Latino/Hispanic Alzheimer's caregivers experiencing dementia-related dressing issues: corroboration of the Preservation of Self model and reactions to a "smart dresser" computer-based dressing aid.

Objective: To gain an understanding of Latino/Hispanic caregivers' dementia-related dressing issues, their impressions of using a "smart" context-aware dresser to coach dressing, and recommendations to improve its acceptability.

Method: The same Latina moderator conducted all the caregiver focus groups. She followed a semi-structured interview guide that was previously used with White and African American family caregivers who experienced Alzheimer's disease related dressing challenges.

Prototype Development of a Responsive Emotive Sensing System (DRESS) to aid older persons with dementia to dress independently.

Background: Prior research has critiqued the lack of attention to the stressors associated with dementia related dressing issues, stigmatizing patient clothing, and wearable technology challenges. This paper describes the conceptual development and feasibility testing of an innovative 'smart dresser' context aware affective system (DRESS) to enable dressing by people with moderate memory loss through individualized audio and visual task prompting in real time.

Methods: Mixed method feasibility study involving qualitative focus groups with 25 Alzheimer's family caregivers experiencing dressing difficulties to iteratively inform system design and a quantitative usability trial with 10 healthy subjects in a controlled laboratory setting to assess validity of technical operations.

Family caregivers' perspectives on dementia-related dressing difficulties at home: The preservation of self model.

Alzheimer's caregiving literature acknowledges dressing as a major daily stressor but research on this topic is negligible. A qualitative grounded theory approach was used to explore Alzheimer's family caregivers' perspectives about issues that arise when their family members lose the ability to dress independently. Three focus groups and seven individual interviews were conducted and audio recorded with 25 information rich caregivers.

Use of a transitional minimum data set (TMDS) to improve communication between nursing home and emergency department providers.

Objective: To study the adoption of a transitional minimum data set (TMDS) and its effectiveness in conveying essential clinical data elements between skilled nursing facility (SNF) and emergency department (ED) staff.

Design: Retrospective medical record review of patients transferred from one SNF to one ED over a 14-month period before and after the implementation of the TMDS, to determine whether it improved data transfer compared with prior practice.

Settings: One urban 140-bed SNF, averaging 17 ED transfers per month, and their affiliated ED at a major tertiary care hospital in Boston, MA.

An Evidence-Based Adoption of Technology Model for Remote Monitoring of Elders' Daily Activities.

What benefit will new technologies offer if they are inadequately or not used? This work presents a meta-synthesis of adoption of technology related findings from four innovative monitoring intervention research studies with older adults and their informal and/or formal caregivers. Each study employed mixed methods analyses that lead to an understanding of the key variables that influenced adoption of telephone and Internet based wireless remote monitoring technologies by elders and their caregivers. The studies were all conducted in "real world" homes ranging from solo residences to multi-story independent living residential buildings.

"Under the radar": nurse practitioner prescribers and pharmaceutical industry promotions.

Objective: To assess nurse practitioners' interactions with pharmaceutical industry promotional activities and their perception of information reliability and self-reported prescribing behaviors.

Study Design: Self-administered online survey.

Methods: A nationally randomized sample of nurse practitioner prescribers was surveyed.

Acceptance of wearable technology by people with Alzheimer's disease: issues and accommodations.

The increasing number of cognitively impaired older adults who exhibit wandering tendencies raises safety concerns. The purpose of the current study was to research the State-of the-Art in Wearable Technologies for persons with Alzheimer's Disease and identify challenges unique to this population and lessons learned. Inclusion criteria specified systems/devices that completed laboratory testing and were commercially available for usage by community-based Alzheimer's family caregivers.

In situ monitoring of health in older adults: technologies and issues.

With the upcoming reform of the healthcare system and the greater emphasis on care in the home and other living environments, geriatric providers will need alternate ways of monitoring disease, activity, response to therapy, and patient safety. Current understanding of the dynamic nature of chronic illnesses, their effects on health over time, and the ability to manage them in the community are limited to measuring a set of variables at discrete points in time, which does not account for the dynamic interactions between physiological systems and the environments of daily life. Recent developments of sensors, data recorders, and communication networks allow the unprecedented measurements of physiological and sociological data for use in geriatrics care.

Tensions in Independent Living Facilities for Elders: A Model of Connected Disconnections.

OBJECTIVE: To gain an increased understanding about the geriatric health and safety concerns related to vulnerable elders residing alone in independent living facilities (ILFs). METHODS: Qualitative focus group methodology was used to elicit the perceptions of elderly residents representing three ILFs, their family members, housing staff, and Nurse Practitioner consultants. RESULTS: Staff comprised 3 focus groups, residents 4 groups, and families 1 group for a total of 26 participants across eight focus groups.

More than a prescriber: gerontological nurse practitioners' perspectives on prescribing and pharmaceutical marketing.

The purpose of this study was to gain understanding about nurse practitioners' (NPs') prescriptive decision making for geriatric patients with attention to pharmaceutical marketing influences. Prior research has focused on physician prescribers and identified suboptimal practices. Because the majority of medications are prescribed to older adults, NPs in geriatric practice were targeted as an information-rich group to interview about prescribing issues.

Technology for long-term care.

Severe staff shortages in long-term care (LTC) make it difficult to meet the demands of the growing aging population. Further, technology-savvy Baby Boomers are expected to reshape the current institutional environments toward gaining more freedom and control in their care and lives. Voices from business, academia, research, advocacy organizations, and government bodies suggest that innovative technological approaches are the linchpin that may prepare society to cope with these projected demands.

In-home monitoring of persons with dementia: ethical guidelines for technology research and development.

Innovative technologies are rapidly emerging that offer caregivers the support and means to assist older adults with cognitive impairment to continue living "at home." Technology research and development efforts applied to older adults with dementia invoke special grant review and institutional review board concerns, to ensure not only safe but also ethically appropriate interventions. Evidence is emerging, however, that tensions are growing between innovators and reviewers.

Workplace response to virtual caregiver support and remote home monitoring of elders: The WIN project.

Research has demonstrated the health and financial cost to working caregivers of older adults and the cost to business in lost productivity. This paper describes the implementation of the Worker Interactive Networking (WIN) project, a Web-based program designed to support employed caregivers at work. WIN innovatively linked working caregivers via the Internet to home to monitor elders' status using wireless sensor technology and included an online information and support group for a six-month period.

African American, Chinese, and Latino family caregivers' impressions of the onset and diagnosis of dementia: cross-cultural similarities and differences.

Purpose: We explored cross-cultural similarities and differences in minority family caregivers' perceptions of the onset and diagnosis of Alzheimer's disease in their relatives, with specific attention to clinical encounters.

Design And Methods: We performed a meta-synthesis of three qualitative studies conducted in Massachusetts with 22 African American, Latino, and Chinese caregivers.

Results: All participants conveyed striking similarities of thought about normalization of cognitive symptoms until one critical event, usually relocation, precipitated family awareness that an elder's behavior was not the result of "normal aging.

Dementia caregiving: the experiences of Hispanic/Latino caregivers.

The purpose of this study was to explore the phenomenon of dementia caregiving in an ethnically diverse group of Latino caregivers, with the goal of identifying cultural influences on the caregiving experience. This qualitative, descriptive, cross-sectional study used Leininger's ethnonursing approach. There were more similarities than differences in this multiethnic sample of Latino caregivers in understanding of dementia symptoms, beliefs about the caregiving role, and in the factors affecting ongoing care.

Variation in cost of informal caregiving and formal-service use for people with Alzheimer's disease.

This study used a geographically diverse sample to estimate the total cost of informal care and formal services for community-residing Alzheimer's disease (AD) care recipients. Baseline data were used for 1200 family caregivers from the Resources for Enhancing Alzheimer's Caregiver Health (REACH) study, a multisite intervention trial. The replacement-wage-rate approach estimated informal cost.

Vigilance. Evolution and definition for caregivers of family members with Alzheimer's disease.

The language of caregiving relies heavily on terms that are frequently negative such as caregiver stress and burden, but these are not universally accepted phenomenon. The purpose of this article is to report on the development of caregiver vigilance and to suggest it offers both neutral terminology and a means to include caregivers' perceptions of their supervisory role. The concept of vigilance emerged from a qualitative study of caregivers of family members with Alzheimer's disease.

Effects of an automated telephone support system on caregiver burden and anxiety: findings from the REACH for TLC intervention study.

Purpose: We determine the main outcome effects of a 12-month computer-mediated automated interactive voice response (IVR) intervention designed to assist family caregivers managing persons with disruptive behaviors related to Alzheimer's disease (AD).

Design And Methods: We conducted a randomized controlled study of 100 caregivers, 51 in the usual care control group and 49 in the technology intervention group, who received yearlong access to an IVR-mediated system. The system provided caregiver stress monitoring and counseling information, personal voice-mail linkage to AD experts, a voice-mail telephone support group, and a distraction call for care recipients.

The Caregiver Vigilance Scale: application and validation in the Resources for Enhancing Alzheimer's Caregiver Health (REACH) project.

This article reports on the measurement properties of Caregiver Vigilance, a four-item caregiver self-report of perceived oversight demand for Alzheimer's disease and related disorders family caregiving. The self-report uses data from the Resources for Enhancing Alzheimer's Caregiver Health (REACH) project, a multisite National Institutes of Health (NIH) sponsored study of over 1,200 family caregivers. Results indicate that the items were clearly understood by the racially/ethnically diverse respondents; and, when responses were transformed into a summary scale and analyzed, unidimensionality was evident and internal consistency reliability favorably demonstrated.

Effects of a multimedia project on users' knowledge about normal forgetting and serious memory loss.

Objective: The aim of the project was to develop and evaluate the effectiveness of a CD-ROM-based multimedia program as a tool to increase user's knowledge about the differences between "normal" forgetfulness and more serious memory loss associated with Alzheimer's disease.

Design And Measurements: The research was a controlled randomized study conducted with 113 adults who were recruited from the community and who expressed a concern about memory loss in a family member. The intervention group (n=56) viewed a module entitled "Forgetfulness: What's Normal and What's Not" on a laptop computer in their homes; the control group (n=57) did not.