Family Members of Alzheimer's Patients Access Support and Services through UC Workspace

March 10, 2008

By Jenny Carless, News@Cisco

Learning that a parent or other loved one has Alzheimer's disease is devastating news that brings with it a distressing combination of challenges - for both the patient and family caregivers. In the United States, it is increasingly common for families to keep Alzheimer's patients in their homes instead of institutions - and for the primary caregiver to be a family member. These caregivers, most often untrained, can easily become overwhelmed, and many experience stress, loneliness and other health difficulties.

In order to help family members tend to their relatives with Alzheimer's disease, the University of Miami Center on Aging has launched an innovative pilot study that uses the latest Unified Communications workspace to help these caregivers cope with the many challenges they face. The program, primarily supported by The Jacob and Valeria Langeloth Foundation, focuses on helping reduce the caregivers' stress and the likelihood of depression and isolation by offering video access, through an Internet Protocol (IP) telephone, to resources such as online support groups and care tips.

"Studying how information technology (IT) can be used to enhance the quality of life for older adults and their families is a unique feature of our program," says Dr. Sara Czaja, co-director of the Center on Aging.

The program, "A Computer Integrated System for Telephones," uses a personal desktop videophone to allow caregivers to access educational seminars and individual counseling sessions.

"If the caregivers have better skills, learn to take better care of themselves and have access to formal and informal resources, we believe we will be enhancing their quality of life as well as that of the family member they're taking care of," Czaja explains.

Reducing the Burden of Family Caregivers

The goal of the pilot, currently underway, is to measure the effectiveness of video-based intervention in terms of caregiver outcomes, such as enhanced social support, reduced depression, better caregiving skills and reduced burden.

The program, which began with six research candidates and will expand to as many as 1,100 caregivers, focuses on supporting African-American, Hispanic and Haitian caregivers. Menus and resources that appear on the IP phones are available in English, Spanish and Creole, as are the counseling sessions.

"The percentage of minority older adults is increasing in the United States - and that trend will continue," Czaja explains. "There are cultural differences in attitudes toward and strategies for caregiving. In developing intervention programs, we need to understand and take into account those differences; this is one case where one size does not fit all."

Offering Access to Support and Community Resources

In the study, caregivers' homes are equipped with a Cisco Unified IP Phone 7985G, a broadband connection, and a Cisco 871 Series Router. The phone connects to the Cisco Unified Communications Manager on the Center on Aging network, rather than the local phone company network, to ensure the quality of service needed to send high-quality video over the Internet. Caregivers can make and receive calls exactly as they would with any other phone.

"Early indications suggest that videoconferencing is more effective and satisfying than voice-only conferencing," says Dr. Czaja. "And seeing a participant's face gives counselors valuable insights into how he or she is coping."

The Center on Aging selected the Cisco desktop videophone because of its large, easy-to-read display area, programming flexibility and ease of use.

The caregivers can use the IP phones for a wide range of activities. For example, they receive individual, face-to-face counseling sessions on topics from stress management and dealing with behavioral problems to legal and financial issues. They can also participate in online support groups with up to six caregivers and a trained facilitator. With the IP videophones, all participants can see each other.

The UC workspace also serves to help the caregivers find resources. Specially programmed buttons on the phones direct them to local and national resources on topics such as wandering, agitation and living wills, for example.

According to Dr. Czaja, using the videophone helps from a number of perspectives:

• Caregivers can more easily access skills training as well as formal and informal support and resources.
• They make real connections with others who are struggling with similar challenges. (Many can't attend regular community programs or support groups because they lack transportation, the programs are at inconvenient times and/or they have no one to watch their loved ones.)
• The Center's interventionists spend much less time traveling to people's homes and have more time to offer support.

"Video telephony is the new standard for caregiving communication," said Brian Dal Bello, director of Marketing for the Cisco IP Communications Business Unit. "It's great to see an innovative program like this Center on Aging study that is taking advantage of IP video telephony to help family members consult with researchers and doctors in real time."

In fact, unified communications - the integration of tools and services, from voice and e-mail to video, Web conferencing and more - helps to upgrade communications and improve customer service in many different industries and scenarios.

"Businesses allow you to make appointments over the phone without the need for a customer service representative, hospitals use video phones to facilitate translation services and your dry cleaner can automatically send you a text message when your shirts are ready," explains Nora Freedman, senior analyst, Enterprise Networks with IDC.

"This technology has tremendous potential to help across all verticals," she continues. "At this point, it's more a matter of people understanding what's available and what they can do with it - rather than having to wait for further technological advances."

Sharing the Benefits of IT

Currently, there are 22 million family caregivers in the United States alone, and that population is expected to increase to 37 million by 2050, according to Dr. Czaja.

"Our concern is to make sure that everyone can jump on the technology bandwagon and use it to maximum advantage," she says. "Technology is becoming ubiquitous, and it is important that we don't break down into technology 'haves' and 'have nots'."

As its study progresses, the Center on Aging plans to add more video-based instruction and is evaluating the feasibility of using video telephony for patient assessment. The researchers may also link caregivers with family members who live farther away.

Dr. Czaja and her team want as many people as possible to enjoy the benefits IT can offer.

"If technology is well designed and implemented, with a focus on diverse user groups, it can help bring about many positive effects," she adds. "It can augment a lot of the work we do."

Jenny Carless is a freelance writer based in Santa Cruz, CA.