Dementia is often associated with memory loss, but for many caregivers, the most challenging symptoms are behavioral changes like aggression, anxiety, irritability, wandering and sleep disturbances.
A new study from UC Davis Health and Drexel University found that WeCareAdvisor, an app designed to help caregivers manage dementia-related behavioral symptoms using practical, non-drug strategies, reduced caregiver distress and improved well-being.
The findings were published in the Journal of the American Geriatrics Society.
"This research shows that caregivers can use technology to learn and apply effective dementia care strategies," said Helen Kales, Joe P. Tupin Professor of Psychiatry, chair of the UC Davis Department of Psychiatry and Behavioral Sciences and senior author of the study. "By giving caregivers the knowledge and confidence to address behavioral symptoms, we can improve quality of life for both caregivers and people living with dementia."
More than 7 million people in the United States are living with Alzheimer's, according to the Alzheimer's Association. By 2050, the number is projected to rise to nearly 13 million.
Trial evaluated DICE Approach
The study is the first randomized trial to evaluate an app that gives caregivers a systematic, non-drug approach to manage dementia-related behavioral symptoms.
The application incorporates the DICE Approach (Describe, Investigate, Create, and Evaluate). Caregivers are guided through a series of questions to describe behaviors, investigate underlying causes, create individual strategies that don't rely on medication, and then evaluate their effectiveness. During the study, caregivers received daily supportive tips via text messages. The app also contains educational materials.
The randomized, controlled trial compared two groups of participants — immediate users and delayed app users — who were the primary caregivers of a family member with dementia.
Participants were interviewed three times: At the beginning of the trial, one month into it and three months later. They evaluated the use of the app and its impact on caregiver distress and well-being, as well as the frequency and severity of behaviors of the person with dementia.
By giving caregivers the knowledge and confidence to address behavioral symptoms, we can improve quality of life for both caregivers and people living with dementia."-Helen Kales, professor and chair, Department of Psychiatry and Behavioral Sciences
Results
By three months, family caregivers reported improvements. Immediate WeCareAdvisor users had modestly — but significantly — lower caregiver distress than the delayed app users (the control group).
For secondary outcomes, such as the number, frequency or severity of dementia behavioral symptoms, immediate users reported significantly fewer behavioral symptoms and associated caregiver upset and improved caregiver well-being.
Laura N. Gitlin, distinguished professor and dean emerita of the College of Nursing and Health Professions at Drexel University, is the first author of the study and a co-inventor of DICE, along with Kales. Both also served on the Lancet Commission for Dementia Prevention, Intervention and Care.
"We found that caregivers used the app on average once a month," Gitlin said. "Caregivers also loved receiving the tip of the day, access to vetted resource educational materials on the app in addition to the strategies personalized to their particular care context and behavioral challenges."
"Caregivers in this sample were managing, on average per month, about six challenging behavioral symptoms such as agitation, restlessness and wandering," Gitlin said. "Using the app reduced caregiver distress with these behaviors even though they still occurred."
The authors note that although the effects were small to moderate, the study provides proof of concept that technology-based innovations like WeCareAdvisor can improve quality of life for caregivers and help families care for loved ones with dementia.
Additional contributors to the study include Leslie McClure, of Saint Louis University, Melinda Webster of Drexel and Constantine Lyketsos, of Johns Hopkins University.
Funding for this research was provided by the National Institute on Aging of the National Institutes of Health (1R01AG061116).
