What Are my Options to Stay Safe at Home: Technology For Aging at Home (COORDINATEs)

Technology to Support Decision Making About Aging at Home (COORDINATEs)

Most older people want to stay at home as long as possible. Effective self-management for people losing autonomy depends on reliable monitoring of their mobility, health and safety and active implication in decision-making. New technologies have the potential to provide information about changing patterns that reflect changing care needs. This information could help older adults, caregivers and health professionals to participate in decision-making about housing options when a change in living environment needs to be considered.

Study Overview

• Status: Unknown
• Conditions: Aging; Mild Cognitive Impairment; Shared Decision Making; Memory Problems
• Intervention / Treatment: Device: GPS and travel diary; Other: e-decision support platform

Detailed Description

This is a multi-phase study to be conducted in 3 countries: Canada (Quebec and Alberta), Sweden and Netherlands. The primary objective is to provide e-decision support technology that will facilitate self-management in the context of aging in place and foster informed value congruent decisions about options to age safely at home.

The aim of the project is to develop and validate a e-technology based on already existing components (e.g. GPS devices, diverse e-platforms and decision support interventions) to 1) help older adults with mild cognitive impairment/memory problems to stay safely at home as long as possible and 2) to provide older adults with decision support tools to help them make informed value congruent decisions (e.g. foster a shared decision-making process) regarding aging at home in a safe manner.

The secondary objectives are:

1. Assess autonomy and mobility of older adults with mild cognitive impairment/memory problems living at home.
2. Inform shared decision-making processes about options to safely age in place for all those involved.

The investigators will apply an integrated Knowledge Translation (iKT), comparative, mixed-methods approach to explore, older adults living at home with mild cognitive impairment/memory problems, their use of space in their homes and neighbourhoods.

The project is divide into 4 work package (WP). In more details, during WP1, the investigators will collect spatial data (e.g. using GPS) and self-reported data (e.g. travel diaries, walking interviews, in-depth interviews, surveys). At WP2, the investigators will use iterative end-user feedback and end-user consultation discussion group to tailor a decision support technology to knowledge-users. At WP3, investigators will assess user opinion regarding factors that could influence their use of the newly adapted e-decision support technology. Finally, at WP4 the investigators will triangulate data and take into account differences between jurisdictions.

This collaboration and our cross-country comparisons will contribute to scaling up e-decision support solutions in the future for the older adults with mild cognitive impairment/memory problems who want to age safely at home.

• Study Type: Observational
• Enrollment (Anticipated): 294

Contacts and Locations

• Study Contact: Name: France Légaré, PhD; Phone Number: 8100 418-663-5919; Email: francelegare@mfa.ulaval.ca
• Study Contact Backup: Name: Danielle Caron, PhD; Phone Number: 418-663-5689; Email: danielle.caro3.ciussscn@ssss.gouv.qc.ca

Study Locations

• Canada
  • Edmonton, Canada
    • Recruiting
    • University of Alberta
    • Contact: Allyson Jones
  • Quebec
    • Québec, Quebec, Canada
      • Recruiting
      • CERSSPL
      • Contact: France Légaré, MD, PhD
• Netherlands
  • Groningen, Netherlands
    • Recruiting
    • University of Groningen
    • Contact: Louise Meijering
• Sweden
  • Falun, Sweden
    • Recruiting
    • Dalarna University
    • Contact: Marie Elf

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 65 years and older (Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

Elderly (>65 years) with mild cognitive impairment or self reported memory problems.

Description

Inclusion Criteria:

• Aged ≥ 65 years
• Living at home
• Diagnosed with mild cognitive impairment or experiencing memory issues
• Able to read, understand and write
• Can provide informed consent

Exclusion Criteria:

• Older adults who are not able to provide informed consent
• Living in nursing home or hospital

Study Plan

How is the study designed?

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort

Intervention / Treatment

Older adults with mild cognitive impairment; WP1, older adults with cognitive impairment will use a GPS tracker for 2 weeks, during which they are asked 1) to keep a daily diary about their activity (travel diary), 2) take the researcher on a walk that they often do (walking interview), and 3) participate in an in-depth interview after 2 weeks, in which their experience with the GPS ans the travel diary data are discussed. WP2, older adults with mild cognitive impairment, caregivers, health professionals and technology developers will collaborate during group discussion meeting to co-design the e-decision support platform to be adapted. WP3, older adults with mild cognitive impairment, caregivers and health professionals will then be asked to use the adapted e-decision support platform and fill a survey.

Device: GPS and travel diary; WP1: GPS tracker for 2 weeks and a daily diary about activity (travel diary).; Other: e-decision support platform; WP2 and WP3: An e-decision support platform that will foster shared decision making about options to stay safe at home for the older adult.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Autonomy and mobility assessment using GPS	WP1: 1) Asses autonomy and mobility of older adults with mild cognitive impairment and memory problems living at home (including caregivers), their movement through their homes and neighborhoods (using GPS and walking interview); 2) how GPS data can support ongoing SDM about housing options for older adults.	Participant will wear a GPS for a total of two weeks. As data collection will occur in parallel at all four sites (Quebec, Alberta, Sweden, Netherlands) data collection will happen over a period of 1 year
Iterative assessment to tailor the e-decision support technology	WP2: 1) Group discussion on if and how to incorporate GPS and adaptation of an existing e-platforms to create an adapted e-decision support technology (noted that the discussion focus will depend on result from WP1).	Immediately after group discussion. 3 sequential group discussion are plan to occur, one in each country (Canada, Sweden, Netherlands) data collection will happen over a period of 1 year.
User experience assessment of the newly adapted technology	WP3: 1) Opinion of older adults with mild cognitive impairment, caregivers and health professionals about the adapted technology (noted that the final survey will depend on result from WP1 and WP2).	Immediately after testing the new platform. As data collection will occur in parallel at all four sites (Quebec, Alberta, Sweden, Netherlands), it will happen over a period of 6 months

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Inform SDM processes about housing option	WP4: 1) Knowledge about differences and similarities between three countries	9 months
Open-ended questionnaire of participant global health status and their experience of using the GPS and filling the travel diary	WP1: Participant will be ask to share their experience with the GPS and the travel diary	Immediately before and after carrying the GPS at WP1. As data collection will occur in parallel at all four sites (Quebec, Alberta, Sweden, Netherlands) data collection will happen over a period of 1 year

Collaborators and Investigators

• Sponsor: CHU de Quebec-Universite Laval
• Collaborators: University of Alberta; Laval University; Dalarna University; University of Groningen
• Investigators: Principal Investigator: France Légaré, PhD, Laval University

Publications and helpful links

General Publications

• Caron CD, Ducharme F, Griffith J. Deciding on institutionalization for a relative with dementia: the most difficult decision for caregivers. Can J Aging. 2006 Summer;25(2):193-205. doi: 10.1353/cja.2006.0033.
• Garvelink MM, Emond J, Menear M, Briere N, Freitas A, Boland L, Perez MMB, Blair L, Stacey D, Legare F. Development of a decision guide to support the elderly in decision making about location of care: an iterative, user-centered design. Res Involv Engagem. 2016 Jul 19;2:26. doi: 10.1186/s40900-016-0040-0. eCollection 2016.
• Pot AM, Willemse BM, Horjus S. A pilot study on the use of tracking technology: feasibility, acceptability, and benefits for people in early stages of dementia and their informal caregivers. Aging Ment Health. 2012;16(1):127-34. doi: 10.1080/13607863.2011.596810. Epub 2011 Jul 25.
• Greenhalgh T, Jackson C, Shaw S, Janamian T. Achieving Research Impact Through Co-creation in Community-Based Health Services: Literature Review and Case Study. Milbank Q. 2016 Jun;94(2):392-429. doi: 10.1111/1468-0009.12197.
• Meijering L, Weitkamp G. Numbers and narratives: Developing a mixed-methods approach to understand mobility in later life. Soc Sci Med. 2016 Nov;168:200-206. doi: 10.1016/j.socscimed.2016.06.007. Epub 2016 Jun 8.
• Sturge J, Meijering L, Jones CA, Garvelink M, Caron D, Nordin S, Elf M, Legare F. Technology to Improve Autonomy and Inform Housing Decisions for Older Adults With Memory Problems Who Live at Home in Canada, Sweden, and the Netherlands: Protocol for a Multipronged Mixed Methods Study. JMIR Res Protoc. 2021 Jan 21;10(1):e19244. doi: 10.2196/19244.

Helpful Links

• Chaire de recherche du Canada sur la décision partagée et l'application des connaissances

Study record dates

Study Major Dates

• Study Start (Actual): November 28, 2018
• Primary Completion (Anticipated): August 1, 2021
• Study Completion (Anticipated): November 1, 2021

Study Registration Dates

• First Submitted: February 7, 2020
• First Submitted That Met QC Criteria: February 12, 2020
• First Posted (Actual): February 13, 2020

Study Record Updates

• Last Update Posted (Actual): February 17, 2020
• Last Update Submitted That Met QC Criteria: February 13, 2020
• Last Verified: February 1, 2020

More Information

Terms related to this study

• Keywords: Mild Cognitive Impairment; Shared decision making; Technology; aging in place; memory problem
• Additional Relevant MeSH Terms: Mental Disorders; Neurocognitive Disorders; Cognition Disorders; Cognitive Dysfunction
• Other Study ID Numbers: 118792

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No