Original Title: Les interventions basées sur les technologies de l'information et de la communication en soutien aux personnes proches aidantes de personnes âgées vivant à domicile

Authors' objectives: How can technologies foster better support for informal caregivers (ICs), as well as the engagement and collaboration of all stakeholders (ICs, care recipients, clinical teams, etc.), with the goal of improving home-based support for older adults experiencing loss of autonomy?

Authors' recommendations: 1. Overview of Digital Support Interventions for Informal Caregivers (ICs) of Older Adults Living at Home A literature review identified 65 interventions. Their analysis made it possible to derive a set of findings that provide an overall picture of digital interventions intended for informal caregivers (ICs) of older adults living at home: In half of the cases, the interventions pursue a dual objective: supporting ICs in their caregiving role and improving their well-being. In the other half, interventions focus exclusively on one or the other of these objectives. In nearly half of the cases, the interventions last between six and twelve weeks. In 85% of cases, the interventions target ICs of older adults with a specific condition, mainly Alzheimer’s disease and related dementias (ADRD). Asynchronous communication modalities (texts, pre-recorded videos) are the most frequently used, often combined with synchronous modalities (teleconferences, webinars), which are rarely used alone. Web-based platforms are the preferred delivery formats, followed by mobile applications. Text-based (web texts, slides) and multimedia (video, audio) content are the most common. Peer exchange spaces (forums, with or without facilitators) are present in approximately half of the cases, while email use remains more marginal. 2. Effects of Digital Interventions for Informal Caregivers of Older Adults Living at Home • Effects on Informal Caregivers (ICs) WITH A HIGH LEVEL OF EVIDENCE¹ The interventions show significant improvements in ICs’ knowledge, as well as in their psychological health and well-being. These interventions are characterized by: The use of various multimedia formats to deliver online training sessions (facilitated by professionals), illustrated with relevant real-life examples, educational videos, or presentations (illustrated slides). Content addresses the management of behavioral symptoms, skills for assisting with basic activities, management of the care recipient’s (CR’s) safety, and especially the well-being of ICs; The provision of ongoing support allowing ICs to contact a professional as needed, as well as facilitated and moderated peer exchange and discussion spaces led by experienced professionals. ¹ It is unlikely that the effects of the interventions will be substantially altered by the results of future studies. The interventions show significant improvements in ICs’ mastery and skills, as well as in their ability to care for the CR and cope with associated difficulties. These interventions are characterized by: A focus on developing knowledge and skills, as well as caregiving competence, by helping ICs better understand the CR’s needs and by providing training and advice tailored to each individual’s personal situation; The provision of training illustrated by multimedia presentations (pre-recorded videos or live teleconferencing), complemented by exercises to be practiced at home. The interventions show significant improvements in the perceived usefulness of IC interventions, with no significant change in ICs’ intention to place the CR in institutional care. These interventions are characterized by: The use of asynchronous communication methods to provide ICs with individualized, interactive, and useful support in the form of text-based and multimedia (video) content tailored to their situation, to help them better manage caregiving challenges and overcome difficult situations; Enabling communication and interaction among ICs (sharing caregiving experiences and problem-solving approaches), as well as with health professionals, by providing access to a secure social community with peers and call centers. WITH A MODERATE LEVEL OF EVIDENCE² The interventions may lead to significant improvements in ICs’ self-efficacy and confidence. These interventions are characterized by: Encouraging ICs to actively manage their lives and identify solutions to their specific needs by offering content focused on role management (e.g., balancing activities of daily living (ADLs)) and emotional needs (e.g., coping with fear and insecurity about the future); Providing educational content focused on adopting attitudes and acquiring adaptive problem-solving skills, which are positively reinforced by professionals through motivational coaching. The interventions may lead to significant improvements in attitudes, adaptive capacity (problem-solving, use of available resources), as well as communication and the relationship between the IC and the CR. These interventions are characterized by: Offering interventions based on mindfulness and self-compassion to improve ICs’ understanding and strengthen their capacity for empathy toward the people they care for, by allowing them to experience the latter’s limitations, thoughts, and feelings; Providing access to instructions on how to seek help from others or available resources. ² It is fairly likely that the effects of the interventions will be substantially affected by the results of future studies. The interventions may lead to significant reductions in depressive symptoms, anxiety, and stress, as well as to a better perception of the positive and negative aspects of caregiving among ICs. These interventions are characterized by: The use of both synchronous and asynchronous communication modalities, and multimedia (video, audio) and text-based (presentations) formats to provide ICs with content aimed at developing emotional regulation skills to better manage their role, negative emotions, and mental load; The use of psychoeducation, behavioral activation, cognitive reframing, relaxation techniques, and communication skills training. The interventions may lead to a significant reduction in caregiver burden and a significant improvement in ICs’ quality of life. These interventions are characterized by: Offering digital informational sessions through various formats: text (presentations), multimedia (videos), complemented by peer exchange and discussion platforms facilitated by experienced professionals; Providing psychoeducational content aimed at reducing isolation and distress, strengthening ICs’ skills and autonomy, and improving time management by facilitating access to resources and encouraging active life management. WITH A LOW LEVEL OF EVIDENCE³ Limited evidence suggests that the interventions may be associated with a significant reduction in fatigue and feelings of loneliness, as well as significant improvements in sleep and perceived social support among ICs. ³ It is very likely that the effects of the interventions will be substantially affected by the results of future studies. • Effects on Care Recipients (CRs) WITH A MODERATE LEVEL OF EVIDENCE² The interventions may lead to significant improvements in the CR’s level of functioning and ability to perform activities of daily living (ADLs) and domestic activities of daily living (IADLs). These interventions are characterized by: The use of both synchronous and asynchronous communication methods to provide peer communication options (forums) for sharing knowledge and experiences, as well as access to resource persons (professionals) for tailored assessments and advice; The provision of caregiver-centered counseling support focused on the IC’s physical, emotional, and social needs, as well as their existing support network. The interventions may lead to a significant reduction in behavioral and psychological symptoms of dementia (BPSD) in the CR. These interventions are characterized by: Providing access to personalized learning pathways (taking into account the severity of the CR’s symptoms) through educational content covering multiple topics: management of BPSD, training in skills for assisting with basic activities, safety management, and the CR’s well-being; Helping ICs to detect early signs of distress or agitation and to identify and target the most disruptive behaviors in the CR in order to develop a personalized change plan to better manage behavioral triggers, behaviors themselves, and their consequences. WITH A LOW LEVEL OF EVIDENCE³ Limited evidence suggests that the interventions may be associated with significant improvements in the CR’s health and quality of life. • Effects on Professionals Available data are insufficient to assess the effects of the interventions on professionals.

Authors' methods: Systematic literature review

Project Status: Completed

Year Published: 2025

URL for published report: https://www.ciusss-capitalenationale.gouv.qc.ca/sites/d8/files/docs/MissionUniversitaire/ETMISSS/Rapport-ETMI-abregee_SAD-VF.pdf

English language abstract: There is no English language summary available

Publication Type: Full HTA

Country: Canada

Province: Quebec

DOI: https://www.ciusss-capitalenationale.gouv.qc.ca/sites/d8/files/docs/MissionUniversitaire/ETMISSS/Rapport-ETMI-abregee_SAD-VF.pdf

Organisation Name: Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale

Contact Address: 525, boulevard Wilfrid-Hamel, bureau A-122

Contact Name: Sylvie St-Jacques

Contact Email: uetmisss.deau.ciussscn@ssss.gouv.qc.ca