Smart technology-assisted Home Nursing Care Program for Persons with Dementia or Hip Fracture: Implementation Difficulties: Thematic Analysis (Preprint)

BACKGROUND Wearable devices have been developed and implemented to improve data collection in remote health care and smart care. Wearable devices have the advantage of always being with individuals, enabling easy detection of their movements. In this study, we developed and implemented a smart-care system using smart clothing for persons with dementia and with hip fracture. We conducted a preliminary study to understand family caregivers’ and care receivers’ experiences of receiving a smart technology-assisted (STA) home-nursing care program. OBJECTIVE This paper reports the difficulties we encountered and strategies we developed during the feasibility phase of studies on the effectiveness of our STA home-nursing care program for persons with dementia and hip fracture. METHODS Our care model, a STA home-nursing care program for persons with dementia and those with hip fracture included a remote-monitoring system for elderly persons wearing smart clothing was used to facilitate family caregivers’ detection of elderly persons’ movements. These movements included getting up at night, staying in the bathroom for more than 30 minutes, not moving more than 2 hours during the day, leaving the house, and daily activities. Participants included 13 families with 5 patients with hip fracture and 7 with dementia. Research nurses documented the difficulties they encountered during the process. RESULTS Difficulties encountered in this smart-care study were categorized into problems setting up the smart-care environment, problems running the system, and problems with participant acceptance/adherence. These difficulties caused participants to drop out, the system to not function or delayed function, inability to collect data, extra costs of manpower, and financial burden. Strategies to deal with these problems are also reported. CONCLUSIONS During the implementation of smart care at home for persons with dementia or hip fracture, different aspects of difficulties were found and strategies were taken. The findings of this study can provide a reference for future implementation of similar smart-home devices.