A Cluster Randomized Controlled Trial Testing the Impact of Function and Behavior Focused Care for Nursing Home Residents With Dementia |
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| Institution: | 1. University of Maryland School of Nursing, Baltimore, MD, USA;1. Multicampus Program in Geriatric Medicine and Gerontology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA;2. Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA;1. School of Public Health, Oregon Health & Science University–Portland State University, Portland, OR, USA;2. Institute on Aging, College of Urban and Public Affairs, Portland State University, Portland, OR, USA;3. Nohad A. Toulan School of Urban Studies and Planning, Portland State University, Portland, OR, USA;1. Healthfirst, New York City, NY, USA;2. Eskenazi Health, Indiana University Center for Aging Research, Indiana University School of Medicine, Regenstrief Institute, Indianapolis, IN, USA;3. LeadingAge, Washington, DC, USA;4. Cecil G. Sheps Center for Health Services Research and Schools of Social Work and Public Health, University of North Carolina at Chapel Hill, NC, USA;1. Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland;2. Department of Social Services and Health Care, Helsinki Hospital, Geriatric Clinic, Helsinki, Finland;3. National Institute of Health and Welfare, Helsinki, Finland;4. Center for Life Course Health Research, University of Oulu, Oulu, Finland;5. Helsinki University Hospital, Unit of Primary Health Care, Helsinki, Finland |
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| Abstract: | ObjectiveThe purpose of this study was to test the effectiveness of the Function and Behavior Focused Care for the Cognitively Impaired (FBFC-CI) intervention on function, physical activity, and behavioral symptoms among nursing home residents with dementia, and to explore the adoption of the intervention at the facility level.DesignThis study was a clustered, randomized controlled trial with a repeated measures design that was implemented in 12 nursing homes randomized to either treatment (FBFC-CI) or educational control Function and Behavior Focused Care Education (FBFC-ED)].Setting and ParticipantsTwelve nursing homes (6 treatment and 6 control) and 336 residents (173 treatment and 163 control) with moderate to severe cognitive impairment.MeasuresOutcomes included functional ability (Barthel Index), physical activity (actigraphy and survey), behavioral symptoms (Resistiveness to Care Scale, Cohen-Mansfield Agitation Inventory, Cornell Scale for Depression in Dementia), and psychotropic medication use.ResultsThe participants were 82.6 (SD = 10.1) years of age, mostly female, and were moderate to severely cognitively impaired (Mini-Mental State Exam of 7.8, SD = 5.1). There was a significantly greater increase in time spent in total activity (P = .004), moderate activity (P = .012), light activity (P = .002), and a decrease in resistiveness to care (P = .004) in the treatment versus control group at 4 months. There was no change in mood, agitation, and the use of psychotropic medications. There was some evidence of adoption of the intervention at treatment sites.Conclusions and ImplicationsThis study provides some support for the use of the FBFC-CI Intervention to increase time spent in physical activity and decrease resistive behaviors during care commonly noted among nursing home residents with moderate to severe cognitive impairment. |
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| Keywords: | Dementia nursing home function physical activity behavior |
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