Ecological Momentary Assessments and Interventions in Alzheimer's Caregiving.

Abstract

Caregivers of persons with Alzheimer's Disease (AD) often experience feelings of lack of support and information from specialists when operating in real scenarios, inclusive of old-age psychiatric wards, care homes, community, and patient's home. AD caregivers can provide narrative about what issues need to be addressed in Ecological Momentary Assessment (EMA) to capture real-time and real-scenario needs in AD caregiving, and Ecological Momentary Interventions (EMI) as online e-learning to assist in areas of concerns. Twelve focus group discussions took place with AD caregivers for a total of 62 people interviewed. Once major themes in surveys and learning were identified by using discourse analysis, AD caregivers expressed the likelihood that these themes (where 0 meant "nil" and 1 meant "completely") would address their focal needs in caregiving and topics in learning. Z scores for proportions and Cohen's d effect size were calculated for each item reporting the averaged scores. AD caregivers indicated that the major areas of concern that could benefit from an EMA/EMI online platform were: support (d=3.08), collaboration (d=1.85), medication review (d=1.21), dealing with grief and mourning, and time (d=0.97). Moreover, they identified personal resources available to provide help to colleagues: support (d=1.34), information (d=0.97), collaboration (d=2.06), hospital admission (d=3.08), and hospital discharge (d=5.50). Focus groups and narratives can be the initial stage in creating a dedicated AD app supporting EMA/EMI in AD care.