UpTech

The Up-Tech study is a multi-component randomized clinical trial (RCT) that integrates previous evidence on the effectiveness of Alzheimer’s Disease (AD) care strategies, in an ambitious comprehensive design, in order to reduce the burden of family caregivers and to maintain AD patients at home. One of the interventions tested during the trial was the installation of an AAL kit. In particular, following a 6-month recruitment period, 438 patient-family caregiver dyads were enrolled in the trial and randomized into one of the three study arms, as detailed in the study protocol.

By employing a user-centered design, the selection of the components of the kit installed in patients’ homes was guided by an analysis of the problems associated with AD patients, such as cognitive impairment and wandering, and the needs of their caregivers. Moreover, the outcomes of previous experiences were incorporated on the adaptation of classic home automation technologies to assistive environments.

Each kit consisted of a central management unit (CMU), that collected the data wirelessly transmitted by a set of sensors located in different positions inside the home, and processed them, according to the specific configuration of the unit itself. The peripheral nodes connected to the CMU included: a sensor to detect the presence of a subject on the bed; a sensor to detect possible flooding or liquid on the floor; a sensor to detect smoke or gas leaks; a magnetic sensor to detect opening/closing of a door or window; an automatic courtesy light.

The UP-TECH kit was designed to work properly 24 hours per day/7 days per week without any kind of user intervention or action, after being setup and configured. In fact, the kit must not affect or impact the patient’s habits or actions inside the home environment. The kit was installed by an expert technician with the support of the study case manager who also trained caregivers on their use.

During the deployment period, we used an ad-hoc form to keep a record of the caregivers that refused to have the kit installed and the related motivations. All the data regarding the kit, collected during this phase, were merged with the clinical trial databases containing all the information collected by the research nurses, in order to assess the clinical outcomes of the RCT.

Out of the 144 dyads entitled to receive the technological intervention, 39 dyads (27.1%) refused the kit, while 23 dyads (16%) left the trial for different reasons (deceased, withdrew, institutionalized). Overall, the technology was installed in the homes of only 82 dyads (56.9%). To understand the degree of user satisfaction with the kit, a qualitative interview composed of 14 questions was carried out after four months of installation.

The qualitative interview revealed that 66.3% of families were satisfied with the kit and an overwhelmingly proportion (97.5%) thought the kit was easy to use. The technology made 43.8% of caregivers feel more secure and at ease, which was associated with a majority (55%) being able to reduce their control. More than a quarter of the interviewees (26.3%) were willing to buy the kit.