Non-contact monitoring of agitation and use of a sheltering device in patients with dementia in emergency departments: a feasibility study (Preprint)

BACKGROUND Agitation is common in geriatric patients with dementia (PWD) admitted to an emergency department (ED) and is associated with a higher risk of an unfavourable clinical course. Hence, monitoring of vital signs and enhanced movement is essential in these patients during their stay in the ED. Since PWD rarely tolerate fixed monitoring devices, non-contact monitoring systems might represent appropriate alternatives. OBJECTIVE To study the reliability of a non-contact monitoring system (NCMSys) and of a tent-like device (“Charité Dome”, ChD), aimed to shelter PWD from the busy ED-environment. Further, effects of the ChD on wellbeing and agitation of PWD will be measured. METHODS Both devices were attached to patient’s bed. Tests on technical reliability and other safety issues of the NCMSys and the ChD were performed at the iDoc-institute. A feasibility study evaluating the reliability of the NCMSys with and without the ChD was performed in the real-life setting of an ED and on a geriatric-gerontopsychiatric ward. Technical reliability and other safety issues were tested with six healthy volunteers. For the feasibility study 19 patients were included (ten males and nine females; mean age: 77.4 (55-93) years of which 14 were PWD. PWD inclusion criteria were age ≥55 years, a dementia diagnosis as well as a written consent (by patients themselves or by a custodian). Exclusion criteria were acute life-threatening situations and a missing consent. RESULTS Heart rate, changes in movement and sound emissions were measured reliably by the NCMSys, whereas patient movements affected respiratory rate measurements. The ChD did not impact patients’ vital signs or movements in our study setting. However, 53% of the PWD (7/13) and most of the patients without dementia (4/5) benefited from its use regarding their agitation and overall wellbeing. CONCLUSIONS NCMSys and ChD work reliably in the clinical setting and have positive effects on agitation and wellbeing. The results of this feasibility study encourages prospective studies with longer durations to further evaluate this concept for monitoring and prevention of agitation in PWD in the ED. CLINICALTRIAL ICTRP: “Charité-Dome-Study - DRKS00014737”