Caregivers of persons with Alzheimer’s disease or related dementia (ADRD) are essential for a better quality of life of those they care for. Their role can have a severe impact on their own physical and mental health, as well as on their social and financial situation, according to the current literature. For this reason, WHO has provided the iSupport tool to provide support to caregivers of people with ADRD. Its adaptation and implementation in Tunisia is challenged by the lack of Tunisian data concerning the experience and needs of this population.

To explore, in cooperation with the WHO, the experience of caregivers of persons with ADRD in Tunisia, and their potential training and support needs.

A qualitative cross-sectional study using individual semi-directive interviews was conducted with caregivers of persons with ADRD in Tunisia. Interviews were recorded and transcribed. A thematic analysis of the interviews was performed by two researchers.

Fifteen caregivers (11 women and 4 men) were interviewed on-site, or by telephone. Concerning their overall experience of caregiving, several main themes have emerged: The disruption of the relationship with the close relative (including the role switching, or the impossible mourning), the disruption of the relationship with oneself (including the forgetting of oneself, or the revision of priorities) and the disruption of the relationship with the others and the world (including the isolation and the withdrawal into the dyad caregiver - close relative with an ADRD, the lack of time, or the life as an unending daily struggle). When it comes to training and support needs, content and format preferences were identified.

This work helped us to adapt iSupport to the specific needs of caregivers in Tunisia. Data concerning their overall experience should provide an opportunity for a better adaptation of the social and policy context.

The number of children and adolescents who have caring responsibilities for a family member with dementia is rising. They need help to understand the illness, what changes are expected and how it can affect their family member. This presentation reports on the co-design of an adapted version of iSupport for young carers.

A theoretically driven co-design approach was followed, drawing on the lived experiences of young dementia carers. Young dementia carers (n=6, age 12-16) and professionals who work with young carers (n=5) took part in three workshops and provided individual contributions. Feedback was analysed and adaptations organized according to the dimensions of the Ecological Validity Model which addressed the structure and design, content, context and language. By focussing on these dimensions, we intended to increase the relevance, acceptability and comprehensibility of iSupport to this new target group while keeping the completeness of the theoretical premises underpinning it.

Informed by feedback from participants a number of adaptations were carried out. Case scenarios included in the original iSupport were edited and other new ones created to place the focus on a young character with caring responsibilities within a family unit. These characters were young people with a parent or grandparent living with dementia. Also, illustrations portraying human characters representing a range of ages and ethnicities were added throughout. These characters emphasised the actions described within the carer case scenarios. Adaptations to the ‘design’ and ‘language’ were also carried out. For example, the quantity and complexity of the text was reduced as much as possible without compromising its readability and meaning. Clarity and appeal were increased by changing font size, style and including brighter colour schemes. Adaptations resulted in the creation of iSupport for Young Carers.

iSupport for Young Carers is the first e-health intervention of its kind and aims to support the mental health, knowledge, and skills of young dementia carers. This new adaptation provides opportunities for other countries and demographic groups to translate and adapt iSupport for Young Carers to their specific cultural context.

The past decade has seen an explosion in the growth of technologies in mental health. Particularly, the scaled adoption of virtual care catalyzed by the COVID-19 pandemic has opened up new frontiers in how digital tools can be incorporated into psychiatry. No area of mental health care is as ripe for digital innovation as psychogeriatrics. In this session, an international group of clinicians and researchers will demonstrate how digital health in psychogeriatrics represents multiple cutting edges of innovation.

Our symposium will include 4 presentations, that represent original research from the USA, Ecuador, Norway, Kosovo and Australia. We will highlight clinical applications of these digital tools and aligned issues such as improved care access in low- and middle-income countries, the ethics of digital data collection and the potential for creating new liabilities.

We will focus on four distinct technologies and applications. Dr. Ipsit Vahia will discuss passive environmental sensing supported by signal processing and artificial intelligence (AI) in guiding treatment decision making, especially in dementia care. His presentation will include discussions on how AI can be incorporated into care while also preserving autonomy. Dr. Kreshnik Hoti will discuss the application of AI on voice-based signals to determine changes in pain levels and psychopathology. His presentation will include research conducted in collaboration between teams based in Australia and Kosovo and through a public-private partnership with a digital health startup. Dr. Ana Trueba will focus on digital interventions, specifically virtual reality (VR). She will present data from two studies, one from McLean hospital In the US, and the other from Ecuador that explore how VR can deliver evidence-based non-pharmacologic interventions. Dr. Bettina Husebø will present data from a project she oversees in Norway. Her talk will discuss how care in nursing homes can be improved by incorporating a range of digital approaches into nursing home care paradigms. A particular focus will be on the relationship between pain and behavior symptoms and dementia among nursing home dwelling older adults.

Thus, the symposium will address diagnostics, treatment and systems level care and how New technologies are shaping the evolution of psychogeriatrics worldwide.

Appropriate and personalized pharmacologic management of behavioral and psychologic symptoms in dementia (BPSD) is among the most complex clinical challenges in dementia care. Use of antipsychotics and mood stabilizers is common but accompanied by risk, including high likelihood of adverse effects that can lead to hospitalization or institutionalization. Information to support decision-making in these scenarios is typically obtained from self-report/caregiver report. This presentation will focus on demonstrating how data obtained through digital phenotyping may augment clinical decision making.

This presentation will include information from 3 completed or ongoing studies. The first looks at radio wave based sensing as a way of passively monitoring behavior and dementia. The second uses wearables to track the impact of psychopharmacologic changes in dementia. The third study focuses on incorporating data from electronic media (e-mail, text messages) impact psychotherapy in early and late life

Preliminary results indicate that passive sensing is able to accurately identify patterns of behavior as well as circumscribed clinical events with a precision that exceeds the current standard of care. Data and insights gained from these three ongoing studies are helping develop best practice models that can impact clinical outcomes.

Collectively, the data in this presentation will demonstrate to clinicians a range of approaches towards developing precision care for older adults with dementia and psychiatric diagnosis. These approaches share the common theme of emphasizing the human element in care, while augmenting it with a range of data that provide objective collateral information to guide more precise decision making. The session will also discuss issues that will impact precision care, including the potential for creating inequities, translation to low income settings and countries as well as the matter of data privacy and security.

Due to communication difficulties, pain assessment in people living with dementia (PLWD) is challenging. In this study we explore vocalisations and facial expressions during assessment of pain and provide evidence in regards to clinical impact of pain assessment, as part of a targeted care program.

In order to determine key facial and vocalisation features and their relationship with pain we analysed a total of 22,194 pain assessments in PLWD (n = 3,144) from 34 different Australian residential aged care homes. Pain assessments were conducted using PainChek, which is a technology-based system comprised of three key components: point-of-care AI-powered application, training and digital analytics. Additionally, we examine the 6-months clinical impact of introducing this system, as part of a wider psychosocial care intervention (i.e., the Reconnect program) in the UK care home setting. Here we focus on how this pain assessment system contributed to the use of psychotropics and issues such as safeguarding.

Likelihood of vocalization feature presence varied based on the intensity of pain. In this regard, sighing and screaming were more likely during experience of higher pain (eight times). During experience of severe pain eyelid tightening was the most frequent facial expression (48.6%) whereas higher pain levels were mostly predicted by horizontal mouth stretch feature. Use of PainChek system as part of the Reconnect program contributed to a more consistent pain management approach, benzodiazepine reduction (29%) and cessation (46%) and reduction of antipsychotic prescribing (22%). Compared to the 6 monthly period from the year prior to implementation of the Reconnect program, a 92% reduction in safeguarding events was reported.

In this study we demonstrate the potential to digitally phenotype key pain behaviours such as vocalizations and facial expressions using the PainChek system. We also evidence the positive impact of pain assessment combined with psychosocial care, on use of psychotropics and safeguarding incidents.

Virtual Reality (VR)-based meditation has shown to help reduce, stress, anxiety, sadness, and anger in younger adults. However, this has not been extensively studied in older adults. Furthermore, there are no standard guidelines on how VR mindfulness interventions should be implemented to ensure successful outcomes in different cultures and languages. The availability of affordable hardware raises the possibility of VR being used in low-income countries. The goal of this study is to describe and highlight some key considerations and challenges when implementing low-cost VR mindfulness interventions with older adults in Quito, Ecuador.

We created a guided mindfulness intervention using low-cost VR (smartphones and Destek V5 headsets) for older adults with anxiety in Quito, Ecuador. This project is a collaboration between the Technology and Aging Lab at McLean Hospital and the Universidad San Francisco de Quito in Ecuador. Our goal was to recruit 20 older adults with anxiety from various outpatient settings in Quito. We used the free “Sites in VR” app and selected different nature scenes for each intervention. The intervention consists of a total of 10 sessions each lasting 30 minutes. We assessed depression using the Geriatric Depression Scale (GDS), and anxiety with the Generalized Anxiety Disorder 7-item scale (GAD-7). In addition, we also administered the Mindfulness Attention Awareness Scale (MAAS) and the Behavior Activation for Depression scale (BADS).

At the time of writing, we have reached 100% of our recruitment goal and anticipate completing data analysis by January 2023. Qualitatively, our intervention revealed barriers to designing scalable VR Spanish language interventions in Latin America. Some of the main difficulties we encountered are described below: (i) There are very few virtual reality videos (360° videos) that are available for use with the DesTeK VS VR Headset in Spanish. We therefore, used a standardized Spanish narration to guide the mindfulness practice based on a script used in the United States. (ii) We found that majority of the available content is not suitable for mindfulness. Using the application Sites in VR remedied this concern, as it provides static 360° images, suitable for mindfulness. (iii) Not all technology necessary for VR interventions is readily available in Latin America: smartphones sold in Latin America do not always have a gyroscope sensor.

Mindfulness interventions using virtual reality may be an effective way to address stress and mood symptoms in older adults across cultures. However, there are many culture-specific aspects that must be addressed before applying these interventions in different cultures. This study, conducted in Latin America, is an initial step toward the establishment of best practices and standardized low-cost VR mindfulness intervention in older adults, and many aspects addressed here may be generalizable to other cultures, settings, and countries.

This international symposium combining experts from Canada, Australia and the USA and supported by the American Association for Geriatric Psychiatry will present an update on the recent advances in therapeutic interventions for late life mood and cognitive disorders, including late life depression, anxiety and apathy associated with dementia, and preventive strategies including mind-body interventions. Four leaders of the field will present the summary of novel studies: starting with Dr. Benoit Mulsant (CA) presenting the results of the recently completed OPTIMUM study of novel strategies optimizing treatment of late-life treatment resistant depression. He will be followed by Dr. Krista Lanctot’ (CA) update on novel therapies for apathy associated with Alzheimer’s disease, and Dr Nancy Pachana (AU) will present on non-pharmacological approaches to treatment of anxiety associated with neurodegenerative disorders. Finally, Dr. Helen Lavretsky (USA) will present on the recent studies of mind-body therapies used to treat and prevent late life depression and cognitive decline, along with the discussion of the underlying neurobiological mechanisms. The panel will conclude with a brief discussion of future directions in the development of therapeutic interventions.

Treatment-resistant depression in late life has been understudied and is lacking evidence supporting augmentation or switching strategies. Recently completed OPTIMUM multi-site study (funded by the PCORI) sought to compare effectiveness of augmentation strategies (bupropion or aripiprazole) to switch to bupropion, in the first step of 1-week acute treatment followed by randomization into the 2nd step of augmentation with Lithium or switch to nortriptyline. The augmentation strategies in the first step produced the most robust response compared to switching, and did not differ in the 2nd step. Primary outcomes included remission rates and wellbeing measures. A discussion of future directions will be provided at the end of this presentation.

In those with Alzheimer’s disease, apathy is common and associated with decreased quality of life, increased risk of decline and increased mortality. As such, apathy is increasingly recognized as an important treatment target. Recent advances in diagnosis and treatment will be reviewed.

In this presentation, several methodological issues will be discussed, such the importance and prevalence of apathy in Alzheimer’s disease (AD); current diagnostic criteria for apathy in neurocognitive disorders, and will present the results of recent pharmacologic interventions for apathy in AD.

In this presentation, new focused and innovative treatments for anxiety in persons with Alzheimer's and Parkinson's disease with co-morbid anxiety will be discussed. Anxiety is common in Alzheimer's Disease and Parkinson's disease and contributes to increased disability and poorer quality of life. Yet only a small fraction of such patients received any form of treatment for mental health issues. Non-pharmacological approaches to address anxiety are advantageous in these populations. Research on tailored CBT and innovations such as virtual reality approaches for these groups will be discussed.

Standard pharmacological therapies for treatment of late life depression offer limited efficacy with the downside of adverse events and drug-drug interaction. Novel strategies are needed for more effective and safe treatment and prevention strategies for mood and cognitive disorders in late life. This presentation will focus on the recently completed studies of Tai Chi for treatment of late life depression, and yoga for prevention of cognitive decline in older women at risk for Alzheimer’s disease. Neural and peripheral biomarkers of treatment response will be described. Future directions in mind-body therapies research will be outlined.

Neuropsychiatric symptoms of dementia (NPSD) are diverse and prevalent group of symptoms that impose significant challenge for people living with dementia (PLWD), their caregivers, and the system of care. Quality standards in all jurisdictions stipulate that individualized, non-pharmacological intervention for NPSD needs to be provided to PLWD before pharmacological interventions are used due to modest effect size and the risks involved in using the latter. Implementation of individualized non-pharmacological plan of care face many challenges including limited staffing, issues with skill development in formal and informal caregivers, difficulty in achieving individualization of behavioral plans with precision, issues with environmental design to name few. To that end, technology has been proposed to address some of these challenges with significant promise at the proof-of-concept level but real-life implementation remains limited.

At the Ontario Shores Centre for Mental Health Sciences in Whitby, Ontario, in collaboration with Ontario Tech University, we have established the “Advancement for Dementia Care Centre”, whereby technological solutions are tested at the point of care considering implementation challenges and engaging formal and informal caregivers in the co-design and implementation of these interventions.

In this symposium, we aim to provide a framework for the successful implementation of different technological solutions for PLWD and NPSD and present the design and preliminary data from four projects that use technology to facilitate standardized, individualized non-pharmacological care for PLWD and their caregivers. The symposium will have 4 talks:

1. 1- Rationale and review of technological solutions to detect emotional distress in PLWD

2. 2- virtual reality to provide reminiscence therapy for PLWD

3. 3- virtual reality to provide caregiver skill development and problem solving

4. 4- the use of simulation platform to provide microcredentialing of health care providers

The objectives of this symposium are:

1. 1- discuss opportunities and challenges related to implementing technological solutions for NPSD at the point of care

2. 2- discuss a framework for co-designing technological solutions with caregivers at the point of care

3. 3- discuss rationale and preliminary findings of 4 projects implemented at the point of care for PLWD presenting with NPSD

This symposium is presented by a multi-ethnic, interprofessional panel including earlier career knowledge mobilization caregiver intervention scientist, a mid career nurse PhD scientist, and a senior clinician investigator geriatric psychiatrist representing a large collaboration team including technology developers, caregivers, engineers, knowledge users and clinicians.

Agitation and aggression (AA) occur frequently in patients with dementia (PwD), and cause distress to PwD and caregivers. This study will investigate whether physiological parameters, such as actigraphy, heart rate variability, temperature, and electrodermal activity, measured via wearable sensors, correlate with AA in PwD. It will also explore whether these parameters could be compiled to create a pre-agitation biometric marker capable of predicting episodes of AA in PwD.

This study will take place at Ontario Shores Centre for Mental Health Sciences. Thirty inpatient participants who are inpatients, males, and females, aged 60 or older, with clinically significant AA, and diagnosis of Major Neurocognitive Disorder will be recruited. Participants will wear the device for 48 to 72 hours on three occasions during an 8-week study period. Participant demographics and clinical measures used to assess behavior will be collected at specific time intervals during the study period.

Ceiling mounted cameras and clinical data are collected to annotate episodes of AA, which will allow identification of peripheral physiological markers “signature” unique to the patient

the algorithm connecting wearable devices, cloud and cameras was tested on healthy volunteers and demonstrated feasibility and reliability. The feasibility of implementation in PwD has been demonstrated in our sample of PwD previously in a sample of 6 participants. Feasibility in this larger sample will be assessed. Correlation analysis between physiological measures, camera capture of agitation onset and clinical measures will be calculated to identify agitation events and pre-agitation triggers. Various machine learning and features extraction/exploration techniques will be used to test whether physiological measures can detect exact time of agitation and predict pre-agitation triggers. This study will provide a reasonable estimation of sample size needed to detect a meaningful effect size, which will be determined from the prediction model.

Early detection of AA in PwD will allow caregivers to offer timely and personalized interventions which will help avoid crises and critical incidents and improve quality of life in PwD and their caregivers.

Dementia care is a critical area of need in the community and institutional settings, with estimated one-third of seniors younger than 80 years of age with dementia living in institutional settings and this proportion increases to 42% for those 80 years and older in Canada. It is of critical importance to promote excellence and best practices in dementia care by preparing for well-trained dementia workforce through capacity building.

This project developed a dementia care micro-credential education to enable competency development of new graduates and upskilling of workers through simulation-based learning. This micro-credential program leveraged interdisciplinary partnership, to develop nine core modules related to best practices in dementia care, facilitated with a Gamified Educational Network (GEN). GEN is an evidence-based learning management platform that provides learners with a simulated and immersive experience to engage them in a virtual learning environment that allows for rich experiential interaction with other users and its content.

Face and content validity was established by an inter-professional committee including geriatric psychiatry, nursing, social work, occupational therapy, behavioral therapy, knowledge mobilization and simulation education experts. Next phase will begin to establish construct validity. It is expected that GEN will have a positive impact on increasing learner’s motivation and engagement in the educational tasks, as well as improving learner’s competencies and outcomes through its multi-modal approaches, including gamification (usage of game-based elements in a non-game context to engage learners and promote learning), active observational practice, independent hands-on practice, case-based discussion, peer-to-peer assessment, expert facilitated feedback, skills debriefing and reflective practice.

This micro-credential program will provide an enhanced dementia care curriculum for building capacity of existing workers, and those entering into the workforce to promote a dementia-friendly environment for older adults.

Reminiscence therapy (RT) is a multi-sensory treatment that uses a combination of sight, touch, taste, smell and sound to help people with dementia (PWD) remember events, people and places from their past lives. Currently, digital technologies such as mobile applications and immersive solutions including virtual and augmented reality, are gaining momentum as supplementary tools for RT. This paper presents a usability study of a web-based and virtual reality application to understand the limitations and opportunities of digital platforms for facilitating engaging experiences for PWD towards recalling memories, while easing the therapy process for the caregivers.

A total of fifteen healthcare caregivers were recruited from the Geriatric Dementia Unit and Geriatric Transitional Unit in Ontario Shores Center for Mental Health Sciences, Ontario Canada. Usability feedback from the caregivers were collected from the interviews after the completion of the System Usability Scale (SUS) questionnaire.

Healthcare caregivers found both web-based and virtual reality (VRRT) usable with SUS score above average (68/100), but required improvements related to the onboarding training of caregivers. The interview revealed four overarching themes related to the VRRT: (1) Ease of use; (2) Positive impact on caregiving; (3) Potential reduction in behavioral symptoms; (4) Feasibility of promoting social connection during COVID-19 pandemic.

Next steps will focus on improving the user experience and expanding the application for immersive VR supporting head-mounted displays, hand tracking, and physiological measures, as well as conducting a usability study with PWD to expand our understanding of using RT digital tools with various levels of immersion.

Caring for persons with dementia (PWD) leads to disproportionate vulnerability to physical, mental, and social adverse health consequences among caregivers (CGs). The VR-SIMS CARERS Initiative aims to engage Knowledge Users (KUs), older adults and community stakeholders in the co-design of a Virtual Reality (VR) simulation training environment for dementia caregivers, and to explore end-user’s perspectives, design and implementation challenges and opportunities (e.g. digital literacy, technology readiness, VR acceptability), to ensure that the resulting “Minimally Viable Prototype” is clinically efficacious, scalable and sustainable.

The specific objectives of this study are to:

1. 1. employ a co-design approach to develop and validate an immersive VR simulation training environment for CGs to be in touch with realities of caregiving, practice communications and behavioural management of PWD based on the well-established CARERS Program;

2. 2. to evaluate feasibility, acceptability, tolerability informed by VR-CORE Framework and Hybrid development-implementation design, and to explore issues around implementation of the VR simulation training platform; and

3. 3. to conduct pilot testing to examine a) initial clinical efficacy of VR-based CG training in improving quality of relationship with PWD, competence, resilience, and reducing depression and stress in dementia CGs and its b) readiness for implementation in the community.

VR-SIMS CARERS innovation is intended to be an accessible, scalable and sustainable VR simulation training platform that will support CGs in the practice and acquisition of essential dementia caregiving skills, enhancing their caregiving competence and resilience. Training CGs to recognize and manage stressors can lower their risk of overall mental health decline.

The use of health care technology to support informal and formal caregivers in decision making for proper guidance of care for people with dementia, is rising over the last decade. For example, (tools within) electronic health records systems, technological devices such as wearables and devices using sensor technology (domotics) are more and more available in health care. Recent developments of artificial intelligence (e.g. machine learning, deep-learning, text mining) can be useful to provide a more advanced use of sensor and other data, and contribute to a better guidance of (person)centered care. However, the use of health care technology (and the data it accumulates) could – when used appropriately and meeting the needs of (in)formal care workers who use this technology- help to relieve the burden of care (in times of lack of staff resources), delay nursing home admission and reduce corresponding costs. Unfortunately, some of these developments, not always meet the needs of care workers and informal caregivers caring for people with dementia.

For health care technology to be able to contribute to personalized dementia care, a combination of innovation (novel technology) and implementation is necessary. A wider use of novel technology on a broader scale is necessary to generate impact. For a proper implementation, several factors such as staff opinions that may be reluctant to using novel technology, data safety and ethical issues have to be taken into account. In addition, a proper training guiding the process of implementation is crucial.

In this workshop, we will provide several examples of applications in health care based on data usage and sensor technology: (1) the use of (the combination of) qualitative and quantitative data for personalized health care, (2) wearable sensors to measure stress, a phenomenon that is regarded as an early warning for the onset of challenging behavior in people with dementia, (3) combination of ambient and body mounted sensors to monitor challenging behavior and to prevent further deterioration, (4) the practical use of communication, tracking and sensor technology to support welfare to people with dementia and caregivers in the community.

In conclusion, this symposium will give insight in the challenges of designing novel technology and its implementation into daily practice, to assist informal and formal cares to be able to deliver person-centered care.

The increasing availability of data offers new possibilities for supporting quality of care in long-term care (LTC) for older adults, also for dementia care units in nursing homes. Examples are quantitative data in electronic health records (i.e. medication), data collected by technological devices such as sensors and wearables (i.e. data related to psychical and mental health including for example heart rate and sleeping patterns), but also qualitative data stored in texts (e.g. transcribed conversations about perceived quality of life). LTC organisations currently lack tools to interpret and integrate the data in the shared decision-making (SDM) process. This project investigates the necessities for data-informed SDM.

The study was conducted in co-design with the knowledge group ‘Data Science’ residing in the Living Lab in Ageing and Long-Term Care, Maastricht. A focus group-setting, in which a diverse set of stakeholders, including data/ICT-specialists, care managers and client representatives, took place to discuss bottlenecks, possibilities and solutions related to data-informed SDM.

In total, representatives (n=18) from 7 care organisations participated in three separated focus groups. This resulted in several themes that were deemed necessary for data-informed SDM: 1) an organisational vision on data and data-informed SDM, 2) investment in data-driven care SDM, 3) the instalment of multidisciplinary teams, including clients, informal and formal caregivers, 4) a planned implementation process is needed, and 5) the use of living lab constructions.

A well-thought-out, integral learning process, including a vision statement on data and the installation of multidisciplinary teams working on data-problems, is deemed necessary in order for LTC organisations to accomplish data-informed SDM. A concrete step-by-step plan, which can provide LTC organizations with tools to embed data in the current SDM process, is suggested to help organisations in their quest to data-informed personal care.

Measuring and monitoring stress has potential benefits for the care and self-management of stressors for people with dementia. Early identification of stressors may help to cope with challenging behaviours (CB), occurring in up to 80% of nursing home residents with dementia. The identification of stressors causing CB is difficult (as often residents cannot themselves indicate what is experienced as stressful or relaxing), hampering the psychosocial approach. Several studies have found that skin conductance and heart activity can be used as a proxy for stress. Measuring these physiological parameters using wearable sensors, might be helpful to identify (de)stressors and consequently, a psychosocial treatment approach. Therefore, wearables are promising as a supportive technology in the care of people with dementia and CB. However, stakeholders (i.e., (in)formal caregivers of people with dementia) indicate that current available (wearable) systems to measure stress are not fit for purpose within the everyday care of people with dementia. In addition, due to legislation, not all systems are allowed. The purpose of the current research is to develop a system prototype together with different stakeholders.

A prototype of a system measuring stress suitable in the care for people with dementia will be developed during different iterations between September 2022-July 2024. A community of stakeholders will be built, in which the needs, requirements and evaluations of people with dementia, (in)formal caregivers, legal- and IT-experts, will be collected through literature studies, focus groups, interviews and co-design sessions. The system will be developed and adjusted appropriately, taking social, technical and legal requirements into account.

Preliminary results will be presented regarding identified requirements for initial system prototypes as well as lessons learned from first iterations with conceptual and working prototypes. Implications for the care and self-management of people with dementia will be discussed.

Neuropsychiatric symptoms (NPS) are common in affected individuals and can be challenging for (in)formal caregivers. Therefore, they are also referred to as challenging behaviors (CBs). Sensor technology measuring context and behavior can be assistive to effectively manage CBs in an objective fashion. Sensors can help support healthcare professionals, such as nurses, by enabling remote monitoring and alarming on early-stage behavioral changes associated with CBs. This might/ will improve the quality of life (QoL) for both caregivers and clients living in a nursing homes (NH).

In the project “MOnitoring Onbegrepen Gedrag bij Dementie met sensortechnologie” (MOOD-Sense), we aim to develop such a monitoring system. Our research focuses on two questions 1) How to develop and implement a monitoring system within the context of nursing homes with parameters on environment, physiology, and behavior, identify and process relevant precursors of challenging behavior with this monitoring system and 2) gain insight in which behaviors are challenging according to nurses and how they are described. This will be represented in an ontology such that sensor data can be translated into the same conceptual information.

The first research question will be examined with a set of experiments in the field (in NH) with an iterative approach. Insights from previous experiments on usability and added value of sensors will be used to improve successive experiments. During each experiment, multiple participants (clients with dementia and CBs) are monitored with both ambient and wearable sensors. For the second research question a qualitative approach is employed, using focus groups (FG) and consensus methods. These FGs will be held amongst nursing staff who are involved in daily care tasks for people with dementia. Subsequently, consensus methods are used to align behavioral descriptors/labels.

early findings will be presented at the symposium

Within this project we expect to find precursors of challenging behavior in a personalized fashion based on nurse’s expert knowledge and sensor data. In order to develop a monitoring system that can be embedded within NH’s, real-time alarming, in-situ behavior recognition and trustworthiness are part of our technological requirements. Just-in-time interventions may then be deployed to prevent behavior escalation or the persistence of undesirable situations.