Ehealth for people with dementia in home-based and residential care

In 2010 an estimated 35.6 million people worldwide were living with dementia, with projections suggesting that this figure will rise to 115.4 million by 2050. A decreasing number of people will be working in the field of healthcare. A change in the field of dementia care is necessary to provide high quality of care for this target group. eHealth could be supportive in this change. This dissertation gives insight and advice into the development and implementation of eHealth in dementia care. The first chapter is a literature research for studies which relate to the field of implementation and evaluation from the use of eHealth in dementia care. After this four case studies are described where the use of eHealth for people with dementia have been evaluated. The used eHealth technologies can be divided into social contact technology and monitoring technology. The monitoring technology used in a situation at the patient’s own home was a preventive sensor technology system. The other monitoring technology in residential care was a watch which measured the sleep/wake pattern. The social contact technology at the patient’s own home was a supportive touchscreen and in residential care a interactive game was used to stimulate social contact between the people with dementia. The first results of the use of eHealth for people with dementia in home-based and residential care are positive; support in the well being of people with dementia and their family caregivers and improvements in the care giving tasks of professional caregivers. Next to these results cost savings could be realized by letting people stay home for a longer period of time.

[1]  A Ralph Henderson,et al.  The bootstrap: a technique for data-driven statistics. Using computer-intensive analyses to explore experimental data. , 2005, Clinica chimica acta; international journal of clinical chemistry.

[2]  S. Czaja,et al.  The value of telephone support groups among ethnically diverse caregivers of persons with dementia. , 2006, The Gerontologist.

[3]  Thad A Polk,et al.  Methodologic and design issues in patient-centered e-health research. , 2010, American journal of preventive medicine.

[4]  Anastasia Papazafeiropoulou,et al.  An evaluation framework for Health Information Systems: human, organization and technology-fit factors (HOT-fit) , 2008, Int. J. Medical Informatics.

[5]  J. Kinney,et al.  Observed well-being among individuals with dementia: Memories in the Making©, an art program, versus other structured activity , 2005, American journal of Alzheimer's disease and other dementias.

[6]  Bryan R. Cole,et al.  Stability of response characteristics of a Delphi panel: application of bootstrap data expansion , 2005, BMC medical research methodology.

[7]  Chris D. Nugent,et al.  COGKNOW: Development of an ICT Device to Support People with Dementia , 2007 .

[8]  M. Carlsson,et al.  Staff perceptions of job satisfaction and life situation before and 6 and 12 months after increased information technology support in dementia care. , 2005, Journal of telemedicine and telecare.

[9]  Van Someren EJ Circadian and sleep disturbances in the elderly. , 2000, Experimental gerontology.

[10]  Josée Hansen,et al.  Medical devices: managing the mismatch : an outcome of the priority medical devices project , 2010 .

[11]  Rose-Marie Dröes,et al.  What do community-dwelling people with dementia need? A survey of those who are known to care and welfare services , 2009, International Psychogeriatrics.

[12]  Norman Alm,et al.  A cognitive prosthesis and communication support for people with dementia , 2004 .

[13]  E. Begley,et al.  "It gives me a sense of independence" Findings from Ireland on the use and usefulness of assistive technology for people with dementia , 2007 .

[14]  Petrina Duff,et al.  Cost-benefit analysis of assistive technology to support independence for people with dementia – Part 2: Results from employing the ENABLE cost-benefit model in practice , 2007 .

[15]  Trisha Greenhalgh,et al.  A systematic review of the literature on diffusion, dissemination and sustainability of innovations in health service delivery and organisation , 2003 .

[16]  A. Schreiner,et al.  Positive affect among nursing home residents with Alzheimer's dementia: The effect of recreational activity , 2005, Aging & mental health.

[17]  P. Topo Technology Studies to Meet the Needs of People With Dementia and Their Caregivers , 2009 .

[18]  P. Ingrand,et al.  Reasons of informal caregivers for institutionalising dementia patients previously living at home: the Pixel study , 2004, International journal of geriatric psychiatry.

[19]  Stuti Dang,et al.  Care coordination assisted by technology for multiethnic caregivers of persons with dementia: a pilot clinical demonstration project on caregiver burden and depression , 2008, Journal of telemedicine and telecare.

[20]  Brian L. Ott,et al.  Gender Differences in the Behavioral Manifestations of Alzheimer's Disease , 1996, Journal of the American Geriatrics Society.

[21]  F. Kianifard,et al.  A nonparametric procedure associated with a clinically meaningful efficacy measure. , 2000, Biostatistics.

[22]  Eugene S. Edgington,et al.  Randomization Tests , 2011, International Encyclopedia of Statistical Science.

[23]  T. Gorlia,et al.  Cost-effectiveness of the addition of early hormonal therapy in locally advanced prostate cancer: results decisively determined by the cut-off time-point chosen for the analysis. , 2001, European journal of cancer.

[24]  L. Morris,et al.  Molecular investigation of two possible cases of accidental HIV-1 transmission in South Africa. , 2003, AIDS research and human retroviruses.

[25]  Andrew Sixsmith,et al.  New technologies to support independent living and quality of life for people with dementia. , 2006 .

[26]  Pieter Jan Stappers,et al.  Designing Leisure Products for People With Dementia: Developing ‘‘the Chitchatters’’ Game , 2010, American journal of Alzheimer's disease and other dementias.

[27]  Robert Mittman,et al.  Diffusion of Innovation in Health Care , 2002 .

[28]  Thant Zin Myint,et al.  An exploratory study on senior citizens' perceptions of the Nintendo Wii: the case of Singapore , 2009, i-CREATe.

[29]  H. Brodaty,et al.  ALZHEIMER'S DISEASE INTERNATIONAL , 1997, International journal of geriatric psychiatry.

[30]  H. Kamphuisen,et al.  Sleep and ageing: the effect of institutionalization on subjective and objective characteristics of sleep. , 1994, Age and ageing.

[31]  Andrew F. Monk,et al.  Technological opportunities for supporting people with dementia who are living at home , 2008, Int. J. Hum. Comput. Stud..

[32]  A. Sheikh,et al.  Evaluating eHealth Interventions: The Need for Continuous Systemic Evaluation , 2009, PLoS medicine.

[33]  M. Orrell,et al.  Camberwell Assessment of Need for the Elderly (CANE) , 2000, British Journal of Psychiatry.

[34]  X. Badia,et al.  Iatrogenic Cost Factors Incorporating Mild and Moderate Adverse Events in the Economic Comparison of Aceclofenac and Other NSAIDs , 2012, PharmacoEconomics.

[35]  Elizabeth Murray,et al.  Understanding the implementation and integration of e-health services , 2007 .

[36]  D. O'Connor,et al.  For Better or for Worse: The Experience of Caring for an Elderly Dementing Spouse , 1991, Ageing and Society.

[37]  Inger Hagen,et al.  Technology in dementia care , 2007 .

[38]  Roger Orpwood,et al.  The design of smart homes for people with dementia—user-interface aspects , 2005, Universal Access in the Information Society.

[39]  S. Folstein,et al.  "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. , 1975, Journal of psychiatric research.

[40]  Tom H. F. Broens,et al.  Determinants of successful telemedicine implementations: a literature study , 2007, Journal of telemedicine and telecare.

[41]  A. King,et al.  Sleep Problems as a Risk Factor for Falls in a Sample of Community‐Dwelling Adults Aged 64–99 years , 2000, Journal of the American Geriatrics Society.

[42]  Jennifer M. Kinney,et al.  Challenges in caregiving and creative solutions: Using technology to facilitate caring for a relative with dementia , 2003 .

[43]  C. Nugent,et al.  Review of ICT-based services for identified unmet needs in people with dementia , 2007, Ageing Research Reviews.

[44]  A. J. Astell,et al.  Facilitating communication in dementia with multimedia technology , 2004, Brain and Language.

[45]  Claire Bamford,et al.  Defining the outcomes of community care: the perspectives of older people with dementia and their carers , 2000, Ageing and Society.

[46]  J. Forlizzi,et al.  Intelligent assistive technology applications to dementia care: current capabilities, limitations, and future challenges. , 2009, The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry.

[47]  S. Scalvini,et al.  Socio-technical and organizational challenges to wider e-Health implementation , 2009, Chronic respiratory disease.

[48]  Alf Westelius,et al.  Gaps Between Intended and Actual Use - Turning Problems into Opportunities in Health Informatics , 2006 .

[49]  R. Lévy,et al.  Psychiatric Phenomena in Alzheimer's Disease. IV: Disorders of Behaviour , 1990, British Journal of Psychiatry.

[50]  Tapio Kirsi,et al.  Always One Step Behind: Husbands’ Narratives about Taking Care of their Demented Wives , 2004, Health.

[51]  Vimla L. Patel,et al.  Cognitive and usability engineering methods for the evaluation of clinical information systems , 2004, J. Biomed. Informatics.

[52]  Norman Alm,et al.  Using a touch screen computer to support relationships between people with dementia and caregivers , 2010, Interact. Comput..

[53]  A. Burns,et al.  Psychiatric Phenomena in Alzheimer's Disease. III: Disorders of Mood , 1990, British Journal of Psychiatry.

[54]  Anthea Tinker,et al.  Housing for elderly people , 1997 .

[55]  Jakob Nielsen,et al.  Usability engineering , 1997, The Computer Science and Engineering Handbook.

[56]  Claudia Pagliari,et al.  Design and Evaluation in eHealth: Challenges and Implications for an Interdisciplinary Field , 2007, Journal of medical Internet research.

[57]  P. Tugwell,et al.  Economic Comparison of Leflunomide and Methotrexate in Patients with Rheumatoid Arthritis , 2002, PharmacoEconomics.

[58]  S. Koger,et al.  Is Music Therapy an Effective Intervention for Dementia?A Meta-Analytic Review of Literature. , 1999, Journal of music therapy.

[59]  N. Nijhof,et al.  Dementie en technologie. Een studie naar de toepassingen van techniek in de zorg voor mensen met dementie en hun mantelzorgers , 2009 .

[60]  Richard Schulz,et al.  E-care: a telecommunications technology intervention for family caregivers of dementia patients. , 2007, The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry.

[61]  A. Burns,et al.  Psychiatric Phenomena in Alzheimer's Disease. II: Disorders of Perception , 1990, British Journal of Psychiatry.

[62]  Melissa Lunsman,et al.  Continuity in the Midst of Change: Behaviors of Residents Relocated from a Nursing Home Environment to Small Households , 2010, American journal of Alzheimer's disease and other dementias.

[63]  Roger Watson,et al.  Working with Family Carers of People with Dementia , 2002 .

[64]  Suzanne Bakken,et al.  Applying an Evaluation Framework for Health Information System Design, Development, and Implementation , 2006, Nursing research.

[65]  D J Foley,et al.  Sleep complaints among elderly persons: an epidemiologic study of three communities. , 1995, Sleep.

[66]  W. Carswell,et al.  A review of the role of assistive technology for people with dementia in the hours of darkness. , 2009, Technology and health care : official journal of the European Society for Engineering and Medicine.

[67]  David H Gustafson,et al.  E-health research and patient-centered care examining theory, methods, and application. , 2010, American journal of preventive medicine.

[68]  P. Good,et al.  Permutation Tests: A Practical Guide to Resampling Methods for Testing Hypotheses , 1995 .

[69]  A. Burns,et al.  Psychiatric Phenomena in Alzheimer's Disease. I: Disorders of Thought Content , 1990, British Journal of Psychiatry.

[70]  Andrew Sixsmith,et al.  Ageing in Place in the United Kingdom , 2008 .