Developing and Evaluating In-Home Supportive Technology for Dementia Caregivers

AbstractCaring for a loved one with Alzheimer’s disease, frontotemporal dementia, or another neurodegenerative disease is a highly meaningful part of family life. However, the associated burden and strain can have adverse effects on caregivers including mental and physical health problems, reduced well-being, and increased mortality. These effects, in turn, can compromise care quality and shorten survival times for people with dementia (PWD). Research has consistently found that behavioral symptoms in PWD are most strongly associated with adverse caregiver effects, even more so than cognitive and functional symptoms. Empirically- supported interventions are needed that: (a) target mechanisms/pathways shown to connect behavioral symptoms in PWD with adverse effects in caregivers, and (b) can be disseminated successfully into larger community settings. In this SBIR Fast Track application, we will develop, refine, and evaluate People Power Caregiver (PPCg), a flexible and expandable hardware/software system designed to integrate in-home sensors and devices, emergency responding, social networking, and Internet-of-Things (i.e., devices that can be controlled and communicated with via the internet) technologies to create a more supportive and safe home environment for caregivers and PWD. PPCg monitors troublesome behaviors in PWD (e.g., wandering), and targets mechanisms (e.g., worry, social isolation) thought to link behavioral symptoms in PWD with adverse caregiver outcomes. PPCg is also designed to minimize demands on caregivers’ limited time and energy and to provide a platform for data collection that can be used by researchers and care professionals.This application is an innovative partnership between People Power (CEO: Gene Wang, www.peoplepowerco.com) in Redwood City, California and the Berkeley Psychophysiology Laboratory (Director: Robert W. Levenson) at the University of California, Berkeley. People Power is an award-winning, established leader in home monitoring and Internet-of-Things technology and has recently started developing assistive technologies for the elderly. The Berkeley Psychophysiology Laboratory has been engaged in basic and applied research with PWD and other neurodegenerative diseases and their caregivers for the past 15 years. The proposal addresses three specific aims: Aim 1: Focus groups. In Phase I of the project, a preliminary version of PPCg will be developed and refined with input from focus groups of caregivers and in- home testing (Study 1). Aim 2: Efficacy. In the first year of Phase II of the project, the first production version of PPCg will be installed by the research team in 80 homes and evaluated in a randomized controlled efficacy trial that includes careful diagnosis and assessment of emotional functioning in PWD and caregivers (Study 2). Aim 3: Effectiveness. In the second year of Phase II of the project, working with energy industry partners, a refined and expanded second production version of PPCg will be provided to 400 homes with familial caregivers for self-installation and evaluation in a community-based effectiveness trial (Study 3).RelevanceDementias cause profound cognitive, emotional, and functional deficits. As the disease progresses, people with dementia become increasingly dependent on caregivers, who are at heightened risk for mental and physical health problems. Applying assistive technology to monitor worrisome behaviors, improve safety, and reduce social isolation in the home environment can reduce caregiver burden and improve care in ways that have major public health benefits.