Study: success of behavioral telehealth for caregivers

Caregivers for those with neurocognitive disorders (Alzheimer’s disease, dementias and other related progressive diseases) have unique, long-term stressors that lead to increased risk for distress, depression, and negative health outcomes. Conventional approaches through support groups and community based programs are helpful but not adequate, especially for those living in rural areas at a distance from care. This study of 74 women caregivers with mild to moderate depression tested two approaches: a 14-week behavioral intervention using video instructional materials (DVD/VHS), in-person telephone coaching in behavioral management and reinforcing workbook materials, with pleasant events scheduling and relaxation, versus a basic education guide and limited telephone support. The first approach was a statistical improvement over the second, easing caregiver depression and helping in their managing patient behavior. Results were maintained six months after the program ended. “Distance-based interventions (e.g., telephone, video, Internet, and bibliotherapy) hold promise for family carers, especially those living in rural or metropolitan areas with limited transportation.” Now if we could add in some tablet based interactive support? A telehealth behavioral coaching intervention for neurocognitive disorder family carers (International Journal of Geriatric Psychiatry)  Hat tip to Mike Clark via Twitter

Telecare helping Alzheimer’s patients live in the ‘connected home’

[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2014/08/140825141047-lively-pillbox-sensor-story-top.jpg” thumb_width=”150″ /]There’s life in telecare–it’s (finally) morphing into ‘connected home’. Is this ‘slope of enlightenment’ and ‘plateau of productivity’ time?  We haven’t had a spotlight on the part of telecare which is sensor-based behavioral monitoring, but here’s one that shines on not just one but four systems which indicates a big change in focus, long developing: SmartThings, Lively, BeClose and certified Grizzled Pioneer GrandCare Systems. CNN.com crafted an article out of a fairly obvious placement by the Alzheimer’s Association, but all to a good end.

Notably SmartThings by Physical Graph (just purchased by Samsung for a reported $200 million after raising $15.5 million through Series A, undoubtedly for their algorithms and in its health reach strategy versus Apple Health) pitches itself on its website as simple home automation, yet this article is all about older adult safety. Lively, which is depicted with an interesting connected pill dispenser (above) and BeClose carve their approaches close to caregivers.  All three are DIY systems. GrandCare remains the anomaly, with the highest (custom) home install price ($699 and up) but with a home tablet that engages the older person with virtual visits, music, pictures, daily updates and family/clinician connectivity. They were also first to move in this direction; this Editor recalls their pioneering in the home automation area with CEDIA, the home electronic design association.

After years, are we finally seeing a shift in consumer perception?  (more…)

Music, art app for Alzheimer’s patients; diagnosing brain performance

GE Healthcare has developed an iPad app, MIND, for patients with Alzheimer’s and other neurological disorders which presents favorite music, music videos and a virtual art gallery. The aim is to stimulate the brain, evoke emotions and promote social interaction.  This extends the pioneering research from New York City’s Institute for Music and Neurologic Function‘s Music and Memory program, which provides personalized music on iPods for those with both cognitive and physical challenges in long-term care to improve quality of life and reduce anti-psychotic drug use. GE release. Website.

Another approach to brain diagnosis and therapy for Alzheimer’s, stroke and brain hemorrhage may be pioneered by Multineurons. This startup has developed a head-worn sensor device that works with an iPad app, WakeUp, for non-invasive brain diagnosis and therapy. It measures speed (connectivity of neurons), fitness (neuroplasticity) and robustness – at 10 different points in the brain. Testing is planned to start in a Swiss rehabilitation facility this summer. MedCityNews

‘Candy Crushing’ stroke rehab

A development that deserves more attention is the use of ‘gamification’ in rehab. In one program, it’s using a combination of incentives, brain stimulation and robotics. The popular Candy Crush Saga game uses a moving candy target, rewards (to higher levels) and reduced reaction times at the harder levels. The Manhasset, New York-based Feinstein Institute for Medical Research at North Shore-LIJ Health System is testing this notion with rehab for paralyzed limbs. Instead of concentrating on training other limbs to compensate for the paralyzed ones, the Non-Invasive Stroke Recovery Lab program focuses on gaining more movement in the affected limbs. Using robots to move the limb at first, then sensing when the patient is moving them on their own, they gradually train the brain to move the limb for whatever motion can be achieved. Therapists use these programs with patients to gain the “just-right” amount of challenge to maintain motivation and attention. According to their website, several programs are being tested using devices for the wrist, shoulder-elbow, hand and an anti-gravity one for the shoulder. A fifth one is in early development to improve gait post-stroke. Also in test is coupling this with trans-cranial direct current stimulation. mHealthNews. Feinstein Institute and researcher (Bruce Volpe) website.

Drug manufacturer Pfizer is also testing gamification for a different sort of rehabilitation–using Evo Challenge from Akili Interactive Labs in determining the status of and improving the abilities of those with cognitive impairments, Alzheimer’s disease (with and without amyloid in the brain) and ADHD. The game, which involves navigation around obstacles and rewards, is designed to improve the impaired processing of cognitive interference, a/k/a distractions. MedCityNews

An Alzheimer’s diagnosis test that could have profound telecare implications

Significant progress on early diagnosis of Alzheimer’s is reported today by Fierce Diagnostics.  The Cognoptix test involves a laser eye-scanning device and an ophthalmic ointment, according to their website, designed to spot telltale beta-amyloid proteins in the lens of the eye.

The excitement in the article is about the possibility of increasing drug sales; the ability to deploy drugs to delay progression of the disease would clearly be very important. However, whilst perhaps less commercially significant, there would be some huge benefits (more…)

Tablets for mental stimulation, concussion detection

Clevermind for dementia, cognitively disabled

The new Clevermind app/user interface for iPad is designed to simplify the internet for active use by those with Alzheimer’s disease, dementias or others who are cognitively impaired for a variety of reasons. According to founder Glenn Palumbo in an interview with Neil Versel, “The initial release, set for June will have limited functionality, serving as the front end for communication and social hubs like Skype, Facebook and Twitter, with a simplified display including a basic Web browser.” Depending on the stage that the dementia is in, it can be a boon in mental stimulation or as their website terms ‘neuroplasticity’, if presented appropriately–or, based on your Editor’s knowledge of working with dementia sufferers, potentially quite upsetting. The secondary markets that Mr. Palumbo mentioned, stroke patients and children with disabilities, may be more favorable. Clevermind is on Kickstarter with an initial goal of $10,000 but has raised a low $1,717 with 23 days to go. (Hint: try a healthcare- oriented crowdfunding site like Medstartr or Health Tech Hatch for your next round.)

GeriJoy’s ‘virtual pet’ to engage older adults

Another iPad and Android tablet app, GeriJoy, uses the interface of a virtual pet to respond to the user both by voice and touch to lessen isolation, loneliness and increase connectivity to loved ones and friends. Another asset of these tablets is that they have two-way capability, and that active monitoring can help an older person in a bad situation. From the release: (Co-founder Victor) “Wang describes how a customer adopted a GeriJoy Companion for her elderly father, who lives alone. One day, the companion woke up to a loud sound, and heard a paid caregiver screaming at the elder. GeriJoy reported the abuse to the customer, who was very grateful and replaced the caregiver that week.”

Sideline and ringside voice testing for concussion

Researchers at the University of Notre Dame have developed a tablet-based test that can detect injury through before-and-after voice analysis. For instance, an athlete recites a series of words before a game, recorded on a tablet. If there’s a suspected concussion or brain injury, the same words are used and software compares differences. Injury indicators can be pitch, hyper nasality, distorted vowels and imprecise consonants–and the tests are far more difficult to fake. In action in this video, the tests also appear to include spatial and balance. Associate Professor Christian Poellabauer describes the research below using Notre Dame’s boxing teams.

[This video is no longer available on this site but may be findable via an internet search]