A Tablet App- and Sensor-Based Assistive Technology Intervention for Informal Caregivers to Manage the Challenging Behavior of People With Dementia (the insideDEM Study): Protocol for a Feasibility Study.

Patrick Pogscheba,Thomas Kirste,Bernhard Holle,Sebastian Bader,Margareta Halek,Daniela Holle,Stefan Teipel,Sven Kernebeck,Felix Jordan,Alina Huldtgren,Fabian Mertl

doi:10.2196/11630

Abstract

BackgroundDespite the enormous number of assistive technologies (ATs) in dementia care, the management of challenging behavior (CB) of persons with dementia (PwD) by informal caregivers in home care is widely disregarded. The first-line strategy to manage CB is to support the understanding of the underlying causes of CB to formulate individualized nonpharmacological interventions. App- and sensor-based approaches combining multimodal sensors (actimetry and other modalities) and caregiver information are innovative ways to support the understanding of CB for family caregivers.ObjectiveThe main aim of this study is to describe the design of a feasibility study consisting of an outcome and a process evaluation of a newly developed app- and sensor-based intervention to manage CB of PwD for family caregivers at home.MethodsIn this feasibility study, we perform an outcome and a process evaluation with a pre-post descriptive design over an 8-week intervention period. The Medical Research Council framework guides the design of this feasibility study. The data on 20 dyads (primary caregiver and PwD) are gathered through standardized questionnaires, protocols, and log files as well as semistructured qualitative interviews. The outcome measures (neuropsychiatric inventory and Cohen-Mansfield agitation inventory) are analyzed by using descriptive statistics and statistical tests relevant to the individual assessments (eg, chi-square test and Wilcoxon signed-rank test). For the analysis of the process data, the Unified Theory of Acceptance and Use of Technology is used. Log files are analyzed by using descriptive statistics, protocols are analyzed by using documentary analysis, and semistructured interviews are analyzed deductively using content analysis.ResultsThe newly developed app- and sensor-based AT has been developed and was evaluated until July in 2018. The recruitment of dyads started in September 2017 and was concluded in March 2018. The data collection was completed at the end of July 2018.ConclusionsThis study presents the protocol of the first feasibility study to encompass an outcome and process evaluation to assess a complex app- and sensor-based AT combining multimodal actimetry sensors for informal caregivers to manage CB. The feasibility study will provide in-depth information about the study procedure and on how to optimize the design of the intervention and its delivery.International Registered Report Identifier (IRRID)DERR1-10.2196/11630

Highlights

BackgroundThe management of dementia is complicated by the presence of behavioral and psychological symptoms, referred to as challenging behavior (CB) [1,2]
The data collection was completed at the end of July 2018
This study presents the protocol of the first feasibility study to encompass an outcome and process evaluation to assess a complex app- and sensor-based assistive technology assistive technology intervention (ATI) (AT) combining multimodal actimetry sensors for informal caregivers to manage CB

Summary

Introduction

BackgroundThe management of dementia is complicated by the presence of behavioral and psychological symptoms, referred to as challenging behavior (CB) [1,2]. CB represents a complex construct that results from the interaction of biological, psychological, and social factors that are idiosyncratic to the person with dementia (PwD) [4]. This behavior causes considerable stress for family caregivers [5] and is one of the most common reasons why family members transfer care responsibilities to residential care, for example, nursing homes [6,7]. Systematic approaches incorporating both the description of the behavior and its underlying causes and linking the assessment to individualized interventions in a meaningful way, especially for the homecare environment, are rare [15]. App- and sensor-based approaches combining multimodal sensors (actimetry and other modalities) and caregiver information are innovative ways to support the understanding of CB for family caregivers

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Methods

Discussion

Conclusion