SAFE at Home: A Service to Provide Social Engagement to Community-Dwelling Persons with Dementia

PROJECT SUMMARY/ABSTRACTNeed: An estimated 6.2 million Americans are currently suffering from Alzheimer’s disease (AD), and, without significant breakthroughs, 12.7 million Americans will be suffering from AD in 2050. While much emphasis has been placed on improving dementia care in long-term care (LTC) over the past decades, the thrust to improve dementia care at home has taken a back seat in some regards. This is unfortunate, because about 70% of PWD (≈4.3 million) live in the community. PWD who live at home are at high risk of isolation, loneliness, and depression. In fact, 50% of older adults are known to be at risk for loneliness, and 53% report experiencing depressive symptoms.Three Existing Solutions with Significant Limitations: There are three main existing solutions to the social isolation experienced by PWD. First, one could provide social engagement by employing a home health service. However, home health only provides engagement with one other person—i.e., a home health worker who is typically much younger than the PWD. Second, one could provide social engagement via adult day services. But adult day centers (ADCs) are not available in all areas (this is especially true in rural areas) and, even when they are, traveling to an ADC presents a logistical issue for the PWD and family members. Third, one could hire (or arrange for) a trained professional (and/or volunteer) to visit the PWD in their home specifically for the purpose of social engagement is also possible. However, this type of service is relatively rare (especially in rural areas) and is typically very expensive.Innovation: The proposed Phase 1 study will involve initial development and evaluation of an innovative new service called Social Activities For Engagement at Home or SAFE at Home (SaH). SaH will enable community-dwelling PWD to participate in videoconference-based group activities with their peers—i.e., other PWD. SaH sessions will be facilitated by highly trained “Engagement Professionals,” who will have a background in recreation therapy, activity coordination, or a similar field. Each SaH Engagement Professional will receive extensive training and coaching on how to properly engage PWD in videoconference-based activity sessions. Activity materials will be visible to participants through the use of screensharing and will be comprised of Hearthstone’s proprietary evidence-based activities. Each SaH session will be comprised of up to five PWD, plus one Engagement Professional, who will facilitate the sessions. Participants will be matched based upon approximate cognitive and communication ability, as well as upon their interests and background. By grouping PWD in this way, there will be a relatively high likelihood that they will enjoy taking part in sessions together.Specific Aims: The proposed study has three Specific Aims:· Aim 1. Develop an Alpha version of the SaH app, including app infrastructure and preliminary activity content forlive group sessions, as well as staff training and coaching modules.· Aim 2. Examine the app’s acceptability/feasibility (by assessing attendance, session length, and engagement/affect).· Aim 3. Examine satisfaction with the app by directly eliciting feedback from PWD and life enrichment staff.