The Value of a virtual Kitchen to assess the activities of Daily life in Alzheimer Disease

Patients with Alzheimer\u27s disease (AD patients) experience difficulties in everyday life activities that effect independence. These difficulties can be tested using virtual reality (VR) environments that simulate real life situations. The purpose of this study was to examine the value of a virtual kitchen as an assessment tool of everyday life activities in AD patients. We focus on the assessment results obtained in a group of AD patients on a virtual kitchen designed to assess their ability to prepare a virtual cup of coffee using a virtual coffee machine. An identical real daily living task was tested. Twenty-four AD patients were matched to 32 healthy elderly controls. Significant differences in performance between research and control groups were detected on the virtual and the real tasks, with the research group performing worse. In addition, regression analyses revealed that the number of errors in the virtual test was the best predictor for the real assessment and the Instrumental Activities of Daily Living score. This provides initial support for the sensitivity and the ecological validity of the virtual kitchen as an assessment tool of everyday life activities in AD patient

Crossing the digital divide : family caregivers' acceptance of technology

The purpose of this pilot project was to collect data on how electronic technology might be used to assist family members who are caring for a relative with dementia at home. In Phase 1, we conducted five focus groups with 26 caregivers of relatives with dementia to document the specific challenges faced by caregivers and assess their access to, and familiarity with, electronic technology. In Phase 2, a technology-based solution B the Xanboo Smart House Management System B was identified. The System allows monitoring of a residence through placement and control of video cameras and other enabled devices, including sensors that detect motion, the presence of water, or noise. Sensors may be set to provide a caregiver or other interested party with immediate notification by e-mail, pager, or text messaging cell phone. In Phase 3, a household was outfitted with The System and two focus groups comprised of 8 caregivers to relatives with dementia were conducted to evaluate its utility. The report concludes with an annotated bibliography on technology and aging, with special focus on caring for a relative with dementia. Key Findings: Caregivers and the relatives for whom they provide care are in an evolving struggle to maintain continuity of roles, relationships, and lifestyles. Challenges include the safety of the individual with dementia and keeping geographically distant family members aware of their relative s condition. Caregivers used a range of technologies in their day-to-day lives, including low- tech solutions to challenges in caregiving. Caregivers felt strongly that technological solutions were neither appropriate nor useful across all situations, and were cognizant of the inherent trade-off between safety on the one hand and dignity, respect, privacy, and desires for independence and autonomy on the other hand. Caregivers do not aspire to become technology whizzes ; rather, they are interested in easily obtained, affordable, easy to use, solutions to some of the challenges they face. An affordable, easy to use, off the shelf, monitoring system (The System) was identified. Caregivers attitudes regarding The System were generally quite positive. When prompted to identify barriers to using The System, caregivers identified the need for a computer and Internet access, and cost. Conclusions: The results from this pilot project suggest that there are affordable technologies that can assist family members in their efforts to care for relatives with dementia at home, and that these caregivers were amenable to the use of these technologies. Future efforts should evaluate the installation, use, and impact of The System in the homes of family caregivers to relatives with dementia

Virtual Reality to Stimulate Cognitive Behavior of Alzheimer's and Dementia Patients

Seniority and Alzheimer’s and dementia’s diseases lead to progressive cognitive impairment. The exploitation of Virtual Reality is investigated to test innovative entertainment and therapeutic activities that can provide new stimuli and interests for patients. The game approach activates mechanisms able to train memory and energize the mind through visuospatial and sound inputs. A full-immersive application has been developed to allow the patient to perform this kind of experience at home for daily training, becoming short therapeutic cycles, thanks to the affordability, the transportability and the flexibility of the infrastructure put in place. The cognitive path foresees successive levels of interaction, alternating relaxing and inspiring settings and exercises. It can improve the quality of life by learning to manage and monitor actions and feelings. In this way, these kind of experience can generate positive benefits not only for those who show fragility, but also for their families in addition to a tool to support health workers for diagnostics and training

Technologies to support community-dwelling persons with dementia: a position paper on issues regarding development, usability, effectiveness and cost-effectiveness, deployment, and ethics

Background: With the expected increase in the numbers of persons with dementia, providing timely, adequate, and affordable care and support is challenging. Assistive and health technologies may be a valuable contribution in dementia care, but new challenges may emerge. Objective: The aim of our study was to review the state of the art of technologies for persons with dementia regarding issues on development, usability, effectiveness and cost-effectiveness, deployment, and ethics in 3 fields of application of technologies: (1) support with managing everyday life, (2) support with participating in pleasurable and meaningful activities, and (3) support with dementia health and social care provision. The study also aimed to identify gaps in the evidence and challenges for future research. Methods: Reviews of literature and expert opinions were used in our study. Literature searches were conducted on usability, effectiveness and cost-effectiveness, and ethics using PubMed, Embase, CINAHL, and PsycINFO databases with no time limit. Selection criteria in our selected technology fields were reviews in English for community-dwelling persons with dementia. Regarding deployment issues, searches were done in Health Technology Assessment databases Results: According to our results, persons with dementia want to be included in the development of technologies; there is little research on the usability of assistive technologies; various benefits are reported but are mainly based on low-quality studies; barriers to deployment of technologies in dementia care were identified, and ethical issues were raised by researchers but often not studied. Many challenges remain such as including the target group more often in development, performing more high-quality studies on usability and effectiveness and cost-effectiveness, creating and having access to high-quality datasets on existing technologies to enable adequate deployment of technologies in dementia care, and ensuring that ethical issues are considered an important topic for researchers to include in their evaluation of assistive technologies. Conclusions: Based on these findings, various actions are recommended for development, usability, effectiveness and cost-effectiveness, deployment, and ethics of assistive and health technologies across Europe. These include avoiding replication of technology development that is unhelpful or ineffective and focusing on how technologies succeed in addressing individual needs of persons with dementia. Furthermore, it is suggested to include these recommendations in national and international calls for funding and assistive technology research programs. Finally, practitioners, policy makers, care insurers, and care providers should work together with technology enterprises and researchers to prepare strategies for the implementation of assistive technologies in different care settings. This may help future generations of persons with dementia to utilize available and affordable technologies and, ultimately, to benefit from them

A Proposal for Design Guidelines for Dementia Care Facilities in Hawaii

In Hawai‘i, there is a significant population of older adults who suffer with some form of dementia, and the numbers are predicted to increase more rapidly over the next decade as the baby boom generation reaches retirement age. At the same time, many care facilities profess to offer various special dementia or memory care programs. But what exactly does this mean? What are the standards these facilities use to ensure proper care of those with dementia? Hawai‘i often trails behind current trends, technologies, and designs, moving laggardly toward necessary change. The field of dementia care in Hawai‘i is no different. There exist no set guidelines or standards by which a care facility must abide in order to offer specialized care. This dissertation addresses this lack. The first part of this project presents the research, which discusses the specifics of Alzheimer's disease and dementia and examines existing design considerations and guidelines, different types of care facilities, and existing dementia care therapies. Case studies take a closer look at four local care facilities that offer dementia or memory care to see how they stand up to the existing body of knowledge and compare to each other. They offer a glimpse into current dementia care in Hawai‘i. The second part of this project presents a set of guidelines for building Dementia Care Facilities in Hawai‘i. This portion is arranged in a format that is accessible to architects and designers

Virtual Reality Applications in Rehabilitation

The final publication is available at Springer via http://dx.doi.org/10.1007/978-3-319-39510-4_1One of the most valuable applications of virtual reality (VR) is in the domain of rehabilitation. After brain injuries or diseases, many patients suffer from impaired physical and/or cognitive capabilities, such as difficulties in moving arms or remembering names. Over the past two decades, VR has been tested and examined as a technology to assist patients’ recovery and rehabilitation, both physical and cognitive. The increasing prevalence of low-cost VR devices brings new opportunities, allowing VR to be used in practice. Using VR devices such as head-mounted displays (HMDs), special virtual scenes can be designed to assist patients in the process of re-training their brain and reorganizing their functions and abilities. However, such VR interfaces and applications must be comprehensively tested and examined for their effectiveness and potential side effects. This paper presents a review of related literature and discusses the new opportunities and challenges. Most of existing studies examined VR as an assessment method rather than a training/exercise method. Nevertheless, promising cases and positive preliminary results have been shown. Considering the increasing need for self-administered, home-based, and personalized rehabilitation, VR rehabilitation is potentially an important approach. This area requires more studies and research effort

Living at home with dementia: a client-centered program for people with dementia and their caregivers

Thesis (O.T.D.)--Boston UniversityThe number of elderly Americans is increasing rapidly, and dementia is prevalent within this population, especially among the growing group of people over the age of 90 (National Institutes of Health, 2011; Plassman, et al., 2007). The majority of elderly people, including many with dementia, report that they would like to stay in their own homes, which is cost effective for the family and community (Keenan, 2010; Alzheimer's Association, 2012). In addition, people with dementia who live at home are happier, safer, and more independent than those who have been placed into another setting (Alzheimer's Society, 2013). However, they present with a variety of health and safety concerns which have an impact on both their own and their caregivers' quality of life (Allan, et al., 2009; Etters, et al., 2007, Gitlin, 2010). Described in this doctoral project is a caregiver- and client-centered program geared towards delaying or even avoiding long-term care placement of people with dementia by helping to increase client tranquility, independence, and safety, therefore decreasing daily challenges and caregiver feelings of burden. Through this intervention, caregivers will be empowered with skills and strategies with which to engage and support their loved one with dementia, as they are educated regarding the following elements: methods for promoting autonomy in self-care; ways of incorporating meaningful activity into the daily routine; methods for increasing home safety; and strategies for challenging behaviors. This program incorporates a personalized approach, the inclusion of meaningful activity, safe and effective strategies for daily tasks, and an introduction to technology aides and adaptive equipment. A thorough review of the literature was completed in order to ascertain the most effective strategies for addressing the problems affecting informal home caregivers. Best practices are incorporated into the group and individual session structure, and included is a detailed information packet for clients with guidance regarding each of the 14 topics included in the program: information about dementia; fall prevention at home; self-care tasks; successful mealtimes; cooking and kitchen safety; medication management; using the telephone/emergency assistance; wandering and getting lost; rummaging, hiding, and hoarding solutions; sleep strategies; meaningful activity; the preferences worksheet; life story books; and useful resources

Recommendations for the non-pharmacological treatment of apathy in brain disorders

Apathy is a common neuropsychiatric syndrome observed across many neurocognitive and psychiatric disorders. Although there are currently no definitive standard therapies for the treatment of apathy, non-pharmacological treatment (NPT) is often considered to be at the forefront of clinical management. However, guidelines on how to select, prescribe and administer NPT in clinical practice are lacking. Furthermore, although new Information and Communication Technologies (ICT) are beginning to be employed in NPT, their role is still unclear. The objective of the present work is to provide recommendations for the use of NPT for apathy, and to discuss the role of ICT in this domain, based on opinions gathered from experts in the field. The expert panel included 20 researchers and healthcare professionals working on brain disorders and apathy. Following a standard Delphi methodology, experts answered questions via several rounds of web-surveys, and then discussed the results in a plenary meeting. The experts suggested that NPT are useful to consider as therapy for people presenting with different neurocognitive and psychiatric diseases at all stages, with evidence of apathy across domains. The presence of a therapist and/or a caregiver is important in delivering NPT effectively, but parts of the treatment may be performed by the patient alone. NPT can be delivered both in clinical settings and at home. However, while remote treatment delivery may be cost and time-effective, it should be considered with caution, and tailored based on the patient's cognitive and physical profile and living conditions