By Christina Orlovsky Page, contributor
November 17, 2012 - People living with Alzheimer’s disease and its related dementia--and the loved ones who care for them--often find daily life challenging and, at times, even frightening. To help ease some of the challenges that arise from Alzheimer’s-associated behavioral changes, a variety of technologies are being tested and put in place in patients’ homes, health care facilities and research institutions.
In Kansas City, Kan., one pilot program conducted by the University of Kansas Alzheimer’s Disease Center has placed in-home monitoring systems in homes to help caregivers learn from difficult experiences with their family member. The system consists of a laptop computer and camera with a remote control that activates a recording session, which includes five minutes prior to the episode being recorded. This allows family members to capture difficult situations, which are then shared with a team of dementia care professionals--a nurse practitioner, medical assistant, support group leader, social worker, home care nurse and nurse educator--to analyze and assess triggers and environmental factors that contributed to the episode.
“The study came out of learning about this technology developed for children with autism who were having behavior issues,” explained Kristine Williams, PhD, RN, an associate professor at the University of Kansas School of Nursing and member of the study team.
“The monitoring system had been helpful to parents and teachers in learning better ways to interact with these children, and we thought it had clear applications for people with dementia who sometimes have behavior issues and can become aggressive or withdrawn,” she continued. “Caregivers of people with Alzheimer’s and its related dementia can be isolated, and as the patient changes it can be difficult to get them to cooperate or take their medications. This technology provides a way for the caregiver to capture video recordings of what goes on in the home; that contextual information enables us to see what led up to that situation and provide suggestions about environmental factors or ways of communication that might be altered to prevent problems or communication breakdowns.”
Williams provided an example of a caregiver husband who was having trouble getting his wife, who had severe dementia, to wash her face in the morning. Through the recordings, the dementia care team was able to determine that, while the husband was showing her to wash by splashing water on her face, what the wife really wanted was a washcloth. They provided the family with pre-soaped cloths and the morning routine rapidly improved.
“Without seeing what was going on, it would have been hard to get the full picture,” Williams said. “The thing is that the caregivers are really personally involved in the situation, so it’s hard for them to have the objective view of things that our group has.”
While the pilot program only has the capacity to test a small group of participants in the Kansas City area, Williams believes that the anecdotal success of the study can lead to much greater use in the future.
“It has a lot of potential to link caregivers who are isolated--especially those in rural areas where services are even more limited--to providers to get feedback on improving care and dealing with difficult situations,” she said. “It’s still going to take a lot more work, but I can see down the road that this can have pretty widespread usage.”
In addition to in-home monitoring, a number of other technologies are being implemented in the fight against Alzheimer’s. GPS tracking devices are being placed in the shoes of people who have a tendency to wander. The Aetrex Navistar GPS Footwear System features GPS technology embedded in the base of the heel of specially designed men’s and women’s walking shoes. The device sends real-time tracking information to a central monitoring system to allow caregivers to determine the wearer’s exact location. A geographic boundary, called a geozone, can be set up by family members, who will then receive email or text messages when their loved one has wandered beyond that zone.
Finally, researchers are using technology to try to get to the bottom of what causes Alzheimer’s in the first place. In a study based at King’s College London, researchers are using a data mining process, creating a computer code with text and linguistic patterns, to mine research and identify 25 potential blood biomarkers for Alzheimer’s disease.
Whether it’s in-home monitoring, real-time tracking, or behind-the-scenes informatics, Williams is certain that technology will continue to be used to help prevent and treat Alzheimer’s disease.
“There’s a lot developing on the horizon,” she concluded. “We are really being challenged to think outside the box in how to use technology in our efforts in caring for those with this disease.”
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