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Kim J, Hwang M, Hwang Y. An Integrative Review of the Feasibility and Effects of the Use of Location-Tracking Devices by Persons Living With Cognitive Impairment. Am J Alzheimers Dis Other Demen 2024; 39:15333175241264767. [PMID: 38896870 PMCID: PMC11189016 DOI: 10.1177/15333175241264767] [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] [Indexed: 06/21/2024]
Abstract
OBJECTIVES This study aimed to examine the effects of location-tracking devices on persons living with cognitive impairment, investigate facilitators of and barriers to using the devices, and provide future directions for the use of the devices. METHODS An integrative review was conducted using 5 databases: PubMed, Embase, Web of Science, CINAHL, and Scopus. From the 1429 initially identified studies, 10 were included in the review. RESULTS Location-tracking devices benefited persons living with cognitive impairment and their informal caregivers. The devices brought more independence to persons living with cognitive impairment, allowing them to go outside and feel safer there. Furthermore, the devices reduced the caregivers' worries about their loved ones being lost. CONCLUSIONS Location-tracking devices have the potential to increase independence in persons living with cognitive impairment and to decrease psychological stress in informal caregivers. In the future, ways to minimize the barriers to using location-tracking devices need to be determined.
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Affiliation(s)
- Jayeong Kim
- Seoul National University College of Nursing and Research Institute of Nursing Science, Seoul, Korea
| | - Mina Hwang
- Seoul National University College of Nursing and Research Institute of Nursing Science, Seoul, Korea
| | - Yeji Hwang
- Seoul National University College of Nursing and Research Institute of Nursing Science, Seoul, Korea
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2
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Brookman R, Parker S, Hoon L, Ono A, Fukayama A, Matsukawa H, Harris CB. Technology for dementia care: what would good technology look like and do, from carers' perspectives? BMC Geriatr 2023; 23:867. [PMID: 38104074 PMCID: PMC10725604 DOI: 10.1186/s12877-023-04530-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 11/29/2023] [Indexed: 12/19/2023] Open
Abstract
BACKGROUND The development of technology in dementia care has largely been without consultation with carers, and has primarily focused on safety, monitoring devices, and supporting activities of daily living. Further, while involving end-users in the design of technology has been recommended, this is yet to become common practice. METHOD We conducted a mixed methods study with the aim of investigating carers' values and priorities for technology development, including prior experiences, barriers to use, and what they would like technology to do. Importantly, we asked carers for their design ideas and bespoke technology solutions for future development. RESULTS Carers of people living with dementia (N = 127), including both unpaid (n = 102) and paid carers (n = 25) residing in Australia, completed an online survey. In addition, a subsample of carers (n = 23) participated in semi-structured interviews. Findings demonstrate that carers want technology to be person-centred, customisable, and to increase opportunities for meaningful social connection. Findings also demonstrate the ability of carers to generate creative design solutions for dementia care. CONCLUSIONS These findings and implications will be discussed in relation to the importance of co-design with carers and engineers during the design phase of assistive technology. Also, the importance of technology to enhance, not replace, human-to-human social interactions is highlighted.
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Affiliation(s)
- Ruth Brookman
- MARCS Institute for Brain, Behaviour and Development, Western Sydney University, Penrith, NSW, Australia.
| | | | | | - Asuka Ono
- Nippon Telegraph and Telephone (NTT), Tokyo, Japan
| | | | | | - Celia B Harris
- MARCS Institute for Brain, Behaviour and Development, Western Sydney University, Penrith, NSW, Australia
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3
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Sharma N, Braakman-Jansen LMA, Oinas-Kukkonen H, Croockewit JH, Gemert-Pijnen JV. Exploring the Needs and Requirements of Informal Caregivers of Older Adults With Cognitive Impairment From Sensor-Based Care Solutions: Multimethod Study. JMIR Aging 2023; 6:e49319. [PMID: 37878353 PMCID: PMC10632915 DOI: 10.2196/49319] [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: 05/31/2023] [Revised: 07/19/2023] [Accepted: 08/25/2023] [Indexed: 10/26/2023] Open
Abstract
BACKGROUND With the increase in the older adult population, sensor-based care solutions that can monitor the deviations in physical, emotional, and physiological activities in real-time from a distance are demanded for prolonging the stay of community-dwelling older adults with cognitive impairment. To effectively develop and implement these care solutions, it is important to understand the current experiences, future expectations, perceived usefulness (PU), and communication needs of the informal caregivers of older adults with cognitive impairment regarding such solutions. OBJECTIVE This comprehensive study with informal caregivers of older adults with cognitive impairment aims to (1) highlight current experiences with (if any) and future expectations from general sensor-based care solutions, (2) explore PU specifically toward unobtrusive sensing solutions (USSs), (3) determine the information communication (IC) needs and requirements for communicating the information obtained through USSs in different care scenarios (fall, nocturnal unrest, agitation, and normal daily life), and (4) elicit the design features for designing the interaction platform in accordance with the persuasive system design (PSD) model. METHODS A multimethod research approach encompassing a survey (N=464) and in-depth interviews (10/464, 2.2%) with informal caregivers of older adults with cognitive impairment was used. The insights into past experiences with and future expectations from the sensor-based care solutions were obtained through inductive thematic analysis of the interviews. A convergent mixed methods approach was used to explore PU and gather the IC needs from USSs by using scenario-specific questions in both survey and interviews. Finally, the design features were elicited by using the PSD model on the obtained IC needs and requirements. RESULTS Informal caregivers expect care infrastructure to consider centralized and empathetic care approaches. Specifically, sensor-based care solutions should be adaptable to care needs, demonstrate trust and reliability, and ensure privacy and safety. Most informal caregivers found USSs to be useful for emergencies (mean 4.09, SD 0.04) rather than for monitoring normal daily life activities (mean 3.50, SD 0.04). Moreover, they display variations in information needs including mode, content, time, and stakeholders involved based on the care scenario at hand. Finally, PSD features, namely, reduction, tailoring, personalization, reminders, suggestions, trustworthiness, and social learning, were identified for various care scenarios. CONCLUSIONS From the obtained results, it can be concluded that the care scenario at hand drives PU and IC design needs and requirements toward USSs. Therefore, future technology developers are recommended to develop technology that can be easily adapted to diverse care scenarios, whereas designers of such sensor-driven platforms are encouraged to go beyond tailoring and strive for strong personalization while maintaining the privacy of the users.
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Affiliation(s)
- Nikita Sharma
- Faculty of Behavioural, Management and Social Sciences, University of Twente, Enschede, Enschede, Netherlands
- Faculty of Information Technology and Electrical Engineering, University of Oulu, Oulu, Finland
| | - Louise M A Braakman-Jansen
- Faculty of Behavioural, Management and Social Sciences, University of Twente, Enschede, Enschede, Netherlands
| | - Harri Oinas-Kukkonen
- Faculty of Information Technology and Electrical Engineering, University of Oulu, Oulu, Finland
| | | | - Jewc van Gemert-Pijnen
- Faculty of Behavioural, Management and Social Sciences, University of Twente, Enschede, Enschede, Netherlands
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4
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Turner NR, Berridge C. How I want technology used in my care: Learning from documented choices of people living with dementia using a dyadic decision making tool. Inform Health Soc Care 2023; 48:387-401. [PMID: 37675938 PMCID: PMC10792656 DOI: 10.1080/17538157.2023.2252066] [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] [Indexed: 09/08/2023]
Abstract
While technologies for aging in place are promoted to support care partners and people living with dementia, perspectives of people living with dementia are underrepresented in both use decisions among families and discussions within academia and industry. This mixed-methods study examined the use preferences of twenty-nine people living with mild Alzheimer's disease (AD) for four categories of technologies: location tracking, in-home sensors, web-cameras, and virtual companion robots. Participants completed a novel dyadic intervention, Let's Talk Tech, where they documented their preferences of the four technology categories for care planning purposes. Post-test interviews were thematically analyzed and provide insight into selection processes. Technology preferences varied considerably by and within participant living with mild AD. Excepting location tracking, non-technology and low-technology options were more desirable than the featured technologies. Control over technology use was of great importance to people living with AD. Considerations given to technology preference selection imperfectly fit within the new Health Technology Acceptance Model (H-TAM) developed for older adults. These findings underscore the importance of including people living with dementia in decision making about technologies to support care at home and the need for further personalization and tailorable technological devices to accommodate and align with their preferences.
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Affiliation(s)
| | - Clara Berridge
- School of Social Work, University of Washington, Seattle, WA, USA
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5
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Berridge C, Turner NR, Liu L, Fredriksen-Goldsen KI, Lyons KS, Demiris G, Kaye J, Lober WB. Preliminary Efficacy of Let's Talk Tech: Technology Use Planning for Dementia Care Dyads. Innov Aging 2023; 7:igad018. [PMID: 37123031 PMCID: PMC10132307 DOI: 10.1093/geroni/igad018] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Indexed: 03/06/2023] Open
Abstract
Background and Objective Care partners of people living with dementia require support to knowledgeably navigate decision making about how and when to use monitoring technologies for care purposes. We conducted a pilot study of a novel self-administered intervention, "Let's Talk Tech," for people living with mild dementia and their care partners. This paper presents preliminary efficacy findings of this intervention designed to educate and facilitate dyadic communication about a range of technologies used in dementia care and to document the preferences of the person living with dementia. It is the first-of-its-kind decision-making and planning tool with a specific focus on technology use. Research Design and Methods We used a 1-group pretest-post-test design and paired t tests to assess change over 2 time periods in measures of technology comprehension, care partner knowledge of the participant living with mild Alzheimer's disease's (AD) preferences, care partner preparedness to make decisions about technology use, and mutual understanding. Thematic analysis was conducted on postintervention interview transcripts to elucidate mechanisms and experiences with Let's Talk Tech. Results Twenty-nine mild AD dementia care dyads who live together completed the study. There was statistically significant improvement with medium and large effect sizes on outcome measures of care partners' understanding of each technology, care partners' perceptions of the person living with dementia's understanding of each technology, knowledge of the person living with dementia's preferences, decision-making preparedness, and care partners' feelings of mutual understanding. Participants reported that it helped them have important and meaningful conversations about using technology. Discussion and Implications Let's Talk Tech demonstrated promising preliminary efficacy on targeted measures that can lead to informed, shared decision making about technologies used in dementia care. Future studies should assess efficacy with larger samples and more diverse sample populations in terms of race, ethnicity, and dementia type.
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Affiliation(s)
- Clara Berridge
- School of Social Work, University of Washington, Seattle, Washington, USA
| | - Natalie R Turner
- School of Social Work, University of Washington, Seattle, Washington, USA
| | - Liu Liu
- College of Education, University of Washington, Seattle, Washington, USA
| | | | - Karen S Lyons
- William F. Connell School of Nursing, Boston College, Boston, Massachusetts, USA
| | - George Demiris
- School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Jeffrey Kaye
- Layton Aging and Alzheimer’s Disease Center and Oregon Center for Aging and Technology, School of Medicine, Oregon Health & Science University, Portland, Oregon, USA
| | - William B Lober
- Clinical Informatics Research Group, School of Nursing, University of Washington, Seattle, Washington, USA
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Wrede C, Braakman-Jansen A, van Gemert-Pijnen L. How to create value with unobtrusive monitoring technology in home-based dementia care: a multimethod study among key stakeholders. BMC Geriatr 2022; 22:921. [PMID: 36451119 PMCID: PMC9713088 DOI: 10.1186/s12877-022-03550-1] [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: 07/12/2022] [Accepted: 10/11/2022] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND There is a growing interest to support extended independent living of people with dementia (PwD) via unobtrusive monitoring (UM) technologies which allow caregivers to remotely monitor lifestyle, health, and safety of PwD. However, these solutions will only be viable if developers obtain a clear picture of how to create value for all relevant stakeholders involved and achieve successful implementation. The aim of this study was therefore to explore the value proposition of UM technology in home-based dementia care and preconditions for successful implementation from a multi-stakeholder perspective. METHODS We conducted an expert-informed survey among potential stakeholders (n = 25) to identify key stakeholders for UM technology in home-based dementia care. Subsequently, focus groups and semi-structured interviews were conducted among 5 key stakeholder groups (n = 24) including informal caregivers (n = 5), home care professionals (n = 5), PwD (n = 4), directors and managers within home care (n = 4), and policy advisors within the aged care and health insurance sector (n = 6). The sessions addressed the value proposition- and business model canvas and were analyzed using thematic analysis. RESULTS Stakeholders agreed that UM technology should provide gains such as objective surveillance, timely interventions, and prevention of unnecessary control visits, whereas pains mainly included information overload, unplannable care due to real-time monitoring, and less human interaction. The overall design-oriented need referred to clear situation classifications including urgent care (fall- and wandering detection), non-urgent care (deviations in eating, drinking, sleeping), and future care (risk predictions). Most important preconditions for successful implementation of UM technology included inter-organizational collaboration, a shared vision on re-shaping existing care processes, integrated care ICT infrastructures, clear eligibility criteria for end-users, and flexible care reimbursement systems. CONCLUSIONS Our findings can guide the value-driven development and implementation of UM technology for home-based dementia care. Stakeholder values were mostly aligned, although stakeholders all had their own perspective on what UM technology should accomplish. Besides, our study highlights the complexity of implementing novel UM technology in home-based dementia care. To achieve successful implementation, organizational and financial preconditions, as well as digital data exchange between home care organizations, will be important.
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Affiliation(s)
- Christian Wrede
- grid.6214.10000 0004 0399 8953Centre for eHealth and Wellbeing Research, Department of Psychology, Health and Technology, University of Twente, Drienerlolaan 5, Enschede, 7522 NB The Netherlands
| | - Annemarie Braakman-Jansen
- grid.6214.10000 0004 0399 8953Centre for eHealth and Wellbeing Research, Department of Psychology, Health and Technology, University of Twente, Drienerlolaan 5, Enschede, 7522 NB The Netherlands
| | - Lisette van Gemert-Pijnen
- grid.6214.10000 0004 0399 8953Centre for eHealth and Wellbeing Research, Department of Psychology, Health and Technology, University of Twente, Drienerlolaan 5, Enschede, 7522 NB The Netherlands
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7
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Howes J, Denier Y, Gastmans C. Electronic Tracking Devices for People With Dementia: Content Analysis of Company Websites. JMIR Aging 2022; 5:e38865. [DOI: 10.2196/38865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 09/02/2022] [Accepted: 09/30/2022] [Indexed: 11/13/2022] Open
Abstract
Background
Electronic tracking devices, also known as locators, monitors, or surveillance devices, are increasingly being used to manage dementia-related wandering and, subsequently, raising various ethical questions. Despite the known importance technology design has on the ethics of technologies, little research has focused on the companies responsible for the design and development of electronic tracking devices. This paper is the first to perform a qualitative analysis of the ethically related content of the websites of companies that design and develop electronic tracking devices.
Objective
The aim of this study was to understand how companies that design, develop, and market electronic tracking devices for dementia care frame, through textual marketing content, the vulnerabilities and needs of persons with dementia and caregivers, the way in which electronic tracking devices respond to these vulnerabilities and needs, and the ethical issues and values at stake.
Methods
Electronic tracking device company websites were identified via a Google search, 2 device recommendation lists (Alzheimer’s Los Angeles and the Canadian Agency for Drugs and Technologies in Health), and the 2 recent reviews of wander management technology by Neubauer et al and Ray et al. To be included, websites must be official representations of companies (not market or third-party websites) developing and selling electronic tracking devices for use in dementia care. The search was conducted on December 22, 2020, returning 199 websites excluding duplicates. Data synthesis and analysis were conducted on the textual content of the included websites using a modified form of the Qualitative Analysis Guide of Leuven.
Results
In total, 29 websites met the inclusion criteria. Most (15/29, 52%) companies were in the United States. The target audience of the websites was largely caregivers. A range of intertwined vulnerabilities facing persons with dementia and their caregivers were identified, and the companies addressed these via care tools that centered on certain values such as providing information while preserving privacy. Life after device implementation was characterized as a world aspired to that sees increased safety for persons with dementia and peace of mind for caregivers.
Conclusions
The way electronic tracking device content is currently conveyed excludes persons with dementia as a target audience. In presenting their products as a response to vulnerabilities, particular values are linked to design elements. A limitation of the results is the opaque nature of website content origins. How or when values arise in the process of design, development, and marketing is unknown. Therefore, further research should explore the process companies use to identify vulnerabilities, how values are decided upon and integrated into the design of products, and the perceptions of developers regarding the ethics of electronic tracking devices.
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8
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Berridge C, Grigorovich A. Algorithmic harms and digital ageism in the use of surveillance technologies in nursing homes. FRONTIERS IN SOCIOLOGY 2022; 7:957246. [PMID: 36189442 PMCID: PMC9525107 DOI: 10.3389/fsoc.2022.957246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 08/26/2022] [Indexed: 05/10/2023]
Abstract
Ageism has not been centered in scholarship on AI or algorithmic harms despite the ways in which older adults are both digitally marginalized and positioned as targets for surveillance technology and risk mitigation. In this translation paper, we put gerontology into conversation with scholarship on information and data technologies within critical disability, race, and feminist studies and explore algorithmic harms of surveillance technologies on older adults and care workers within nursing homes in the United States and Canada. We start by identifying the limitations of emerging scholarship and public discourse on "digital ageism" that is occupied with the inclusion and representation of older adults in AI or machine learning at the expense of more pressing questions. Focusing on the investment in these technologies in the context of COVID-19 in nursing homes, we draw from critical scholarship on information and data technologies to deeply understand how ageism is implicated in the systemic harms experienced by residents and workers when surveillance technologies are positioned as solutions. We then suggest generative pathways and point to various possible research agendas that could illuminate emergent algorithmic harms and their animating force within nursing homes. In the tradition of critical gerontology, ours is a project of bringing insights from gerontology and age studies to bear on broader work on automation and algorithmic decision-making systems for marginalized groups, and to bring that work to bear on gerontology. This paper illustrates specific ways in which important insights from critical race, disability and feminist studies helps us draw out the power of ageism as a rhetorical and analytical tool. We demonstrate why such engagement is necessary to realize gerontology's capacity to contribute to timely discourse on algorithmic harms and to elevate the issue of ageism for serious engagement across fields concerned with social and economic justice. We begin with nursing homes because they are an understudied, yet socially significant and timely setting in which to understand algorithmic harms. We hope this will contribute to broader efforts to understand and redress harms across sectors and marginalized collectives.
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Affiliation(s)
- Clara Berridge
- School of Social Work, University of Washington, Seattle, WA, United States
| | - Alisa Grigorovich
- Recreation and Leisure Studies, Brock University, St. Catharines, ON, Canada
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9
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Together they shall not fade away: Opportunities and challenges of self-tracking for dementia care. Inf Process Manag 2022. [DOI: 10.1016/j.ipm.2022.103024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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10
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Löbe C, AboJabel H. Empowering people with dementia via using intelligent assistive technology: A scoping review. Arch Gerontol Geriatr 2022; 101:104699. [DOI: 10.1016/j.archger.2022.104699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 02/28/2022] [Accepted: 03/24/2022] [Indexed: 11/16/2022]
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Ahmed M, Marín M, How D, Judica E, Tropea P, Bentlage E, J. Ferreira J, Bouça-Machado R, Brach M. End-Users and Other Stakeholders’ Needs and Requirements in the Development of a Personalized Integrated Care Platform (PROCare4Life) for Older People with Dementia or Parkinson Disease: A Mixed-Methods Study (Preprint). JMIR Form Res 2022; 6:e39199. [DOI: 10.2196/39199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 07/18/2022] [Accepted: 08/17/2022] [Indexed: 11/13/2022] Open
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Neubauer N, Spenrath C, Philip S, Daum C, Liu L, Miguel-Cruz A. Identifying adoption and usability factors of locator devices for persons living with dementia. DEMENTIA 2021; 21:862-881. [PMID: 34964391 PMCID: PMC8996292 DOI: 10.1177/14713012211065381] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
A growing number of Canadians live with dementia. Strategies to reduce the risks of
getting lost include physical barriers, restraints and medications. However, these
strategies can restrict one’s participation in meaningful activities and reduce quality of
life. Locator devices can be used to manage safety risks while also supporting engagement
and independence among persons living with dementia. As more locator devices become
available on the market, adoption rates would be affected by certain factors. There is no
clear, standardized approach to identify the factors that have an influence on the
acceptance and usability of locator devices for persons with dementia and their care
partners. This project aimed to identify factors related to acceptance and usability of
locator devices that are important to individuals with dementia, their care partners,
service providers and technology developers. Qualitative description and conventional
content analysis guided our approach. We conducted 5 focus groups with 21 participants.
Trustworthiness strategies included multiple data sources, data verification for accuracy
and peer debrief. Five overarching factors emerged as critical aspects in the acceptance
and usability of locator devices. These factors were inclusivity, simplicity, features,
physical properties and ethics. Participants thought that locator devices do not
adequately consider privacy and stigma. Therefore, the acceptance and usability of locator
devices could be enhanced if privacy and stigma are addressed. The factors identified will
inform the creation of an acceptance and usability scale for locator devices used by
persons living with dementia, their care partners and service providers.
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Affiliation(s)
- Noelannah Neubauer
- 8430University of Waterloo, Canada.,Department of Occupational Therapy, 70412University of Alberta, Canada
| | - Christa Spenrath
- Department of Occupational Therapy, 70412University of Alberta, Canada
| | | | - Christine Daum
- 8430University of Waterloo, Canada.,Department of Occupational Therapy, 70412University of Alberta, Canada
| | - Lili Liu
- 8430University of Waterloo, Canada
| | - Antonio Miguel-Cruz
- 8430University of Waterloo, Canada.,Department of Occupational Therapy, 70412University of Alberta, Canada.,Glenrose Rehabilitation Research, Innovation & Technology (GRRIT) Hub, 60351Glenrose Rehabilitation Hospital, Canada
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13
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Remote activity monitoring for family caregivers of persons living with dementia: a mixed methods, randomized controlled evaluation. BMC Geriatr 2021; 21:715. [PMID: 34922475 PMCID: PMC8684277 DOI: 10.1186/s12877-021-02634-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Accepted: 11/09/2021] [Indexed: 11/10/2022] Open
Abstract
Background The goal of the present study was to determine whether a remote activity monitoring (RAM) system benefited caregivers who aided relatives with Alzheimer’s disease or related dementias (ADRD) living at home. We hypothesized that over 18 months, families randomly assigned to receive RAM technology in the home of the person with ADRD would experience statistically significant (p < .05): 1) improvements in caregiver self-efficacy and sense of competence when managing their relative’s dementia; and 2) reductions in caregiver distress (e.g., burden, role captivity, and depression). Methods An embedded mixed methods design was utilized, where 179 dementia caregivers were randomly assigned to receive RAM or not. Caregivers were surveyed bi-annually over an 18-month period to collect quantitative and qualitative data on RAM’s effects. Semi-structured interviews with 30 caregivers were completed following the 18-month data collection period to explore more in-depth how and why RAM was perceived as helpful or not. Results Growth curve models showed no direct or moderation effect of RAM on dementia caregiver outcomes. The qualitative data revealed a complex utilization process of RAM influenced by the care environment/context as well as the temporal progression of ADRD and the caregiving trajectory. Conclusions The findings suggest the need for developing more effective mechanisms to match appropriate technologies with the heterogeneous needs and care contexts of people living with ADRD and their caregivers. A triadic approach that incorporates professional care management alongside passive monitoring systems such as RAM may also enhance potential benefits. Trial registration ClinicalTrials.govNCT03665909, retrospectively registered on 11 Sept 2018. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-021-02634-8.
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Bastoni S, Wrede C, da Silva MC, Sanderman R, Gaggioli A, Braakman-Jansen A, van Gemert-Pijnen L. Factors Influencing Implementation of eHealth Technologies to Support Informal Dementia Care: Umbrella Review. JMIR Aging 2021; 4:e30841. [PMID: 34623314 PMCID: PMC8538023 DOI: 10.2196/30841] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 07/13/2021] [Accepted: 07/15/2021] [Indexed: 01/26/2023] Open
Abstract
Background The worldwide increase in community-dwelling people with dementia underscores the need for innovative eHealth technologies that aim to provide support to both patients and their informal caregivers in the home setting. However, sustainable implementation of eHealth technologies within this target group can be difficult. Objective The goal of this study was to gain a thorough understanding of why it is often difficult to implement eHealth technologies in practice, even though numerous technologies are designed to support people with dementia and their informal caregivers at home. In particular, our study aimed to (1) provide an overview of technologies that have been used and studied in the context of informal dementia care and (2) explore factors influencing the implementation of these technologies. Methods Following an umbrella review design, five different databases were searched (PubMed, PsycINFO, Medline, Scopus, and Cochrane) for (systematic) reviews. Among 2205 reviews retrieved, 21 were included in our analysis based on our screening and selection procedure. A combination of deductive and inductive thematic analyses was performed, using the Nonadoption, Abandonment, Scale-Up, Spread, and Sustainability (NASSS) framework for organizing the findings. Results We identified technologies designed to be used “by informal caregivers,” “by people with dementia,” and “with people with dementia.” Within those groups, most of the represented technologies included, respectively: (i) devices for in-home monitoring of lifestyle, health, and safety; (ii) technologies for supporting memory, orientation, and day structure; and (iii) technologies to facilitate communication between the informal caregiver and person with dementia. Most of the identified factors influencing implementation related to the condition of dementia, characteristics of the technology, expected/perceived value of users, and characteristics of the informal caregiver. Considerably less information has been reported on factors related to the implementing organization and technology supplier, wider institutional and sociocultural context of policy and regulations, and continued adaptation of technology over time. Conclusions Our study offers a comprehensive overview of eHealth technologies in the context of informal dementia care and contributes to gaining a better understanding of a broad range of factors influencing their implementation. Our results uncovered a knowledge gap regarding success factors for implementation related to the organizational and broader context and continuous adaptation over the long term. Although future research is needed, the current findings can help researchers and stakeholders in improving the development and implementation of eHealth technologies to support informal dementia care.
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Affiliation(s)
- Sofia Bastoni
- Department of Psychology, Health & Technology, Centre for eHealth and Wellbeing Research, University of Twente, Enschede, Netherlands
| | - Christian Wrede
- Department of Psychology, Health & Technology, Centre for eHealth and Wellbeing Research, University of Twente, Enschede, Netherlands
| | - Marcia Cristina da Silva
- Department of Psychology, Health & Technology, Centre for eHealth and Wellbeing Research, University of Twente, Enschede, Netherlands
| | - Robbert Sanderman
- Department of Psychology, Health & Technology, Centre for eHealth and Wellbeing Research, University of Twente, Enschede, Netherlands.,Department of Health Psychology, University Medical Center Groningen, Groningen, Netherlands
| | - Andrea Gaggioli
- Department of Psychology, Universitá Cattolica del Sacro Cuore, Milan, Italy.,Applied Technology for Neuro-Psychology Lab, Istituto Auxologico Italiano, Milan, Italy
| | - Annemarie Braakman-Jansen
- Department of Psychology, Health & Technology, Centre for eHealth and Wellbeing Research, University of Twente, Enschede, Netherlands
| | - Lisette van Gemert-Pijnen
- Department of Psychology, Health & Technology, Centre for eHealth and Wellbeing Research, University of Twente, Enschede, Netherlands
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15
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Effects of e-Health Training and Social Support Interventions for Informal Caregivers of People with Dementia-A Narrative Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18157728. [PMID: 34360020 PMCID: PMC8345641 DOI: 10.3390/ijerph18157728] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 07/15/2021] [Accepted: 07/19/2021] [Indexed: 01/11/2023]
Abstract
Along with the burden commonly experienced by informal caregivers (ICs) of people with dementia (PwD), associated with the progressive decline that accompanies dementia, the lockdown due to the public health crisis has had a great negative impact on the emotional wellbeing, physical health, and social relationships of ICs. Support interventions through telemedicine represent an opportunity for ICs to learn the skills required for the care and maintenance of social networks. In this work, a narrative review of the effects of e-health training and social support interventions was carried out. A literature search was conducted using the ProQuest, Ovid, and Scopus databases. Information regarding social support (SS), psychological interventions, and training for the management of medications and behavioral changes was extracted. One hundred and nine studies were included in this review. Forums and training platforms were the main tools for ICs. The most effective platforms to improve SS include the participation of both ICs and health professionals. However, no significant improvements in objective caring skills were identified. Platforms developed specifically for ICs should be based in tools that ICs are familiar with, because many ICs have not yet incorporated Information and Communication Technologies in many activities of their daily lives. Education in the digitalization to ICs of PwD should be one of the priority objectives in telehealth interventions.
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16
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Freiesleben SD, Megges H, Herrmann C, Wessel L, Peters O. Overcoming barriers to the adoption of locating technologies in dementia care: a multi-stakeholder focus group study. BMC Geriatr 2021; 21:378. [PMID: 34154542 PMCID: PMC8218472 DOI: 10.1186/s12877-021-02323-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Accepted: 05/13/2021] [Indexed: 11/19/2022] Open
Abstract
Background Locating technologies are a subtype of assistive technology that aim to support persons with dementia by helping manage spatial orientation impairments and provide aid to care partners by intervening when necessary. Although a variety of locating devices are commercially available, their adoption has remained low in the past years. Several studies have explored barriers to the adoption of assistive technologies from the perspective of professional stakeholders, but in-depth explorations for locating technologies are sparse. Additionally, the inputs of business professionals are lacking. The aim of this study was to expand knowledge on barriers to the adoption of locating technologies from a multi-stakeholder professional perspective, and to explore strategies to optimize adoption. Methods In total, 22 professionals working in business (n = 7), healthcare (n = 6) and research (n = 9) fields related to gerontology and gerontechnology participated in our focus group study. Perceptions on the value of using locating technologies for dementia care, barriers to their adoption, as well as salient services and information dissemination strategies were explored. After verbatim transcription, transcripts were analysed following an inductive data-driven content analysis approach in MAXQDA. Results Six key adoption barriers centering on: (1) awareness-, (2) technological-, (3) product characteristic- and (4) capital investment-based limitations, (5) unclear benefits, as well as (6) ethical concerns emerged. The interplay between barriers was high. Five core themes on services and information dissemination strategies centering on: (1) digital autonomy support, (2) emergency support, (3) information dissemination actors, (4) product acquisition, and (5) product advertising were extracted. Conclusions Our study with interdisciplinary stakeholders expands knowledge on barriers to the adoption of locating technologies for dementia care, and reinforces recommendations that an interdisciplinary strategy is needed to optimize adoption. Also, our findings show that focusing on services to increase digital autonomy and on information dissemination strategies has been largely overlooked and may be particularly effective. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-021-02323-6.
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Affiliation(s)
- Silka Dawn Freiesleben
- Department of Psychiatry, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health (BIH), Lindenberger Weg 80, 13125, Berlin, Germany. .,German Center for Neurodegenerative Diseases (DZNE), Berlin, Germany. .,Memory Clinic and Dementia Prevention Center, Experimental and Clinical Research Center (ECRC), Lindenberger Weg 80, 13125, Berlin, Germany.
| | - Herlind Megges
- Department of Psychiatry, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health (BIH), Lindenberger Weg 80, 13125, Berlin, Germany.,German Center for Neurodegenerative Diseases (DZNE), Berlin, Germany.,Memory Clinic and Dementia Prevention Center, Experimental and Clinical Research Center (ECRC), Lindenberger Weg 80, 13125, Berlin, Germany.,Present address: Federal Ministry for Family Affairs, Senior Citizens, Women and Youth (BMFSFJ), Berlin, Germany
| | - Christina Herrmann
- Department of Psychiatry, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health (BIH), Lindenberger Weg 80, 13125, Berlin, Germany.,Memory Clinic and Dementia Prevention Center, Experimental and Clinical Research Center (ECRC), Lindenberger Weg 80, 13125, Berlin, Germany
| | - Lauri Wessel
- European New School of Digital Studies, European University Viadrina, Große Scharrnstraße 59, 15230, Frankfurt (Oder), Germany
| | - Oliver Peters
- Department of Psychiatry, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health (BIH), Lindenberger Weg 80, 13125, Berlin, Germany.,German Center for Neurodegenerative Diseases (DZNE), Berlin, Germany.,Memory Clinic and Dementia Prevention Center, Experimental and Clinical Research Center (ECRC), Lindenberger Weg 80, 13125, Berlin, Germany
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17
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Wrede C, Braakman-Jansen A, van Gemert-Pijnen L. Requirements for Unobtrusive Monitoring to Support Home-Based Dementia Care: Qualitative Study Among Formal and Informal Caregivers. JMIR Aging 2021; 4:e26875. [PMID: 33843596 PMCID: PMC8076981 DOI: 10.2196/26875] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 02/23/2021] [Accepted: 02/28/2021] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Due to a growing shortage in residential care, people with dementia will increasingly be encouraged to live at home for longer. Although people with dementia prefer extended independent living, this also puts more pressure on both their informal and formal care networks. To support (in)formal caregivers of people with dementia, there is growing interest in unobtrusive contactless in-home monitoring technologies that allow caregivers to remotely monitor the lifestyle, health, and safety of their care recipients. Despite their potential, these solutions will only be viable if they meet the expectations and needs of formal and informal caregivers of people with dementia. OBJECTIVE The objective of this study was to explore the expected benefits, barriers, needs, and requirements toward unobtrusive in-home monitoring from the perspective of formal and informal caregivers of community-dwelling people with dementia. METHODS A combination of semistructured interviews and focus groups was used to collect data among informal (n=19) and formal (n=16) caregivers of people with dementia. Both sets of participants were presented with examples of unobtrusive in-home monitoring followed by questions addressing expected benefits, barriers, and needs. Relevant in-home monitoring goals were identified using a previously developed topic list. Interviews and focus groups were transcribed and inductively analyzed. Requirements for unobtrusive in-home monitoring were elicited based on the procedure of van Velsen and Bergvall-Kåreborn. RESULTS Formal and informal caregivers saw unobtrusive in-home monitoring as a support tool that should particularly be used to monitor (the risk of) falls, day and night rhythm, personal hygiene, nocturnal restlessness, and eating and drinking behavior. Generally, (in)formal caregivers reported cross-checking self-care information, extended independent living, objective communication, prevention and proactive measures, emotional reassurance, and personalized and optimized care as the key benefits of unobtrusive in-home monitoring. Main concerns centered around privacy, information overload, and ethical concerns related to dehumanizing care. Furthermore, 16 requirements for unobtrusive in-home monitoring were generated that specified desired functions, how the technology should communicate with the user, which services surrounding the technology were seen as needed, and how the technology should be integrated into the existing work context. CONCLUSIONS Despite the presence of barriers, formal and informal caregivers of people with dementia generally saw value in unobtrusive in-home monitoring, and felt that these systems could contribute to a shift from reactive to more proactive and less obtrusive care. However, the full potential of unobtrusive in-home monitoring can only unfold if relevant concerns are considered. Our requirements can inform the development of more acceptable and goal-directed in-home monitoring technologies to support home-based dementia care.
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Affiliation(s)
- Christian Wrede
- Centre for eHealth and Wellbeing Research, Department of Psychology, Health & Technology, University of Twente, Enschede, Netherlands
| | - Annemarie Braakman-Jansen
- Centre for eHealth and Wellbeing Research, Department of Psychology, Health & Technology, University of Twente, Enschede, Netherlands
| | - Lisette van Gemert-Pijnen
- Centre for eHealth and Wellbeing Research, Department of Psychology, Health & Technology, University of Twente, Enschede, Netherlands
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18
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Ahmed M, Marín M, Bouça-Machado R, How D, Judica E, Tropea P, Bentlage E, Brach M. Investigating Users' and Other Stakeholders' Needs in the Development of a Personalized Integrated Care Platform (PROCare4Life) for Older People with Dementia or Parkinson Disease: Protocol for a Mixed Methods Study. JMIR Res Protoc 2021; 10:e22463. [PMID: 33433394 PMCID: PMC7837994 DOI: 10.2196/22463] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 09/27/2020] [Accepted: 11/10/2020] [Indexed: 01/27/2023] Open
Abstract
Background Dementias—including Alzheimer disease—and Parkinson disease profoundly impact the quality of life of older population members and their families. PROCare4Life (Personalized Integrated Care Promoting Quality of Life for Older Adults) is a European project that recognizes the benefit of technology-based integrated care models in improving the care coordination and the quality of life of these target groups. This project proposes an integrated, scalable, and interactive care platform targeting older people suffering from neurodegenerative diseases, their caregivers, and socio-health professionals. PROCare4Life adopts a user-centered design approach from the early stage and throughout platform development and implementation, during which the platform is designed and adapted to the needs and requirements of all the involved users. Objective This paper presents the study protocol for investigating users’ needs and requirements regarding the design of the proposed PROCare4Life platform. Methods A mixed qualitative and quantitative study design is utilized, including online surveys, interviews, and workshops. The study aimed to recruit approximately 200 participants, including patients diagnosed with dementia or Parkinson disease, caregivers, socio-health professionals, and other stakeholders, from five different European countries: Germany, Italy, Portugal, Romania, and Spain. Results The study took place between April and September 2020. Recruitment is now closed, and all the data have been collected and analyzed in order to be used in shaping the large-scale pilot phase of the PROCare4Life project. Results of the study are expected to be published in spring 2021. Conclusions This paper charts the protocol for a user-centered design approach at the early stage of the PROCare4Life project in order to shape and influence an integrated health platform suitable for its intended target group and purpose. International Registered Report Identifier (IRRID) DERR1-10.2196/22463
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Affiliation(s)
- Mona Ahmed
- Institute of Sport and Exercise Sciences, Münster University, Münster, Germany
| | | | | | - Daniella How
- Institute of Sport and Exercise Sciences, Münster University, Münster, Germany
| | - Elda Judica
- Department of Neurorehabilitation Sciences, Casa di Cura del Policlinico, Milan, Italy
| | - Peppino Tropea
- Department of Neurorehabilitation Sciences, Casa di Cura del Policlinico, Milan, Italy
| | - Ellen Bentlage
- Institute of Sport and Exercise Sciences, Münster University, Münster, Germany
| | - Michael Brach
- Institute of Sport and Exercise Sciences, Münster University, Münster, Germany
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Jacklin K, Pitawanakwat K, Blind M, Lemieux AM, Sobol A, Warry W. Peace of mind: A community-industry-academic partnership to adapt dementia technology for Anishinaabe communities on Manitoulin Island. J Rehabil Assist Technol Eng 2020; 7:2055668320958327. [PMID: 32999732 PMCID: PMC7509219 DOI: 10.1177/2055668320958327] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 08/24/2020] [Indexed: 11/17/2022] Open
Abstract
Introduction Aging Technologies for Indigenous Communities in Ontario (ATICON) explores the technology needs of Anishinaabe older adults in the Manitoulin region of Northern Ontario. Our program of research addresses inequitable access to supportive technologies that may allow Indigenous older adults to successfully age in place. Methods Using Indigenous research methodologies (IRM) and community-based participatory research (CBPR) we explored the acceptability of CareBand - a wearable location and activity monitoring device for people living with dementia using a LoRaWAN, a low-power wide-area network technology. We conducted key informant consultations and focus groups with Anishinaabe Elders, formal and informal caregivers, and health care providers (n = 29) in four geographically distinct regions. Results Overall, participants agreed that CareBand would improve caregivers' peace of mind. Our results suggest refinement of the technology is necessary to address the challenges of the rural geography and winter weather; to reconsider aesthetics; address privacy and access; and to consider the unique characteristics of Anishinaabe culture and reserve life. Conclusion All three partners in this research, including the Indigenous communities, industry partner, and academic researchers, benefited from the use of CBPR and IRM. As CareBand is further developed, community input will be crucial for shaping a useful and valued device.
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Affiliation(s)
- Kristen Jacklin
- Memory Keepers Medical Discovery Team, University of Minnesota Medical School - Duluth Campus, Duluth, USA
| | | | - Melissa Blind
- Memory Keepers Medical Discovery Team, University of Minnesota Medical School - Duluth Campus, Duluth, USA
| | - Andrine M Lemieux
- Memory Keepers Medical Discovery Team, University of Minnesota Medical School - Duluth Campus, Duluth, USA
| | | | - Wayne Warry
- Memory Keepers Medical Discovery Team, University of Minnesota Medical School - Duluth Campus, Duluth, USA
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Vermeer Y, van Santen J, Charlesworth G, Higgs P. People with dementia and carers online discussing surveillance. JOURNAL OF ENABLING TECHNOLOGIES 2020. [DOI: 10.1108/jet-07-2019-0032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
This paper aims to interrogate online comments from consumers with dementia and family carers on surveillance technology products used by or for people with dementia.
Design/methodology/approach
A naturalistic, observational study of qualitative posts (N = 120) by people with dementia (n = 7) and family carers (n = 38) to discussion threads on surveillance technology (ST), hosted by an online dementia support forum in the Netherlands. Kozinet’s (2002) typology was used to describe respondent characteristics, and comments on features of ST products were analysed within a pre-existing framework.
Findings
Forum users were mainly “tourists” interested in ST, with some “insiders” interested in sharing experiences of ST use. They expressed a lack of trust in information from marketers and providers to the experience of being provided with poor information. Consumer-to-consumer comments on products triangulated with previous face-to-face qualitative studies. Carers prioritised “peace of mind” through location monitoring. In contrast, people with dementia prioritised user-friendliness (simple, with capability and compatible with daily routines).
Practical implications
Using online discussions of ST products provides a rapid approach to understanding current consumer needs and preferences in the ever-changing world of technology.
Originality/value
No previous study is known to have explored the views of carers and people with dementia in online discussions about ST.
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