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Arthanat S, Wilcox J, LaRoche D. Smart home automation technology to support caring of individuals with Alzheimer's disease and related dementia: an early intervention framework. Disabil Rehabil Assist Technol 2024; 19:779-789. [PMID: 36136955 DOI: 10.1080/17483107.2022.2125088] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 07/25/2022] [Accepted: 09/11/2022] [Indexed: 10/14/2022]
Abstract
PURPOSE Home automation technology comprising of Internet of Things and Smart gadgets is a rapidly growing industry that is projected to have a major scope for ageing-in-place and caregiving. This study examined the feasibility and cost-benefits of a personalized home automation intervention for care of individuals with Alzheimer's disease and related dementia (ADRD) with emphasis on their safety and independence, and reduction of care burden. METHODS A mixed method intervention study was conducted with five dyads each comprising of a caregiver and care recipient with ADRD. Each dyad received personalized home automation intervention with individualized goals centred on home safety, activity engagement, and caregiver-recipient connectivity. The goals were created and monitored using goal attainment scaling (GAS). The dyads were followed up after three months with a home visit and interview. Goal attainment scoring and thematic analysis of the interviews were conducted to examine the findings from the study. RESULTS All dyads indicated positive goal attainment between pre and post intervention. Goals that were met were complimented by the categories of peace of mind, self-efficacy, and care recipient engagement, while unmet goals as well as complexities with the technology were elucidated under challenges. Overarching and conceptually linked themes from the study were unfamiliarity, value, and timing. CONCLUSION Home automation technology has the potential to be adapted to promote independence and safety of individuals with ADRD while relieving care burden. Nonetheless, we propose an early intervention framework to overcome identified challenges and optimize the technology's usability and sustainability.IMPLICATIONS FOR REHABILITATIONHome automation involving Internet of Things and Smart gadgets has gained rapid popularity owing to the comfort and connectivity they provide to mainstream consumers.The technology has an emerging significance to ageing-in-place and care of individuals with Alzheimer's Disease and Related Dementia (ADRD) as it can be adapted and implemented to enhance home safety and activity engagement of the care recipients while also strengthening their connectivity with the caregivers.Unfamiliarity with the technology compounded by the progression of ADRD can, however, be detrimental to its adoption.Individualized focus and early integration of the technology for caregiver-care recipient dyads can mitigate these challenges and optimize its usability and long-term value in relation to ageing-in-place and caregiver wellbeing.
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Affiliation(s)
- Sajay Arthanat
- Department of Occupational Therapy, University of New Hampshire, Durham, NH, USA
| | - John Wilcox
- Department of Occupational Therapy, University of New Hampshire, Durham, NH, USA
| | - Dain LaRoche
- Department of Kinesiology, University of New Hampshire, Durham, NH, USA
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Savoy A, Holden RJ, de Groot M, Clark DO, Sachs GA, Klonoff D, Weiner M. Improving Care for People Living With Dementia and Diabetes: Applying the Human-Centered Design Process to Continuous Glucose Monitoring. J Diabetes Sci Technol 2024; 18:201-206. [PMID: 36384313 PMCID: PMC10899847 DOI: 10.1177/19322968221137907] [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] [Indexed: 11/18/2022]
Abstract
People with Alzheimer's disease or related dementias and diabetes mellitus (ADRD-DM) are at high risk for hypoglycemic events. Their cognitive impairment and psychosocial situation often hinder detection of hypoglycemia. Extending use and benefits of continuous glucose monitoring (CGM) to people with ADRD-DM could improve hypoglycemia detection, inform care, and reduce adverse events. However, cognitive impairment associated with ADRD presents unique challenges for CGM use. This commentary proposes applying the human-centered design process to CGM, investigating design solutions or interventions needed to integrate CGM into the health care of patients with ADRD-DM. With this process, we can identify and inform CGM designs for people with ADRD-DM, broadening CGM access, increasing detection and treatment of the silent threat posed by hypoglycemia.
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Affiliation(s)
- April Savoy
- Purdue School of Engineering & Technology, Indiana University-Purdue University Indianapolis, Indianapolis, IN, USA
- Regenstrief Institute, Inc., Indianapolis, IN, USA
- Center for Health Information and Communication, Department of Veterans Affairs, Veterans Health Administration, Health Services Research and Development Service CIN 13-416, Richard L. Roudebush VA Medical Center, Indianapolis, IN, USA
| | - Richard J. Holden
- Regenstrief Institute, Inc., Indianapolis, IN, USA
- Indiana University School of Public Health-Bloomington, Bloomington, IN, USA
- Indiana University School of Medicine, Indianapolis, IN, USA
| | - Mary de Groot
- Indiana University School of Medicine, Indianapolis, IN, USA
| | - Daniel O. Clark
- Regenstrief Institute, Inc., Indianapolis, IN, USA
- Indiana University School of Medicine, Indianapolis, IN, USA
| | - Greg A. Sachs
- Regenstrief Institute, Inc., Indianapolis, IN, USA
- Indiana University School of Medicine, Indianapolis, IN, USA
- Eskenazi Health, Indianapolis, IN, USA
| | - David Klonoff
- School of Medicine, University of California San Francisco, San Francisco, CA, USA
- Dorothy L. and James E. Frank Diabetes Research Institute, Mills-Peninsula Medical Center, San Mateo, CA, USA
| | - Michael Weiner
- Regenstrief Institute, Inc., Indianapolis, IN, USA
- Center for Health Information and Communication, Department of Veterans Affairs, Veterans Health Administration, Health Services Research and Development Service CIN 13-416, Richard L. Roudebush VA Medical Center, Indianapolis, IN, USA
- Indiana University School of Medicine, Indianapolis, IN, USA
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Holden SK, Bedenfield N, Taylor AS, Bayram E, Schwilk C, Fleisher J, Duda J, Shill H, Paulson HL, Stacy K, Wood J, Corsentino P, Sha SJ, Litvan I, Irwin DJ, Quinn JF, Goldman JG, Amodeo K, Taylor JP, Boeve BF, Armstrong MJ. Research Priorities of Individuals and Caregivers With Lewy Body Dementia: A Web-based Survey. Alzheimer Dis Assoc Disord 2023; 37:50-58. [PMID: 36821177 PMCID: PMC9971616 DOI: 10.1097/wad.0000000000000545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 12/01/2022] [Indexed: 02/24/2023]
Abstract
INTRODUCTION Lewy body dementia (LBD) is common, yet under-recognized and under-researched. To plan studies with the highest impact, engagement of the community personally affected by these conditions is essential. METHODS A web-based survey of people living with LBD and current and former caregivers of people with LBD queried research priorities through forced ranking and exploration of burden of LBD symptoms. Specific caregiving needs in LBD and perceptions of research participation were also investigated. RESULTS Between April 7, 2021 and July 1, 2021, 984 responses were recorded. Top research priorities included disease-modifying therapies and improved disease detection and staging. People with LBD were interested in pathophysiology and more bothered by motor symptoms; caregivers were interested in risk factors and symptomatic therapies and more bothered by neuropsychiatric symptoms. Few available LBD treatments and resources were rated as helpful, and many valuable services were never received. Previous participation in LBD research was infrequent, but interest was high. DISCUSSION People with LBD and caregivers highlighted the need for research across all aspects of LBD, from pathophysiology and disease modification to prognosis, education, symptomatic treatments, and caregiver support. Funders should increase support for all aspects of LBD research to target the many needs identified by individuals and families living with LBD.
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Affiliation(s)
- Samantha K. Holden
- Department of Neurology, University of Colorado School of Medicine, Aurora, CO
| | - Noheli Bedenfield
- Department of Neurology, University of Florida, Dorothy Mangurian Clinical-Research Headquarters for Lewy Body Dementia, Gainesville, FL
| | | | - Ece Bayram
- Department of Neurosciences, University of California San Diego, San Diego, CA
| | | | - Jori Fleisher
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL
| | - John Duda
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Holly Shill
- Department of Neurology, Barrow Neurological Institute, Phoenix, AZ
| | | | - Kelly Stacy
- College of Nursing, University of Cincinnati, Cincinnati, OH
| | - Julia Wood
- Lewy Body Dementia Association, Liliburn, GA
| | | | - Sharon J. Sha
- Department of Neurology and Neurological Sciences, Stanford University, Stanford, CA
| | - Irene Litvan
- Department of Neurosciences, University of California San Diego, San Diego, CA
| | - David J. Irwin
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Joseph F. Quinn
- Department of Neurology, Oregon Health and Science University, Portland, OR
| | - Jennifer G. Goldman
- Shirley Ryan AbilityLab, Parkinson’s Disease and Movement Disorders Program, Northwestern University, Chicago, IL
| | - Katherine Amodeo
- Department of Neurology, Westchester Medical Center- MidHudson Regional Hospital, Poughkeepsie, NY
| | - John-Paul Taylor
- Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
| | | | - Melissa J. Armstrong
- Department of Neurology, University of Florida, Dorothy Mangurian Clinical-Research Headquarters for Lewy Body Dementia, Gainesville, FL
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