Study into the effect of domotics in small-scale groupliving faclities on people with dementia and their professional carers.

According to the Netherlands Health Council six new nursing homes would have to
be build every year to cope with the growing need for care of people with
dementia. However, to live in large institutions is not what the majority of
the elderly want. We therefore see a growing number of small-scale living
facilities for people with dementia. It is expected that there will be a
shortage of these facilities in the future due to a lack of sufficient
qualified personnel and the constant pressure on health care organisations to
reduce costs. New solutions are necessary to help address these problems with
respect to quality of care. Technology in the home, also known as domotics, is
one of the possible measures that can help improve quality of care and/or cost
effectiveness. As the application of domotics has never been investigated in
small-scale living facilities for people with dementia, an evaluation study
into the effect of domotics is proposed.

The aim of the study is to assess the effects of domotics on people with
dementia living in small-scale living facilities and their professional carers.
Also, we will investigate whether domotics can be used as an alternative for
traditional preventive means and measures of restraints. Furthermore, the study
will be carried out to evaluate legislation and financial means as potentially
impeding factors in the implementation of domotics. Finally, the study will
provide insight in the (change of) labour productivity as a consequence of the
implementation of domotics.

In this study a randomised controlled trial will be conducted (RCT). Based on
their number on the waiting list for a small-scale living facility and need of
care, people will be assigned in groups of six people, with a similar
variation in need of care, to the small-scale living facilities. Next, the
facilities are assigned by drawing of lots either to the experimental
(domotics) or the control condition (without domotics). Data are collected one
month after people start living in the small-scale living facilities and two
months later. At the end of the intervention period the people with dementia
and their professional carers will be interviewed (semi-structured interviews)
to evaluate the quality of life and functioning of the persons with dementia.

The intervention in this study consists of the application of domotics in
small-scale living facilities for people with dementia. The domotics encompass
the following elements:
- Environment control: movement sensors, light control, sun shade, cookery
safety devices, orientation lights;
- Monitoring devices: wandering detection, time control, camera control,
intercom function at the entrance;
- Alarm systems: acoustic monitoring, passive alarm en heat control.
So-called *life circles* (leefcirkels) will be used where residents can go
independently. Within this space a person with dementia is able to walk freely
without the risk of getting lost. By means of a customized profile that can be
implemented in the monitoring-system elements of domotics, such as light, heat,
alarm system, sun shade, independent toilet use, and the space of life circles
or a combination of these, can be adapted to the individual needs of the person
with dementia.

The burden for patients and professional carers of participation in the project
(two questionnaires of one hour and an interview of 30 minutes in a research
period of four months) is minimal and without risk for the persons with
dementia and carers in our opinion. Trained interviewers will carry out de
questionnaires.