App will be ‘virtual coach’ for LTC caregivers

Families and others responsible for making decisions for those entering long-term care facilities may have another resource to help them if two-year tests of an avatar-based decision technology are successful. Among other things, the app is expected to help caregivers improve their ability to communicate residents’ healthcare preferences to providers.

Researchers at the Case Western Reserve University (CWRU) nursing and engineering schools in Cleveland, aided by a $460,000 grant from the National Institute of Nursing Research, are developing the Electronic Surrogate Decision Maker Resources and Tailored Training (eSMARTT) app to help caregivers learn about available resources and medical care so they can practice and improve on making necessary choices for those undergoing rehabilitation or planning to live in a skilled nursing facility.

“There are limited decision support resources to help families of patients faced with advanced care planning decisions,” Ronald Hickman, PhD, RN, ACNP-BC,assistant professor of nursing at CWRU’s Frances Payne Bolton School of Nursing, tells Long-Term Living. “The research plan is to develop, and more importantly, establish an evidence base that supports use of this decision support technology in acute and extended care facilities.”

The eSMARTT app, for iPads and other tablets, is touted as being the first avatar-based decision support technology for caregivers. “We are taking advantage of serious gaming technology to create an interactive learning experience that is customizable to the caregiver’s decisional needs and prior decision-making experience,” Hickman says.

The app will aim to:

• Inform families what they need to do to prepare for long-term care.
• Provide opportunities for caregivers to practice communicating a resident’s healthcare preferences to virtual providers.
• Offer interactive simulations to clarify resident and family preferences.
• Supply coaching to enhance the quality of the decision-making process.

Nurse scientists, software engineers, graphic animators and social workers will develop the technology with feedback from caregivers of cognitively impaired patients discharged from the hospital to a nursing home. Hickman will incorporate information from the caregivers to ensure that the technology is useful to those in similar situations. A subsequent clinical trial, planned for the spring, is expected to test the technology’s effectiveness with more than 200 caregivers of people being discharged from University Hospitals Case Medical Center in Cleveland, where Hickman is an acute care nurse practitioner.

Lois Bowers

Lois A. Bowers was senior editor of I Advance Senior Care / Long-Term Living from 2013-2015.