Goodbye UTI (GUTI): Prototyping A Digital Intervention to Support Dementia Family Caregivers with Urinary Tract Infection Prevention and Management

Abstract

Urinary tract infections (UTIs) are a leading cause of potentially preventable hospitalizations for persons living with dementia (PLWD), significantly increasing caregiver burden and healthcare costs. This dissertation proposes the development of Goodbye UTI (GUTI), a digital intervention designed to assist family caregivers (FCGs) in preventing, managing, and tracking UTIs in PLWD. Given the unique challenges of dementia care, where PLWD often cannot express urinary discomfort, caregivers face difficulties in recognizing early symptoms and ensuring timely treatment. The goal of GUTI is to bridge this gap through an accessible digital tool that empowers caregivers by providing clinical guidance, symptom tracking, and educational content aligned with UTI prevention guidelines.The paper followed the three-paper dissertation format and was structured into three phases, following a human-centered design (HCD) approach. In the first phase, a comprehensive conceptual framework for UTI prevention and management was created, informed by a scoping review of the literature and the Centers for Disease Control and Prevention’s (CDC) four-tiered Social Ecological Model. The second phase examined the current digital interventions for UTI prevention and management in PLWD and their FCG through a comprehensive scoping review. By analyzing various study designs, intervention types, frameworks, and operation methods, we aimed to inform the development of a more effective, tailored prototype that better serves the needs of PLWD and their caregivers. The final phase involved identifying the context of use, user needs and preferences through interviews and surveys with main stakeholders, especially FCGs. These insights will inform our future study regarding the design of the GUTI prototype, tailored to the specific requirements of caregivers managing PLWD with moderate to late-stage dementia. The GUTI digital intervention aims to alleviate caregiver burden by equipping FCGs with tools to manage urinary health for their loved ones more effectively. This digital support could potentially reduce UTI-related emergency department visits and hospitalizations among PLWD. As a scalable, home-based solution, GUTI has the potential to enhance the well-being and quality of life for both caregivers and PLWD. If successful in reducing caregiver burden, improving urinary health management, and lowering emergency visits and hospitalizations, GUTI could serve as a model for developing similar digital health solutions to address other challenges in dementia care.