JMIR Publications

ABSTRACT

Background:

Family members caring for older persons living with dementia at home often experience high caregiver burden and depression. Support interventions that include smart-clothes technology for monitoring care receivers can ease caregiver burden and improve quality of care.

Objective:

To examine the effects of a smart clothes-assisted homecare nursing program for persons living with dementia on outcomes for family caregivers.

Methods:

A non-randomized, quasi-experimental research design with an intervention and control group. Family caregivers and persons living with dementia were recruited by convenience sampling from dementia-care centers in northern Taiwan. The nurse-led intervention was conducted in care receivers’ homes from August 2020 to November 2023. Sixty dyads agreed to participate. Care receivers in the intervention group (n = 30) wore a smart-clothes vest 24 hours per day for a 6-month period; care receivers in the control group (n = 30) received usual care. Sensors in the smart-clothes vest and in the home transmitted activity signals to a nurse via a smartphone app who then provided real-time feedback to caregivers. This information was used to formulate individualized care plans. The effect of the intervention was assessed by comparing scores for caregivers in the intervention and control group on self-report structured questionnaires for caregiving preparedness and balance, depressive symptoms, and health-related quality of life. Intention-to-treat analysis was employed; data were analyzed using generalized estimating equations. Baseline measures were compared with assessments at 2-, 4-, and 6-months.

Results:

Baseline measures did not differ between groups. Compared with controls, increases from baseline for caregiving preparedness and balance were statistically significantly greater at 6 months (ß = 2.594, 95% CI = 4.888, 4.700; P = .01 and ß = 0.181, 95% CI = 0.001, 0.361; P = .049, respectively), and for mental health at 2 months (ß = 4.535, 95% CI = 0.049, 9.022; P = .048). Compared with controls, caregiving balance was statistically significantly greater for the intervention group at 2-, 4-, and 6-months (95 % CI: 0.011, 0.506; P = .04, 0.078, 0.575; P = .01 and 0.176, 0.602; P <.001, respectively). Within the intervention group, statistically significantly increases from baseline were seen for preparedness at 4-, and 6-months (95 % CI: 0.492, 4.041; P = .01 and 0.534, 3.798; P = .009, respectively).

Conclusions:

Our findings suggest support from the smart clothes-assisted homecare nursing program enhanced caregiving balance, increased preparedness, and improved mental health over the 6-month intervention. These findings provide a reference for implementing wearable technology when developing a support intervention for family caregivers of persons living with dementia. Clinical Trial: ClinicalTrials.gov Protocol Record NCT05063045