Title: CARETAKVR: A Virtual Reality Environment to Train Alzheimer's Caregivers
The number of patients diagnosed with Alzheimer's disease is significantly increasing, given the boom in the aging population (i.e., 65 years and older). There exist approximately 5.5 million people in the United States that have been diagnosed with Alzheimer's, and as a result friends and family often need to provide care and support (estimated at 15 million people to the cost of $1.1 trillion). Common symptoms of Alzheimer's disease include memory loss, drastic behavioral change, depression, and loss in cognitive and/or spatial abilities. To support the growing need for caregivers, this project developed a prototype virtual reality (VR) environment for enabling caregivers to experience typical scenarios, as well as common strategies for managing each scenario, that they may experience when providing care and support, thereby providing. For instance, a patient may turn on a gas stove and then leave, forgetting that the stove is on. The caregiver then would be required to turn the stove off, to minimize any potential
dangers.
The prototype environment, CARETAKVR, was developed as an undergraduate research project for learning the process of research as well as the Unity programming environment and VR. The prototype provides a gamified training tool, masking scenarios as objectives and success with a score, to enable the potential caregiver to feel rewarded for correctly supporting the patient. The virtual patient is controlled via artificial intelligence and follows an initial set of guidelines to behave as a patient with early-stage Alzheimer's may behave. The caregiver is provided with a set of tasks to perform, in VR space, to achieve their goals for each scenario. Common tasks include Check Refrigerator, Check Stove, and Comfort Patient. This project has been demonstrated to colleagues in the health care domain and has seeded future collaborations to iterate the capabilities of this tool. All project artifacts have been open-sourced and are available online. more »« less
We aim to explore Current Procedural Terminology (CPT) codes for caregiving training services and their potential impacts on caregivers of people living with dementia.
Description of the Project/Program
In response to the growing need for support for caregivers of people living with physical and mental health issues, CPT codes for caregiving training services will be activated for the calendar year 2024. These codes cover (1) family group behavior management and modification training services and (2) caregiver training for techniques to help patients maintain their quality of life. Caregivers will access such training support through the CPT codes provided by treating practitioners. The duration of training will vary by code.
Outcome
Implementing CPT codes for caregiver training services highlights the vital role of caregivers in patient care. This support may improve their skills and communication with healthcare providers. However, timing and accessibility in care delivery need clarification, especially for caregivers of people living with dementia. Regular skill assessment and culturally competent care are essential. Before providing the service, provider training may also promote person-centered care, benefiting patients and their caregivers.
Conclusion
Activating CPT codes for caregiving training services may enhance caregivers' support and skills, including dementia care.
Rose, Karen M.; Coop Gordon, Kristina; Schlegel, Emma C.; Mccall, Matthew; Gao, Ye; Ma, Meiyi; Lenger, Katherine A.; Ko, Eunjung; Wright, Kathy D.; Wang, Hongning; et al(
, Journal of Advanced Nursing)
AbstractAim
The aim of this study is to develop a Smarthealth system of monitoring, modelling, and interactive recommendation solutions (for caregivers) for in‐home dementia patient care that focuses on caregiver–patient relationships.
Design
This descriptive study employs a single‐group, non‐randomized trial to examine functionality, effectiveness, feasibility, and acceptability of the novel Smarthealth system.
Methods
Thirty persons with Alzheimer's Disease or related dementia and their family caregivers (N = 30 dyads) will receive and install Smarthealth technology in their home. There will be a 1‐month observation phase for collecting baseline mood states and a 2‐month implementation phase when caregivers will receive stress management techniques for each detected, negative mood state. Caregivers will report technique implementation and usefulness, sent via Ecological Momentary Assessment system to the study‐provided smartphone. Caregivers will provide daily, self‐reported mood and health ratings. Instruments measuring caregiver assessment of disruptive behaviours and their effect on caregivers; caregiver depressive symptoms, anxiety and stress; caregiver strain; and family functioning will be completed at baseline and 3 months. The study received funding in 2018 and ethics board approval in 2019.
Discussion
This study will develop and test novel in‐home technology to improve family caregiving relationships. Results from this study will help develop and improve the Smarthealth recommendation system and determine its usefulness, feasibility, and acceptability for persons with dementia and their family caregiver.
Impact
The Smarthealth technology discussed will provide in‐home stress reduction resources at a time when older adults may be experiencing increasingly high rates of isolation and anxiety and caregiver dyads may be experiencing high levels of relationship strain.
Trial Registration
This study was registered with Clinical Trials.gov (Identifier NCT04536701).
Telehealth technologies play a vital role in delivering quality healthcare to patients regardless of geographic location and health status. Use of telehealth peripherals allow providers a more accurate method of collecting health assessment data from the patient and delivering a more confident and accurate diagnosis, saving not only time and money but creating positive patient outcomes. Advanced Practice Nursing (APN) students should be confident in their ability to diagnose and treat patients through a virtual environment. This pilot simulation was completed to help examine how APN students interacted in a simulation-based education (SBE) experience with and without peripherals, funded by the National Science Foundation’s Future of Work at the Human-Technology Frontier (FW-HTF) program. The SBE experience was created and deployed using the INACSL Healthcare Simulation Standards of Best PracticesTM and vetted by a simulation expert. APN students (N = 24), in their first assessment course, were randomly selected to be either a patient (n = 12) or provider (n = 12) in a telehealth simulation. Student dyads (patient/provider) were randomly placed to complete a scenario with (n = 6 dyads) or without (n = 6 dyads) the use of a peripheral. Students (providers and patients) who completed the SBE experience had an increased confidence level both with and without the use of peripherals. Students evaluated the simulation via the Simulation Effectiveness Tool-Modified (SET-M), and scored their perception of the simulation on a 1 to 5 point Likert Scale. The highest scoring areas were perceived support of learning by the faculty (M=4.6), feeling challenged in decision-making skills (M=4.4), and a better understanding of didactic material (M=4.3). The lowest scoring area was feeling more confident in decision making (M=3.9). We also recorded students’ facial expressions during the task to determine a probability score (0- 100) for expressed basic emotions, and results revealed that students had the highest scores for joy (M = 8.47) and surprise (M = 4.34), followed by disgust (M = 1.43), fear (M = .76), and contempt (M = .64); and had the lowest scores of anger (M = .44) and sadness (M = .36). Students were also asked to complete a reflection assignment as part of the SBE experience. Students reported feeling nervous at the beginning of the SBE experience, but acknowledged feeling better as the SBE experience unfolded. Based on findings from this pilot study, implications point towards the effectiveness of including simulations for nurse practitioner students to increase their confidence in performing telehealth visits and engaging in decision making. For the students, understanding that patients may be just as nervous during telehealth visits was one of the main takeaways from the experience, as well as remembering to reassure the patient and how to ask the patient to work the telehealth equipment. Therefore, providing students opportunities to practice these skills will help increase their confidence, boost their self- and emotion regulation, and improve their decision-making skills in telehealth scenarios.
Abstract Background and Objectives Neuropsychiatric symptoms (NPS) are a core feature of Alzheimer’s disease and related dementias that are characterized by a fluctuating course. NPS are challenging to manage and contribute to high rates of burden among family caregivers. Successful information exchange between clinicians and family caregivers is critical for facilitating effective management of NPS. However, this communication is often challenging due to inconsistent terminology and classification of symptoms and limited understanding of how family caregivers recognize and describe symptoms. The objective of this study was to examine the language family caregivers’ use to describe and contextualize NPS. Research Design and Methods Descriptive qualitative study of 20 family caregivers in a mostly urban county in the Midwestern United States using semistructured interviews. Caregiver descriptions of NPS were analyzed using directed content and text analysis to examine terminology, followed by a thematic analysis approach to examine contextualization of NPS. Results Caregivers employed shared terminologies to describe NPS that differed substantially from clinical terminology used to classify symptoms. Caregivers frequently engaged sense-making as a strategy to explain NPS. This sense-making served to contextualize patterns in behavior and was characterized by explanatory, situational, and strategy-oriented frameworks for understanding behavior in terms of its purpose and meaning. Caregivers’ descriptions of NPS reflected broad overlap between individual NPS (i.e., agitation and care resistance) that would generally be considered clinically distinct symptoms. Discussion and Implications Nomenclature surrounding NPS may vary considerably between family caregivers and clinicians, and should be evaluated in partnership with people with dementia and their caregivers to ensure supportive interventions and resources are responsive to caregivers’ interpretation of symptoms and sense-making.
Guan, Connie; Bouzida, Anya; Oncy-avila, Ramzy M.; Moharana, Sanika; Riek, Laurel D.(
, CHI Conference on Human Factors in Computing Systems (CHI ’21))
null
(Ed.)
Dementia affects >50 million worldwide, causing progressive cognitive and physical disabilities. Its caregiving burden falls largely onto informal caregivers, who experience their own health problems, and face tremendous stress with little support–all exacerbated during COVID-19. In this paper, we present a new caregiver sup- port perspective, where the lenses of health equity and community health can shape future technology design. Through a 1.5 year long, in-depth research process with dementia community health workers, we learned how caregiving support technology can reflect key concepts in dementia community health practice. This paper makes two contributions: 1) We propose employing embodied cueing, such as imitation or action mimicry, as a communication modality that can align technology with community caregiving approaches, promote agency in people with dementia, and relieve caregiver burden, and 2) We suggest new avenues for HCI research to advance health equity in the context of dementia technology design.
Fredericks, Erik M.
Kerns. CARETAKVR: A Virtual Reality Environment to Train Alzheimer's Caregivers. Retrieved from https://par.nsf.gov/biblio/10088804. Proceedings of the 2019 American Society for Engineering Education North Central Section Conference .
Fredericks, Erik M.
Kerns. CARETAKVR: A Virtual Reality Environment to Train Alzheimer's Caregivers. Proceedings of the 2019 American Society for Engineering Education North Central Section Conference, (). Retrieved from https://par.nsf.gov/biblio/10088804.
Fredericks, Erik M.
Kerns.
"CARETAKVR: A Virtual Reality Environment to Train Alzheimer's Caregivers". Proceedings of the 2019 American Society for Engineering Education North Central Section Conference (). Country unknown/Code not available. https://par.nsf.gov/biblio/10088804.
@article{osti_10088804,
place = {Country unknown/Code not available},
title = {CARETAKVR: A Virtual Reality Environment to Train Alzheimer's Caregivers},
url = {https://par.nsf.gov/biblio/10088804},
abstractNote = {The number of patients diagnosed with Alzheimer's disease is significantly increasing, given the boom in the aging population (i.e., 65 years and older). There exist approximately 5.5 million people in the United States that have been diagnosed with Alzheimer's, and as a result friends and family often need to provide care and support (estimated at 15 million people to the cost of $1.1 trillion). Common symptoms of Alzheimer's disease include memory loss, drastic behavioral change, depression, and loss in cognitive and/or spatial abilities. To support the growing need for caregivers, this project developed a prototype virtual reality (VR) environment for enabling caregivers to experience typical scenarios, as well as common strategies for managing each scenario, that they may experience when providing care and support, thereby providing. For instance, a patient may turn on a gas stove and then leave, forgetting that the stove is on. The caregiver then would be required to turn the stove off, to minimize any potential dangers. The prototype environment, CARETAKVR, was developed as an undergraduate research project for learning the process of research as well as the Unity programming environment and VR. The prototype provides a gamified training tool, masking scenarios as objectives and success with a score, to enable the potential caregiver to feel rewarded for correctly supporting the patient. The virtual patient is controlled via artificial intelligence and follows an initial set of guidelines to behave as a patient with early-stage Alzheimer's may behave. The caregiver is provided with a set of tasks to perform, in VR space, to achieve their goals for each scenario. Common tasks include Check Refrigerator, Check Stove, and Comfort Patient. This project has been demonstrated to colleagues in the health care domain and has seeded future collaborations to iterate the capabilities of this tool. All project artifacts have been open-sourced and are available online.},
journal = {Proceedings of the 2019 American Society for Engineering Education North Central Section Conference},
author = {Fredericks, Erik M.
Kerns},
}
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