Impact of Monitoring Technology on Family by Semaj1212

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									What’s Mom Doing Now? Impact of Monitoring Technology on Family Caregiving

Jennifer M. Kinney
Cary S. Kart and Jennifer M. Kinney

& Cary S. Kart

Technology is All Around Us
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Health (telemedicine) Living environments Communication Work Learning/education
Czaja & Schulz, 2006

Technology, Aging & The Future

QuickTime™ and a TIFF (Uncompressed) decompressor are needed to see this picture.

The SAFE House Project
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Agency-initiated project (Ohio District V Area Agency on Aging, Mansfield, Ohio) Over-arching question: What role might technology play in assisting families who care at home for a relative with dementia?

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Step One: Talk to Current and Former Caregivers
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5 focus groups, with a total of 26 current and former caregivers Explore caregivers’ biggest challenges; the extent to which they already use technology; their willingness to try additional technology

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Step One Findings
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Safety is caregivers’ over-arching concern Caregivers use “low-level” technology (e.g., intercoms), but lack a comprehensive system

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Caregivers are willing to use technology, but do not want to become “technology nerds”

Desired Characteristics of Technology:
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Readily available Affordable Adaptable Stable “Set it and forget it”

Step Two: Identify Technology/Technologies
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Hard-wired, motion-activated cameras Battery-powered sensors to detect doors opening/closing, noise, water, power on/off Controller unit Computer with broadband access Cell phone with text messaging capability

Step Three: Have Caregivers Use the Technologies
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19 families who were caring for a relative with dementia agreed to have the technology installed in their homes for 24 weeks

Characteristics of Participants
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Caregivers ranged in age from 36-82 (average= 56); 11 were female Caregivers were ethnically/racially diverse (13 White, 4 Black, 1 Hispanic, 1 Asian American) Caregivers represented a variety of kinship ties with the individual with dementia (7 spouses, 7 daughters, 3 sons, 1 sister, 1 grand niece)

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Characteristics of Participants
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Caregivers had been providing care for an average of almost 5 years Individuals with dementia ranged in age from 61 - 103 (average = 76); 14 were female; they were severely impaired

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The Installation Process…
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Working with the researchers, families decided on camera and sensor placement While the technology was installed by researcher, another researcher trained the caregiver on how to use the technology (the average initial installation/education time was 2.5 hours)

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What System Components did Participants Choose?
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17 families had at least one camera (average = 2; maximum = 4)
17 families had at least one door sensor (average=2.75; max =4)

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7 families had at least one water sensor (average=1.5; max=2) 1 family had a power on-off sensor

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Performance and Maintenance of the Technology– and Participants
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On average, a sensor was activated 14.22 times each day (range = 0 – 35); most activations involved a door opening Neither participants nor technologies are maintenance free (e.g., extensive and ongoing training is necessary, equipment stops working, web servers and cell phones “go down”)

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Over the course of 24 weeks…..
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We did experience attrition: 1 caregiver found the technology “too bothersome” 1 individual with dementia kept disassembling the technology 4 individuals with dementia became sufficiently impaired that the technology was no longer useful and/or they were placed in institutional housing

Over the course of 24 weeks…..
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13:19 caregivers used the system for the entire 24 week evaluation period
16 caregivers completed exit interviews in which they discussed the advantages and disadvantages of the technology

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Exit interviews revealed….
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12:13 caregivers using the system for the full 24 weeks reported they would like to continue to use the technology (the remaining caregiver’s relative with dementia had declined such that the technology was no longer helpful) The technology had more advantages than disadvantages

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How the Technologies Affected the Caregivers’ Lives
The System……. Number of Caregivers 14 7 Made life easier (provided peace of mind; reduced vigilance) Made life more difficult (one more thing to worry about)

Changed relationships with family members
Positive Change (cameras “let others in”) Negative Change (cameras invaded privacy)

4
2 2

Changed relationships with friends
Positive Change (cameras “let others in”) Negative Change (cameras invaded privacy)

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Changed the caregiver’s relationship with the PWD
Positive Change (helped caregiver relax a bit) Negative Change

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Changed how the caregiver spends his/her time Positive Change (e.g., more free time, more time for self) Negative Change

11 11 0

Step Three Findings
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It is possible to bundle readily available technologies and outfit peoples’ homes with these technologies Regardless of previous experience with technology, caregivers can learn to use these technologies

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Step Three Findings
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Although these technologies are not without problems, for most of the caregivers in our research, the advantages of the technologies outweighed the disadvantages Successful use of these technologies requires constant monitoring and maintenance

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Step Three Findings
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The cost of the bundle of these technologies is modest compared to the average rate of a paid, in-home licensed practical nurse or nursing home placement

Issues of Trust and Privacy that Emerged
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Caregivers are willing to sacrifice their own privacy and the privacy of their relative with dementia if they believe it will result in increased safety for their relative These technologies cannot guarantee that a relative with dementia will always be safe

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Issues of Trust and Privacy that Emerged
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The technology caused some caregivers to question the extent to which they could trust others

Issues of Trust and Privacy that Emerged
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When technology alerts a caregiver to a potentially dangerous situation (e.g., an individual with dementia is viewed doing something dangerous from a remote location), adequate protocols must be in place to intervene in a timely manner

The Use of Monitoring Technologies in the “Real World”
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It takes a village…and even then it isn’t easy Caregiving as a partnership between individual who needs care, family and formal service providers

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The Use of Monitoring Technologies in the “Real World”
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Defining key values: safety, privacy, autonomy, choice, dignity

Next Steps, Thanks to the National Institute on Aging
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explore issues of personal control and the trade-offs between assuring safety for the family member with AD and maintaining an acceptable level of privacy assess caregivers trust in the use of monitoring technology

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For more information about this research…
Jennifer M. Kinney, Ph.D.
Professor of Gerontology Department of Sociology and Gerontology & Scripps Gerontology Center Miami University Oxford, OH 45056 kinneyjm@muohio.edu


								
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