Ambient Assisted Living (AAL) For Dementia Patients And Their Caregivers: Effects On Care Coordination and Monitoring Sleep/Wake Rhythm
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Abstract
Background: The number of people with dementia in the Netherlands is quickly growing. More people with dementia come into the Dutch nursing homes, but less people start working in these nursing homes. The people with dementia in a nursing home have a disturbed sleep/wake rhythm. This can cause very sleepy patients or very nervous patients during day and night.
Objectives: To identify the potential for ambient assisted living (AAL) technology for dementia patients and caregivers; in particularly technology for monitoring the sleep/wake rhythm of dementia patients in a nursing home to make interventions for a better sleep/wake rythm and coordination of care possible. Due to these interventions and coordination improve care and realize work savings in the perception of caregivers and actual time savings
Methods: A study has been carried out with the IST Vivago Watch to monitor the sleep/wake rhythm in a nursing home for 7 dementia patients for a period of 6 months. The IST Vivago Watch is a wrist worn activity monitoring device, which measures temperature and has a movement sensor particularly sensitive to low intensity movements. Only at the start of the project caregivers filled in validated questionnaires (response rate from 30%) about their work satisfaction (these data hasn’t been used in the research because a re-organisation caused bias in the work satisfaction data), acceptance of the technology and some general questions about their education and date of birth. The activity data from the IST Vivago Watch has been analyzed; these data show the periods of sleep and being awake. Finally, based on these analyses several interviews with 5 caregivers and different stakeholders (director and projectleader) were hold, based on the chronic care model. This model says there are six fundamental areas identified that encourages high-quality chronic disease management. Because of the small size of the project most of the research done is qualitative.
Results: The results of this IST Vivago Watch project confirm the results from earlier research and also from other studies with the IST Vivago Watch. In these studies the Watch can be assumed to be comparable to actigraphy in sleep/wake studies and gives indication of the overall sleep quality. To our knowledge, our study is the first that evaluates the effects on the coordination of care with the Watch. The caregivers are satisfied with the usability of the Watch. The Watch made it possible to start interventions in quality of life (give the patient a bad just before going to bed), medication (changing time or dose of medication) and sleeptime (let someone sleep longer in the morning). Due to the Watch it became easier to coordinate care during the night and day (see who’s awake during the night and visit only these persons, wake up the patient when he had enough sleep etc.) The interventions and coordination of care results in better care (people sleep significant longer and better),work savings and actual time savings (no unnecessary walking, less visits to patients during the night).
Conclusion: The IST Vivago Watch make it possible to start interventions and coordinate care better during day and night. This makes it possible to create time savings for caregivers by the perception of caregivers, but also actual time savings due to less unnecessary visits to patients. The Watch also makes better care possible for the patients due to improvements in the sleep/wake rhythm of patients. Further research with the Watch will focus on more quantitative efficiency results with more respondents wearing the Watch. This PhD research in general will focus on effects of technology (registration and social contact technology) for people with dementia and their caregivers as to their quality of life, feeling of safety, work satisfaction and work savings in actual time, money and staff respectively.
Objectives: To identify the potential for ambient assisted living (AAL) technology for dementia patients and caregivers; in particularly technology for monitoring the sleep/wake rhythm of dementia patients in a nursing home to make interventions for a better sleep/wake rythm and coordination of care possible. Due to these interventions and coordination improve care and realize work savings in the perception of caregivers and actual time savings
Methods: A study has been carried out with the IST Vivago Watch to monitor the sleep/wake rhythm in a nursing home for 7 dementia patients for a period of 6 months. The IST Vivago Watch is a wrist worn activity monitoring device, which measures temperature and has a movement sensor particularly sensitive to low intensity movements. Only at the start of the project caregivers filled in validated questionnaires (response rate from 30%) about their work satisfaction (these data hasn’t been used in the research because a re-organisation caused bias in the work satisfaction data), acceptance of the technology and some general questions about their education and date of birth. The activity data from the IST Vivago Watch has been analyzed; these data show the periods of sleep and being awake. Finally, based on these analyses several interviews with 5 caregivers and different stakeholders (director and projectleader) were hold, based on the chronic care model. This model says there are six fundamental areas identified that encourages high-quality chronic disease management. Because of the small size of the project most of the research done is qualitative.
Results: The results of this IST Vivago Watch project confirm the results from earlier research and also from other studies with the IST Vivago Watch. In these studies the Watch can be assumed to be comparable to actigraphy in sleep/wake studies and gives indication of the overall sleep quality. To our knowledge, our study is the first that evaluates the effects on the coordination of care with the Watch. The caregivers are satisfied with the usability of the Watch. The Watch made it possible to start interventions in quality of life (give the patient a bad just before going to bed), medication (changing time or dose of medication) and sleeptime (let someone sleep longer in the morning). Due to the Watch it became easier to coordinate care during the night and day (see who’s awake during the night and visit only these persons, wake up the patient when he had enough sleep etc.) The interventions and coordination of care results in better care (people sleep significant longer and better),work savings and actual time savings (no unnecessary walking, less visits to patients during the night).
Conclusion: The IST Vivago Watch make it possible to start interventions and coordinate care better during day and night. This makes it possible to create time savings for caregivers by the perception of caregivers, but also actual time savings due to less unnecessary visits to patients. The Watch also makes better care possible for the patients due to improvements in the sleep/wake rhythm of patients. Further research with the Watch will focus on more quantitative efficiency results with more respondents wearing the Watch. This PhD research in general will focus on effects of technology (registration and social contact technology) for people with dementia and their caregivers as to their quality of life, feeling of safety, work satisfaction and work savings in actual time, money and staff respectively.
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