The COACH prompting system to assist older adults with dementia through handwashing: An efficacy study

被引：167

作者：

Mihailidis A. ^{[1
,2
]}

Boger J.N. ^{[1
,2
]}

Craig T. ^{[1
]}

Hoey J. ^{[3
]}

机构：

[1] Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, ON M5G 1V7

[2] Toronto Rehabilitation Institute, Toronto, ON

[3] School of Computing, University of Dundee, Dundee

来源：

BMC Geriatrics | / 8卷 / 1期

关键词：

Dementia; False Alarm; MMSE Score; Caregiver Burden; Belief State;

D O I：

10.1186/1471-2318-8-28

中图分类号：

学科分类号：

摘要：

Background. Many older adults with dementia require constant assistance from a caregiver when completing activities of daily living (ADL). This study examines the efficacy of a computerized device intended to assist people with dementia through ADL, while reducing caregiver burden. The device, called COACH, uses artificial intelligence to autonomously guide an older adult with dementia through the ADL using audio and/or audio-video prompts. Methods. Six older adults with moderate-to-severe dementia participated in this study. Handwashing was chosen as the target ADL. A single subject research design was used with two alternating baseline (COACH not used) and intervention (COACH used) phases. The data were analyzed to investigate the impact of COACH on the participants' independence and caregiver burden as well as COACH's overall performance for the activity of handwashing. Results. Participants with moderate-level dementia were able to complete an average of 11% more handwashing steps independently and required 60% fewer interactions with a human caregiver when COACH was in use. Four of the participants achieved complete or very close to complete independence. Interestingly, participants' MMSE scores did not appear to robustly coincide with handwashing performance and/or responsiveness to COACH; other idiosyncrasies of each individual seem to play a stronger role. While the majority (78%) of COACH's actions were considered clinically correct, areas for improvement were identified. Conclusion. The COACH system shows promise as a tool to help support older adults with moderate-levels of dementia and their caregivers. These findings reinforce the need for flexibility and dynamic personalization in devices designed to assist older adults with dementia. After addressing identified improvements, the authors plan to run clinical trials with a sample of community-dwelling older adults and caregivers. © 2008 Mihailidis et al; licensee BioMed Central Ltd.

引用

共 43 条

[1]

Census Bureau U.S., Global Population Profile: 2002, (2004)

[2]

Ferri C., Prince M., Brayne C., Brodaty H., Fratiglioni L., Ganguli M., Hall K., Hasegawa K., Hendrie H., Huang Y., Jorm A., Mathers C., Menezes P., Rimmer E., Scazufca M., Global prevalence of dementia: A Delphi consensus study, The Lancet, 366, pp. 2112-2117, (2006)

[3]

Shenk D., Kuwahara K., Zablotsky D., Older women's attachments to their home and possessions, Journal of Aging Studies, 18, pp. 157-169, (2004)

[4]

Bryant L., In their own words: A model of healthy aging, Social Science and Medicine, 53, pp. 927-941, (2001)

[5]

Cutchin M., The process of mediated aging-in-place: A theoretically and empirically based model, Social Science and Medicine, 57, pp. 1077-1090, (2003)

[6]

Intille S.S., A New Research Challenge: Persuasive Technology to Motivate Healthy Aging, IEEE Transactions on Information Technology in Biomedicine, 8, pp. 235-237, (2004)

[7]

Dura J., Stukenberg K., Kiecolt-Glaser J., Anxiety and depressive disorders in adult children caring for demented parents, Pscyhology and Aging, 6, pp. 467-473, (1991)

[8]

Aguglia E., Onor M.L., Trevisiol M., Stress in the caregivers of Alzheimer's patients: An experimental investigation in Italy, American Journal of Alzheimer's Disease and Other Dementias, 4, pp. 248-252, (2004)

[9]

Pollack M.E., Planning Technology for Intelligent Cognitive Orthotics, 6th International Conference on AI Planning and Scheduling, (2002)

[10]

Mann W.C., Ottenbacher K.J., Fraas L., Tomita M., Granger C.V., Effectiveness of assistive technology and environmental interventions in maintaining independence and reducing home care costs for the frail elderly, Archives of Family Medicine, 8, pp. 210-217, (1999)

← 1 2 3 4 5 →