SAFE at Home: A Service to Provide Social Engagement to Community-Dwelling Persons with Dementia

项目总结/摘要 需求：据估计，目前有620万美国人患有阿尔茨海默病（AD），而且没有显著的 到2050年，将有1270万美国人患有AD。虽然人们一直强调 在过去的几十年里，改善长期护理（LTC）中的痴呆症护理， 在某些方面退居二线这是不幸的，因为大约70%的残疾人（1430万人）生活在社区。 住在家里的残疾人有很高的孤立，孤独和抑郁的风险。事实上，已知50%的老年人 有孤独的风险，53%的人报告有抑郁症状。 三种现有的解决方案具有显著的局限性：针对社会隔离，现有的解决方案主要有三种 经历过PWD。首先，可以通过家庭保健服务提供社会参与。然而，家 健康仅提供与另一个人的参与-即，一个家庭健康工作者，通常比 PWD。第二，可以通过成人日间服务提供社会参与。但成人日托中心（ADC）不是 在所有地区（尤其是在农村地区）都有，即使有，前往ADC也是一个后勤问题。 残疾人及其家庭成员的问题。第三，可以雇用（或安排）训练有素的专业人员（和/或志愿者）， 也可以专门为参与社会活动而到残疾人家中进行探访。然而，这种服务 相对罕见（特别是在农村地区），并且通常非常昂贵。 创新：拟议的第一阶段研究将涉及创新新服务的初步开发和评估 这就是所谓的“在家参与社会活动”（Social Activities for Engagement at Home，简称SAH）。SaH将使社区居住的残疾人能够 与他们的同伴一起参与基于视频会议的小组活动--即，其他PWD SaH会议将由 训练有素的“参与专业人员”，他们将具有娱乐治疗，活动协调或 类似的领域。每位SaH参与专业人员将接受有关如何正确参与的广泛培训和指导， PWD在基于视频会议的活动会话中。活动材料将通过使用 屏幕共享，并将由炉石的专有证据为基础的活动。每次SAH会议将 由最多五名残疾人组成，加上一名参与专业人员，他们将促进会议。参与者将被 根据大致的认知和沟通能力以及他们的兴趣和背景进行匹配。通过 以这种方式将残疾人士分组，他们很可能会喜欢一起参加会议。 具体目标：拟议研究有三个具体目标： ·目标1。开发SaH应用程序的Alpha版本，包括应用程序基础设施和初步活动内容， 现场小组会议，以及工作人员培训和辅导模块。 ·目标2。检查应用程序的可接受性/可行性（通过评估出勤率，会话长度和参与/影响）。 目标3。通过直接征求残疾人和生活丰富工作人员的反馈，检查对应用程序的满意度。

PROJECT SUMMARY/ABSTRACT Need: An estimated 6.2 million Americans are currently suffering from Alzheimer’s disease (AD), and, without significant breakthroughs, 12.7 million Americans will be suffering from AD in 2050. While much emphasis has been placed on improving dementia care in long-term care (LTC) over the past decades, the thrust to improve dementia care at home has taken a back seat in some regards. This is unfortunate, because about 70% of PWD (≈4.3 million) live in the community. PWD who live at home are at high risk of isolation, loneliness, and depression. In fact, 50% of older adults are known to be at risk for loneliness, and 53% report experiencing depressive symptoms. Three Existing Solutions with Significant Limitations: There are three main existing solutions to the social isolation experienced by PWD. First, one could provide social engagement by employing a home health service. However, home health only provides engagement with one other person—i.e., a home health worker who is typically much younger than the PWD. Second, one could provide social engagement via adult day services. But adult day centers (ADCs) are not available in all areas (this is especially true in rural areas) and, even when they are, traveling to an ADC presents a logistical issue for the PWD and family members. Third, one could hire (or arrange for) a trained professional (and/or volunteer) to visit the PWD in their home specifically for the purpose of social engagement is also possible. However, this type of service is relatively rare (especially in rural areas) and is typically very expensive. Innovation: The proposed Phase 1 study will involve initial development and evaluation of an innovative new service called Social Activities For Engagement at Home or SAFE at Home (SaH). SaH will enable community-dwelling PWD to participate in videoconference-based group activities with their peers—i.e., other PWD. SaH sessions will be facilitated by highly trained “Engagement Professionals,” who will have a background in recreation therapy, activity coordination, or a similar field. Each SaH Engagement Professional will receive extensive training and coaching on how to properly engage PWD in videoconference-based activity sessions. Activity materials will be visible to participants through the use of screensharing and will be comprised of Hearthstone’s proprietary evidence-based activities. Each SaH session will be comprised of up to five PWD, plus one Engagement Professional, who will facilitate the sessions. Participants will be matched based upon approximate cognitive and communication ability, as well as upon their interests and background. By grouping PWD in this way, there will be a relatively high likelihood that they will enjoy taking part in sessions together. Specific Aims: The proposed study has three Specific Aims: · Aim 1. Develop an Alpha version of the SaH app, including app infrastructure and preliminary activity content for live group sessions, as well as staff training and coaching modules. · Aim 2. Examine the app’s acceptability/feasibility (by assessing attendance, session length, and engagement/affect). · Aim 3. Examine satisfaction with the app by directly eliciting feedback from PWD and life enrichment staff.