To explore the benefits and barriers of using an interactive robotic seal (PARO, Figure 1) based on the experiences of nursing home residents living with dementia and chronic pain, their family members, and formal caregivers.

Semi-structured interviews were conducted alongside a feasibility randomized controlled trial at one nursing home in Brisbane, Australia between July 2021 and January 2022 (Trial registration: ACTRN 12621000837820). Residents with dementia and chronic pain interacted with PARO individually for 15 min once or twice daily, five days per week for three consecutive weeks. After which, individual interviews were conducted with residents who were capable of communicating (n=13), family members (n=3), registered nurses (n=4), care assistants (n=11), a physical therapist (n=1), a diversional therapist (n=1) and the facility manager (n=1) who experienced or observed the residents’ interactions with PARO. The interviews were audio-recorded, transcribed, and analyzed using thematic analysis.

Almost all participants reported that interacting with PARO benefited residents with dementia and their caregivers. These benefits included (1) reducing pain by providing distraction and stimulation; (2) reducing behavioral and psychological symptoms of dementia; (3) promoting positive emotions by recalling memories; and (4) reducing anxiety and care burden for family and formal caregivers. Neutral attitudes toward PARO were reported by three residents with mild cognitive impairment as they reported it did not make any difference. Barriers to using PARO included limited staff training and the implementation of person‐ centered care due to limited resources.

Overall, multiple stakeholders were positive about using PARO to reduce pain and behavioral symptoms of nursing home residents living with dementia and chronic pain. PARO may also reduce the care burden of family and formal caregivers. PARO might be incorporated into daily practice to support nursing home residents living with dementia. Improving staff training and understanding individual preferences of residents may enhance the implementation of PARO in this population.

Figure 1

A resident living with dementia and her family after interacting with PARO (Distribution of this photo has been approved by the resident and her family)

The objective of this study is to describe the prevalence of benzodiazepine in a sample of patients (≥65 years) attended by liaison psychiatry units (LPU) in Spain and its possible relation to falls.

This is an observational., cross-sectional, multicenter study. We obtained data from a sample of 165 patients (≥65 years) admitted to 7 general hospitals in Spain referred from different departments to each liaison psychiatry unit. Data was collected for a month and a half period. Psychiatric evaluations were performed while the patients were on wards.

We obtained a sample of 165 patients (78 women, 88 men) with a mean age of 76,03 years old (42.10% <75 years, 57,83% ≥ 75 years). Most of them were married and they lived accompanied (67,27%). Only 5,45% lived in a nursing home. 65,45% of patients had prescribed at least one psychotropic drug before LPU intervention; mainly (50,9%) benzodiazepines (60%women/40%men). 70,9% of these group of patients had more than one psychotropic drug prescribed before LPU. After LPU intervention in 39,39% at least one drug was withdrawn (in 50,81 % of cases benzodiazepines). Falls in the past 6 months were reported in 24.8% of total patients. Patients under benzodiazepine treatment had fallen in 29% of cases. After LPU intervention benzodiazepines were withdrawn in 56,25% % of them.

Benzodiazepines are widely used in our sample and frequently is associated with polypharmacy. LPU intervention might be a useful tool to reduce the use of them, specially for those who reported falls.

Longitudinal studies might be carried out to study these factors and their possible relationship with falls, given that Benzodiazepines are consistently associated with a higher risk of falls. It is unclear whether specific subgroups such as short-acting benzodiazepines and selective serotonin reuptake inhibitors are safer in terms of fall risk. Ppropriate prescription of medications such as BZDs is an important public health issue.

We have reported parkinsonism and psychiatric symptoms were the most important treatment needs of patients with dementia with Lewy bodies (DLB) and their caregivers, respectively 1). However, the frequency presenting clinical symptoms and the onset time vary among patients. We investigated the impact of the disease duration on clinical symptoms, prescribed medication and treatment needs of patients and their caregivers.

Disease duration was defined as time after diagnosis with DLB. Patient-caregiver pairs were classified into two groups; one with a disease duration <24 months (S-group) and the other with a disease duration ≥24 months (L-group). Comparisons were made between two groups regarding background characteristics and treatment needs of patients and caregivers. Treatment needs were defined as symptom domains most distressing to patients and caregivers.

S-group and L-group were consisted of 126 and 137 pairs of patients and their caregivers, respectively. Regarding patientsʼ current symptoms, parkinsonism and autonomic dysfunction were significantly higher in L-group than S-group. MDS-UPDRS Part III total score and the frequency of prescription for memantine and antiparkinsonian were also significantly higher in L-group than in S- group. The treatment needs most frequently selected by patients was cognitive impairment (20.6%) followed by autonomic dysfunction (16.7%) and parkinsonism (11.9%) in S-group, and parkinsonism (24.6%), followed by cognitive impairment and autonomic dysfunction (11.1% each) in L-group, suggesting no significant difference in the tendency of symptom domains to desire treatment between groups (P=0.056). However, residual analysis showed that patients in S-group were more likely to select cognitive impairment than in L-group (P=0.045), and those in L-group were more likely to select parkinsonism than in S-group (P=0.003). The treatment needs most frequently selected by caregivers in S-group was cognitive impairment (29.4%) followed by psychiatric symptoms (20.6%) and parkinsonism (10.3%) in S-group, and psychiatric symptoms (24.6%), followed by parkinsonism (16.7%) and cognitive impairment (14.3%) in L-group, suggesting significant difference in the tendency of patientsʼ symptom domains to desire treatment between groups (P=0.032). Dara from the onset will be added at the poster presentation.

It was suggested that the treatment needs of patients and their caregivers might change with duration after diagnosis.

The use of side-rails from the headboard to the foot of both sides of the bed (from now on “the rails”) is the most used tool to prevent falls in our hospital setting. However, its consideration as physical restraint in the different international consensus is not clear. In the GERBAR study (NCT04861025), we intend to evaluate the perception of the rails as a measure of physical restraint, both by hospitalized users and by the health personnel who care for them. The trial is being performed at the Consorci Sanitari Alt Penedes-Garraf, CSAPG (Barcelona, Spain). In this report we show partial results of the data obtained from the health personnel belonging to Nursing Department.

An online poll has been carried out through the intranet and corporate emails in the last two months of 2022. All the people who works as health personnel at the CSAPG (1652 people) have been invited to this poll.

We obtained a total of 246 responses, of which 27 responses have been removed for not being completed correctly. 152 responses were made by health personnel attached to the Nursing Department: 72 auxiliary nursing personnel (15.38% of the total CSAPG professionals in this professional group) and 80 nurses (14.47%). Proportion of job seniority greater than two years was 74.34% (69.44% auxiliary personnel, 78.75% nurses). 91.67% have been women with a median age of 40.87 years. 46.40% of this sample does not considered the rails as physical restraints (50% auxiliary personnel and 41.25% nurses). When analyzing by job seniority, 48.72% of the professionals with <2 years of seniority does not consider the rails as a physical restraint (44.25% in those with >=2 years). Professional group and job seniority were not significantly associated with perception of the rails as a physical restraint (chi-square 1.17, p 0.2793 for professional group and chi-square 0.23, p 0.6288 for job seniority).

An important proportion of health professional belonging to Nursing Department does not consider the rails as a physical restraint. This perception was not related to the professional group or job seniority.

Major depression is one of the most widely recognized psychiatric disorders in cancer patients. In Spain,16.49% of cancer patients develop a Major Depressive Disorder. It arises as a reaction to a traumatic experience influenced by events and environmental conditions and develops as a consequence, of an adverse event, whether single or recurring. When depressive symptoms interfere with the proper functioning of cancer patients, antidepressants are the first line of treatment. We refer to Vortioxetine as the antidepressant of choice.

We present a 68-year-old patient diagnosed with Prostate Neoplasm (Gleason Grade 6 STAGE IV Adenocarcinoma) with Bone and Pulmonary Metastasis, who was referred, to the PADES Service of CSS Bernat Jaume, for poor pain control at the L5-L7 lumbar spine level. (VAS 9/10), immobility and depression after his prognostic information and short-term expectations.

We want to assess the usefulness of Vortioxetine for depression in cancer terminal patients. The diagnostic criteria for depressive disorder were evaluated according to the DSM-V(6) risk factors for depression in palliative patients. The Visual Analogue Scale for the evaluation of the pain (0 no pain and 10, unbearable pain). Previously used medications for pain control, and depression were assessed. It was decided to start treatment with Vortioxetine and assess the response.

We started Vortioxetine 5 mg for a week and appetite improved, as well as VAS 5/10. After fifteen days, he was able to walk, and his insomnia and anxiety decreased. He remained stable with the prescribed medication until, due to complications secondary to his oncological pathology, he was admitted to The Palliative Care Unit to begin sedation.

In terminal cancer patients with depression, it would be advisable to use Vortioxetine to improve their quality of life in situation of last days.

Cognitive impairment is common and underdiagnosed in patients in hemodialysis (HD) can be moderate and severe. About 38% of patients in Dialysis has serious deficits in executive function and this affects patients of all ages.

Based on the case of an 82-year-old patient in a HD program who enters from Nephrology to the Convalescence Unit for miscontrol of pain due to ganglion and liver recidivism after years of cystectomy by bladder neoplasia and having acute confusional syndrome (ACS) subsequently presented after treatmet with morphine MST and Tramadol. We performed an integral geriatric evaluation that showed a deterioration of the executive functions. Through medical literature we analyze this find of atypical pattern and its possible relationship to renal disease.

BI 100/100. No known history of cognitive impairment. Despite optimal pain control with fentanyl patch, pregabalin, paracetamol, metamizol and dexamethasone, without new episodes of ACS, we saw high difficulties in comprehension time schedule, spatial location, bad understanding of medical treatment, etc. Neuropsychological study showed MMSE 24/30; SKT subtest of immediate memory 1/12, null recognition without understanding the task. Memory Imparily Screen 5/8, Test clock 3/7. In summary there were deficits in executive functions such as complex attention, mental control, fluency and reasoning. Fluctuating memory abilities. Mild multiple cognitive impairment executive domain. Atypical Profile.

There is a strong correlation between the decrease in GF and the degree of cognitive impairment. This worsens with the Dialysis due to hemodynamic changes. It is essential to evaluate the cognitive situation in all patients with CKD. Being the most affected cognitive domain, the function executive,it can avoid in these patients the correct assesment of established medications and dietary restrictions that are so important in the control of potassium, phosphorus and liquids that cause greater complications and even more mortality.

Being diagnosed with dementia can be a hectic and critical period. While severe dementia may act as a shield when it comes to suicidal risk, mild and early dementia stages may still preserve cognitive functions to elaborate a suicidal plan. Having insight may lead to feelings of despair and sadness that patients find unbearable to deal with. The aim of this article is to review the current literature regarding suicidal risk after a dementia diagnosis.

Review of the most recent literature regarding the risk of suicide among patients with a recent dementia diagnosis. The research was carried out through the PubMed and UptoDate databases, using the terms “dementia”, “diagnosis” and “suicidal risk”.

Previous research showed inconclusive findings, with some authors suggesting a higher risk of an early suicide attempt in patients recently diagnosed with dementia, and others suggesting otherwise. Nowadays, the literature mainly reports that older adults with recent dementia diagnoses are at increased risk of endeavoring suicide. There is an important requirement to offer appropriate support to patients and their families, at the time, or as soon as possible, when a dementia diagnosis is made, to diminish the risk of suicide attempts in these patients.

Patients with recent diagnosis of dementia, or diagnosed at an earlier age, seem to have higher suicidal risk. The period immediately after diagnosis is when individuals need greater support, so these results demand for better assistance for those experiencing such intellectual decline.

The amyloid hypothesis suggests that errors in production, accumulation, or disposal of beta-amyloid are the primary causes of Alzheimer's disease (AD). Since this was hypothesized, there has been significant effort in developing treatments that prevent the build-up of amyloid beta (Aβ) plaques in the brain. A disease modifying therapy (DMT) changes the clinical progression of AD by interfering in its pathophysiological mechanisms.

The aim of this article is to review the current literature regarding the role of new DMTs for Alzheimer’s dementia and assess the preparedness of health care systems to implement these treatment options.

Review of the most recent literature regarding the role of new DMTs for Alzheimer’s dementia and the challenges faced by the health care system to implement these treatment options. The research was carried out through the PubMed and UptoDate databases, using the terms “amyloid hypothesis”, “Alzheimer”, “disease modifying treatments” and “dementia”.

Research has been focusing on developing monoclonal antibodies as potential DMTs that target Aβ. Aducanumab, a human antibody, or immunotherapy, is the only disease-modifying medication currently approved to treat AD. It targets the Aβ protein and helps to reduce amyloid plaques and is currently the only FDA approved medication to slow the progression of AD. Lecanemab, a humanized IgG1 monoclonal antibody, binds to Aβ soluble protofibrils with high affinity. Even though there is considerable optimism about its potential, lecanemab will probably be more useful to patients on early stages of the disease.

DMTs administration obeys to certain needs such as a vacancy in Day Hospital for infusion and regular monitorization and for lumbar punction. It demands a complex network involving general practitioner, neurologist, psychiatrist, psychologist, and social services. It also involves a genetic study and complementary diagnosis exams such as PET (Positron emission tomography) scans and MRIs (Magnetic resonance imaging), which are expensive. There is an emerging need to develop enhanced and safer treatments.

Elderly people who live in nursing homes can be faced with intramural relocations for various reasons, whether individual or per group. Because the impact of these intramural relocations on residents is unknown, our aim is to explore how relocations within nursing homes affect residents from different stakeholder-perspectives.

We performed semi-structured individual interviews and a focus group with various stakeholders of intramural relocations to collect a broad outlook on its practice based on diverse perspectives and lived experiences. The interviews and focus group were audio-recorded, transcribed verbatim and analyzed using responsive and thematic analysis.

Seventeen interviews were held and one online focus group with six participants. In the interviews, participants mentioned various reasons for intramural relocations, such as outdated real estate for group relocations or changing healthcare demand for individual relocations. Participants distinguished various levels of impact on residents on different moments in time (before, during and after the relocation). The impact varied from very positive (e.g. looking forward and excited) to very negative (e.g. stressful, traumatic, hard to understand). Aspects that influenced the impact of relocation were related to 1) the mental resilience of residents, 2) how relocations were organized, 3) the presence and quality of social connections of residents and 4) if benefits of the new (care) environment were experienced. The focus group added insights on the importance of clear and timely communication with residents and recognizability of (personal) items and personnel from the former nursing home to reduce negative experiences of residents relocating within nursing homes.

The impact of relocations within nursing homes differs per situation, moment in time and resident. Aspects found that influence the impact provide targets to reduce the negative impact on residents: practices should focus on good preparation, clear communication, preserving social connections of residents where possible and paying attention to the benefits of the new (care) environment for the residents. Further research may focus on the lived experiences and perceived impact of relocations within nursing homes of residents themselves to develop in depth insights into tailored (care) needs of residents during the relocation process.

Major neurocognitive disorder (or simply Dementia) is one of the main causes of disability and burden disease to caregivers and the health system, and a frequent cause of mortality worldwide. Alzheimer`s disease (AD) is the most common type (60-70%).

AD is a progressive neurodegenerative disorder characterized by amyloid-β (Aβ) deposition, causing neuronal and synaptic loss with subsequent cognitive disfunction.

There is cumulating evidence that sleep disturbances are associated with several pathological conditions, and AD is one of these. The prevalence and severity of sleep disorders is significant in AD patients, with sleep disturbances often precede its clinical diagnosis in many years. Some studies focus on possible mechanisms by which (abnormal) sleep participate in AD pathogenesis, and concluded individuals with sleep disturbances are at higher risk of developing dementia.

To highlight the current evidence on whether sleep disorders could precipitate or accelerate the clinical course of AD.

Non-systematic review about sleep abnormalities and AD pathogenesis.

Several authors described a two-way relationship between sleep and amyloid pathology - sleep deprivation would lead to increased production and decreased clearance of Aβ; once Aβ is accumulated it results in more disrupted sleep, with an increase of Aβ production during wakefulness and a decrease of its clearance during sleep.

Recent data showed that sleep continuity and architecture (decreased total sleep time, slow-wave sleep, and REM sleep) are disturbed in AD patients.

Otherwise, sleep deprivation may be associated with decreased glymphatic system clearance, leading to accumulation of neurotoxic proteins, particularly Aβ (and tau). It`s also associated with proinflammatory states due to accumulation of reactive oxygen species, nucleotides and proteins during wakefulness, which leads to immune response that causes neuronal dysfunction and cellular death. Insomnia and sleep deprivation were also associated with activation of complement pathway and immunoglobulins secretion. Many studies suggest chronic sleep disruption changes blood–brain barrier structure and function leading to Aβ accumulation.

There is emerging evidence that points sleep disturbances as both a potential marker for AD pathology and risk predictor of developing the disease. Future investigations should evaluate the relationship between specific sleep disorders and AD physiopathology.

Historically, older adults in residential aged care facilities (RACF) in Australia had no access to government funded psychology services despite high rates of anxiety and depression. Change Futures is a registered charity that provides funded psychology to more than 220 RACFs in south-east Queensland and northern New South Wales, Australia, and since 2015 has been providing free psychology services to older adults living in aged care, using a predominately provisional psychologist workforce. This presentation will discuss the model of service that is provided, and the findings of a recent outcomes report.

Data was collected via clinician entered eHealth records in the 2021/2022 financial year from 01/07/2021 to 30/06/2022. Outcome measures were analysed using six repeated measure t-tests to compare clinical change from first and last assessments.

A total of 2865 residents were seen in 17,754 individual sessions and 298 group sessions. Staff education was provided in 94 sessions with 838 participants, who worked in RACFs. The most common presenting issue was difficulties with adjustment (70%), comorbid anxiety and depression (28%), depression (27%), loneliness (18%), and anxiety (17%). Outcomes of the psychology program showed statistically significant improvements on all measures, including the Kessler 5 psychological distress scale, Geriatric anxiety scale, Patient health Questionaire-9, De Jong Gierveld Loneliness Scale, and Brief Adjustment Scale.

The described service model resulted in significant improvements to the psychological wellbeing of older adults, and represents an effective and sustainable training approach for provisional psychologists.

Falls is the leading cause of injury, and injury-related cognitive decline and death for older adults. Weight loss and malnutrition contribute to the risk of falls through increased frailty, visual and cognitive impairment, and predicts both the severity and recovery time of falls. Psychological and social factors such as isolation, loneliness, cognitive impairment, anxiety and depression are significantly associated with falls and weight loss for older adults. Reminiscence therapy is a psychological intervention that can improve anxiety, mood disorders, cognition and isolation; however, it is not yet known the impact that reminiscence therapy has on the incidence of falls and weight loss. This abstract will present the existing research on reminiscence therapy for the prevention of falls and weight loss, describe a group reminiscence therapy protocol to target these risk factors, and outline preliminary findings from a small pilot trial group therapy program conducted in February, 2023.

Data on pre and post incidence of falls and weight loss collected from eHealth records for: 1) 3 months prior to the group, and 2) the 9-week duration of the group will be discussed. Group participants will complete a pre and post Depression Anxiety Stress Scale (DASS21) and provide feedback on the therapy protocol.

This presentation will discuss the suitability of a group reminiscence therapy protocol to reduce psychological and social risk factors associated with falls and weight loss for older adults in residential aged care.

Reminiscence therapy is an evidence-based treatment for late life depressive symptoms, and has been associated with improvements in cognitive function, loneliness, happiness, and wellbeing for older people. While music is often involved in reminiscence therapy, little is known about how music is used or works in this context. Specifically, we do not know what purpose music serves, or how it works to enhance the experience when combined with reminiscence therapy. This presentation will provide an overview of two studies exploring how music enhances reminiscence therapy.

A narrative literature review was conducted with a structured search strategy to identify all relevant literature. Furthermore, a single-case repeated measures experimental EEG study with 4 older adults experiencing psychological distress was conducted. Participants were randomly assigned to a single session of either verbal reminiscence therapy or music-assisted reminiscence therapy. EEG recordings of resting states (e.g., eyes closed) were taken before and after the session, together with different epochs recorded during the session (e.g., during the start of reminiscence, the problem solving success, and music played). Analysis involved calculating the standardised LORETA (sLORETA) calculations to map regions and sources of EEG activity during these epochs.

The SEED model proposed that music enhances reminiscence through: Summoning autobiographical memories, eliciting physiological responses, evoking emotional reactions and pleasure, and defining and describing self-identity and social connectedness. Findings of the EEG study suggested that for the individual participants, both verbal and music-assisted reminiscence therapy resulted in widespread and lateralised activation. These activations were stronger for music- assisted reminiscence than for verbal reminiscence, particularly in the central and frontal areas. Only participants who received music-assisted reminiscence demonstrated activation in areas associated with emotional regulation and meditation, providing preliminary evidence for the SEED model.

The two presented studies contribute to our understanding of the potential mechanisms for change when applying reminiscence and music-assisted reminiscence therapy interventions to improve wellbeing for older people.

We aimed to study the relationship between glutathione (GSH), a key molecule of the anti-oxidant defense system in the blood, and glutathione reductase (GR), which reduces oxidized GSSG to GSH and maintains redox balance, with the prevalence of Alzheimer’s dementia and cognitive decline.

20 with normal cognition and 20 with Alzheimer's dementia who completed the 3rd f/u clinical evaluation over 6 years were selected by matching age and gender. Plasma glutathione (GSH) and glutathione reductase (GR) concentrations were independent variables. Clinical diagnosis and neurocognitive test scores were used as dependent variables indicating cognitive status.

The higher the GR, the greater the possibility of normal cognition rather than Alzheimer's dementia. Also, the higher the GR, the higher the neurocognitive score. However, this association was not significant in GSH in any way. After 6 years, the conversion rate from normal cognition to cognitive impairment was significantly higher in the lower 50th percentile of the GR group than in the upper 50th percentile.

According to the result of this study, the higher the GR, the lower the prevalence of Alzheimer's dementia and incidence of cognitive impairment, and the higher the cognitive outcome. Therefore, GR can be regarded as a protective biomarker for Alzheimer’s dementia and cognitive decline.

Maintaining remission after electroconvulsive therapy (ECT) is of clinical relevance in patients with depression, and maintenance ECT is introduced in patients who fail to maintain remission after ECT. However, the clinical characteristics and the biological background of patients who receive maintenance ECT are barely understood.

At Keio University Hospital, Patients with major depressive disorder according to DSM-IV who received ECT between January 2012 and March 2019 followed by maintenance ECT (mECT group) and those who did not (aECT group) were included. Clinical characteristics including the results of neuroimaging marker for Parkinson’s disease and dementia with Lewy bodies were compared between groups.

Thirteen and one hundred forty-six patients were included in mECT and aECT groups, respectively. Compared with aECT group, the age of onset and the age of the first ECT was older in mECT group. Besides, mECT group showed significantly higher prevalence of melancholic feature (92.3% vs. 27.4%, p<0.001) and catatonic feature (46.2% vs. 9.6%, p=0.002). The results of neuroimaging marker obtained in 123I-metaiodobenzylguanidine scintigraphy and dopamine transporter scan revealed that 5 of 13 patients and 16 of 146 patients showed Parkinson’s disease and dementia with Lewy bodies in mECT and aECT groups, respectively.

Patients who underwent acute and maintenance ECT have impaired dopamine function. Investigating the neurobiology of patients who receiving maintenance ECT is an important area for development of appropriate treatment for depression.

Internet-based interventions have been explored for their potential to minimize the negative outcomes of caring, accounting for their convenient delivery, ubiquity, potential scalability and presumed (cost) effectiveness. A new online training and support programme for dementia caregivers was recently created by the World Health Organization and culturally adapted to European-Portuguese. The programme (iSupport) was developed to prevent or minimize the negative psychological effects of providing informal care to a person with dementia and relies on problem-solving and cognitive behavioural therapy techniques.

To study the usability and feasibility of the European-Portuguese version of iSupport (iSupport- Portugal).

The usability study was aimed at collecting data on user satisfaction and requirements on the programme's contents and interface. A mixed-methods design consisted of focus groups discussion and usability test sessions with informal caregivers (N=17) and health/social support professionals (N=13). The pilot study followed a mixed-methods experimental parallel between-group design with two arms (iSupport, N=21 and e-book, N=21).

The usability tests show a success rate superior to 80% in completing tasks within the platform and an excellent perception of the program's usability (M= 89.5 on the System Usability Scale). The feasibility study allowed to explore usage data for iSupport-Portugal (e.g., lessons visited, time on sessions) and explore how the intervention and control arms compare over time (baseline, 3 and 6 months after) on well-being outcomes. For a per-protocol analysis, significant group-by-time interaction effects favouring the intervention were found for anxiety (Wald χ2=6.17, p=.046) and for environmental QoL (Wald χ2=7.06, p=.029). Interviewees with the intervention arm (N=12) revealed positive impacts of iSupport on knowledge and on experiencing positive feelings.

The usability and feasibility studies of iSupport-Portugal suggest that this is a promising resource to support informal dementia caregivers. Lessons were learned on the ethical, technological, and research-related challenges for online interventions.