- Sometimes the most effective telehealth programs focus not on the patient, but on the caregiver.
This past June, the National Institute on Aging awarded a three-year, $4.5 million grant to People Power to explore how a home-based telehealth program could help caregivers of people suffering from dementia. Working with the University of California at Berkeley, the Palo Alto, Calif.-based IoT company is developing connected care technology that offers assistance and peace of mind to an often-forgotten link on the healthcare chain.
“We can help people care for their loved ones using smart home services that reduce stress, anxiety and loneliness,” Gene Wang, the company’s CEO, said in a press release. “Receiving this grant and our collaboration with Professor (Dr. Robert W.) Levenson at UC Berkeley is the first step in providing desperately needed support for caregivers through carefully designed connected services.”
“Caregiving for persons with dementia and other neurodegenerative diseases can be extremely stressful, and many caregivers experience marked declines in mental and physical health,” added Levenson, a Professor of Psychology at UC Berkeley. “Our participation in this collaborative research with People Power will address the profound intertwining of the lives and well-being of caregivers and persons with dementia as they engage in one of life’s most challenging and intimate relationships.”
To better understand how mHealth and telehealth can be used to make the caregiver’s life easier, mHealthIntelligence talked with Marguerite Manteau-Rao, director of product management for People Power’s Care Services unit and an advisor and judge for the 2018 Caregiver for Dementia Innovation Challenge, sponsored by UnitedHealthCare and the AARP.
Q. How would digital health technology help people living at home with dementia and their caregivers?
A. First, let's be a bit more specific about dementia. Dementia is an umbrella that covers many different types of diseases. The most well-known and prevalent is Alzheimer's Disease (AD), which starts with memory loss and tends to be a disease of the old or very old (80+). Another type that will be studied in our grant is Frontotemporal Dementia (FTD), which is more a dementia of the relatively young (50's - 60's) and affects the part of the brain that regulates behaviors and judgment. So two very different demographics for both the person with dementia and their caregivers.
Digital health technology can help lessen caregiver stress and improve quality of life for the person with dementia. How can that be done? By addressing the factors of caregiver stress and daily living challenges for persons with dementia. Changes in the brain of a person with dementia make it more difficult to perform activities of daily living and function within the home environment. This can lead to behaviors that contribute to caregiver stress. Caregivers also isolate and have a high rate of depression (40 percent). Technology can address the root causes - environmental, social and behavioral.
Q. How might artificial intelligence AI software enhance that platform?
A. Traditional caregiving technologies have not been very smart and have not been able to generate personalized solutions without asking questions from their users. That is a problem, given that dementia is a progressive disease and symptoms are very unique to each person. Caregivers or patients usually don't like to be burdened with questions.
An intelligent software solution can be more caring and anticipate needs for both the person with dementia and the caregiver. It learns from its users' interactions with their environment and the devices. The more intelligent the software, the more 'caring' it can be, and the more peace of mind it can provide to the caregiver.
Q. What challenges or concerns are there in developing new technology solutions for this population?
A. Home privacy and cybersecurity are big concerns for seniors. Another is accessibility related to hearing, vision, mobility and cognitive challenges. Many of those disabilities co-exist, creating an added layer of complexity when developing technology solutions
Comfort with technology and adoption of new technologies significantly decreases with age. In order to be successful, technology needs to ask little from seniors. This is why voice technologies hold so much promise
Engagement has also been a big problem. Seniors crave social connections and natural language and need technologies that 'talk' to them.
Q. Specifically, how could these solutions be developed to help caregivers?
A. Caregivers wear out because of constant worry about the safety of the person they’re caring for. They’re also being exposed to the person's behaviors and not knowing how to respond or prevent such behaviors. And finally, they often isolate themselves.
Technology can help by monitoring, and alerting in the case of detected safety issues in the home - stove safety, water safety, wandering, etc. It can also help mitigate environmental factors at home - noise, lighting, temperature - thereby diminishing the chance of distress and resulting behaviors in the person with dementia.
Technology can play a direct caregiving role, for example, providing voice assistance for repetitive questions from the person with dementia. And it can facilitate social support from trusted circles - family, friends, neighbors and other caregivers - for both the person with dementia and the caregiver.
Q. How do healthcare providers (primary care physicians, home health agencies, specialists) figure into this platform?
A. Automatized tracking of changes in a person's activities or daily living can provide very useful data points to healthcare providers. This can be done in the form of alerts, calling attention to unusual patterns and the need to consult with a doctor.
Q. Is there a current fad or technological trend for senior care that won’t pan out?
A. Any technology that requires too much from seniors, particularly the very old, is not going to work. Also, any technologies that just look or feel “old,” and dispensable technologies for which seniors have acceptable low-tech alternatives.