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

Study Overview
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Brief Summary
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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.

Detailed Description
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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: Assess autonomy and mobility of older adults with mild cognitive impairment/memory problems living at home. 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.

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

Conditions
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Memory Problems, Aging, Mild Cognitive Impairment, Shared Decision Making

Intervention / Treatment
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* Device: GPS and travel diary
* Other: e-decision support platform


Participation Criteria
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Eligibility Criteria
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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

Ages Eligible for Study
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Minimum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Older adults with mild cognitive impairment<br>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<br>* WP1: GPS tracker for 2 weeks and a daily diary about activity (travel diary).<br>Other: e-decision support platform<br>* 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.<br>|

What is the study measuring?
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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 | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Shared decision making, Mild Cognitive Impairment, Technology, aging in place, memory problem