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Learning from trials: [email protected], a stepped-wedge cluster randomized controlled trial of care coordination and implementation for home-dwelling people with dementia.

Published online by Cambridge University Press:  02 February 2024

Bettina S. Husebo
Affiliation:
Department of Global Public Health and Primary Care, Centre for Elderly and Nursing Home Medicine, University of Bergen, Bergen, Norway
Maarja Vislapuu
Affiliation:
Centre of Care Research (West), Western Norway University of Applied Sciences (HVL), 5009 Bergen, Norway
Marie H. Gedde
Affiliation:
Department of Global Public Health and Primary Care, Centre for Elderly and Nursing Home Medicine, University of Bergen, Bergen, Norway
Renira C Angeles
Affiliation:
NORCE Norwegian Research Centre AS, Bergen, Norway
Nathalie Puaschitz
Affiliation:
NKS Olaviken Gerontopsychiatric Hospital, Askoy, Norway
Line I. Berge
Affiliation:
Department of Global Public Health and Primary Care, Centre for Elderly and Nursing Home Medicine, University of Bergen, Bergen, Norway NKS Olaviken Gerontopsychiatric Hospital, Askoy, Norway

Abstract

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Background:

Dementia is not an unavoidable consequence of aging, but for most home-dwelling people with dementia (PwD) a result of complex chronic health conditions. About 95% of PwD have multimorbidity, which requires a multicomponent approach and interdisciplinary collaboration to support patients and relatives, and to implement welfare technology and smart solutions.

Method:

The [email protected] study is a 2-year, mixed-method, stepped-wedged, cluster randomized controlled trial, including home-dwelling PwD and their informal caregivers (N=320 dyads) in Norway (May 2019 – December 2021), to investigate the efficacy of the multicomponent LIVE intervention (LIVE is the acronym for Learning, Innovation, Volunteerism, and Empowerment) on resource utilization and use of welfare technology. The intervention was implemented by a skilled coordinator from the municipality with high focus on use, usefulness, and experiences in welfare technology, both at baseline and during the implementation period.

Results:

At baseline, we found that most participants had traditional equipment such as stove guards (43.3%), social alarms (39.5%) or everyday technology (45.3%) (e.g., calendar, door locks). A social alarm was more often available for alone-living elderly women, while tracking devices (14.9%) were associated with lower age. Everyday technology was more often available for women at increased age, higher comorbidity, and poor instrumental activities of daily living (IADL). In people with severe dementia, welfare technology was associated with poor IADL function, children as the main caregiver (61.3%), and having caregivers who contributed 81–100% to their care (49.5%).

Discussion:

We describe unmet potential for communication, tracking, and sensing technology and especially, for devices not offered by the municipalities. In our symposium, we will present early findings on the implementation effect of welfare technology and participants experiences related to usage and awareness.

Type
Symposia
Copyright
© International Psychogeriatric Association 2024