Engaging older adults with cognitive impairment in planning for technology use in their care: the Identifying Needs for Optimal Remote Monitoring tool (INFORM)

项目摘要 使用互联网连接的设备来预测健康问题，并通过被动地 监测老年人的增长速度快于我们对如何帮助家庭做出决定的理解， 如何以及何时使用它们。这些技术的监视性质可能会导致冲突，并危及价值观， 对认知障碍的人来说很重要，比如自主、隐私、控制和自由。的 本研究的目标是开发和测试沟通的可行性和初步有效性 和教育工具，用于被动远程监测老年人早期阿尔茨海默病， AD相关痴呆（AD/ADRD）及其护理人员。这项工作意义重大，因为它将推动 科学地理解如何让认知障碍者参与决策，同时帮助家庭 来驾驭复杂的技术领域。候选人已成功地进行了试点工作， 创新的方法，与体弱的老年人沟通这些技术的基本功能， 实现理解，以便他们能够参与有关他们的决定。拟议项目将以此为基础 有前途的沟通研究，以开发一种工具，引导病人和他们的照顾者通过一个 讨论哪些技术是可以接受的，以及在什么条件下应该使用这些技术。的 确定最佳远程监护工具的需求将在预先护理计划后建模，并将 以记录的偏好结束。为工具、技术和老化专家提供最佳输入 来自学术界和工业界的专家将确定最合适的技术特征和选项， 工具使用德尔菲方法（目标1）。对这些技术的普遍以患者为中心的偏好将 通过对有和没有诊断为轻度认知障碍的老年人的调查来确定（目标2）。 该工具将整合这些调查结果，并将在混合方法可行性研究中进行测试， 分阶段进行AD/ADRD护理配对，以评估初步有效性， 患者偏好、随着AD/ADRD进展做出决策的准备以及其他关键的积极因素 （目标3）。这项研究是响应国家信息评估的优先领域，即改善沟通， 为护理人员和AD/ADRD患者提供教育、决策、规划和减压， 推进技术，以减少不必要的护理过渡，并实现就地养老。候选人是一名 华盛顿大学社会工作助理教授，其长期职业目标是 提高AD/ADRD老年人在家中安全生活的自主能力。K01 将使她能够建立一个跨学科的研究计划，重点是改善健康结果， 通过促进有认知障碍的老年人有效使用技术， 损伤拟议的研究通过确保我们以某种方式整合技术来推进这项工作， 尊重老年人的价值观和尊严，从而实现他们延长独立的好处。

Project Summary The use of Internet-connected devices to predict health problems and support aging in place by passively monitoring older adults is growing faster than our understanding of how to help families make decisions about how and when to use them. These technologies’ surveilling nature can cause conflict and endanger values that are important to people with cognitive impairment, such as autonomy, privacy, control, and freedom. The objectives of this study are to develop and test the feasibility and preliminary effectiveness of a communication and education tool for passive remote monitoring use with older adults at early stage Alzheimer's disease and AD-related dementias (AD/ADRD) and their caregivers. This work is significant because it will advance scientific understanding of how to engage people with cognitive impairment in decisions while helping families to navigate the complex technology landscape. The candidate has conducted successful pilot work using an innovative method for communicating the basic functions of these technologies with frail, older adults to achieve comprehension so they can participate in decisions about them. The proposed project will build on this promising communication research to develop a tool to guide patients and their caregivers through a discussion about what technologies are acceptable and under what conditions they should be used. The Identifying Needs For Optimal Remote Monitoring tool will be modeled after advance care planning and will conclude with documented preferences. To generate the best input for the tool, technology and aging experts from academia and industry will identify the most suitable technology features and options to be included in the tool using the Delphi approach (Aim 1). Prevalent patient-centered preferences for these technologies will then be identified through surveys with older adults with and without diagnosed mild cognitive impairment (Aim 2). The tool will integrate these findings and it will be tested in a mixed methods feasibility study with 30 early stage AD/ADRD care dyads to assess preliminary effectiveness for ensuring comprehension, identification of patient preferences, preparation to make decisions as AD/ADRD progresses, and other key positive dyad outcomes (Aim 3). This research is responsive to the priority areas of NIA of improving communication, education, decision-making, planning, and stress reduction for caregivers and people with AD/ADRD and advancing technologies to reduce unnecessary care transitions and enable aging in place. The candidate is an Assistant Professor of Social Work at the University of Washington whose long-term career objective is to improve the ability of older adults with AD/ADRD to remain living at home safely with autonomy. The K01 would enable her to establish an interdisciplinary research program focused on improving health outcomes for older adults and caregivers by promoting the effective use of technologies for older adults with cognitive impairment. The proposed study advances this work by ensuring that we are integrating technologies in ways that respect older adults’ values and dignity so their benefits of prolonging independence are realized.