Dataset Information

A randomized clinical trial of theory-based activities for the behavioral symptoms of dementia in nursing home residents.

ABSTRACT:

Objectives

To test the main and interactive effects of activities derived from the Need-Driven Dementia-Compromised Behavior model for responding to behavioral symptoms in nursing home residents.

Design

Randomized double-blind clinical trial.

Setting

Nine community-based nursing homes.

Participants

One hundred twenty-eight cognitively impaired residents randomly assigned to activities adjusted to functional level (FL) (n=32), personality style of interest (PSI) (n=33), functional level and personality style of interest (FL+PSI) (n=31), or active control (AC) (n=32).

Intervention

Three weeks of activities provided twice daily.

Measurements

Agitation, passivity, engagement, affect, and mood assessed from video recordings and real-time observations during baseline, intervention, random times outside of intervention, and 1 week after intervention.

Results

All treatments improved outcomes during intervention except mood, which worsened under AC. During intervention the PSI group demonstrated greater engagement, alertness, and attention than the other groups; the FL+PSI group demonstrated greater pleasure. During random times, engagement returned to baseline levels except in the FL group in which it decreased. There was also less agitation and passivity in groups with a component adjusted to PSI. One week after the intervention, mood, anxiety, and passivity improved over baseline; significantly less pleasure was displayed after withdrawal of treatment.

Conclusion

The hypothesis that activities adjusted to FL+PSI would improve behavioral outcomes to a greater extent than partially adjusted or nonadjusted activities was partially supported. PSI is a critical component of individualized activity prescription.

SUBMITTER: Kolanowski A

PROVIDER: S-EPMC3381903 | biostudies-literature | 2011 Jun

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

A randomized clinical trial of theory-based activities for the behavioral symptoms of dementia in nursing home residents.

Kolanowski Ann A Litaker Mark M Buettner Lin L Moeller Joyel J Costa Paul T PT

Journal of the American Geriatrics Society 20110607 6

<h4>Objectives</h4>To test the main and interactive effects of activities derived from the Need-Driven Dementia-Compromised Behavior model for responding to behavioral symptoms in nursing home residents.<h4>Design</h4>Randomized double-blind clinical trial.<h4>Setting</h4>Nine community-based nursing homes.<h4>Participants</h4>One hundred twenty-eight cognitively impaired residents randomly assigned to activities adjusted to functional level (FL) (n=32), personality style of interest (PSI) (n=33 ...[more]

PMID: 21649633

Similar Datasets

Project description:BackgroundThe COVID-19 pandemic significantly disrupted nursing home (NH) care, including visitation restrictions, reduced staffing levels, and changes in routine care. These challenges may have led to increased behavioral symptoms, depression symptoms, and central nervous system (CNS)-active medication use among long-stay NH residents with dementia.MethodsWe conducted a retrospective, cross-sectional study including Michigan long-stay (≥100 days) NH residents aged ≥65 with dementia based on Minimum Data Set (MDS) assessments from January 1, 2018 to June 30, 2021. Residents with schizophrenia, Tourette syndrome, or Huntington's disease were excluded. Outcomes were the monthly prevalence of behavioral symptoms (i.e., Agitated Reactive Behavior Scale ≥ 1), depression symptoms (i.e., Patient Health Questionnaire [PHQ]-9 ≥ 10, reflecting at least moderate depression), and CNS-active medication use (e.g., antipsychotics). Demographic, clinical, and facility characteristics were included. Using an interrupted time series design, we compared outcomes over two periods: Period 1: January 1, 2018-February 28, 2020 (pre-COVID-19) and Period 2: March 1, 2020-June 30, 2021 (during COVID-19).ResultsWe included 37,427 Michigan long-stay NH residents with dementia. The majority were female, 80 years or older, White, and resided in a for-profit NH facility. The percent of NH residents with moderate depression symptoms increased during COVID-19 compared to pre-COVID-19 (4.0% vs 2.9%, slope change [SC] = 0.03, p < 0.05). Antidepressant, antianxiety, antipsychotic and opioid use increased during COVID-19 compared to pre-COVID-19 (SC = 0.41, p < 0.001, SC = 0.17, p < 0.001, SC = 0.07, p < 0.05, and SC = 0.24, p < 0.001, respectively). No significant changes in hypnotic use or behavioral symptoms were observed.ConclusionsMichigan long-stay NH residents with dementia had a higher prevalence of depression symptoms and CNS active-medication use during the COVID-19 pandemic than before. During periods of increased isolation, facility-level policies to regularly assess depression symptoms and appropriate CNS-active medication use are warranted.

Project description:Objective and rationaleThe prevalence of depression among older adults residing in nursing homes has risen. While physical activity interventions based on the self-determination theory have been shown to reduce depressive symptoms among students and middle-aged adults, research in nursing home residents is scarce. This study aimed to investigate whether physical activity can alleviate depressive symptoms in nursing home residents over an extended period.MethodsBetween September 2020 and August 2021, 46 nursing home residents in Shenyang were randomly assigned to either a control group (n = 23) or an intervention group (n = 23). The control group followed a standard physical activity programme, whereas the intervention group underwent a programme based on self-determination theory. Both groups were monitored for 24 weeks post-intervention. Depression scores were assessed using the Geriatric Depression Scale, sociodemographic data collected via a self-designed questionnaire, cognitive function evaluated using the Mini-Mental State Examination, and weight and body fat measured using the Omron KARADA Scan Body Composition and Scale.ResultsDepression scores were measured at five time points: baseline (T0), weeks 12 (T1), and 24 (T2) of the intervention, and weeks 12 (T3) and 24 (T4) during follow-up. Both groups exhibited a trend of decline by more than five points. The intervention group demonstrated more favourable pre-to-post changes in depression scores compared to the control group.ConclusionsA physical activity intervention based on self-determination conceptual framework has been proven to be effective for nursing home residents with depressive symptoms, also aiding in the maintenance of their physical activity levels. This study offers a theoretical foundation for the development of intervention programmes by researchers and identifies potential intervention strategies for caregivers in nursing homes.Trial registrationThe Chinese Clinical Trial Registry (ChiCTR2200060598) (June 5, 2022).

Project description:Background. Quality staff-resident communication is crucial to promote outcomes in nursing home residents with dementia requiring assistance during mealtimes. Better understanding of staff-resident language characteristics in mealtime interactions help promote effective communication, yet evidence is limited. This study aimed to examine factors associated with language characteristics in staff-resident mealtime interactions. Methods. This was a secondary analysis of 160 mealtime videos involving 36 staff and 27 residents with dementia (53 unique staff-resident dyads) in 9 nursing homes. We examined the associations of speaker (resident vs. staff), utterance quality (negative vs. positive), intervention (pre- vs. post-communication intervention), and resident dementia stage and comorbidities with expression length (number of words in each utterance) and addressing partner by name (whether staff or resident named their partner in each utterance), respectively. Results. Staff (utterance n = 2990, 99.1% positive, mean = 4.3 words per utterance) predominated conversations and had more positive, longer utterances than residents (utterance n = 890, 86.7% positive, mean = 2.6 words per utterance). As residents progressed from moderately-severe to severe dementia, both residents and staff produced shorter utterances (z=-2.66, p = .009). Staff (18%) named residents more often than residents (2.0%; z = 8.14, p < .0001) and when assisting residents with more severe dementia (z = 2.65, p = .008). Conclusions. Staff-resident communication was primarily positive, staff-initiated, and resident-oriented. Utterance quality and dementia stage were associated with staff-resident language characteristics. Staff play a critical role in mealtime care communication and should continue to initiate resident-oriented interactions using simple, short expressions to accommodate resident declining language abilities, particularly those with severe dementia. Staff should practice addressing residents by their names more frequently to promote individualized, targeted, person-centered mealtime care. Future work may further examine staff-resident language characteristics at word and other levels using more diverse samples.

Project description:BackgroundQuality staff-resident communication is crucial to promote outcomes in nursing home residents with dementia requiring assistance during mealtimes. Better understanding of staff-resident language characteristics in mealtime interactions help promote effective communication, yet evidence is limited. This study aimed to examine factors associated with language characteristics in staff-resident mealtime interactions.MethodsThis was a secondary analysis of 160 mealtime videos involving 36 nursing staff and 27 residents with moderately severe to severe dementia in 9 nursing homes. Mixed-effects models was used to examine the relationships between factors and language characteristics in staff-resident mealtime interactions. The independent variables were speaker (resident vs. staff), utterance quality (negative vs. positive), intervention (pre- vs. post-communication intervention), and resident dementia stage and comorbidities. The dependent variables were expression length (number of words in each utterance) and addressing partner by name (whether staff or resident named their partner in each utterance). All models included staff, resident, and staff-resident dyad as random effects.ResultsStaff (utterance n = 2990, 99.1% positive, mean = 4.3 words per utterance) predominated conversations and had more positive, longer utterances than residents (utterance n = 890, 86.7% positive, mean = 2.6 words per utterance). As residents progressed from moderately severe to severe dementia, both residents and staff produced shorter utterances (z=-2.66, p = .009). Staff (18%) named residents more often than residents (2.0%; z = 8.14, p < .0001) and when assisting residents with more severe dementia (z = 2.65, p = .008).ConclusionsStaff-resident communication was primarily positive, staff-initiated, and resident-oriented. Utterance quality and dementia stage were associated with staff-resident language characteristics. Staff play a critical role in mealtime care communication and should continue to initiate resident-oriented interactions using simple, short expressions to accommodate resident declining language abilities, particularly those with severe dementia. Staff should practice addressing residents by their names more frequently to promote individualized, targeted, person-centered mealtime care. Future work may further examine staff-resident language characteristics at other levels of language using more diverse samples.

Dataset Information

A randomized clinical trial of theory-based activities for the behavioral symptoms of dementia in nursing home residents.

Objectives

Design

Setting

Participants

Intervention

Measurements

Results

Conclusion

Publications

A randomized clinical trial of theory-based activities for the behavioral symptoms of dementia in nursing home residents.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets