Older adults living in residential care facilities with diagnosis of mild to moderate dementia Mental and Behavioural Disorders Unspecified dementia
Conditions
Interventions
The predetermined iM activity/intervention was delivered/implemented by an interventionist (i.e., staff or family) in a private area (e.g., resident room) between 10:00 am to 1:00 pm or 2:00 to 5:00 p
Sponsors
University of Victoria
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: 1. Mild to moderate dementia (i.e., a CPS score 2 to 4) using as a proxy of cognitive capability, the Cognitive Performance Scale (CPS) that is part of the Resident Assessment Instrument Minimum Data Set 2.0 (RAI-MDS 2.0) (reference period of seven days) 2. Manifested BPSD, when at least two indicators (e.g., resistance to care, abusiveness, aggressive or socially inappropriate behavior) are present in the last assessment as they are monitored in the RAI-MDS section E4 (i.e., a, b, c, d, e) (reference period of seven days) 3. Lived in the residential care home for at least one month (at the start of the study)
Exclusion criteria
Exclusion criteria: 1. Accompanying diagnosis of manic depressive – bipolar disorder or schizophrenia 2. Living in a hospice care program
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| 1. Affect measured through direct observation of facial expression and body movement using Lawton’s Modified Behavior Stream (LMBS), which assesses positive affect (i.e., pleasure, interest, contentment) and negative affect (i.e., sadness, anxiety, anger); observation conducted a) before the iM intervention (for 5 min); b) during (for 10 min); c) immediately after the intervention was complete (for 5 min); and d) 10 min after the intervention was complete (for 5 min). For example, pleasure was noted when the participant smiled, laughed, or showed other outward manifestation of happiness using a 5-point Likert scale (1=never, 2= less than 16 seconds, 3= 17-59 seconds, 4= 1-3 minutes, and 5= more than 3 minutes of the observation time). Also, an option 6= “cannot tell” added for the observer. All affect and behavior measures represent duration (amount of time) and frequency. At the same time, resident behavior (i.e., non-verbal and verbal) was also recorded. 2. Quality of Life (QoL) measured using the Quality of Life–Alzheimer’s Disease Scale (QoL-AD) of 13-item (i.e., physical health, energy, mood, living situation, memory, family, marriage, friends, self as a whole, ability to do chores around the house, ability to do things for fun, money, and life as a whole) survey questionnaire with 4-point (1= poor to 4= excellent) Likert response scales through both self (via interview; about 10 min) and proxy (via family or caregiver self-administered survey; about 5 min) ratings for capturing both perspectives; the score ranges from 13 to 52 points. Measured at baseline and follow-up (after three weeks of the intervention). | — |
Secondary
| Measure | Time frame |
|---|---|
| 1. Behavior and psychological symptoms of dementia (BPSD) measured using the Canadian version of the Resident Assessment Inventory Minimum Data Set version 2.0 (RAI-MDS 2.0) and administrative data to capture resident patterns of BPSD: wandering (i.e., E4a), verbally abusive behavior (i.e., E4b), physically abusive behavior (i.e., E4c), socially inappropriate or disruptive behavior (i.e., E4d), and resistance of care (i.e., E4e); and any potential change of them (i.e., E5) at baseline, during the intervention, and follow-up (after three weeks of the intervention). 2. Antipsychotics measured using administrative data (resident charts and nursing records of medications) such as the number, type and dose of medications (e.g., antipsychotics) administered to each resident-participant at baseline, during the intervention, and follow-up (after three weeks of the intervention). 3. Experiences and perceptions of the use of iM intervention recorded via face-to-face, one-on-one semi-structured interviews with family and caregivers in a private space within the facility (e.g., resident room) at baseline and follow-up. | — |
Countries
Canada
Outcome results
None listed