Innovation in Person-centered Dementia Care and Dementia Assessments: Development of the Care Team Connect App deployed for Home Care Agencies

1 7. Project Summary2 Due to the degenerative nature of the disease, people with dementia (PWD) require escalating support for their3 care and are increasingly vulnerable to institutionalization. The Centers for Medicare andamp; Medicaid Services (CMS)4 is transitioning long-term care services from institutional care to home- or community-based services, including5 expanding Medicare Advantage (MA) plans to include non-clinical services as reimbursable supplemental6 benefits. To live at home longer, PWD require support from: (1) formal caregivers (i.e., paid professionals) who7 often lack knowledge of PWDs’ personal histories and have high turnover, and/or (2) informal care partners (e.g.,8 family or friends) who may have difficulty coping with behavioral and psychological symptoms of dementia 9 (BPSD) (e.g., aggression, anxiety). Although technological solutions can focus on BPSDs, formal 10 caregivers/informal care partners in home care underuse such resources. If frontline caregivers in home care 11 settings more routinely used technology that addresses social engagement and data collection for PWD and 12 caregivers, this could result in decreased BPSDs and reduced transitions from in-home care. 13 In this Phase 1 SBIR grant, Generation Connect (GC) – a gerontology technology company that develops 14 personalized dementia care engagement solutions – will begin to meet this need by completing a three-part 15 process. First, GC will develop and refine a Care Team Connect (CTC) mobile app to prompt PWD and informal 16 care partners to create a collection of personalized photos, stories, and music preferences for PWD engagement. 17 Second, GC will integrate clinical assessment tools into the CTC app to streamline data collection related to 18 clinical outcomes for PWD and their caregivers. Finally, GC will station tablets with the CTC app in the home to 19 help formal caregivers enhance engagement routines. 20 The Technology-Enabled Caregiving in the Home (TECH) framework will be used to examine key features that 21 influence caregivers’ utilization of the CTC app and contribute to PWD and caregiver outcomes. These key 22 features include: (1) Individual, socioeconomic, or technical moderators, (2) barrier or facilitator mediators, and 23 (3) technology-related measurement. Using insights from focus group sessions, informal care partners will 24 increase the utilization of the CTC app, resulting in an increased amount of user-generated engagement content 25 added to the CTC app. Semi-structured interviews of formal caregivers and case managers will ensure an 26 intuitive and practical CTC app for collecting data related to PWD cognition and BPSD, and formal caregiver 27 well-being. GC leadership and franchise owners are committed to PAS-19-316 goals to reduce caregiving burden 28 for PWD, evaluate changes in cognition, preserve functional independence, and promote PWD/caregiver 29 interactions. Successful completion of the Phase 1 project will lead to a larger Phase 2 trial to assess CTC app 30 effectiveness and commercial viability in support of emerging MA plans.8. Project Narrative For people with dementia (PWD) who are increasingly vulnerable to institutionalization, there is a growing call from Federal agencies to promote in-home care where formal caregivers and informal care partners have access to technological solutions to address behavioral and psychological symptoms of dementia (BPSD) and mitigate caregiver turnover. To begin meeting this need, this Phase 1 study will develop a mobile app that (1) prompts PWD and informal care partners to create a collection of personalized photos, stories, and music preferences for PWD engagement, and (2) integrates data collection tools related to clinical outcomes for PWD and their caregivers – while also stationing HIPAA-compliant tablets in the home to help formal caregivers enhance engagement routines. This innovative approach addresses an important public health need by creating an intuitive and practical app for facilitating the availability and use of personalized evidence-based engagement content, as well as using psychometrically validated assessment tools to collect data related to PWD cognition, BPSD, and formal caregiver well-being, which will lead to a Phase 2 trial to assess app effectiveness and commercial viability.