Integration of Health Information Technology and Promotion of Personhood in Family-Centered Dementia Care

Purpose

Alzheimer's disease and related dementias (ADRD) are leading causes of disability and often result in communication deficits of the person with dementia (PWD) that can complicate ADRD caregiving and clinical care. The research team will work with stakeholders to develop and design a personalized Assistive and Alternative Communication (AAC) device that relies on information technology (IT) and touchscreens to promote communication and personhood for PWD about their care preferences and experiences. This study will integrate the AAC into an existing health IT intervention that already facilitates clinical communication between caregivers and providers of PWD. A clinical trial will be conducted to evaluate outcomes of 58 dyads (PWD/caregivers) and their health care provider utilizing the My PATI (My Person Assisted Touchscreen Interface)intervention as an adjunct to care and care giving for 6 months.

Conditions

  • Neurocognitive Disorders
  • Alzheimer Disease
  • Caregiver

Eligibility

Eligible Ages
Between 21 Years and 99 Years
Eligible Genders
All
Accepts Healthy Volunteers
No

Inclusion Criteria

Caregivers: - Regular access to the internet (via computer or smartphone) and telephone - 21 years-old or older - Providing caregiving activities (Activities of Daily Living and/or Instrumental Activities of Daily Living) for an average of 2 hours or more per day of direct assistance or supervision for a person with ADRD - Speak and understand English or Spanish. Care Recipient: - 60 years or older - Speak and understand English or Spanish - Have an established diagnosis of a Neurocognitive Disorder (Alzheimer's disease, vascular dementia, frontotemporal dementia, Lewy body dementia or Parkinson's disease dementia) - Receive a score on the Mini Mental Status Exam of less than 24 - Be able to complete the eligibility vision screen. Healthcare Providers: * Provide ongoing healthcare and support services to PWD and their families.

Exclusion Criteria

Caregivers: - Provide care to a PWD living in an assisted living facility or nursing home - Plan for the PWD to be placed in a long-term care facility during the study period - Plan to end their role as caregiver within 6 months of study enrollment - Have their own major medical conditions affecting independent functioning (e.g. illness or disability) or cognitive impairment - Do not speak and read English or Spanish - Have known active suicidal ideation Care Recipients: - Significant visual or hearing impairment (with supports) - Known active suicidal ideation - Schizophrenia diagnosis

Study Design

Phase
N/A
Study Type
Interventional
Allocation
Randomized
Intervention Model
Parallel Assignment
Primary Purpose
Supportive Care
Masking
Single (Outcomes Assessor)
Masking Description
Outcome Assessors will not be involved with the intervention implementation and study participants will be asked not to reveal their group assignment.

Arm Groups

ArmDescriptionAssigned Intervention
Experimental
Full Intervention
Dyads (caregiver, PWD) randomly assigned to the experimental arm will have access to the newly developed My PATI app. Providers' will receive information via the app.
  • Other: My PATI ( Person Assisted Touchscreen Interface)
    My PATI was designed to support communication between PWD and their caregiver, and healthcare provide; promotes person centered care by giving the PWD their voice and specifically by supporting the PWD in expressing their experiences , needs, preferences in care activities (e.g., food choices, clothing), and entertainment ( personalized pictures, videos , and music). My PATI has multiple features including allowing the caregiver to assess symptoms of the PWD using clinical assessments, which can be shared with the healthcare provider. The clinical trial evaluates the impact of the My PATI interface that relies on touchscreen technology ( two interfaces one for PWD that can be used independently or with assistance, and a 2nd caregiver interface for customization ). The comparison group will receive usual care.
No Intervention
Usual Care
Dyads (caregiver, PWD) randomly assigned to the usual care condition will receive usual care from the memory clinic.

Recruiting Locations

UAB Alzheimer's Risk Assessment and Intervention Clinic
Birmingham, Alabama 35233
Contact:
David S Geldmacher, MD
205-934-0683
dgeldmacher@uabmc.edu

More Details

Status
Recruiting
Sponsor
Florida International University

Study Contact

Ellen L Brown, EdD,RN,FAAN
305-348-1312
ebrown@fiu.edu

Detailed Description

The target enrollment for the clinical trial is 58 dyads of caregivers and people with dementia (PWD), where 58 unique dyads of caregivers/PWD will participate. The team plans to enroll a total of 58 dyads across two participating clinical sites. Participants will be randomly assigned to either the full intervention or a control condition for a period of 6 months, where they will be asked to communicate clinical and other relevant information with one another as part of regular caregiving and clinical care activities. Several psychosocial outcome variables for providers, caregivers, and PWD will be assessed. We will compare outcomes based on group assignment and different amounts and patterns of use of the MyPATI (e.g., minimal/non-users versus frequent users). The primary outcome variables are quality of life for caregivers and PWD. The research team will recruit an estimated 15 healthcare providers across both sites at the end of study to assess their experience with My PATI using open and closed ended queries.