What are the innovations you would suggest to ease caregiver burden?

Information and communication technology as a delivery channel. The textbook already identifies that the use of telephone support highlights the potential of alternative modes of delivery to enhance or replace face-to-face interventions, and reviews the impact of information and communication technology on family carers of older people and professionals. Innovation therefore begins by moving proven interventions onto remote platforms rather than inventing new content — telephone, video, app and web-based delivery of psychoeducation, counselling and behaviour-management training.

Online and remote psychological interventions. A twice-weekly mindfulness intervention delivered online was correlated with a decrease in caregiver burden and an increase in quality of life — direct textbook support for remote delivery of stress-reduction programmes, extendable to online yoga and compassion meditation, which improved quality of life and self-compassion in caregivers of people with Alzheimer’s disease.

Telemedicine and telepsychiatry for the care recipient. Telemedicine prevents psychiatric admissions from long-term care homes, and geriatric telepsychiatry has a role in long-term care psychiatry, in the assessment and management of dementias in primary care, in geriatric emergencies in the emergency department, and in managing depression in primary care through collaborative care. Every avoided admission or avoided journey is caregiver burden removed.

Ambient and assistive technology in the home. Context-aware computing and context-awareness — technology that senses the situation and responds — together with design and technology for older people and assistive devices, reduce supervision demand. Practical applications are wandering alerts and GPS location, fall detection, medication reminders and automated dispensers, stove and door sensors, and video check-in. Security must be built in, since these systems carry recognised risks of denial of service and identity theft.

Restructured services and new models of care. Community-based, multidisciplinary geriatric mental health treatment teams are the ideal model of community psychiatry service delivery, supported by hospital-based consultation-liaison services, care home liaison services and memory clinics giving informed discussion of diagnosis and prognosis with arrangements for ongoing review, support and management. Adult day programmes reduce the risk of accelerated cognitive decline associated with nursing home placement, and respite and adult day care are core components of multidimensional caregiver programmes.

Reduce demand at source and fund the workforce. Burden falls when the patient’s condition is better managed: exercise plus behavioural management reduces disability in people with dementia; comprehensive nutritional treatment prevents weight loss; family intervention delays institutionalisation; and DICE training for family and professional caregivers manages agitation and aggression without psychotropic drugs. Structurally, more funding and new payment models are needed to train health professionals, primary care providers and family caregivers in assessing and managing NPS, and primary care providers should be reimbursed for time spent on approaches like DICE and given better access to backup specialist services.

Digital caregiver platforms have moved from pilot to evidence. Randomised trials and systematic reviews (2024–2026) of home-based digital interventions — web psychoeducation, telecoaching, digital cognitive training, assistive technology and multicomponent platforms — show reductions in caregiver burden and depression, with dedicated platforms (GamePlan4Care, TeleCARE) tested in randomised designs, and nature-based and community respite models under formal evaluation. For India specifically, a coproduced digital media caregiver resource developed at NIMHANS and registered with CTRI has demonstrated feasibility and acceptability for Indian family caregivers — the model most likely to scale, given that India has one of the world’s fastest-growing dementia populations, over 90% of care is family-provided, and formal respite and long-term care infrastructure is scarce.