Effect of a Smart Clothes-Assisted Care System for Persons Living With Dementia on Family Caregivers: Longitudinal Nonblinded Quasi-Experimental Study

Abstract

Background: Caregiving preparedness (perceived confidence in caregiving abilities) and caregiving balance (perceived confidence in finding equilibrium among overlapping demands of caregiving and personal needs) can reduce caregiver burden and depression and improve health-related quality of life. Smart clothes technology for monitoring persons living with dementia may help reduce caregiver burden and improve quality of care, but empirical evidence remains limited.

Objective: This study aims to examine the preliminary effects of a smart clothes-assisted care system that monitors the daily activity of persons living with dementia on outcomes for the family caregivers.

Methods: This nonrandomized, quasi-experimental study recruited dyads of family caregivers and persons living with dementia by convenience sampling from dementia care centers in northern Taiwan. A total of 60 dyads agreed to participate in the 6-month study. Persons living with dementia received either usual care (n=30, 50% control group) or usual care in addition to smart clothes-assisted care (n=30, 50% intervention group), which required wearing a smart clothes vest 24 hours per day. The nurse-led intervention was conducted in the homes of the persons living with dementia from August 2020 to November 2023. Sensors in the smart clothes vest and home monitored the activity of persons living with dementia, which was transmitted via a smartphone app to a nurse who provided caregivers with real-time feedback and individualized care plans. Caregivers completed the self-report-structured questionnaires for outcomes of caregiving preparedness, balance, depressive symptoms, and health-related quality of life at baseline and at 2, 4, and 6 months. Effects of the intervention were assessed by comparing scores and changes in scores between the intervention and control groups.

Results: The mean age of the 60 caregivers was 59.32 (SD 11.46) years; most were female, married, college-educated, and co-residing with their relative. The mean age of the 60 persons living with dementia was 79.95 (SD 7.05) years; most were female, widowed, and diagnosed with Alzheimer disease; 53.5% (32/60) had a Clinical Dementia Rating of 1.0. Compared with controls, caregiving balance was significantly higher for the intervention group at 2, 4, and 6 months (P=.04, P=.01, and P<.001, respectively). In addition, scores for preparedness increased significantly for caregivers in the intervention group at 4 and 6 months (P<.05). Within-group changes from baseline for balance or mental health scores were not significant at any time point for the intervention group. However, scores for balance and mental health for the control group decreased significantly from baseline at 6 months (P=.01) and at 2 months (P=.02), respectively.

Conclusions: Smart clothes-assisted care enhanced caregiver preparedness and helped prevent declines in caregiving balance and mental health. These findings provide preliminary evidence supporting the integration of wearable technology into family caregiver support interventions for persons living with dementia.

Keywords: caregiver preparedness; family caregivers; persons living with dementia; smart clothes–assisted care; smart technology.