Bel Wong

Background: Hospitalisation is challenging for individuals with cognitive impairment and their care partners. This paper describes the protocol of an ongoing study that investigates a medical-social collaboration model in which trained non-governmental organisation (NGO) staff deliver symptom-focused activities in hospital and care partner coaching, with the aim of enhancing short-term patient outcomes and caregiving self-efficacy. Methods: In the planned study, a single-arm, pre-test–post-test cohort study design is adopted. Participants include dyads of 250 inpatients with cognitive impairment (aged ≥ 60 years) and 250 family care partners (aged ≥ 18 years). The intervention adapts the Tailored Activity Program for Hospitalised Patients to two 60-min individual sessions over two weeks, featuring positive psychosocial activities. Care partners will receive two 30-min support sessions focusing on preparation for post-discharge care. Expected Results: The primary outcome is inpatient quality of life; the secondary outcomes are agitation, caregiving self-efficacy, change in sedative medication use, length of stay, and discharge destination. Data will be collected at baseline and post-intervention. Statistical analyses include within-group pre-test–post-test comparison, regression analyses, and descriptive process evaluation. Conclusions: This protocol describes the design, intervention, outcomes, and planned analyses of a study that evaluates the changes in the psychological well-being of inpatients with cognitive impairment and family care partners after a medical-social collaborative intervention. Findings are anticipated to contribute to the development of medical-social collaboration in hospital practice in the long term. Anticipated limitations related to study design, recruitment, and data collection are discussed.

Background: Dementia increases the risk of individuals getting lost due to cognitive decline, impacting daily functioning and heightening caregiver worry. Traditional search methods are often time-consuming and stressful, whereas GPS-based technologies face limitations such as battery dependency. A crowdsourcing Internet of Things (IoT) technology using energy-efficient Bluetooth Low Energy (BLE) offers a potential solution to locate missing individuals with dementia more effectively by harnessing the power of the crowd and fostering a caring and inclusive community. Objective: This study aimed to evaluate the effectiveness of a BLE-based privacy-preserving crowdsourcing IoT system consisting of a BLE tag and an Android and iOS app in improving lost-related behavior and psychological well-being by facilitating searches, after-care arrangements, and reducing caregiver worry, as well as to assess its usability among caregivers of individuals with dementia in Hong Kong. Methods: A single-arm, prospective observational study was conducted from November 2020 to October 2023. Caregivers (N=1034) of individuals with dementia used a staff-assisted crowdsourcing IoT technology comprising a BLE tag, mobile app sensor, and location cloud server. Outcomes included search strategies, post–getting lost care arrangements, caregiver worry and distress (10-point scale), and usability (modified Quebec User Evaluation of Satisfaction with Assistive Technology 2.0 survey). Data were collected at 6- and 12-month follow-ups and analyzed using generalized estimating equations and linear mixed models. Results: Of the 1034 participants, 143 (13.82%) reported lost episodes, with 51 (35.7%) using BLE tags for searches. Worry about future lost episodes decreased significantly over time ( P =.008), especially among BLE tag users ( P =.04). There was an association between BLE tag use and adoption of proactive search strategies (eg, going out to search: adjusted odds ratio 2.78, 95% CI 1.33-5.82; P =.007) and preventative measures (eg, IoT devices or CCTV: adjusted odds ratio 2.92, 95% CI 1.61-5.29; P <.001). Usability satisfaction was high for design and data security, whereas approximately half of the participants (309/707, 43.7%) were satisfied with accuracy. Conclusions: The BLE crowdsourcing system may reduce caregiver worry and encourage proactive search behaviors, although accuracy depends on broader community adoption. Integration into dementia care plans could enhance safety and autonomy. Further research with a randomized controlled trial design is needed to confirm these findings.

Background: The carers of people with dementia (PWD) often face physical, emotional, and financial challenges; their well‐being is influenced by various carer‐related and care recipient‐related factors within the stress and process framework. This study aimed to examine the factors associated with the quality of life and caregiving well‐being of dementia carers to better inform the design of supportive interventions and enhance carer support. Method: This study adopted a longitudinal cohort design. The outcome measures were carers’ physical‐ and mental‐related quality of life, and caregiving self‐efficacy. The data were obtained from the effectiveness study of iSupport for Dementia, an online psychoeducation programme developed by The World Health Organization, conducted in Hong Kong and Macau, and were analysed using Generalized Estimating Equation. This study was funded by the National Foundation for Australia‐China Relations, Australian Government. Result: Data from 63 carers of PWD were analysed. The results showed that, after adjusting for covariates, carers’ health‐related quality of life was positively associated with carers’ education level (Adjusted odds ratio [AOR]=4.03, 95% CI=0.05 – 8.00, p = 0.047) and support from other family members (AOR=5.20, 95% CI=0.75 – 9.64, p = 0.022), but negatively associated with carers’ own medical condition (AOR=‐2.70, 95% CI=‐4.88 – ‐0.52, p = 0.015) and caregiving‐related financial burden (AOR=‐4.57, 95% CI=‐8.29 – ‐0.86, p = 0.016). Higher caregiving time (AOR=‐0.14, 95% CI=‐0.26 – ‐0.02, p = 0.024) and caregiving‐related financial burden (AOR=‐7.35, 95% CI=‐12.80 – ‐1.91, p = 0.008) were linked to worse caregiving self‐efficacy, while older carer age (AOR=0.32, 95% CI=0.09 – 0.55, p = 0.006) and family support (AOR=12.98, 95% CI=1.71 – 24.26, p = 0.024) were associated with better caregiving self‐efficacy. Conclusion: Family support plays a crucial role in enhancing health‐related quality of life and caregiving self‐efficacy, while financial burden negatively impacts carers’ well‐being. iSupport for Dementia emphasises sharing caregiving responsibilities and exploring available support through self‐reflection exercises and practical scenarios. It also includes region‐specific resources during adaptation to help carers access affordable dementia care. Future psychoeducation interventions for carers should consider these factors to address their challenges effectively and provide comprehensive support to enhance their overall well‐being.

Individuals from the Jockey Club Centre for Positive Ageing discuss reducing using restraint on residents in Hong Kong care home settings

E-Learning platform for dementia caregivers: Jockey Club Centre for Positive Ageing is developing a multimedia e-learning platform for dementia caregivers; here, they share the vast benefits. Taking care of a loved one who has dementia is a challenging task for family members. According to an opinion survey conducted by Jockey Club Centre for Positive Ageing (JCCPA), almost 90% of caregivers reported experiencing stress while caring for a family member with dementia, with about half of them experiencing frequent episodes of stress.(1) Data indicates that family members who assume the primary role of caring for individuals with dementia experience a significant burden of caregiving. On average, caregivers devote between five and 20 hours per day to caring for these individuals.(2) Extended caregiving hours can reduce the time available for rest and social engagement, leading to feelings of loneliness and social isolation.(3) It is common for caregivers to experience high levels of depression.(4)

Researchers from the Jockey Club Centre for Positive Ageing analyse the services available for people with younger onset dementia

Getting lost can affect caregivers and families of older people with dementia – now, a Bluetooth tracking device can assist the search

Objectives: This study aimed at revealing the caregiving challenges of the caregivers of people with dementia (PwD) during the COVID‐19 pandemic when daycare service was stopped as an infection control measure, and discussed ways to help PwD and their family caregivers to maintain their well‐being in the era of the pandemic.Methods: Between April and May 2020, a cross‐sectional survey was conducted in 152 family caregivers of PwD who were clients of daycare service prior to the pandemic. The survey examined caregivers' stress and challenges faced during daycare service cessation, their perceived needs for continuation of daycare service, and observed changes in functional status of PwD. Regression analyses were performed to explore the associated factors of caregiving stress and preference for continuation of daycare service.Results: Family caregivers of PwD experienced greater caregiving stress after cessation of daycare service. Infection was their main challenge in caregiving, and their physical and emotional health was adversely affected by the longer time commitment with PwD under the stay‐home policy. Older age of caregivers, greater emotional and communication problems of PwD, and more time spent with PwD were associated with greater caregiving stress. More than one‐third of the participants preferred the continuation of daycare service during the pandemic.Conclusions: Policy makers should consider the well‐being of PwD and their caregivers when planning infection control measures. Daycare service with enhanced infection controlled measures should remain available to PwD during the COVID‐19 pandemic.

Background: To investigate the effect of a modified mindfulness‐based stress reduction (mMBSR) program on mental well‐being and cognitive function of older adults.Method: Two hundred and fourty‐six participants were randomly assigned to mMBSR (n = 120) group or waitlist control group which received mMBSR at 2‐month (n = 123). Data collected at baseline, 2 and 4 months after recruitment. Primary outcome: mental well‐being: Short Warwick‐Edinburgh Mental Well‐being Scale (SWEMWBS). Secondary outcomes: Five Facet Mindfulness Questionnaire Short Form, Montreal Cognitive Assessment (MOCA), Verbal Fluency Test (VFT), international shopping list test, self‐compassion scale, peace of mind scale, geriatric depression scale (GDS), and Pittsburgh sleep quality index (PSQI). In modified‐intention‐to‐treat analysis, paired t‐test for within group comparison, and ANCOVA to compare group differences at 2‐months with adjustment of baseline values.Results: Most participants were female (83.7%), living with others (67.0%), and married (50.7%). No significant difference of baseline characteristics except sleep quality. At 2 months, intervention group reported better mental well‐being (0.9, 95%CI: 0.1–1.8, p = 0.025) and less depressive symptoms (−1.0; 95%CI: −1.7 to −0.3, p = 0.004). Within group at 2 months, intervention group had improvement in: mental well‐being (SWEMWBS: 22.5–23.4, p = 0.011), cognitive function (MOCA: 24.6–25.8, p < 0.001; VFT: 38.7–42.1, p < 0.001), depressive symptoms (GDS: 4.1–3.1, p < 0.001), and sleep quality (PSQI: 8.3–6.7, p < 0.001). All these changes, except mental well‐being, were sustained at 4 months.Discussion: Attrition rate was 14% and mindfulness intervention was found to be feasible and acceptable in older adults. Major limitation of the study was the absence of an active control group to control for non‐specific effect.