Effects of Assistive Home Technology on quality of life and falls of people with dementia and job satisfaction of caregivers: Results from a pilot randomized controlled trial

Abstract

Objectives: Determine the effects of the implementation of Assistive Home Technology (AHT) in group homes on the quality of life (QoL) of people with dementia and on job satisfaction of caregivers. Method: Pilot randomized controlled trial in nine in-patient care group homes (group homes with vs. without AHT). Participants were 54 people with dementia and 25 professionals. Outcome measurements were QoL, fall incidents, needs, use of restraints, job satisfaction, workload, and general health. Results: Living in a group home with AHT had a positive effect on four QoL domains: 'social isolation', 'having things to do', 'esthetics', and 'quality of life appreciation'. No effects were found on 12 other QoL domains. Fall incidents during bathroom visits were significantly reduced by the application of AHT. During this implementation phase, in the AHT group home, a moderate negative effect was found on caregiver's appreciation of work circumstances. No effects on other outcome measures were found. Conclusion: Positive effects were found on aspects of QoL and fall incidents in the bathroom. The lower caregiver appreciation of work circumstances in the AHT group confirms the importance of intensive support and guidance of personnel during the implementation of AHT.

The Effectiveness of Assistive Technologies for Older Adults and the Influence of Frailty: Systematic Literature Review of Randomized Controlled Trials

“…Having a mean age ≥65 years as an inclusion criterion for our search, there were still large differences in the inclusion criteria at the study level: ≥18 years in three studies [ 13 , 14 , 24 ], 45-90 years in one study [ 17 ], 55-79 years in one study [ 49 ], ≥60 years in one study [ 11 ], and ≥65 years in six studies [ 7 , 23 , 50 - 53 ]. The other seven trials did not have age as an inclusion criterion but targeted conditions present specifically in older adults, such as cardiovascular conditions, dementia, or being a senior housing resident [ 6 , 8 , 12 , 22 , 27 , 48 , 54 ]. Table 1 provides the mean (SD) age for each study stratified by intervention and control group.…”

“…The 19 selected trials evaluated devices representing the following six domains: (1) mobility (n=5 [ 6 , 7 , 14 , 52 , 53 ]), (2) personal disease management (n=5 [ 13 , 22 , 48 , 51 , 54 ]), (3) medication (n=4 [ 12 , 17 , 27 , 50 ]), (4) mental support (n=2 [ 8 , 11 ]), (5) hearing (n=2 [ 23 , 49 ]), and (6) vision (n=1 [ 24 ]). All devices addressed at least one of the areas of autonomy, safety, or communication.…”

“…Significant effectiveness was only reported in a pilot study for a nightlight path, which reduced falls among older people classified as slightly impaired/prefrail who had mild and moderate Alzheimer disease (odds ratio 0.73, 95% CI 0.15-0.88) [ 7 ]. Home automatization for people with dementia living in group homes [ 6 ], a mobile safety alarm with a drop sensor for community-dwelling older persons [ 52 ], and a gait-speed monitoring and feedback device for older people at risk for falling [ 53 ] were not effective. In a crossover study on the use of a metronome to improve QoL in individuals classified as slightly impaired/prefrail who were suffering from Parkinson disease, no evidence of effectiveness could be shown.…”

“…Nevertheless, unblinded studies are considered to have a higher RoB. In six studies, outcome assessors were not blinded, although it would have been possible [ 6 , 7 , 12 , 17 , 22 , 48 , 54 ]. These studies were thus judged to have a high RoB.…”

“…The two trials with two publications each reported the largest diversity of measures with five (QoL, functionality, mental status, health impact, caregivers) [ 23 , 55 ] and four (QoL, efficacy, usability, economic) [ 24 , 56 ] outcome categories covered, respectively. The highest overall number of primary outcomes was collected by two studies with eight measures, respectively [ 6 , 22 ].…”