Telegerontology Update for Research in Progress Dec.

10th, 2014INVESTIGATORS: Dr. Roger Butler, Dr. Gerard Farrell, Dr. Michelle Ploughman, Dr. Susan Mercer, Dr. Cathy Hickey, Ms. Ann Hollett, Ms. Elizabeth Wallack, Ms. Chelsea Harris

Why?

1. Realization the current system is in crisis. ALC rise.

2. Dementia doubling rate will exhaust NH capacity.

3. Lack of alternative housing options.4. Lack of community home supports. 5. High rate of poverty in seniors.6. The catalyst.

Funding Partners

Alzheimer Society. NLCAHR.Government of Newfoundland and Labrador. NLMA. eHealth Research Unit, MUN. Lawson Foundation (Dr. Maxwell House).Health Care Foundation (Dr. Gerard Farrell).

Some Key Questions

Can a remote team help manage a patient with dementia in their home and improve their care, reduce caregiver burden and enhance the caregiver family physician dyad?

What are the caregiver features which help sustain people with dementia in their home?

What supports are necessary? Can we prevent visits to ER and subsequent

NH admissions (premature)?

The Home Assessment

Introductions / Circle of Care / Consent.Home video / OT assessment. Caregiver

Hassle scale IV about patients functional status / supports FIM

Patient Cognitive status: MMSE / MOCAGait and balance: Get up and go Executive function and safety: Kettle test

Computer instruction for caregiver / patient with APPS.

Telegerontology Home Assessment Video

Control

Same intervention as the test group. All patients receive iPads with apps. All patients invited to receive Alzheimer’s

first link program.All patients invited to Alzheimer’s

educational series via skype.The Test group receive a weekly call from

Dr. Butler or team member to discuss concerns if any, and to tabulate data.

Telegerontology Project Timeline: Update

Task Jan-June 2014

June 2014

Jul-Dec 2014

Dec 2014

Jan-June 2015

June 2015

Dec 2015

June 2016

Dec 2016

Jan-June 2017

Group 1 Recruitment

X

Group 2 Recruitment

X

Group 1 Physician and Caregiver Pre-Interviews

X

Group 1 Intervention

X

Group 2 Physician and Caregiver Pre-Interviews X

Group 2 Intervention

X

Group 1 6 month follow-up X

Group 2 6 month follow up

X

Group 1 12 month follow up

X

Group 2 12 month follow up

X

Group 1 18 month follow up

X

Group 1 Physician & Caregiver Post Interviews X

Group 2 18 Month follow up

X

Group 2 Physician & Caregiver Post-Interviews X

Analysis and Write up

X

Lessons Learned

1. Good app development requires excellent communication between the computer specialist and the clinician.

Dr. Gerard Farrell has been essential in this area.2. Caregiver profiles.3. Support patterns 80/20.4. Which computers and which apps.5. Contact frequency / time per week per

family.

Patient Scenarios

Cornell scale picking up depression. Falls and system navigation are key

features.Patient aggression at home / validation

and help with the Cohen Mansfield. Controls also looking for help / advice

given and directed to help.

Next Steps

2nd group recruitment. 2 student projects analyzing data for

family physician needs (MD focus groups) and patient / caregiver interviews qualitative data.

6 month data collection point. 18 month pilot study. Big picture.