Gregor Hohenberg

Background/Objectives: Family caregivers play a central role in the provision of long-term home-based care and often provide unpaid support over extended periods. This role is associated with substantial psychological, physical, social, and financial burden. Despite high support needs, access to psychosocial services remains limited for many family caregivers. Against this background, AI-based care companions are discussed as a potential low-threshold supplement to existing support structures. The objective of this study was to explore subjectively perceived family caregiver burden and to examine expectations, acceptance conditions, and concerns regarding a hypothetical AI-based care companion, rather than to evaluate effectiveness. Methods: An exploratory mixed-methods study was conducted using an anonymous online survey. Perceived family caregiver stress was assessed using self-developed, non-validated ordinal items, including a single-item global burden rating and categorical stress domains. The questionnaire combined closed-ended items (Likert-scale and multiple-choice) with one open-ended question to assess perceived stress, experiences with psychosocial support, and attitudes toward a hypothetical AI care companion. Participants were recruited via an online caregiving course platform. Data collection was voluntary and anonymous and took place in Germany between October and November 2025. Quantitative data were analyzed descriptively and exploratorily, and qualitative responses were analyzed using thematic analysis. Results: Fifty-five family caregivers participated in the survey. Overall, perceived family caregiver burden was high, with psychological stress most frequently identified as the dominant stress domain. Difficulties in accessing psychosocial support were reported by 58% of the respondents. Willingness to consider using an AI-based care companion varied by degree of acceptance: 36% reported clear willingness, 31% expressed conditional or tentative willingness, and 33% indicated reluctance or rejection. The most frequently selected expected functions included emotional support, early detection of overload, and caregiving-related information. Data protection, professional reliability, and concerns regarding incorrect advice were identified as the most relevant perceived risks. Conclusions: The findings reflect family caregivers’ perceived burden and anticipated needs, highlighting persistent gaps in psychosocial support. From the perspective of respondents, a hypothetical AI-based care companion could represent a complementary support option if it provides personalized, non-judgmental, and reliable assistance. These results describe perceived potential and acceptance conditions, not verified efficacy. Further research, including prototype development, usability testing, and pilot studies, is required to examine feasibility, ethical implications, and real-world impact.

Background/Objectives: Family caregivers play a central role in long-term care but are frequently exposed to considerable physical, emotional, and social strain. In Germany, care counseling pursuant to §45 SGB XI aims to identify caregiver burden at an early stage and provide preventive, resource-oriented support. Structured self-assessment tools may facilitate reflective dialogue within time-limited counseling sessions. The Self-Assessment Tool for Family Caregivers (SSA-PA) was developed to support this process; however, empirical evidence regarding its applicability in statutory counseling settings remains limited. This exploratory mixed-methods study aimed to generate empirical insights into (1) the perceived usefulness and acceptance of the SSA-PA among care advisors, (2) opportunities and challenges associated with its practical implementation, and (3) its perceived integration potential within routine counseling practice. Methods: Thirteen care advisors working under §45 SGB XI applied the SSA-PA in routine counseling and subsequently completed a structured online survey combining Likert-scale items and open-ended questions. Quantitative data were analyzed descriptively using IBM SPSS Statistics (Version 29), and qualitative responses were examined using thematic analysis. Given the moderate sample size (n = 13), analyses were primarily descriptive and exploratory in nature. Results: Care advisors reported high perceived usefulness and broad acceptance of the SSA-PA as a structuring and reflective instrument in counseling sessions. The tool was described as supportive in facilitating discussion of caregiver burden across multiple life domains and enhancing transparency of stress-related issues. At the same time, participants identified practical challenges, including time constraints, emotional strain for caregivers, technical barriers, and the need for clearer evaluation outputs. Suggestions for further development included automated result processing, individualized recommendations, and longitudinal tracking functions. Conclusions: From the perspective of participating care advisors, the SSA-PA demonstrates promising feasibility and acceptance within statutory preventive counseling under §45 SGB XI. While the findings provide practice-based evidence for its applicability, conclusions regarding effectiveness or outcome improvements cannot be drawn. Further research with larger samples and outcome-oriented designs is required to evaluate its impact on caregiver burden and counseling processes.

Background/Objectives: Home care plays a crucial role in contemporary healthcare systems, particularly in the long-term care of people with chronic and progressive illnesses. Family caregivers often experience substantial physical, emotional, and organizational burden. Telemedicine and digital health applications have the potential to support home care by improving health monitoring, communication, and care coordination. However, their use among family caregivers remains inconsistent, and little is known about how organizational support structures such as telemedicine centers influence acceptance and everyday use. This study aims to examine the benefits of telemedicine in home care and to evaluate the role of telemedicine centers as supportive infrastructures for family caregivers. Methods: A mixed-methods design was applied. Quantitative data were collected through an online survey of 58 family caregivers to assess the use of telemedicine and digital health applications, perceived benefits, barriers, and support needs. This was complemented by an in-depth qualitative case study exploring everyday caregiving experiences with telemedicine technologies and telemedicine center support. A systematic literature review informed the theoretical framework and the development of the empirical instruments. Results: Most respondents reported not using telemedicine or digital health applications in home care. Among users, telemedicine was associated with perceived improvements in quality of care, particularly through enhanced health monitoring, improved communication with healthcare professionals, and increased feelings of safety and control. Key barriers to adoption included technical complexity, data protection concerns, and limited digital literacy. Both quantitative findings and the qualitative case study highlighted the importance of structured support. Telemedicine centers were perceived as highly beneficial, providing technical assistance, training, coordination, and ongoing guidance that facilitated technology acceptance and sustained use. Conclusions: Telemedicine and digital health applications can meaningfully support home care and reduce caregiver burden when they are embedded in supportive socio-technical structures. Telemedicine centers can function as central points of contact that enhance usability, trust, and continuity of care. The findings suggest that successful implementation of telemedicine in home care requires not only technological solutions but also accessible organizational support and targeted training for family caregivers.

Background/Objectives: The digitization of care opens up new opportunities to support family caregivers, who play a key role in home care. While telemedicine applications have already shown initial relief effects, AI-supported chatbots are increasingly coming into focus as an innovative form of digital support. The aim of this study was to build on an earlier study on the integration of telemedicine into home care and to conduct a complementary study on AI-based chatbots to analyze their acceptance, perceived benefits, and potential barriers from the perspective of family caregivers. Methods: The study comprises two consecutive online surveys with a total of n = 62 family caregivers. The first study assessed the use and acceptance of telemedicine systems; the second complementary survey examined attitudes toward AI-supported chatbots. Both questionnaires were developed based on a systematic literature review and in accordance with the Technology Acceptance Model (TAM). The dimensions of user-friendliness, data protection, communication support, emotional relief, and training needs were among those recorded. The data were evaluated using descriptive statistics, including comparative analyses between the two studies. Results: The results show that family caregivers generally have a positive attitude toward digital health solutions, but at the same time identify specific barriers. While technical barriers and privacy concerns dominated the telemedicine study, the AI results place greater emphasis on psychosocial factors. It also became clear that participants assumed that chatbots would be more acceptable if they were designed to be empathetic and dialogue-oriented. A comparison of the two data sets shows that the perceived benefits of digital systems are shifting from functional support to interactive, emotional support. Conclusions: The results suggest that AI-powered chatbots could offer significant added value to family caregivers by combining information sharing, emotional support, and self-reflection. In doing so, they expand the focus of traditional telemedicine to include a communicative and psychosocial dimension. Future research should examine the actual user experience and effectiveness of such systems in longitudinal and qualitative designs. Despite limitations in terms of sample representativeness and hypothetical usage estimates, the study makes an important contribution to the further development of digital care concepts and the ethically responsible integration of AI into home care.

Background: The increasing prevalence of Alzheimer’s disease and related dementia are a global problem generating social and economic burdens. Cognitive Stimulation Therapy is a non-pharmaceutical aid for people with dementia. In this context, digital and virtual reality approaches are underinvestigated, especially with respect to explorable open-world environments. The pilot aims to evaluate the feasibility, acceptability, and safety of an immersive, open-world virtual reality application for people with dementia. Methods: We conducted a single-arm, unrandomised study with three male participants diagnosed with dementia. The intervention consisted of a single virtual reality session in an immersive, open-world environment, where participants were able to explore freely while seated, using arm movements and head control to navigate an avatar. Results: All three participants finished the session without the occurrence of adverse events. The mean session time was 28 min, and the average walking distance was 0.9 km, with 1210 steps on average. Questionnaire results indicate acceptance and a positive attitude toward the usability of the intervention. We measured minimal changes in mood. Anecdotal reports indicate high immersion and autobiographical stimulation. We detected no adverse events or occurrences of cybersickness. Conclusions: Immersive, open-world virtual reality proved to be feasible, safe, and well accepted by the participants. The combination of state-of-the-art hardware and exploration-based software design enabled cognitive and motoric stimulation. The results indicate strong feasibility for the application of exploratory three dimensional virtual reality applications and further support the execution of controlled trials to assess therapeutic outcomes.

Background/Objectives: Family members who provide care play a central but often underestimated role in the healthcare system and are frequently exposed to considerable physical, emotional, and social stress. To better understand and support their needs, a structured self-assessment tool (SSA-PA) was developed. This development addresses the current lack of practical, validated instruments that enable caregivers to systematically reflect on their own stress levels and resources, which is becoming increasingly important in view of the growing demand for care and the risk of caregiver burnout. This tool aims to promote self-reflection, identify individual stresses and resources, and enable more targeted support for family caregivers. Methods: The development process (September–December 2024) followed a multi-phase design that integrated theoretical foundations from nursing, health, and psychology, in particular Orem’s theory of self-care deficit, Lazarus and Folkman’s stress and coping model, and Engel’s biopsychosocial model. Four core dimensions were defined: (1) health and self-care, (2) burden and stress, (3) support and resources, and (4) satisfaction and quality of life. The final tool comprises 37 items (mostly 5-point Likert scales), supplemented by multiple-choice and open-ended questions. Content validity was ensured through expert review and testing with nine family caregivers. Internal consistency was assessed using Cronbach’s alpha (α = 0.998), indicating very high reliability, although possible item redundancies were identified. The evaluation took place in January 2025 with 33 family caregivers to assess user-friendliness, relevance, and perceived usefulness. Results: The majority of participants rated the tool as user-friendly and clearly structured. Around 80% reported a high level of comprehensibility, and over half stated that the tool provided new insights into their own health and care burden. Qualitative feedback highlighted the value of the tool for self-reflection and motivation to seek external support. Suggestions for improvement included shorter item formulations, improved visual feedback (e.g., progress bars or charts), and expanded question areas on financial burdens and digital support options. Conclusions: The SSA-PA is a theoretically grounded and user-centered tool for assessing and reflecting on the situation of family caregivers. It not only enables systematic self-assessments but also promotes awareness and proactive coping strategies. Future research should focus on conducting factor analyses to further validate the construct, testing the tool in larger samples, and exploring its integration into structured care consultations to improve the quality of home care.

Background/Objectives: In view of demographic change and the increase in chronic illnesses, home care poses a considerable challenge. Telemedical technologies offer considerable potential for improving the quality of care and relieving the burden on family caregivers. With this study, we aim to develop appropriate training strategies for the use of telemedical applications in home care, focusing on the specific requirements of patients with dementia, heart failure, diabetes mellitus, chronic obstructive pulmonary disease, and stroke. Methods: A comprehensive survey was conducted among 31 family caregivers to record their experience with digital technologies and to analyze caregiver acceptance of these technologies and barriers to their use. The survey comprised 29 questions, including a mix of multiple-choice, Likert scale, and open-ended questions. The internal consistency of the questionnaire was high (Cronbach’s alpha = 0.8876). Results: The results show that although 32% of respondents already use digital technologies, there is a significant need for training and support. Key barriers identified include a lack of technical skills (cited by 45% of respondents), limited access to suitable devices (38%), and privacy concerns (35%). In addition, 90% of respondents expressed a willingness to participate in training programs. Conclusions: Based on the survey results, evidence-based recommendations are provided for the design of training programs tailored to the individual needs of family caregivers. Through a targeted combination of e-learning modules, webinars, and practical exercises, family caregivers can be empowered to take full advantage of telemedical technologies and thus significantly improve the quality of care at home. The results underscore the importance of overcoming technical barriers and providing comprehensive training to ensure the effective use of telemedicine in home care.

Background: This review investigates the use of virtual and augmented reality games in dementia care. It provides an insight into the last 13 years of research, including the earliest publications on this topic, and takes a systematic and bibliographic approach. Methods: We sourced research publications from three different scientific databases (PubMed, Scopus, and APA PsycInfo) for this publication. We chose the PRISMA approach and categorized the studies according to the publisher. A set of 12 variables was defined across three categories (bibliographic, medical, and technical). Results: Of the 389 identified articles, 36 met the inclusion and exclusion criteria. After a phase of pilot studies mainly being conducted, the number of publications increased by four times but decreased again in 2023. Dominating were pilot and feasibility studies; 8 out of the 36 trials were RCTs. The median trial population was 24, and the protocols were performed for an average of 10 weeks, with two 40-min sessions a week. Simulator sickness was reported but not by the majority of participants. A total of 59% of the studies used fully immersive 3D-VR systems. We identified only three publications that provided high immersion quality. These findings indicate the positive effects of using virtual and augmented reality systems on participants’ cognitive function and mood. Conclusions: This publication focuses on the technical aspects of the applied technologies and immersion levels of the patients. Using augmented and virtual reality methods to improve the quality of life and physical interaction of dementia patients shows the potential to enhance cognitive functioning in this population, but further investigation and multicenter RCTs are needed. There are strong indications that this research branch has high potential to benefit both caretakers and patients.

Zusammenfassung: Die Digitalisierung initiiert einen sozialen Wandel, der weit über technologische Fortschritte hinausgeht, indem sie die Art und Weise, wie wir kommunizieren und interagieren, tiefgreifend verändert. Im Kontext von Demenz wird die soziale Teilhabe als essentiell für die Lebensqualität Betroffener erachtet, wobei eine adäquate Hörfähigkeit entscheidend ist, um Isolation zu vermeiden und das Demenzrisiko zu minimieren. Das Dementia Care Management (DCM) adressiert diese Aspekte durch individuell angepasste Betreuungs- und Unterstützungsmaßnahmen, wobei das vorgestellte H3-Training als Aktivierungsprogramm speziell die kognitive und physische Gesundheit sowie soziale Integration fördert. Diese Ansätze tragen nicht nur zur Verbesserung der Lebensqualität von Menschen mit Demenz bei, sondern bieten auch das Potenzial für signifikante Kosteneinsparungen im Gesundheitswesen durch die Verzögerung des Krankheitsfortschritts und die Reduzierung begleitender Gesundheitsprobleme.

Background: Dementia patients often experience a decline in both their cognitive and sensory functions, particularly hearing, which significantly impacts their quality of life. This study evaluates the effectiveness of a combined Digital Cognitive Stimulation Therapy (DKST) and online hearing training intervention in enhancing the quality of life of individuals with dementia. Methods: Twenty-three patients participated in a six-month program integrating cognitive exercises and hearing rehabilitation, facilitated by trained co-therapists. Quality of life was assessed using the Quality of Life (QoL) Questionnaire, while the Mini-Mental State Examination (MMSE) was employed to categorize participants based on their cognitive status. Results: The results revealed significant improvements in the overall quality of life. Conclusions: This study demonstrates that combining DKST with hearing training effectively addresses sensory and cognitive challenges, supporting improved quality of life and highlighting the potential of digital interventions in dementia care.