The Use of Technology in Dementia Family Caregiving in Rural Michigan of the United States: Barriers and Strategies

Background and Purpose: Alzheimer’s and related dementias (ADRD) affects about 180,000 people in the state of Michigan, and most of them live in rural areas with limited access to diagnosis and treatment, long-term care services, and caregiver support resources. The purposes of this study are 1) to investigate the particular challenges that rural ADRD family caregivers face; and 2) to develop an intervention module to facilitate the optimal mastery and use of technology to improve caregiver wellbeing and quality of care for care recipients; and 3) to pilot-test the efficacy of this intervention module on a small caregiver group.

Methods:

This study used a two phase mixed method research design. Six focus groups with family caregivers (n=32), two groups with Persons with Dementia (PWD) (n=8), and one group with service professionals (n=6) including healthcare professionals and technology developers) were run to seek their perspectives on challenges and barriers in rural dementia caregiving, and possible solutions for increased technology literacy and accessibility, and resource creation. Information from focus groups was then analyzed to inform the design of intervention training modules to improve technology literacy in dementia family caregivers. In phase II, a five-session training module were developed and then provided to a group of four family caregivers in a community aging service center. Focused outcomes included awareness of online resources and technology means available to caregivers as well as the capacity to use technology such as social media, caregiver websites, and assistive devices) in dementia care.

Results: Thematic analyses were conducted on transcribed interviews of focus group interviews conducted in phase I. Challenge themes included minimal transportation, limited financial means, lack of health care providers and social services, and stigma toward dementia. Participants tended to agree that technology can enhance services available for persons who otherwise have little or no access to them. Common technology used included support groups via Internet or phone, smart devices, and in-home cameras. Barriers such as lack of technology literacy, no time to learn about new technologies, and unavailability of reliable Internet services were reported. In phase II, the efficacy of the five weekly session has shown some promising trend in increased awareness of technology resources and increased technology competency. Given a very small sample size, we did not perform any inferential statistics.

Conclusions and Implications: Findings suggest a great need to facilitate technology literacy and competency for rural family caregivers to access caregiving resources. Health and social service professionals should consider collaborations with public service institutions (e.g. libraries) and faith-based organizations to provide educational workshops on technology and other supportive services for this population. Subsequent to these findings of the study, a five-module training intervention for the use of technology in dementia care was developed. The modules of the intervention include communication tools, resource hubs, and assistive devices for care recipients. Preliminary results from a pilot test of the training intervention with a caregiver group indicate self-reported increase in technology literacy for dementia care and a desire to acquire additional technological skills for improved caregiving.