Given that, by and large, Information and Communication Technologies (ICTs) are aimed at increasing efficacy of workflows, faster and more accurate transfer of information, and decreasing cumbersome procedures, at least some ICTs are directed towards promoting a high quality of life. Particularly, if technologies are used to enhance services, ensure or increase safety and security, promote independence, and/or facilitate social interaction, they impact domains specifically measured in quality of life assessments. As there is no cure for most dementias, the focus of care is largely on the individual’s quality of life, applying technologies to this area of health and social care would seem an appropriate fit. One of the aims of technology solutions to benefit aging adults is to improve quality of life and capability to live independently and healthily; however, improvements in life quality are difficult to measure, and showing the effectiveness of gerontechnology-based solutions is problematic.
This research investigated the quantitative data to see if technology use was indeed a facilitator of increased quality of life. The hypothesis was that the older adults and their caregivers would report a positive influence on their quality of life after using the technologies. The end users gave reports via questionnaires on quality of life while metrics, such as frequency of use of a technology and time of use were recorded through the technology system. The work is based on data collected through the clinical intervention trial, and the courses, publications, independent analysis, and interdisciplinary collaboration during the PhD study. The PhD was with the Department of Electronic Systems at Aalborg University in Aalborg, Denmark. The research has been funded through Aalborg University and the European Union Information and Communication Technology Policy Support Program Pilot Type B Project ISISEMD (Intelligent System for Independent living and SElf-care of seniors with cognitive problems or Mild Dementia). Conclusions drawn from the study show that gerontechnology can indeed have a positive influence on quality of life in dementia care; however, significant effects on life quality were confirmed only in the caregivers. There are still knowledge gaps in evaluating quality of life outcomes from using technology in dementia care, and more homogenous, rigorous studies need to be done in this field. Without careful operationalization of the concept, it will be difficult for researchers to interpret the (clinical) outcomes into meaningful results that can be used by other researchers, caregivers, and medical professionals.
Objective: Intervention analysis on the efficacy of telecare services in home-based dementia care after 15 months.
Design: Multinational, non-blinded, quasi-experimental, clinical intervention trial (nonpharmacological)
Setting: Homes of individuals with dementia in North Ireland, Denmark, Finland, and Greece Participants: From 63 individuals with dementia and their caregivers, 31 intervention dyads are compared to 22 control dyads.
Intervention: A telecare system consisting of domotics with a centralized architecture aimed to support safety, independence, and quality of life, and to reduce caregiver burden through the transfer of tasks and care support.
Main outcome measures: Physical functioning (ADL and IADL), quality of life (QOL-AD and SQLC), caregiver burden (ZBI) are comparative outcomes, and global responses provide exploratory outcomes in the intervention group. The statistical analysis applies t-tests to verify significant differences in means and Pearson correlations to test for linear relationships within the data, all using 95% Confidence Interval.
Results: There is a highly significant difference in caregiver burden between the technology intervention and control groups (p=0,02**). The intervention group showed a non-significant reduction in caregiver burden (p=0,51) while the control group showed a highly significant increase in caregiver burden (p=0,01**). The intervention group shows improvement in home safety (80,6%), a high level of user satisfaction (88,7%), and the majority expresses desire to continue using (90,3%) the telecare services and a willingness to pay for such services (53,2%).
Conclusion: This study showed that the use of telecare intervention to support dementia care has protective and positive effects for the informal caregivers, but overall does not measure as performing significantly different than usual care. The evidence suggests telecare can be beneficial but methodology limitations prevent definitive conclusions.
Trial registration: The Phase I clinical intervention trial did not require registration. The trial was funded by the European Commission Competitiveness and Innovation Programme - Information and Communication Technology - Policy Support Programme. The pilot type B.2008.1.4 project ISISEMD was executed from 01/03/2009 to 31/08/2011. Reference: CIP-ICT-PSP-2-238914. Trial information can be found at the project website http://www.isisemd.eu/.
Full text can be accessed via Aalborg University at http://vbn.aau.dk/en/publications/gerontechnology-outcomes-technology-intervention-on-quality-of-life-in-dementia-care(79f9afd3-eb57-4997-a5ee-a2dacf5990ab).html