Top

Published in:

Open Access 01-12-2016 | Study protocol

Effect of a tailored assistive technology intervention on older adults and their family caregiver: a pragmatic study protocol

Authors: Louise Demers, W. Ben Mortenson, Marcus J. Fuhrer, Jeffrey W. Jutai, Michelle Plante, Jasmine Mah, Frank DeRuyter

Published in: BMC Geriatrics | Issue 1/2016

Abstract

Background

Many older adults with mobility limitations use assistive technology to help them perform daily activities. However, little attention has been paid to the impact on their family caregivers. This neglect produces an incomplete portrayal of the outcomes of assistive technology provision. This paper describes the protocol for a study that examines the impact of a tailored assistive technology intervention that is inclusive of assistance users and their family caregivers.

Methods/design

This research will use a combination of quantitative and qualitative methods. The quantitative portion will be an experimental, single-blinded study in which participants are randomly assigned to either an experimental assistive technology intervention or a standard care group. We will enroll 240 participants (120 dyads) into the study from three Canadian sites. Participants will include older adults (>55) and family caregivers who provide ≥4 h per week of assistance with daily activities and social participation. The primary outcome measure for the older adults will be the Functional Autonomy Measurement System, and the primary outcome measure for the caregivers will be the Caregiver Assistive Technology Outcomes Measure. Qualitative data will be collected through detailed records of the therapists’ interventions, as well as through interviews with dyads and therapists following the interventions. Data collection will occur at baseline (T₀) with follow-ups at 6 weeks (T₁), 22 weeks (T₂), and 58 weeks (T₃) after baseline evaluation.

Discussion

The findings from this study will help service providers and clinicians to move forward with assistive technology recommendations that are more attuned to the needs of both older adults with mobility limitations and their family caregivers. Additionally, the study’s findings will enhance our conceptual understanding of the spectrum of assistive technology outcomes and set the stage for econometric studies assessing cost-effectiveness.

Trial registration

ClinicalTrials.gov Identifier: NCT01640470. Registered 11/21/2011.

Kaye HS. Disability rates for working-age adults and for the elderly have stabilized, but trends for each mean different results for costs. Health Aff (Millwood). 2013;32(1):127–34. doi:10.1377/hlthaff.2012.0533.CrossRef

Cook AM, Polgar JM. Assistive technologies: principles and practice. 4th ed. St. Louis: Mosby; 2014.

Cornman JC, Freedman VA, Agree EM. Measurement of assistive device use: Implications for estimates of device use and disability in late life. Gerontologist. 2005;45(3):347–58. doi:10.1093/geront/45.3.347.CrossRefPubMed

Gitlin LN. Assistive technology in the home and community for older people: psychological and social considerations. In Scherer MJ, editor. Assistive technology: matching device and consumer for successful rehabilitation. Washington: American Psychological Association; 2002. p. 109–22. doi:10.1037/10420-007.

Kaye HS, Yeager P, Reed M. Disparities in usage of assistive technology among people with disabilities. Assist Technol. 2008;20(4):194–203. doi:10.1080/10400435.2008.10131946.CrossRefPubMed

McCreadie C, Tinker A. The acceptability of assistive technology to older people. Ageing Soc. 2005. doi.10.1017/S0144686X0400248X

Gramstad A, Storli SL, Hamran T. “Do I need it? Do I really need it?” elderly peoples experiences of unmet assistive technology device needs. Disabil Rehabil Assist Technol. 2013;8(4):287–93. doi:10.3109/17483107.2012.699993.CrossRefPubMed

Statistics Canada. Participation and activity limitation survey 2006: a profile of assistive technology for people with disabilities. Ottawa: Statistics Canada; 2008. p. 89–628. X-no.005.

Gitlin LN, Winter L, Dennis MP, Corcoran M, Schinfeld S, Hauck WW. A randomized trial of a multicomponent home intervention to reduce functional difficulties in older adults. J Am Geriatr Soc. 2006;54(5):809–16. doi:10.1111/j.1532-5415.2006.00703.x.CrossRefPubMed

10.

Ahn M, Beamish JO, Goss RC. Understanding older adults’ attitudes and adoption of residential technologies. Fam. Consum. Sci. Res. J. 2008. doi:10.1177/1077727X07311504

11.

Demers L, Fuhrer MJ, Jutai JW, Scherer MJ, Pervieux I, DeRuyter F. Tracking mobility-related assistive technology in an outcomes study. Assist Technol. 2008;20(2):73–83. doi:10.1080/10400435.2008.10131934.CrossRefPubMed

12.

Phillips B, Zhao H. Predictors of assistive technology abandonment. Assist Technol. 1993;5(1):36–45. doi:10.1080/10400435.1993.10132205.CrossRefPubMed

13.

Dijcks BP, De Witte LP, Gelderblom GJ, Wessels RD, Soede M. Non-use of assistive technology in the Netherlands: a non-issue? Disabil Rehabil Assist Technol. 2006;1(1-2):97–102. doi:10.1080/09638280500167548.CrossRefPubMed

14.

Fuhrer M, Jutai J, Demers L, Scherer M, Bloch E, DeRuyter F. Effects of type of locomotive device and disabling condition on device use and disuse among elderly individuals following hospitalization. Proceedings of the International Conference of Aging, Disability and Independence. St-Petersburg, FL; 2006

15.

Hammel J. Assistive technology as tools for everyday living and community participation while aging. In: Burdick D, Kwon S, editors. Gerontechnology: research and practice in technology and aging. New York: Springer Publishing Company; 2004. p. 119–31.

16.

Marasinghe KM. Assistive technologies in reducing caregiver burden among informal caregivers of older adults: a systematic review. Disabil Rehabil Assist Technol. 2015. doi:10.3109/17483107.2015.1087061

17.

Mortenson WB, Demers L, Fuhrer MJ, Jutai JW, Lenker J, DeRuyter F. How assistive technology use by individuals with disabilities impacts their caregivers: a systematic review of the research evidence. Am J Phys Med Rehabil. 2012;91(11):984–98. doi:10.1097/PHM.0b013e318269eceb.CrossRefPubMed

18.

Agree EM, Freedman VA, Cornman JC, Wolf DA, Marcotte JE. Reconsidering substitution in long-term care: when does assistive technology take the place of personal care? J Gerontol B Psychol Sci Soc Sci. 2005;60(5):S272–80. doi:10.1093/geronb/60.5.S272.CrossRefPubMed

19.

Allen S, Foster A, Berg K. Receiving help at home: the interplay of human and technological assistance. J Gerontol B Psychol Sci Soc Sci. 2001;56(6):S374–82. doi:10.1093/geronb/56.6.S374.CrossRefPubMed

20.

Taylor DH, Hoenig H. The effect of equipment usage and residual task difficulty on use of personal assistance, days in bed, and nursing home placement. J Am Geriatr Soc. 2004;52(1):72–9. doi:10.1111/j.1532-5415.2004.52013.x.CrossRefPubMed

21.

Arno PS, Levine C, Memmott, MM. The economic value of informal caregiving. Health Aff (Millwood). 1999. doi:10.1377/hlthaff.18.2.182

22.

Zukewich N. Unpaid informal caregiving. Canadian Social Trends. 2003;70:14–8. Statistics Canada Catalogue no. 11–008.

23.

Schulz R, Martire LM, Klinger JN. Evidence-based caregiver interventions in geriatric psychiatry. Psychiatr Clin North Am. 2005;28(4):1007–38. doi:10.1016/j.psc.2005.09.003.CrossRefPubMed

24.

Agree EM, Freedman VA, Sengupta M. Factors influencing the use of mobility technology in community-based long-term care. J Aging Health. 2004;16(2):267–307. doi:10.1177/0898264303262623.CrossRefPubMed

25.

Fast J, Niehaus L, Eales J, Keating N. A profile of Canadian palliative care providers. Research on aging, policies and practice. Edmonton: Department of Human Ecology, University of Alberta; 2002. http://www.rapp.ualberta.ca/en/Publications/~/media/rapp/Publications/Documents/Canadian_palliative_care_providers_profile.pdf.

26.

Health Council of Canada. Seniors in need, caregivers in distress: What are the home care priorities for seniors in Canada? Toronto: Health Council of Canada; 2012. http://www.alzheimer.ca/durham/~/media/Files/on/Media%20Releases/2012/April%202012/HCC_HomeCare_2d.pdf

27.

Fast J, Eales J, Keating N. Economic impact of health, income security and labour policies on informal caregivers of frail seniors. Ottawa: Status of Women Canada; 2001. http://www.rapp.ualberta.ca/en/Publications/~/media/252B8FC3C74842D683739868EF7E9CD7.pdf.

28.

Demers L, Fuhrer MJ, Jutai JW, Lenker JA, DeRuyter F. A framework for evaluating assistive technology outcomes on the user-caregiver dyad. Festival of International Conferences on Caregiving, Disability, Ageing, and Technology (FICCDAT) – Festival Proceedings 2007 [CD-ROM], T0076.

29.

Demers L, Mortenson WB. Measuring the impact of assistive technology on family caregivers. In: Scherer M, Federici S, editors. Assistive technology assessment handbook. Boca Raton: CRC Press; 2012. p. 83–106.

30.

Demers L, Fuhrer MJ, Jutai J, Lenker J, Depa M, DeRuyter F. A conceptual framework of outcomes for caregivers of assistive technology users. Am J Phys Med Rehabil. 2009;88(8):645–55. doi:10.1097/PHM.0b013e3181ae0e70.CrossRefPubMed

31.

Mortenson WB, Demers L, Fuhrer MJ, Jutai JW, Lenker J, DeRuyter F. Effects of an assistive technology intervention on older adults with disabilities and their informal caregivers. An exploratory randomized controlled trial. Am J Phys Med Rehabil. 2013;92(4):297–306. doi:10.1097/PHM.0b013e31827d65bf.CrossRefPubMed

32.

Wisdom J, Creswell JW. Mixed methods: integrating quantitative and qualitative data collection and analysis while studying patient-centered medical home models. Rockville: Agency for Healthcare Research and Quality; 2013. AHRQ Publication No. 13-0028-EF.

33.

Nasreddine ZS, Phillips NA, Bédirian V, Charbonneau S, Whitehead V, Collin I, et al. The Montreal cognitive assessment, MoCA: a brief screening tool for mild cognitive impairment. J Am Geriatr Soc. 2005;53(4):695–-9. doi:10.1111/j.1532-5415.2005.53221.x.CrossRefPubMed

34.

Roelands M, Van Oost P, Stevens V, Depoorter AM, Buysse A. Clinical practice guidelines to improve shared decision-making about assistive device use in home care: a pilot intervention study. Patient Educ Couns. 2004;55(2):252–64. doi:10.1016/j.pec.2003.10.002.CrossRefPubMed

35.

Bellg AJ, Borrelli B, Resnick B, Hecht J, Minicucci DS, Ory M, et al. Enhancing treatment fidelity in health behavior change studies: best practices and recommendations from the NIH behavior change consortium. Health Psychol. 2004;23(5):443–51. doi:10.1037/0278-6133.23.5.443.CrossRefPubMed

36.

Desrosiers J, Bravo G, Hébert R, Dubuc N. Reliability of the revised functional autonomy measurement system (SMAF) for epidemiological research. Age Ageing. 1995;24(5):402–6. doi:10.1093/ageing/24.5.402.CrossRefPubMed

37.

Jensen MP, Abresch RT, Carter GT. The reliability and validity of a self-report version of the FIM instrument in persons with neuromuscular disease and chronic pain. Arch Phys Med Rehabil. 2005;86(1):116–22. doi:10.1016/j.apmr.2004.01.040.CrossRefPubMed

38.

Masedo AI, Hanley M, Jensen MP, Ehde D, Cardenas DD. Reliability and validity of a self-report FIM™ (FIM-SR) in persons with amputation or spinal cord injury and chronic pain. Am J Phys Med Rehabil. 2005. doi:10.1097/01.PHM.0000154898.25609.4A

39.

Wood-Dauphinee SL, Williams JI. Reintegration to normal living as a proxy to quality of life. J Chronic Dis. 1987;40(6):491–502. doi:10.1016/0021-9681(87)90005-1.CrossRefPubMed

40.

Wood-Dauphinee SL, Opzoomer A, Williams JI, Marchand B, Spitzer WO. Assessment of global function: the reintegration to normal living index. Arch Phys Med Rehabil. 1988;69(8):583–90.PubMed

41.

Mortenson WB, Demers L, Fuhrer MJ, Jutai JW, Lenker J, DeRuyter F. Development and preliminary evaluation of the caregiver assistive technology outcome measure. J Rehabil Med. 2015;47(5):412-–-8. doi:10.2340/16501977.CrossRefPubMed

42.

Novak M, Guest C. Application of a multidimensional caregiver burden inventory. The Gerontologist. 1989;29(6):798–803. doi:10.1093/geront/29.6.798.CrossRefPubMed

43.

The EuroQol Group. EuroQol – a new facility for the measurement of health-related quality of life. Health Policy. 1990;16(3):199–208. doi:10.1016/0168-8510(90)90421-9.CrossRef

44.

Demers L, Desrosiers J, Nikolova R, Robichaud L, Bravo G. Responsiveness of mobility, daily living, and instrumental activities of daily living outcome measures for geriatric rehabilitation. Arch Phys Med Rehabil. 2010;91(2):233–40. doi:10.1016/j.apmr.2009.10.007.CrossRefPubMed

45.

Desrosiers J, Rochette A, Noreau L, Bravo G, Hébert R, Boutin C. Comparison of two functional independence scales with a participation measure in post-stroke rehabilitation. Arch Gerontol Geriatr. 2003;37(2):157–72. doi:10.1016/S0167-4943(03)00044-X.CrossRefPubMed

46.

Cohen J. Statistical power analysis for the behavioural sciences. 3rd ed. Hillsdale: Erlbaum; 1998.

47.

Faul F, Erdfelder E, Lang AG, Buchner A. G^* power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods. 2007;39(2):175–91. doi:10.3758/BF03193146.CrossRefPubMed

48.

Kenward MG, Carpenter J. Multiple imputation: current perspectives. Stat Methods Med Res. 2007;16(3):199–218. doi:10.1177/0962280206075304.CrossRefPubMed

49.

Sandelowski M. Sample size in qualitative research. Res. Nurs. Health. 1995. doi:10.1002/nur.4770180211

50.

Morse JM, Field PA. Nursing research: the application of qualitative approaches. 2nd ed. Cheltenham: Nelson Thornes; 1995.

51.

Hammersley M, Atkinson P. Ethnography: principles in practice. 3rd ed. New York: Routledge; 2007.

52.

Mann WC, Ottenbacher KJ, Fraas L, Tomita M, Granger CV. Effectiveness of assistive technology and environmental interventions in maintaining independence and reducing home care costs for the frail elderly. A randomized controlled trial. Arch Fam Med. 1999;8:210–7.CrossRefPubMed

53.

Wilson DJ, Mitchell JM, Kemp BJ, Adkins RH, Mann WC. Effects of assistive technology on functional decline in people aging with a disability. Assist Technol. 2009;21(4):208–17. doi:10.1080/10400430903246068.CrossRefPubMed

54.

Pettersson I, Berndtsson I, Appelros P, Ahlström G. Lifeworld perspectives on assistive devices: lived experiences of spouses of persons with stroke. Scand J Occup Ther. 2005;12(4):159–69. doi:10.1080/11038120510031789.CrossRefPubMed

55.

Rudman DL, Hebert D, Reid D. Living in a restricted occupational world: the occupational experiences of stroke survivors who are wheelchair users and their caregivers. Can J Occup Ther. 2006;73(3):141–52. doi:10.2182/cjot.05.0014.CrossRefPubMed

Title: Effect of a tailored assistive technology intervention on older adults and their family caregiver: a pragmatic study protocol
Authors: Louise Demers
W. Ben Mortenson
Marcus J. Fuhrer
Jeffrey W. Jutai
Michelle Plante
Jasmine Mah
Frank DeRuyter
Publication date: 01-12-2016
Publisher: BioMed Central
Published in: BMC Geriatrics / Issue 1/2016
Electronic ISSN: 1471-2318
DOI: https://doi.org/10.1186/s12877-016-0269-3

ACC 2024 Congress Coverage

Heart Failure Video

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Effect of a tailored assistive technology intervention on older adults and their family caregiver: a pragmatic study protocol

Abstract

Background

Methods/design

Discussion

Trial registration

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

Incentivised to exercise

New intervention for STEMI-related cardiogenic shock

» View more highlights on the ACC 2024 congress hub page

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Background

Methods/design

Discussion

Trial registration

Please log in to get access to this content

Other articles of this Issue 1/2016

Delirium is not associated with anticholinergic burden or polypharmacy in older patients on admission to an acute hospital: an observational case control study

An intervention targeting fundamental values among caregivers at residential facilities: effects of a cluster-randomized controlled trial on residents’ self-reported empowerment, person-centered climate and life satisfaction

Impact of pain characteristics and fear-avoidance beliefs on physical activity levels among older adults with chronic pain: a population-based, longitudinal study

The effects of a life goal-setting technique in a preventive care program for frail community-dwelling older people: a cluster nonrandomized controlled trial

Prescription of potentially inappropriate medication in Korean older adults based on 2012 Beers Criteria: a cross-sectional population based study

Reaching the Elderly: Understanding of health and preventive experiences for a tailored approach – Results of a qualitative study

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

Incentivised to exercise

New intervention for STEMI-related cardiogenic shock

» View more highlights on the ACC 2024 congress hub page