Post on 29-Dec-2015
Telegerontology Update for Research in Progress Dec.
10th, 2014INVESTIGATORS: Dr. Roger Butler, Dr. Gerard Farrell, Dr. Michelle Ploughman, Dr. Susan Mercer, Dr. Cathy Hickey, Ms. Ann Hollett, Ms. Elizabeth Wallack, Ms. Chelsea Harris
Why?
1. Realization the current system is in crisis. ALC rise.
2. Dementia doubling rate will exhaust NH capacity.
3. Lack of alternative housing options.4. Lack of community home supports. 5. High rate of poverty in seniors.6. The catalyst.
Funding Partners
Alzheimer Society. NLCAHR.Government of Newfoundland and Labrador. NLMA. eHealth Research Unit, MUN. Lawson Foundation (Dr. Maxwell House).Health Care Foundation (Dr. Gerard Farrell).
Some Key Questions
Can a remote team help manage a patient with dementia in their home and improve their care, reduce caregiver burden and enhance the caregiver family physician dyad?
What are the caregiver features which help sustain people with dementia in their home?
What supports are necessary? Can we prevent visits to ER and subsequent
NH admissions (premature)?
The Home Assessment
Introductions / Circle of Care / Consent.Home video / OT assessment. Caregiver
Hassle scale IV about patients functional status / supports FIM
Patient Cognitive status: MMSE / MOCAGait and balance: Get up and go Executive function and safety: Kettle test
Computer instruction for caregiver / patient with APPS.
Control
Same intervention as the test group. All patients receive iPads with apps. All patients invited to receive Alzheimer’s
first link program.All patients invited to Alzheimer’s
educational series via skype.The Test group receive a weekly call from
Dr. Butler or team member to discuss concerns if any, and to tabulate data.
Telegerontology Project Timeline: Update
Task Jan-June 2014
June 2014
Jul-Dec 2014
Dec 2014
Jan-June 2015
June 2015
Dec 2015
June 2016
Dec 2016
Jan-June 2017
Group 1 Recruitment
X
Group 2 Recruitment
X
Group 1 Physician and Caregiver Pre-Interviews
X
Group 1 Intervention
X
Group 2 Physician and Caregiver Pre-Interviews X
Group 2 Intervention
X
Group 1 6 month follow-up X
Group 2 6 month follow up
X
Group 1 12 month follow up
X
Group 2 12 month follow up
X
Group 1 18 month follow up
X
Group 1 Physician & Caregiver Post Interviews X
Group 2 18 Month follow up
X
Group 2 Physician & Caregiver Post-Interviews X
Analysis and Write up
X
Lessons Learned
1. Good app development requires excellent communication between the computer specialist and the clinician.
Dr. Gerard Farrell has been essential in this area.2. Caregiver profiles.3. Support patterns 80/20.4. Which computers and which apps.5. Contact frequency / time per week per
family.
Patient Scenarios
Cornell scale picking up depression. Falls and system navigation are key
features.Patient aggression at home / validation
and help with the Cohen Mansfield. Controls also looking for help / advice
given and directed to help.