Real World Implementation Lessons and Outcomes from the Worker Interactive Networking (WIN) Project: Workplace-Based Online Caregiver Support and Remote Monitoring of Elders at Home

Abstract

The objective of this research was to determine the feasibility of and receptivity to the first computerized workplace-based direct caregiver intervention and to assess the effects on businesses, working family caregivers, and their elderly relatives. Working family caregivers, with at least one health and/or safety concern related to an elder residing alone at home during the workday, were recruited from five companies (n = 27). Caregivers received free computer access to the Worker Interactive Networking (WIN) Internet online caregiver support group and a remote elder monitoring system at home for 6 months. The remote monitoring system provided Web-based status reports and e-mail/pager alerts when individualized parameters were exceeded. Motion sensor signals were transmitted to a transponder that uploaded via wireless cellular communications to the project server, thereby not interfering with elders' telephone use. Formative qualitative analyses clarified acceptance and implementation issues. Summative quantitative evaluation determined pilot intervention effects and was conducted by external evaluators. Despite interoperability and cellular reception issues, the system was successfully deployed across four states to a variety of businesses and housing types. Positive results occurred on worker morale, productivity, and reduction of caregiver stress. Participants found it easy to learn and use. Elders did not find the technology "intrusive" or "isolating." Contrary to their expectations, managers reported no abuse of Internet access. Workers expressed a willingness to pay for a similar system in the future ranging from $10 to $130, depending on the features. They would pay the most for the option involving a geriatric nurse coach. The WIN system innovatively tailored to users' wants, and provided users customized control and personalized support. Use of the system was associated with positive outcomes. Enrollment response suggests a specific niche market for remote home monitoring, making it a manageable employee benefit.

Expanding the Walls of the Health Care Encounter: Support and Outcomes for Patients Online

“…Research has found that the implementation of an automated telephone follow-up system with diabetes patients and nurse practitioners improved outcomes with fewer symptoms of depression, fewer days in bed because of illness, and greater satisfaction with health care (Piette, 2000). Remote monitoring systems coupled with online support opportunities have been found to reduce caregiver stress (Mahoney et al, 2008), improve health care (McMahon et al, 2005), and provide a more economic approach to patient assessment and monitoring of rural patients (Santamore et al, 2008). As wireless technology continues to advance, the possibilities for remote monitoring to provide medical information to the health care practitioner at the right time and place grows as well (Yu et al, 2008).…”

Effectiveness of Web-Based Psychosocial Interventions for Family Caregivers of Older People: What Do We Know?

“…Few studies on psychoeducational programs for caregivers of older people with dementia have come instead with mixed or inconclusive results [18][19][20][21][22]. In two cases, STAR in the EU and AlzOnline in the US, the outcome improvements were quite weak, concerning only better empathy feeling between caregivers and intervention staff [18] and selfefficacy [19].…”

Participation of Older Adults in Virtual Volunteering: A Qualitative Analysis

“…The dichotomy between the real face-to-face world and the virtual world of the Internet was so apparent in early literature that it almost appeared to be an either-or phenomenon (Matei and BallRokeach 2001;Reid 1995;Shields 2003). Recent empirical evidence and theories on virtual communication over the years have established that Internet stimulates social faculties similar to face-to-face communication and works as supplemental to face-to-face communication (Castells 2009;Mahoney et al 2008;Putnam and Feldstein 2003). Existing research suggest that civic participation of older adults positively influences their health and wellbeing (Moody 2010).…”