Sensor-based technologies that operate remotely and are non-invasive could assist family caregivers monitor the daily function of persons with Alzheimer's disease or a related dementia (ADRD). For example, the eNeighbor technology platform includes a combination of remote sensors that are located in key areas of a person with ADRD's home (e.g., bed, medicine cabinet or refrigerator doors, toilet, and living rooms). Such sensors can immediately communicate any function that is outside of an expected threshold for the person with ADRD to both a family caregiver and a care professional (e.g., nurse care manager). The goal of remote health monitoring technology such as eNeighbor is to prevent negative health transitions such as falls or wandering events, and thus provides a more proactive intervention model than many clinical protocols that are currently delivered to family caregivers of persons with ADRD. The Lutheran Home Association, a non-profit long-term care provider located in Belle Plaine, Minnesota, has deployed eNeighbor in residential and home settings throughout Minnesota and Wisconsin over the past 5 years. The objective of this 5-year demonstration project is to build on the work of The Lutheran Home Association and conduct an embedded experimental mixed methods evaluation to determine the efficacy of the eNeighbor technology in improving outcomes among persons with ADRD living in the community and their family caregivers.
The Specific Aims are as follows: 1) To compare 100 ADRD caregivers randomly assigned to an attention control with 100 ADRD caregivers who utilize eNeighbor over an 18-month period to determine if the use of the remote sensor technology results in a) significant (p <.05) increases in caregiver self-efficacy and sense of competence, b) significant decreases in caregiver distress (subjective stress, depressive symptoms), c) significant delays of or reductions in negative health transitions (falls, wandering events) and service utilization (residential care placement, hospitalizations) for persons with ADRD;and d) greater cost- effectiveness;2) To determine through "embedded" qualitative data collection components how eNeighbor is successfully utilized and why this health monitoring technology benefits persons with ADRD and their family caregivers;and 3) To engage stakeholders on a quarterly basis throughout this 5-year demonstration project in order to enhance the utility of health monitoring technology for families who care for persons with ADRD. We anticipate that the successful completion of the project aims will position the eNeighbor as an innovative, stakeholder-centric option that offers robust support for family caregivers of persons with ADRD in their communities.

Public Health Relevance

The Lutheran Home Association (TLHA), a non-profit long-term care provider located in Belle Plaine, Minnesota, has deployed remote health monitoring technology for older adults (eNeighbor) in residential and home settings across Minnesota and Wisconsin the past 5 years. The proposed demonstration project will build on TLHA's current work by evaluating eNeighbor for 200 persons with Alzheimer's disease or a related dementia (ADRD) and their family caregivers. We will utilize an embedded experimental mixed methods design to determine whether and how the eNeighbor technology improves ADRD caregivers'self-efficacy and sense of competence in managing the complicated nature of ADRD symptoms, reduces ADRD caregivers'distress, and delays or reduces negative health transitions and service use in persons with ADRD over an 18- month period. The proposed 5-year demonstration project will also engage and collaborate with a Community Advisory Board on a quarterly basis to ensure that the health monitoring technology is appropriately designed, delivered, evaluated, and disseminated for families caring for persons with ADRD. We anticipate that this innovative health monitoring intervention, which adopts a proactive approach to chronic disease care, will result in a cost-effective protocol that offers robust support for family caregivers of persons with ADRD in the community.

Agency
National Institute of Health (NIH)
Institute
Agency for Healthcare Research and Quality (AHRQ)
Type
Research Demonstration and Dissemination Projects (R18)
Project #
1R18HS022836-01
Application #
8664511
Study Section
Health Care Technology and Decision Science (HTDS)
Program Officer
Mullican, Charlotte
Project Start
2014-04-01
Project End
2019-03-31
Budget Start
2014-04-01
Budget End
2015-03-31
Support Year
1
Fiscal Year
2014
Total Cost
Indirect Cost
Name
University of Minnesota Twin Cities
Department
None
Type
Schools of Nursing
DUNS #
555917996
City
Minneapolis
State
MN
Country
United States
Zip Code
55455