department of Community Health, School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - William Nketsia
- School of Education, Western Sydney University, Sydney, Australia
| | - Charles Hammond
- Department of Community Health, School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| |
Collapse
|
20
|
Sriram V, Jenkinson C, Peters M. Informal carers' experience of assistive technology use in dementia care at home: a systematic review. BMC Geriatr 2019; 19:160. [PMID: 31196003 PMCID: PMC6567448 DOI: 10.1186/s12877-019-1169-0] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Accepted: 05/23/2019] [Indexed: 12/03/2022] Open
Abstract
Background Dementia is a health and care priority globally. Caring for persons with dementia is a challenge and can lead to negative psychological, physiological and financial consequences for informal carers. Advances in technology have the potential to assist persons with dementia and their carers, through assistive technology devices such as electronic medication dispensers, robotic devices trackers and motion detectors. However, little is known about carers’ experience and the impact of these technologies on them. This review aims to investigate the outcomes and experience of carers of persons with dementia, who live at home and use assistive technology. Methods A systematic search in seven databases and manual searches were carried out using pre-defined inclusion and exclusion criteria to identify studies on carers of persons with dementia involving the use of assistive technology. The search identified 56 publications with quantitative, qualitative and mixed-method designs. Results The studies reported positive and negative findings and focused on a wide variety of assistive technology devices. There were large differences in the uses of assistive technology, outcome measures used and the quality of studies. Knowledge and acceptance, competence to use and ethical issues when using assistive technology were themes that emerged from the studies. Carers generally appreciated using assistive technology and their experience of use varied. Conclusions The intention of this systematic review is to list and classify the various types of assistive technology used by carers of persons with dementia and explores the positive and negative aspects, knowledge, acceptance and ethical issues in the use of assistive technology by carers of persons with dementia. We recommend the use of a standard and person-centred system of classifying and naming assistive technology devices and systems and for future research efforts in assistive technology to incorporate a family/carer centred model. Systematic review registration PROSPERO - CRD42017082268. Electronic supplementary material The online version of this article (10.1186/s12877-019-1169-0) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Vimal Sriram
- Health Services Research Unit, Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Old Road Campus, Oxford, OX3 7LF, UK.
| | - Crispin Jenkinson
- Health Services Research Unit, Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Old Road Campus, Oxford, OX3 7LF, UK
| | - Michele Peters
- Health Services Research Unit, Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Old Road Campus, Oxford, OX3 7LF, UK
| |
Collapse
|