Article

A Pilot Study of the Telecare Medical Support System as an Intervention in Dementia Care: The Views and Experiences of Primary Caregivers

Department of Information Management, National Chung Cheng University, Taipei, Taiwan.
The journal of nursing research: JNR (Impact Factor: 0.97). 09/2012; 20(3):169-80. DOI: 10.1097/jnr.0b013e318263d916
Source: PubMed

ABSTRACT

As a progressive degenerative illness, dementia can reveal itself through a variety of symptoms such as intellectual deterioration, loss of recent memory, loss of cognitive ability, and psychological and behavioral problems. The telecare medical support system (TMSS) has been a part of dementia care in many countries for many years. Although worth considering, the TMSS model is difficult to directly implement in Taiwan because of cultural and social issues.
This study explores the ease of use and usefulness of TMSS from the perspective of primary caregivers and assesses the benefits of TMSS in home dementia care.
We used a qualitative research method to explore the experience and perceptions of 30 primary caregivers who each used TMSS for 6 months in dementia care. Data were collected using 1-hour in-depth interviews. Four senior nurses conducted the content analysis.
Approximately two thirds (63.3%) of the participants were primary caregivers of patients with Alzheimer's disease in the mild to medium stage of their illness. After using TMSS for the 6-month study period, participants held generally positive views of its usefulness and ease of use. Participants generally appreciated the ability of TMSS to self-diagnose care recipient conditions; provide reminders, care, and emotional support; and help stabilize the care recipient's condition and emotions.
We showed TMSS as an effective tool that helps reduce primary caregiver isolation and uncertainty and provides round-the-clock care management and safety checks using advanced technology and a professional care team. TMSS can effectively enhance dementia care.

Download full-text

Full-text

Available from: I Chun Lin
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Purpose: The purpose of this study was to describe humor and laughter in persons with cognitive impairment (PWCI) and caregivers who were recalling a shared experience in a focus group. Design: Twenty participants attended an Art Engagement Activity at the Andy Warhol Art Museum, which included a guided tour and an art project. All PWCI had medically diagnosed cognitive disorders and all caregiver participants did not. Four focus groups were conducted and transcripts of audio-recorded sessions were transferred to a qualitative software program. Method: Words, phrases, and episodes of humor and laughter were used to construct codes, which were refined during group analysis using constant comparison. Findings: Humor and laughter were present in all four focus groups. Emerging themes of humor included silliness, sarcasm, and commenting about hardships of dementia. Laughter was identified in segments with and without humor. Some PWCI were unable to follow social cues. Conclusions: Humor and laughter played a role in creating a safe social environment. PWCI were able to engage in humor during social interactions, yet some had difficulty recognizing social cues. Further study may reveal roles of humor and laughter in adaptation to cognitive decline and holistic interventions for improved quality of life.
    Preview · Article · Aug 2013 · Journal of Holistic Nursing
  • [Show abstract] [Hide abstract]
    ABSTRACT: Over recent years a number of Information and Communication Technologies (ICTs) have emerged aiming at falls prevention, falls detection and alarms for use in case of fall. There are also a range of ICT interventions, which have been created or adapted to be pro-active in preventing falls, such as those which provide strength and balance training to older adults in the prevention of falls. However, there are issues related to the adoption and continued use of these technologies by older adults. This review provides an overview of older adults' perceptions of falls technologies. We undertook systematic searches of MEDLINE, EMBASE, CINAHL and PsychINFO, COMPENDEX and the Cochrane database. Key search terms included 'older adults', 'seniors', 'preference', 'attitudes' and a wide range of technologies, they also included the key word 'fall*'. We considered all studies that included older adults aged 50 and above. Studies had to include technologies related specifically to falls prevention, detection or monitoring. The Joanna Briggs Institute (JBI) tool and the Quality Assessment Tool for Quantitative Studies by the Effective Public Health Practice Project (EPHPP) were used. We identified 76 potentially relevant papers. Some 21 studies were considered for quality review. Twelve qualitative studies, three quantitative studies and 6 mixed methods studies were included. The literature related to technologies aimed at predicting, monitoring and preventing falls suggest that intrinsic factors related to older adults' attitudes around control, independence and perceived need/requirements for safety are important for their motivation to use and continue using technologies. Extrinsic factors such as usability, feedback gained and costs are important elements which support these attitudes and perceptions. Positive messages about the benefits of falls technologies for promoting healthy active ageing and independence are critical, as is ensuring that the technologies are simple, reliable and effective and tailored to individual need. The technologies need to be clearly described in research and older peoples' attitudes towards different sorts of technologies must be clarified if specific recommendations are to be made.
    No preview · Article · Apr 2014 · International Journal of Medical Informatics
  • [Show abstract] [Hide abstract]
    ABSTRACT: The purpose of this study is to develop and extend our understanding of dementia care-giving by introducing a typology of informal care-giving across four different diseases. Care-giving factors were examined with respect to specific dementia presentation in mild cognitive impairment, Alzheimer's disease, dementia with Lewy bodies and Parkinson's disease-associated dementia. Informal care-giving literature in the four diseases was systematically searched to identify specific disease symptoms and resultant care-giving strains and outcomes. Key concepts were extracted and grouped thematically. The first classification, ‘role-shift’, reflects care-giving where cognitive deterioration results in changing roles, uncertainty and relational deprivation among married partners. The second classification, ‘consumed by care-giving’, refers to those caring for persons with dementia-motor decline that greatly increases worry and isolation. Finally, in the ‘service use’ classification, formal support is needed to help care-givers cope with daily responsibilities and behaviour changes. In each case, the dementia presentation uniquely impacts care-giver strains. A major conclusion is that the same support to all care-givers under the umbrella term ‘dementia’ is unwarranted; the development of targeted support is required.
    No preview · Article · Jun 2014 · Ageing and Society
Show more