Care4AD: A Comprehensive Care Coordination and Management Platform for Alzheimer Disease and Related Dementias

照顾痴呆症患者需要持续有效地管理和协调照顾者和家庭成员之间的护理工作。一个强大的、技术驱动的护理管理和协调解决方案可以显著减轻护理负担，并提高阿尔茨海默病(AD)患者的生活质量。有人尝试使用技术来支持护理协调，但没有一个集成的系统来支持自我护理，帮助护理人员进行护理协调，并促进患者护理团队内的信息共享。为了回应这一需求，BioSensics与贝勒医学院合作，提议开发一个名为Care4AD™的综合护理平台。Care4AD平台将允许照顾者计划护理任务，监控体力活动和日常生活活动(ADL)，并通过视觉和语音提醒促进ADL的及时完成(例如，服药、定时如厕、补充水分和进餐，以及出席预定约会)。 Care4AD将由四项技术组成，这些技术协同工作，实现有效的护理协调。护理人员将使用Care4AD应用程序来协调护理、查看体力活动和ADL信息，以及安排提醒。Care4AD平板电脑在患者家中充当一个信息亭，显示预定的活动和提醒，它还支持音频提醒和语音识别。Care4AD标签是一系列无线传感器，将附着在家庭内的各种感兴趣对象上，以便于监控日常生活的工具活动。最后，Care4AD传感器是一种可穿戴传感器(基于BioSensics现有的商用技术)，可以监控身体活动和ADL，从标签收集数据，并将数据传输到Care4AD平板电脑，后者充当从传感器和标签收集的所有数据的数据网关。 BioSensics拥有成功完成这一项目的必要经验，该公司开发了一种名为PAMSys™的基于传感器的老年人远程监测平台并将其商业化。对于这个项目，我们已经进行了三项初步研究，使用PAMSys来监测认知障碍患者的体力活动。此外，BioSensics已经开发了Care4AD标签的原型，将在这个项目中进一步完善。在第一阶段，我们将开发Care4AD平台的原型，并进行利益相关者访谈，以评估Care4AD的可行性和可接受性，并收集将用于改进平台的反馈。在第二阶段，我们将完成Care4AD的开发，纳入第一阶段的反馈，并进行随机对照临床研究，以评估使用Care4AD平台是否减轻了护理负担和压力，增加了对预定ADL的依从性，并改善了患者的身体功能和生活质量。

Care for persons with dementia requires constant and effective management and coordination of delivery of care between caregivers and family members. A robust, technology-driven solution for care management and coordination could significantly reduce the burden of caregiving and improve quality of life for patients with Alzheimer’s disease (AD). A few attempts have been made to use technology to support care coordination, but there is no integrated system to support self-care, assist caregivers with care coordination, and facilitate information sharing within a patient's caregiving team. In response to this need, BioSensics, in collaboration with Baylor College of Medicine (BCM), proposes to develop a comprehensive care platform called Care4AD™. The Care4AD platform will allow caregivers to schedule caregiving tasks, monitor physical activity and activities of daily living (ADL), and facilitate timely completion of ADLs (e.g., taking medication, scheduled toileting, hydration and meals, and attendance at scheduled appointments) through visual and voice reminders. Care4AD will consist of four technologies that work in tandem to enable effective care coordination. The Care4AD app will be used by caregivers to coordinate care, view physical activity and ADL information, and schedule reminders. The Care4AD tablet serves as a kiosk in the patient’s home to show scheduled activities and reminders, and it also supports audio reminders and voice recognition. Care4AD tags are a series of wireless sensors that will be attached to various objects of interest within the home to facilitate the monitoring of instrumental activities of daily living. Finally, the Care4AD sensor is a wearable sensor (based on existing commercially available technology from BioSensics) that monitors physical activity and ADLs, collects data from the tags, and transfers data to the Care4AD tablet, which serves as a data gateway for all the data collected from the sensor and tags. BioSensics has the requisite experience to successfully complete this project having developed and commercialized a sensor-based remote monitoring platform for older adults called PAMSys™. For this project, we have conducted three preliminary studies using PAMSys to monitor physical activity in individuals with cognitive impairment. In addition, BioSensics has already developed a prototype of the Care4AD tag, which will be further refined in this project. In Phase I, we will develop a prototype of the Care4AD platform and carry out stakeholder interviews to assess the feasibility and acceptability of Care4AD and gather feedback that will be used to improve the platform. In Phase II, we will complete the development of Care4AD, incorporating feedback from Phase I, and carry out a randomized controlled clinical study to evaluate if using the Care4AD platform reduces the burden and stress of caregiving, increases adherence to scheduled ADLs, and improves physical function and quality of life of patients.