Effects of Computer Technology Use on Older Adults in Long Term Care Laura Mock, CTRS, Christy Kyrus, CTRS, Tenley Scott, student, Wayne Pollock, CTRS April 14,2016 Southeast Recreational Therapy Symposium

Learning Outcomes: Participants will be able to verbally identify a minimum of three therapeutic interventions available through the IN2L computer technology. Participants will be able to verbally describe a minimum of three consumer outcomes that are expected as a result of the IN2L intervention. Participants will be able to verbally identify three assessment instruments used to assess consumer’s general well-being, quantity and quality of social engagement and level of depression.

How We Got Here! Who What Why How

Since 2011 Therapeutic Recreation Staff utilizing IN2L-”Its Never Too Late” computer system www.in2l.com

Westminster Canterbury’s President/CEO Ben Unkle Eastern Virginia Medical School Dr. Sautter PhD and Dr. Aravich PhD Philanthropists – Mr. and Mrs. George and Sue Birdsong Westminster Canterbury’s Therapeutic Recreation Dept and Virginia Wesleyan College Dr Wayne Pollock (VWC Rec Therapy students) and EVMS medical students

IRB (Internal Review Board) Approval

Project Objectives:   This project will evaluate the feasibility of applying computer technology, the “It’s Never 2 Late” (IN2L) system, to increase socialization of nursing home patients with cognitive impairment, at the bedside of long-term care residents.

Project Objectives: This study is intended to assess whether or not the IN2L system will improve the resident’s general well-being, social engagement, decrease stress and depression while increasing caregiver’s satisfaction and reduce caregiver strain.

Project Objectives: This project is designed as a research project to assess the generalizable findings to the larger community of long term care residents with cognitive impairment.

Elements of the Study 24 week research study, partnering with EVMS (Eastern Virginia Medical School) and Virginia Wesleyan College 62 participants living in The Hoy Center (healthcare) and The Chesapeake (secure memory enhanced unit) Dx of cognitive impairment 31 touch-screen computers with IN2L technology (It’s Never Too Late)

Elements of the Study 62 consent forms/photo release approval for participants and staff Training/Educating families, staff and students VWC Therapeutic Recreation “interns” provide 5 hours/week of one-on-one training/engagement Encouraging residents to use IN2L at any time of day or night at their leisure

Team Birdsong Initiative-Providing 1:1 interactions with the IN2Ls (Just some of Our VWC and TR Staff who are dedicated to working one to one with our residents during our study!)

Elements of the Study We will monitor the participant’s engagement, interaction and satisfaction in using the IN2L system as well as the caregiver’s satisfaction. To do so we will be utilizing on the following measurements/assessments: Demographics - MoCA (24/30) Affect Balance Scale -Geriatric Depression Scale Perceived Stress Scale (staff) -Client Satisfaction Questionnaire Blood pressure (nursing) and cortisol levels by salivary stress hormone (EVMS)

Pre-/Post Assessments

Before we begin...

Montreal Cognitive Assessment (MoCA)

Cognitive Areas Assessed Attention and concentration Executive functions Memory Language Visuoconstructional skills Conceptual thinking Calculations And orientation

Results Cognitive/brain power scores rose nearly 23.5%. The average increase was 4.86 points on a 30 point scale.

Results Depression decreased overall 41% in the residents over the duration of the 24 week period.

Results Stress indicators for staff caregivers dropped by 47%. Behavioral episodes became less frequent for 54% of participants, ceasing entirely for for 30% of those. Behavioral episodes became less intense for 75% of participants. There was a clinically significant reduction of antipsychotic drug doses among 40% of the intervention group over the 24 week period who had been taking medications throughout the study. 6 out of 7 participants or 86% who are on continuous antipsychotic medications decreased their use to various degrees.

The In2L Computer

Hardware of the computer & multiple functions of the surface.

The Home Screen Home Screen:

My Community Button

A video of our results! Birdsong Video

Our residents spent an average of 30.7 hours OUR RESIDENTS HAD FUN! Our residents spent an average of 30.7 hours per week using the computer ON THEIR OWN!

Additional Results Success Stories/Mission Moments Set backs Where can we go with this? Projected benefits in LT care/ Dementia units/other populations More information available at www.wcbay.com/birdsong

IN2L Computer Demonstration