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 使用连接互联网的设备被动地预测健康问题和支持就地老龄化 监控老年人的增长速度超过了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 对有认知障碍的人来说很重要，比如自主、隐私、控制和自由。这个 这项研究的目的是开发和测试沟通的可行性和初步有效性 和用于被动远程监测的教育工具，用于老年早期阿尔茨海默病和 AD相关痴呆症(AD/ADRD)及其照顾者。这项工作意义重大，因为它将推动 科学地理解如何在帮助家庭的同时让认知障碍患者参与决策 以驾驭复杂的技术格局。应聘者成功地进行了试点工作，使用 与虚弱的老年人交流这些技术的基本功能的创新方法 获得理解，这样他们才能参与到有关他们的决策中来。拟议中的项目将建立在此基础上 有希望的沟通研究，以开发一种工具，指导患者和他们的护理人员通过 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。这个 确定最佳远程监控工具的需求将在预先制定护理计划后进行建模，并将 以记录在案的首选项结束。为工具、技术和老化专家生成最佳输入 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，以纳入 使用Delphi方法的工具(目标1)。然后，以患者为中心的对这些技术的普遍偏好 通过对患有和不患有轻度认知障碍的老年人进行调查来确定(目标2)。 该工具将整合这些发现，并将在30个早期的混合方法可行性研究中进行测试 阶段AD/ADRD护理二重评估初步有效性以确保理解、识别 患者偏好，随着AD/ADRD进展而做出决定的准备，以及其他关键的积极二元体 成果(目标3)。这项研究回应了NIA改善通信的优先领域， 为照顾者和AD/ADRD患者提供教育、决策、规划和减压 先进的技术可减少不必要的护理过渡并实现就地老龄化。候选人是一位 华盛顿大学社会工作助理教授，其长期职业目标是 提高患有AD/ADRD的老年人在家中安全自理生活的能力。K01 将使她能够建立一个跨学科的研究计划，专注于改善 通过促进有认知障碍的老年人有效使用技术来促进老年人和照顾者 减损。拟议的研究通过确保我们正在以各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.