Novel multi-sensing seat cover system for prevention of sitting-related pressure injuries in individuals with Alzheimer's disease or related dementias

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ABSTRACT The long-term objective of this project is to create a sensor-based monitoring technology for use by caregivers, clinicians, and individuals living with Alzheimer’s disease or Alzheimer’s disease related dementia (AD/ADRD) to mitigate the risk of pressure injuries related to prolonged sitting. Pressure injury prevalence is disproportionately high in the aging AD/ADRD population due to physiological, cognitive, and mobility changes that lead to increased sitting time and reduced awareness of risk factors. Impact on the AD/ADRD population is devastating because it leads to pain that often is untreated, hospital stays which further reduce function, increase likelihood of needing additional care support, and earlier death than those who do not experience a pressure injury. This project specifically addresses external risk factors of pressure, shear, movement, and microclimate at the sitting surface by providing feedback to the caregiver in real-time from a multi-sensing system embedded in a seat cover. These factors can’t be readily “seen” by the caregiver and apathy may prevent someone with AD/ADRD from seeking assistance to mitigate a problem, the feedback will increase caregiver awareness so that they can take action before pressure injuries appear. While sensors exist to detect moisture or fall risk, none continuously detect and display meaningful data to the caregiver about pressure, shear, movement or microclimate factors directly between the person and their sitting surface. The goal of this project is to engage with caregivers of individuals with AD/ADRD and stakeholders who are experts in sensor technology, pressure injury prevention, and medical device innovation to design an acceptable, usable, and feasible multi-sensing seat cover and associated software integration. The research design uses mixed methods and includes the use of a survey, a series of focus groups with caregivers who have had experience with pressure injuries in the AD/ADRD population, and usability assessments. An expert stakeholder design review team will meet throughout the project to review user requirements from caregivers and build a comprehensive set of design requirements. Prototype development of the multi-sensor technology will occur throughout the project with consideration of caregiver and stakeholder requirement feedback. The resulting proof-of-concept multi-sensing seat cover and updated user-facing software will undergo initial performance testing for accuracy, durability, and validity. This project is based on the premise that by providing day-long meaningful detail about the conditions directly between a person with AD/ADRD and their sitting surface, caregivers will have access to information that currently does not exist, and they can then take appropriate therapeutic action to mitigate risks. This system has the potential to reduce pressure injury prevalence therapeutically through awareness, early detection, and risk mitigation.