Improving a Mobile Telepresence Robot for People With Alzheimer Disease and Related Dementias: Semistructured Interviews With Stakeholders

Abstract

Background By 2050, nearly 13 million Americans will have Alzheimer disease and related dementias (ADRD), with most of those with ADRD or mild cognitive impairment (MCI) receiving home care. Mobile telepresence robots may allow persons with MCI or ADRD to remain living independently at home and ease the burden of caregiving. The goal of this study was to identify how an existing mobile telepresence robot can be enhanced to support at-home care of people with MCI or ADRD through key stakeholder input. Objective The specific aims were to assess what applications should be integrated into the robot to further support the independence of individuals with MCI or ADRD and understand stakeholders’ overall opinions about the robot. Methods We conducted in-person interviews with 21 stakeholders, including 6 people aged >50 years with MCI or ADRD living in the community, 9 family caregivers of people with MCI or ADRD, and 6 clinicians who work with the ADRD population. Interview questions about the robot focused on technology use, design and functionality, future applications to incorporate, and overall opinions. We conducted a thematic analysis of the data obtained and assessed the patterns within and across stakeholder groups using a matrix analysis technique. Results Overall, most stakeholders across groups felt positively about the robot’s ability to support individuals with MCI or ADRD and decrease caregiver burden. Most ADRD stakeholders felt that the greatest benefits would be receiving help in emergency cases and having fewer in-person visits to the doctor’s office. Caregivers and clinicians also noted that remote video communication with their family members using the robot was valuable. Adding voice commands and 1-touch lifesaving or help buttons to the robot were the top suggestions offered by the stakeholders. The 4 types of applications that were suggested included health-related alerts; reminders; smart-home–related applications; and social, entertainment, or well-being applications. Stakeholders across groups liked the robot’s mobility, size, interactive connection, and communication abilities. However, stakeholders raised concerns about their physical stability and size for individuals living in smaller, cluttered spaces; screen quality for those with visual impairments; and privacy or data security. Conclusions Although stakeholders generally expressed positive opinions about the robot, additional adaptations were suggested to strengthen functionality. Adding applications and making improvements to the design may help mitigate concerns and better support individuals with ADRD to live independently in the community. As the number of individuals living with ADRD in the United States increases, mobile telepresence robots are a promising way to support them and their caregivers. Engaging all 3 stakeholder groups in the development of these robots is a critical first step in ensuring that the technology matches their needs. Integrating the feedback obtained from our stakeholders and evaluating their effectiveness will be important next steps in adapting telepresence robots.

Poor insight and future thinking in early dementia limit patient projections of potential utility of technological innovations and advanced care planning

“…While our previous study ( 9 ) showed that those with MCI or early ADRD were able to provide overall feedback regarding the proposed assistive technology, when asked to imagine the assistance they may require in the future, they lacked future thinking capability in predicting their own future cognitive and functional abilities. Participants had a limited ability to independently identify potential cognitive challenges and suggest technology that could be of assistance for their future cognitive and functional declines.…”

“…For this brief report, we analyzed qualitative interview data collected in a previous study (July to August 2019) in which we obtained feedback on possible adaptations to a mobile telepresence robot and the robot’s potential utility from stakeholder groups, including patients with MCI or early ADRD ( 9 ). Approval from the Institutional Review Board at the Veterans Affairs (VA) Bedford Healthcare System (approval number 110818) was received.…”

“…Recruitment was completed at the VA Bedford and inclusion criteria for the specific population of interest in this brief report included patients: (1) who were ages 50 and older with a diagnosis of MCI or early ADRD in their medical chart and living in the community (not a nursing home or assisted living facility); (2) who were routinely left home alone for periods of at least 4 h; and (3) who had no indication of incompetence in their medical record ( 9 ). Potential participants were identified as having either MCI or ADRD based on the terminology used in the most recent physician note of neurological function in their medical record from either the dementia clinic or outpatient primary care clinics at the Bedford VA.…”

“…Participants were compensated $50 for participating in the interview and an additional $30 stipend if they traveled to attend the interview in person. Additional details of the recruitment process, the mobile telepresence robot, the data collection process, and participant demographics are described in our previous study ( 9 ).…”

“…For this brief report, we conducted a content analysis using the reports that had been generated from the coding of the qualitative interview data in our previous study, which further describes our process ( 9 ). In this analysis, we focus on two specific areas of interest: participants’ perceptions of technology to (1) help with day-to-day functioning and (2) help people with memory problems or dementia stay home alone safely.…”