A Proactive Health Monitoring Intervention for Dementia Caregivers: The eNeighbor

描述（由申请人提供）：基于传感器的远程操作非侵入性技术可以帮助家庭护理人员监测阿尔茨海默病或相关痴呆（ADRD）患者的日常功能。例如，“邻居”技术平台包括一组远程传感器，这些传感器位于ADRD患者家中的关键区域（如床、药柜或冰箱门、厕所和客厅）。这种传感器可以立即将任何超出ADRD患者预期阈值的功能传达给家庭护理人员和护理专业人员（例如，护士护理经理）。邻里等远程健康监测技术的目标是防止诸如跌倒或流浪事件等负面健康转变，因此提供了比目前提供给ADRD患者的家庭护理人员的许多临床方案更主动的干预模式。路德家庭协会是一家位于明尼苏达州贝尔普莱恩的非营利性长期护理机构，在过去的5年里，它在明尼苏达州和威斯康星州的住宅和家庭环境中部署了邻居。这个为期5年的示范项目的目标是建立在路德家庭协会的工作基础上，进行一项嵌入式实验混合方法评估，以确定邻里技术在改善生活在社区的ADRD患者及其家庭照顾者的预后方面的功效。具体目标如下：1)在18个月的时间里，将100名随机分配到注意控制组的ADRD照顾者与100名使用邻居的ADRD照顾者进行比较，以确定遥感技术的使用是否会导致a)照顾者自我效能感和能力感的显著（p < 0.05）提高，b)照顾者痛苦（主观压力、抑郁症状）的显著降低，c)负面健康转变（跌倒、抑郁、抑郁）的显著延迟或减少。流浪事件)和对ADRD患者的服务利用（住宿护理安排、住院治疗）；d)更高的成本效益；2)通过“嵌入式”定性数据收集组件确定如何成功利用邻里，以及为什么这种健康监测技术有利于ADRD患者及其家庭照顾者；3)在这个为期5年的示范项目中，每季度让利益相关者参与，以提高照顾ADRD患者的家庭对健康监测技术的效用。我们预计，项目目标的成功完成将使邻里成为一个创新的、以利益相关者为中心的选择，为社区中ADRD患者的家庭照顾者提供强有力的支持。

DESCRIPTION (provided by applicant): Sensor-based technologies that operate remotely and are non-invasive could assist family caregivers monitor the daily function of persons with Alzheimer's disease or a related dementia (ADRD). For example, the eNeighbor technology platform includes a combination of remote sensors that are located in key areas of a person with ADRD's home (e.g., bed, medicine cabinet or refrigerator doors, toilet, and living rooms). Such sensors can immediately communicate any function that is outside of an expected threshold for the person with ADRD to both a family caregiver and a care professional (e.g., nurse care manager). The goal of remote health monitoring technology such as eNeighbor is to prevent negative health transitions such as falls or wandering events, and thus provides a more proactive intervention model than many clinical protocols that are currently delivered to family caregivers of persons with ADRD. The Lutheran Home Association, a non-profit long-term care provider located in Belle Plaine, Minnesota, has deployed eNeighbor in residential and home settings throughout Minnesota and Wisconsin over the past 5 years. The objective of this 5-year demonstration project is to build on the work of The Lutheran Home Association and conduct an embedded experimental mixed methods evaluation to determine the efficacy of the eNeighbor technology in improving outcomes among persons with ADRD living in the community and their family caregivers. The Specific Aims are as follows: 1) To compare 100 ADRD caregivers randomly assigned to an attention control with 100 ADRD caregivers who utilize eNeighbor over an 18-month period to determine if the use of the remote sensor technology results in a) significant (p < .05) increases in caregiver self-efficacy and sense of competence, b) significant decreases in caregiver distress (subjective stress, depressive symptoms), c) significant delays of or reductions in negative health transitions (falls, wandering events) and service utilization (residential care placement, hospitalizations) for persons with ADRD; and d) greater cost- effectiveness; 2) To determine through "embedded" qualitative data collection components how eNeighbor is successfully utilized and why this health monitoring technology benefits persons with ADRD and their family caregivers; and 3) To engage stakeholders on a quarterly basis throughout this 5-year demonstration project in order to enhance the utility of health monitoring technology for families who care for persons with ADRD. We anticipate that the successful completion of the project aims will position the eNeighbor as an innovative, stakeholder-centric option that offers robust support for family caregivers of persons with ADRD in their communities.