Cecelia Marshall and Dr. Andrea Iaboni
Cecelia Marshall (L), social worker, Geriatric Psychiatry, and Dr. Andrea Iaboni, geriatric psychiatrist, aim to launch the new behavioural app across Ontario improving care for people with dementia. (Photo: UHN)

Toronto Rehab researchers have begun developing a first-of-its-kind app that will allow nurses and personal support workers (PSW) to more accurately track behaviours of people with dementia – resulting in better treatment of their symptoms.

Dr. Andrea Iaboni, geriatric psychiatrist and researcher, Toronto Rehab, saw a need for a more sophisticated tool to gather this important data at point of care. The current paper model can give a biased impression of the patients' behaviours.

The nurse or PSW – depending on the care environment – is intended to record behaviours on paper every 30 minutes, but often gets sidetracked with other shift duties. This means they complete the assessment later on, losing the real-time accuracy.

"The existing tool is cumbersome and hard to incorporate into the flow of patient care," says Dr. Iaboni. "The app will make it easier to report in the moment, creating more systematic and comprehensive reporting.

"In turn, the hope is that the more accurate assessments will improve decision-making in terms of interventions for patients."

Nurses and therapists reviewed prototypes

Cecelia Marshall, social worker, Geriatric Psychiatry, Toronto Rehab, spearheaded the development of the prototype working alongside University of Toronto students who supported the app development.

As part of the process, Cecelia presented the prototype at its various stages to nurses and therapists on the Geriatric Psychiatry Unit to gather feedback on how to optimize it for the end-user.

In addition to hospitals, the app can be used in nursing homes and potentially by caregivers in the home.

"This apps means that instead of providing anecdotes when meeting with the doctor, for example, a caregiver can provide data collected through the app," said Cecelia.

Clinicians and nurses can tailor the app in terms of which behaviours to track – for example, physical aggression, verbal agitation, sleep patterns – individualizing the observation record based on the needs of the patient.

Improved treatment and care for people with dementia

By more accurately tracking this information, Dr. Iaboni believes the interprofessional teams will better understand what the patient is communicating and also pinpoint what times of day they are most distressed. This will allow for improved treatment and care for people with dementia.

When the app is developed, it will be piloted on the Geriatric Psychiatry Unit. And if it proves to be effective, Behavioural Supports Ontario plans to disseminate it within Ontario for clinical use.

"Once we have a wealth of data generated by this app, it may create opportunities for more sophisticated analyses that can improve patient outcomes," said Dr. Iaboni.

The app development is funded by a SPARK grant from the Canadian Centre for Aging & Brain Health Innovation.​

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