scholarly journals Typology of Technology-Supported Dementia Care Interventions From an In-Home Telehealth Trial

2019 ◽  
Vol 41 (12) ◽  
pp. 1724-1746 ◽  
Author(s):  
Sohyun Kim ◽  
Clarissa Shaw ◽  
Kristine N. Williams ◽  
Maria Hein
Keyword(s):  
Positive Reinforcement ◽  
Psychological Symptoms ◽  
Qualitative Content Analysis ◽  
Dementia Care ◽  
Video Data ◽  
Care Recipient ◽  
Dementia Caregivers ◽  
Caregiver Support ◽  
Care Experience ◽  
Wide Range

Identifying the needs of dementia caregivers is critical for supporting dementia home care. This study identified a typology of expert interventions delivered to dementia caregivers during an innovative telehealth trial that used in-home video recordings to directly observe care challenges. Qualitative content analysis was used to analyze narrative notes describing interventions that were developed based on video data submitted by 33 caregiver–care recipient dyads. Two major themes emerged: education and skills for dementia care and caregiver support. Ten subthemes included education and skills related to: behavioral and psychological symptoms of dementia, disease expectations, safety, activities of daily living, medical care optimization, and medication utilization and caregiver support related to: respite, positive reinforcement, social and financial support, and self-care. Families providing in-home dementia care experience a wide range of care challenges. By using video data, dementia care experts were able to witness and evaluate challenging care situations and provide individualized feedback.

scholarly journals RELATIONSHIP BETWEEN CARE CHALLENGE TYPE AND PSYCHOSOCIAL OUTCOMES IN FAMILY CAREGIVERS OF PERSONS WITH DEMENTIA

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S916-S916
Author(s):  
Clarissa Shaw ◽  
Kristine N Williams ◽  
Maria Hein ◽  
Carissa Coleman ◽  
Yelena Perkhounkova
Keyword(s):  
Public Health ◽  
Sleep Quality ◽  
Family Caregivers ◽  
Daily Living ◽  
Psychological Symptoms ◽  
Memory Loss ◽  
Dementia Care ◽  
Dementia Caregivers ◽  
Tailored Interventions ◽  
Behavioral And Psychological Symptoms

Abstract Enhancing dementia care is a public health priority and supporting family caregivers of persons living with dementia (PLWD) is a critical need. This poster reports the relationships between the types of care challenges reported by family caregivers and their scores on psychosocial measures. Family caregivers (N=83) participating in the FamTechCare clinical trial identified three top priority care challenges and completed a series of measures (i.e., burden, depression, sleep quality, and reaction to dementia behaviors) at baseline. Priority care challenges were classified using the 10-category Technology-supported Dementia Care Typology. Three of the categories (i.e., behavioral and psychological symptoms of dementia [BPSD], activities of daily living [ADL], and disease expectations [DE]) were reported by an adequate number of caregivers in order to test relationships with psychosocial measures using the Kruskal-Wallis Test. Caregivers reporting 2 or 3 BPSD challenges had higher burden (p=.007), more depression (p=.022) and worse sleep quality (p=.020) compared to those reporting 0 or 1 care challenges related to BPSD. In comparison, caregivers with 2 or 3 challenges related to DE (e.g., PLWD memory loss) had less burden (p=.008), less depression (p=.030), and better sleep quality (p=.042), compared to those reporting 0 or 1 challenge related to DE. Caregivers identifying 2 or 3 care challenges related to ADLs also reported higher levels of depression (p=.036). Dementia caregivers face vast caregiving responsibilities. Caregivers facing BPSD challenges report greater burden and depression. These results reinforce the need for tailored interventions to assist family caregivers in the managing varied care challenges.

scholarly journals Voices of Caregivers: Key Demands Towards AI-driven Home Monitoring in Community-based Dementia Care

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 664-664
Author(s):  
Christian Wrede ◽  
Annemarie Braakman-Jansen ◽  
Lisette van Gemert-Pijnen
Keyword(s):  
Ethical Issues ◽  
Qualitative Content Analysis ◽  
Home Monitoring ◽  
Dementia Care ◽  
Community Dwelling ◽  
Care Recipient ◽  
Informational Privacy ◽  
People With Dementia ◽  
Home Based ◽  
Monitoring Technologies

Abstract While most people with dementia prefer to live at home for as long as possible, this also puts more pressure on both their informal and formal care network. To provide support in home-based dementia care, there is growing interest in technology that allows caregivers to remotely monitor health and safety of people with dementia. Novel generations of these technologies are using non-wearable, pervasive sensors coupled with algorithms to continuously collect and model meaningful in-home information. However, while these self-learning monitoring systems develop rapidly, their target users’ views and demands are still insufficiently mapped out. To identify possible barriers to acceptance and ways to overcome these, we conducted a scenario-based study, including semi-structured interviews with informal caregivers (n=19) and focus groups with home care professionals (n=16) of community-dwelling people with dementia. Inductive qualitative content analysis revealed that both groups of caregivers were concerned about the informational privacy of their care recipient with dementia, information overload, and ethical issues related to dehumanizing care. Identified demands mainly centered around how to overcome these barriers. We identified several demands related to specific functionalities, user experience factors, services surrounding the technology, and integration into the existing work context. Most notably, caregivers highlighted the importance of introducing AI-driven in-home monitoring technologies in a way it prevents them from feeling undervalued. In conclusion, our findings can help to inform the development of more acceptable and unobtrusive in-home monitoring technologies to support home-based dementia care.

scholarly journals Positive Aspects of Caregiving in Incident and Long-Term Caregivers: Role of Social Engagement and Distress

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 254-254
Author(s):  
Chelsea Liu ◽  
Victoria Marino ◽  
Virginia Howard ◽  
William Haley ◽  
David Roth
Keyword(s):  
African American ◽  
Social Network ◽  
Social Engagement ◽  
Network Size ◽  
Demographic Variables ◽  
Care Recipient ◽  
Dementia Caregivers ◽  
Wide Range ◽  
White Caregivers ◽  
Positive Aspects Of Caregiving

Abstract Positive aspects of caregiving (PAC) are positive appraisals that caregivers report about their role such as feeling appreciated or important, and may increase with caregiver adaptation over time. We aimed to examine differences in PAC by caregiving duration and social engagement, controlling for measures of distress. A total of 283 African American or White caregivers from the Caregiving Transitions Study with a wide range of caregiving durations were included in our analysis. We used multivariable linear regressions to model total PAC score on years of caregiving and social engagement (social network, monthly social contact), adjusting for age, sex, race, marital status, relationship to care recipient, dementia status of care recipient and measures of distress (depressive symptoms, perceived stress, caregiving strain). Caregivers with higher social engagement reported significantly higher PAC while caregivers with longer duration of care reported marginally higher PAC in most analytic models. African American caregivers reported higher PAC compared to White caregivers. Dementia caregivers reported lower PAC than non-dementia caregivers in models that adjusted for demographic variables and social network size, but the association was attenuated with the addition of caregiving strain. In summary, higher social engagement and longer care duration were associated with higher PAC after adjusting for demographic variables and measures of distress. Future studies should aim to understand how caregivers shift appraisal to positive aspects of their role and explore implementation of interventions targeting PAC in order to improve the caregiving experience.

“Care to Plan”: Delivering Personalized Recommendations to Support Caregivers of People Living with Dementia (Preprint)

2021 ◽  
Author(s):  
Jinhee Cha ◽  
Colleen M. Peterson ◽  
Ashley N Millenbah ◽  
Katie Louwagie ◽  
Zachary G Baker ◽  
...  
Keyword(s):  
Health System ◽  
Family Members ◽  
Extended Period ◽  
Care Recipient ◽  
Dementia Caregivers ◽  
Caregiver Support ◽  
Care Plans ◽  
Dementia Caregiver ◽  
Facilitators And Barriers ◽  
Additional Support

BACKGROUND Estimates suggest that 6.2 million Americans aged 65 and older are living with Alzheimer’s dementia in 2021 and by 2060, that number could more than double to 13.8 million. As a result, public health officials anticipate a greater need for caregivers for persons with Alzheimer’s disease or a related dementia (ADRD), as well as support resources for both people living with dementia (PLWD) and their caregivers. Despite the growing need for dementia caregiver support services, there is a lack of consensus regarding how to tailor these services to best meet the heterogeneous needs of individual caregivers. To fill this gap, “Care To Plan” (CtP), an online tool for caregivers of PLWD, was developed to provide tailored support recommendations to dementia caregivers. OBJECTIVE The objective of this study was to formally explore the feasibility, acceptability and utility of CtP for 20 family members of PLWD within a health system over a one month time period using a mixed methods parallel convergent design. METHODS A moderately sized health system in the mid-Atlantic region was selected as the site for CtP implementation where 20 caregivers who were family members of PLWD were enrolled. The web-based CtP tool was used directly by caregivers and facilitated by a healthcare professional (i.e., a “senior care navigator”/SCN). Caregivers were given a 21-item review checklist to assess barriers and facilitators associated with reviewing CtP with a SCN. Following the 21-item review checklist, semi-structured telephone interviews, which included 18 open-ended questions, focused on the facilitators and barriers to CtP implementation and recommendations for future implementation. RESULTS Quantitative results suggested that 76.5% and 85.7% of caregivers agreed or strongly agreed that after using the tool they were able to find a service that would meet their needs and those of their care recipient, respectively. Qualitative analysis identified four themes regarding facilitators and barriers to implementation: 1) caregiver factors, 2) SCN factors, 3) CtP tool system factors, and 4) recommendations and resources factors. CONCLUSIONS Care to Plan was not only found to be feasible, but a valuable tool for caregivers seeking resources for themselves as well as their PLWD. Longer-term evaluation findings aim to generate results as to how CtP can be integrated into care plans for caregivers and how SCNs can provide additional support for caregivers for PLWD over an extended period of time.

How family dementia caregivers perceive benefits of a 4-week MIT mindfulness and guided imagery program: a pilot study

2019 ◽  
Author(s):  
Francis Yang ◽  
Joseph Zamaria ◽  
Stefana Morgan ◽  
Eric Lin ◽  
Andrew F. Leuchter ◽  
...  
Keyword(s):  
Psychological Symptoms ◽  
Pilot Trial ◽  
Well Being ◽  
Mental States ◽  
Care Recipient ◽  
Structured Interviews ◽  
Active Components ◽  
Post Intervention ◽  
Dementia Caregivers ◽  
Self Compassion

BackgroundFamily caregivers of patients with dementia experience high levels of interpersonal stress that often results in elevated anxiety, depression and negative impacts on social networks. Changes in behaviors and the structure of relationships with the care recipient (CR) and others in the social milieu challenge the caregivers’ ability to mentalize, or understand the links between mental states and behaviors. This study investigates the perceived benefits for family dementia caregivers of Mentalizing Imagery Therapy (MIT), which aims to improve balanced mentalizing of both self and others and reduce psychological symptoms. Methods11 family members who identified as the primary caregiver of a relative with dementia underwent a 4-week pilot trial of MIT and completed semi-structured interviews post-intervention to identify subjective benefits, putative psychological mediators and perceived active components. ResultsCaregivers reported improvements in general well-being, mood, anxiety, and sleep, and a majority stated the intervention helped with forming and maintaining healthier relationships. Some participants noted benefits extending to how they reacted to their social environment and perceived themselves more objectively from others’ perspectives. Specific elements of the intervention, including self-compassion, self-care, and the ability to reflect on emotionally arousing challenges, might have mediated these improvements. The combination of instructor, meditations, homework, group sessions, and educational sessions was well received by participants.ConclusionOur results show that family dementia caregivers described perceived salutary benefits of MIT on multiple domains of well-being. The self reports suggest MIT holds promise for reducing non-mentalizing patterns of thought, and facilitating improvements in balanced mentalization within the caregivers’ relationships. These results should be further extended in larger samples.

Moving through predeath grief: Psychological support for family caregivers of people with dementia

Dementia ◽  
2017 ◽  
Vol 18 (7-8) ◽  
pp. 2474-2493 ◽  
Author(s):  
Franziska Meichsner ◽  
Stefanie Köhler ◽  
Gabriele Wilz
Keyword(s):  
Qualitative Content Analysis ◽  
Behavioral Therapy ◽  
Controlled Trial ◽  
Well Being ◽  
Care Recipient ◽  
Physical And Mental Health ◽  
Dementia Caregivers ◽  
Loss And Grief ◽  
People With Dementia ◽  
Mental Health Interventions

When caring for a family member with dementia, continuous losses and predeath grief can adversely affect the caregivers’ physical and mental health. Interventions for caregivers should therefore also aim at coping with loss and managing predeath grief. It was the objective of the present study to describe sources of grief caregivers report during therapy and to investigate how therapists can support caregivers. Two caregivers who participated in a randomized controlled trial were selected for this case study. Both caregivers received an intervention based on the principles of cognitive-behavioral therapy with grief-focused content that consisted of 12 sessions within six months. Three therapy sessions per participant were transcribed, coded, and analyzed using qualitative content analysis. Results illustrate that both caregivers experienced a loss of companionship with their respective care recipient and ambiguous loss that resulted in intense grief that they found difficult to manage. Therapists responded by supporting the caregivers to acknowledge their losses and identify individual ways to cope with and accept loss and grief. Both caregivers reported higher well-being and an increased ability to manage their grief-related emotions after the therapy ended. The identified intervention strategies fit well into a theoretical framework for grief interventions for dementia caregivers, i.e. the dementia grief model.

scholarly journals Chinese American Caregivers of Older Adults With Alzheimer’s Disease and Other Dementias: A Scoping Review

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 160-160
Author(s):  
Mengyao Hu ◽  
Laura Grunin ◽  
Bei Wu
Keyword(s):  
Alzheimer’S Disease ◽  
Older Adults ◽  
Alzheimer's Disease ◽  
Asian American ◽  
Scoping Review ◽  
Filial Piety ◽  
Chinese American ◽  
Dementia Caregivers ◽  
Caregiver Support ◽  
Care Experience

Abstract With the rapid growth of aging populations, the number of older adults with dementia is increasing worldwide. While there is a significant amount of research on dementia caregivers, we know very little about Chinese American (the largest subgroup of the Asian American population in America) caregivers. Therefore, the aims of this study are to 1) conduct a scoping review by identifying existing studies on Chinese American dementia caregivers, 2) present the current state of the science on Chinese American dementia caregiving, and 3) provide direction for future research. Twenty-one studies were included in the final review with 3 main themes synthesized (care experience, utilization of programs/services, and recruitment for caregivers). Care experience included illness perception towards Alzheimer’s Disease and related dementia (ADRD) such as stigma and normalization of the disease process. Filial piety was another important cultural belief underpinning care experience. An underutilization of supportive programs/services among this population was identified. Additionally, the few existing programs/services for Chinese American caregivers as well as the barriers encountered when seeking these programs/services were seen in the literature. The strategies and barriers of the included research articles for recruitment of Chinese American caregivers are also discussed in this study. These findings provide an overview of the current knowledge about Chinese American caregivers and serve as a stepping stone for future studies on similar populations in promoting caregiver’s health and developing culturally sensitive caregiver support services.

scholarly journals Using Video Telehealth to Support Family Caregivers of People With Dementia

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 660-661
Author(s):  
Joleen Sussman ◽  
Lauren Moo ◽  
Michele Karel
Keyword(s):  
Support Groups ◽  
Caregiver Burden ◽  
Challenging Behavior ◽  
Psychological Symptoms ◽  
Actual Behavior ◽  
Dementia Caregivers ◽  
Caregiver Support ◽  
Rural Caregivers ◽  
People With Dementia ◽  
Highly Correlated

Abstract In 2030, predictions indicate that dementia will affect 75 million people worldwide and increase to 132 million by 2050. Persons’ with dementia (PWD) associated behavioral changes are highly correlated with caregiver burden. Caregivers of PWD commonly report concerns regarding personal and home safety, meaningful activities, advance care planning, and evaluation and diagnosis of dementia of the PWD. Further, caregivers’ emotional response to PWD challenging behavior has greater influence than the actual behavior on decisions to place PWD in a nursing home. Caregiver intervention reduces behavioral and psychological symptoms in the PWD, the caregiver’s emotional distress from these symptoms, and cost to healthcare systems. Yet, one in four dementia caregivers are not receiving dementia support services. Difficulty attending in person clinic-based appointments may be one barrier to caregivers engaging in treatment. This symposium highlights telehealth approaches, by various disciplines (Geriatrician, Neurologist, Geriatric Psychiatric, Geropsychologist, and Occupational Therapist), across urban and rural settings to address caregiver needs and improved access to care. The first presentation will focus on education of rural caregivers of PWD and increased connection to services (Sussman et al). The second presentation will focus on Video to home dementia visits for caregivers (Gately & Moo). The third study will focus on rural tele dementia caregiver support groups and effects on caregiver burden (Rossi et al). The final study will describe co-occurring caregiver and PWD telehealth groups (Thielke & Fredrickson).

Using Motion Detection to Measure Social Polarization in the U.S. House of Representatives

2020 ◽  
pp. 1-10
Author(s):  
Bryce J. Dietrich
Keyword(s):  
Motion Detection ◽  
House Of Representatives ◽  
Social Science Research ◽  
Image Data ◽  
Science Research ◽  
Video Data ◽  
Social Scientists ◽  
Wide Range ◽  
Party Voting ◽  
The Many

Abstract Although previous scholars have used image data to answer important political science questions, less attention has been paid to video-based measures. In this study, I use motion detection to understand the extent to which members of Congress (MCs) literally cross the aisle, but motion detection can be used to study a wide range of political phenomena, like protests, political speeches, campaign events, or oral arguments. I find not only are Democrats and Republicans less willing to literally cross the aisle, but this behavior is also predictive of future party voting, even when previous party voting is included as a control. However, this is one of the many ways motion detection can be used by social scientists. In this way, the present study is not the end, but the beginning of an important new line of research in which video data is more actively used in social science research.

scholarly journals Person-Centered Care in Persons Living with Dementia: A Systematic Review and Meta-Analysis

2020 ◽  
Author(s):  
Kyung Hee Lee ◽  
Ji Yeon Lee ◽  
Bora Kim
Keyword(s):  
Systematic Review ◽  
Cognitive Function ◽  
Effect Size ◽  
Psychological Symptoms ◽  
Meta Analysis ◽  
Healthcare Providers ◽  
Clinical Excellence ◽  
Dementia Care ◽  
Person Centered Care ◽  
Centered Care

Abstract Background and Objectives The concept of person-centered care has been utilized/adapted to various interventions to enhance health-related outcomes and ensure the quality of care delivered to persons living with dementia. A few systematic reviews have been conducted on the use of person-centered interventions in the context of dementia care, but to date, none have analyzed intervention effect by intervention type and target outcome. This study aimed to review person-centered interventions used in the context of dementia care and examine their effectiveness. Research Design and Methods A systematic review and meta-analysis were conducted. We searched through five databases for randomized controlled trials that utilized person-centered interventions in persons living with dementia from 1998 to 2019. Study quality was assessed using the National Institute for Health and Clinical Excellence. The outcomes of interest for the meta-analysis were behavioral and psychological symptoms in dementia (BPSD) and cognitive function assessed immediately after the baseline measurement. Results In total, 36 studies were systematically reviewed. Intervention types were: reminiscence, music, and cognitive therapies, and multisensory stimulation. Thirty studies were included in the meta-analysis. Results showed a moderate effect size for overall intervention, a small one for music therapy, and a moderate one for reminiscence therapy on BPSD and cognitive function. Discussion and Implications Generally speaking, person-centered interventions showed immediate intervention effects on reducing BPSD and improving cognitive function, although the effect size and significance of each outcome differed by intervention type. Thus, healthcare providers should consider person-centered interventions as a vital element in dementia care.

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