JMIR Publications

ABSTRACT

Background:

People living with dementia (PLWD) represent a significant and growing segment of the older adult (65 years and over) population. PLWD are often challenged expressively and may experience difficulties with sharing their feelings or moods. Availability of and easy access to tablets facilitates use of information and communication technologies (ICTs) as a delivery mechanism for non-pharmacological interventions, especially for PLWD. Evidence of the impact of ICTs in different community settings on mood with older adults, as well as the impact of engagement on their caregivers, is needed to promote broader adoption and sustainment of these technologies in the U.S.

Objective:

This projects’ aim was to determine extent of the effects of tablets on positive mood change, and examine effects of study variables on care recipients’ mood changes and caregivers’ daily interactions.

Methods:

The tablet intervention was developed and evaluated in five programs. The primary outcome was caregiver-assessment of care recipients’ mood (n=1,089) before and after a tablet engagement session using an 8-point mood visual analog scale. Session influence on caregiver daily activities was captured for a sub-sample of participants (n=542). Frequency distributions were computed for each study variables. χ2 tests of association were calculated to determine the association of the variables on mood changes for all care recipients, as well as those being treated in SNFs and in-home, and then those that affected caregiver daily activities.

Results:

The study sample comprised 1,089 care recipient/caregiver engagement sessions. Cumulatively, 51% (553/1,089) of care recipients showed a transition from negative to positive moods, while another 42% (455/1,089) maintained an already-positive mood after the caregiver engagement session. χ2 analyses demonstrated that positive mood changes resulted from using music (χ2(10) = 72.95, P < .001), using YouTube as the sole app (χ2(12) = 64.50, P < .001), using multiple engagement strategies (χ2(2) = 42.84, P < .001), and when cared for in a skilled nursing facility (χ2(4) = 236.75, P < .001) across the entire care recipient sample. In addition, although many features of the engagement session positively influenced the caregivers’ day, the largest effect was observed when care recipients’ mood was considered to have improved following the session (χ2(4) = 234.71, P < .001).

Conclusions:

The study is one of the first in the U.S. to explore the impact of ICTs, in particular managed tablets and web-based video services that can be used on a tablet through an app, to improve mood in PLWD and enhance caregiver perceptions about their care recipient interactions. Importantly, these pilot data substantiate ICTs as part of a personalized engagement approach, as beneficial alternatives to pharmaceutical interventions for mood enhancement. However, a more comprehensive study that explores the ICT impact on additional clinical outcomes is needed to confirm these preliminary findings.