Emerging roles for telemedicine and smart technologies in dementia care

Abstract

Demographic aging of the world population contributes to an increase in the number of persons diagnosed with dementia (PWD), with corresponding increases in health care expenditures. In addition, fewer family members are available to care for these individuals. Most care for PWD occurs in the home, and family members caring for PWD frequently suffer negative outcomes related to the stress and burden of observing their loved one’s progressive memory and functional decline. Decreases in cognition and self-care also necessitate that the caregiver takes on new roles and responsibilities in care provision. Smart technologies are being developed to support family caregivers of PWD in a variety of ways, including provision of information and support resources online, wayfinding technology to support independent mobility of the PWD, monitoring systems to alert caregivers to changes in the PWD and their environment, navigation devices to track PWD experiencing wandering, and telemedicine and e-health services linking caregivers and PWD with health care providers. This paper will review current uses of these advancing technologies to support care of PWD. Challenges unique to widespread acceptance of technology will be addressed and future directions explored.

UnderstAID, an ICT Platform to Help Informal Caregivers of People with Dementia: A Pilot Randomized Controlled Study

“…Information and communications technology (ICT) in the frame of AAL interventions is a promising treatment not only for people suffering from cognitive decline, thus slowing the evolution to dementia [37], but also for patients with dementia and their informal caregivers [19]. According to a recent review of the emerging role of smart technologies in dementia care, patients can benefit by maintaining their cognitive skills and social interaction while the informal caregivers are the vast majority target group for telemedicine [38] as it happens with the understAID application whose main target group are the informal caregivers of people with dementia. In addition, ICT have been suggested as a suitable tool to teach the caregivers better ways of coping with the stress of caregiving [17].…”

Adapting Telemonitoring Technology Use for Older Adults: A Pilot Study

“…Telehealth is one of a number of available technologies to assist older adults, including those with Alzheimer’s disease and other dementias to remain living in the community (Bossen et al, 2015; Godwin, Mills, Anderson, & Kunik, 2013). New technology is meeting the needs of persons with early stage dementia through memory aides, cognitive stimulation, wayfinding, and information resources on the internet.…”

“…Support for family caregivers, who experience a number of negative physical and psychological effects from the stress and burden of caregiving, has now been identified as a growing public health crisis (Talley & Crews, 2007). Technology currently supports family caregivers of persons with dementia through information and support resources available online, monitoring of movement, vital signs, and ambient and environmental conditions, tracking systems, and telemedicine and ehealth services (Bossen et al, 2015; Godwin et al, 2013). …”

“…Technology can extend the reach of expert practitioners to patients and families in the community and the home and in rural and isolated populations. Though there are barriers to address (Bossen, Kim, Williams, Steinhoff, & Strieker, 2015; Wu, Damnee, Kerherve, Ware, & Rigaud, 2015), virtual care in the community delivered via technology-based approaches is able to overcome the limitations of face-to-face delivery, namely time constraints, geographic limitations, and transportation issues (Lewis, Hobday, & Hepburn, 2010; White & Dorman, 2001). With the advent of the Affordable Care Act, industry projections include an increase in the use of telehealth technology in the United States by 500% by 2017 (Roashan, 2014).…”

Using design fiction to reflect on autonomy in smart technology for people living with dementia

“…[8]). A strong focus is on technologies embedded into the environment, particularly so called 'Smart Houses' [3]. Initial usability tests of these devices promise individual benefits, such as increased quality of life for people living with dementia [14], but also benefits to the health care system, such as cost reductions [12].…”