A Proactive Health Monitoring Intervention for Dementia Caregivers: The eNeighbor

描述(申请人提供)：基于传感器的远程操作和非侵入性技术可以帮助家庭照顾者监测阿尔茨海默病或相关痴呆症(ADRD)患者的日常功能。例如，eNeighbor技术平台包括位于ADRD家中关键区域(如床、药柜或冰箱门、卫生间和起居室)的远程传感器组合。这种传感器可以立即将ADRD患者预期阈值之外的任何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)。ENeighbor等远程健康监测技术的目标是防止跌倒或走动等负面健康转变，因此提供了一种比目前提供给ADRD患者家庭照顾者的许多临床方案更主动的干预模式。路德之家协会是一家位于明尼苏达州贝勒平原的非营利性长期护理提供者，在过去5年里，该协会在明尼苏达州和威斯康星州的住宅和家庭环境中部署了eNeighbor。这一为期5年的示范项目的目标是在路德之家协会工作的基础上，进行嵌入式实验性混合方法评估，以确定eNeighbor技术在改善居住在社区的ADRD患者及其家庭照顾者中的效果。具体目标如下：1)将100名随机分配到注意力控制组的ADRD照顾者与100名使用eNeighbor的ADRD照顾者进行18个月的比较，以确定远程传感器技术的使用是否导致a)照顾者自我效能和能力感显著增加(p&lt；.05)，b)照顾者痛苦(主观压力，抑郁症状)显著减少，c)对ADRD患者的负面健康过渡(跌倒、游荡事件)和服务利用(住院护理安置、住院)显著延迟或减少；以及d)更具成本效益；2)通过“嵌入式”定性数据收集部分，确定eNeighbor是如何被成功利用的，以及为什么这种健康监测技术使ADRD患者及其家庭照顾者受益；以及3)在这一为期5年的示范项目中，每季度与利益攸关方接触，以便为照顾ADRD患者的家庭提高健康监测技术的效用。我们预计，项目AIMS的成功完成将使eNeighbor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.