“It’s Like a Cyber-Security Blanket”: The Utility of Remote Activity Monitoring in Family Dementia Care

Abstract

Technologies have emerged that aim to help older persons with Alzheimer's disease and related dementias (ADRDs) remain at home while also supporting their caregiving family members. However, the usefulness of these innovations, particularly in home-based care contexts, remains underexplored. The current study evaluated the acceptability and utility of an in-home remote activity monitoring (RAM) system for 30 family caregivers of persons with ADRD via quantitative survey data collected over a 6-month period and qualitative survey and interview data collected for up to 18 months. A parallel convergent mixed methods design was employed. The integrated qualitative and quantitative data suggested that RAM technology offered ongoing monitoring and provided caregivers with a sense of security. Considerable customization was needed so that RAM was most appropriate for persons with ADRD. The findings have important clinical implications when considering how RAM can supplement, or potentially substitute for, ADRD family care.

Six-Month Effectiveness of Remote Activity Monitoring for Persons Living With Dementia and Their Family Caregivers: An Experimental Mixed Methods Study

“…In some ways this reflects how families would likely use RAM in "real-world" situations, particularly as RAM technologies that are simple to install and operate become more widely available in retail stores (Moylan, 2017). As both the quantitative and qualitative findings of this study imply, the initial months spent calibrating and modifying the system to meet the particular needs of persons living with ADRD and their family caregivers are potentially challenging if families are solely responsible for responding to alerts and activity pattern data (see also Mitchell et al, 2018). The mixed methods findings also imply that RAM technologies may be best suited for persons living with ADRD in the less severe stages of the disease.…”

“…Comfort with technology, which was identified as an important caregiver characteristic in qualitative analysis, was not assessed quantitatively and could not be examined in the post-hoc analyses. For additional limitations, see Mitchell et al, (2018).…”

“…The information provided by RAM may contribute to more accurate information on daily activities, improved communication, early identification of problems, and facilitation of caregiving (Nauha, Keranen, Kangas, Jamsa, & Reponen, 2016;Nijhof, van Gemert-Pijnen, Woolrych, & Sixsmith, 2013;Wild, Mattek, Austin, & Kaye, 2016;Williams, Arthur, Niedens, Moushey, & Hutfles, 2013). There are several barriers to implementing and utilizing RAM, including cumbersome devices (Matthews et al, 2015), a lack of user-friendly interfaces (Nauha et al, 2016;Preusse, Mitzner, Fausset, & Rogers, 2017), frequent false alarms (Mitchell et al, 2018;Nauha et al, 2016;Nijhof et al, 2013), and unanticipated technological difficulties (Mitchell et al, 2018;Nauha et al, 2016;Williams et al, 2013). Beyond technical problems, the trade-off between privacy and usefulness of monitoring is an important ethical issue (Mitchell et al, 2018;Mulvenna et al, 2017;Wild, Boise, Lundell, & Foucek, 2008;Williams et al, 2013).…”

“…There are several barriers to implementing and utilizing RAM, including cumbersome devices (Matthews et al, 2015), a lack of user-friendly interfaces (Nauha et al, 2016;Preusse, Mitzner, Fausset, & Rogers, 2017), frequent false alarms (Mitchell et al, 2018;Nauha et al, 2016;Nijhof et al, 2013), and unanticipated technological difficulties (Mitchell et al, 2018;Nauha et al, 2016;Williams et al, 2013). Beyond technical problems, the trade-off between privacy and usefulness of monitoring is an important ethical issue (Mitchell et al, 2018;Mulvenna et al, 2017;Wild, Boise, Lundell, & Foucek, 2008;Williams et al, 2013). Nonetheless, many older adults are interested in the potential of monitoring technologies to improve and maintain their health status and independence (Chaudhuri et al, 2017;Preusse et al, 2017;Shreve, Baier, Epstein-Lubow, & Gardner, 2016;Wild et al, 2008).…”

“…The RAM Review Checklist was administered to ADRD caregivers in the treatment condition at the 6-month follow-up survey interval. The checklist consists of 22 Likert scale items and 8 open-ended questions that measure/ explore acceptability, feasibility, and perceived utility of RAM (for details, see Mitchell et al, 2018). Only the openended questions were analyzed for themes.…”