Real-time decision support tool aims to help staff treat dementia-related behaviours

A residential aged care trial underway is testing an Australian-developed web, tablet and mobile tool that aims to help aged care professionals better respond to the behavioural and psychological symptoms of dementia (BPSD).

A residential aged care trial underway is testing an Australian-developed web, tablet and mobile tool that aims to improve the way aged care professionals respond to the behavioural and psychological symptoms of dementia (BPSD).

iSeeBehaviour is a decision support system that uses evidence-based strategies and a patient-centred care approach to guide aged care workers through responding to and managing BPSD with an aim of reducing future episodes.

Key features of the tool include analytics to help identify triggers and patterns, a secure electronic record to record events and interventions, real-time instructions on implementing and monitoring interventions and downloadable resources.

The tool teaches expert skills in an easy way to people who do not have a background in behavioural observation, said lead developer Professor Britt Klein, who is director of the Centre for Biopsychosocial and eHealth Research & Innovation (CBeRI) at Federation University.

Britt Klein
Professor Britt Klein

“We are trying to automate as much as possible what we as psychologists do through a lot of observations to work out what those triggers are,” Professor Klein told Australian Ageing Agenda.

The current trial involves registered nurses, enrolled nurses and personal care workers at an aged care facility in Melbourne and among other things will assess whether iSeeBehaviour leads to a decreased use of medications and improved stress levels in workers.

“The system provides aged care workers with standard psychological stress reductions tools… so they can use that to generally reduce stress levels overtime,” said Professor Klein who is a clinical psychologist by training and a mental health researcher at the university.

The interventions in the tool draw on both dementia and psychological guidelines as well as feedback from focus groups. This trial and the current model of tool were informed by a pilot study using an earlier version at a low care nursing home in the Grampians region of Victoria.

iSB 1Professor Klein said the tool collected information on resident behaviour and responses to interventions to create an in-depth profile of every resident’s behaviour.

“For example, if you know singing to Mary really calms her down when she is aggressive then you can load that intervention specifically for Mary for that type of behaviour. It becomes extremely individualised so when you have nurses on shift who don’t know who they are working with, they can very easily use that.”

The system learns about each resident over time and slowly builds up a profile to provide increasingly more nuanced responses.

iSB 9“It will rank order so nurses can make much quicker decisions about interventions that work best for that particular behaviour for that particular person but they are also free to make other choices.

“The one thing we didn’t want to create was a very strict rigid rule bound system because decision making in the actual environment is also very important,” Professor Klein said.

She said the step-by-step approach allowed for many different responses and if something didn’t work the system would suggest something else to try, but that loop was not endless.

“There is a point where the nurse will hit a threshold then it will hit administration. The administration knows that this is a particularly difficult behaviour to manage and therefore that is where you get the external support coming in.”

iSB 11The current evaluation trial will be used to drill down in the effects of the tool as well as its usability.

“If the nurses can’t use it or they find it cumbersome, they are not going to use it,” Professor Klein said.

The research team is now working on expanding iSeeBehaviour to integrate biometric devices so they could take inputs from the nurses to see how they were responding to each situation and see how resident physiological data correlated with their behaviour.

They are also working on including telehealth and case conferencing facilities to connect GPs, behavioural experts and aged cared staff, for example, from within the platform, she said.

The tool is partly funded by the Telematics Trust Fund, the Collaborative Research Network and the Centre for Biopsychosocial and eHealth Research & Innovation (CBeRI) at Federation University Australia.

It is expected the tool will be ready for use in aged care facilities later this year. For more informaiton, see iSeeBehaviour.

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Tags: bpsd, britt-klein, dementia, federation-university,

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