Alzheimer Disease, Behavior, Dementia
Conditions
Brief summary
The objectives of our project are to: 1.) Develop a training program and manual for volunteers to implement evidence-based, non-pharmacological interventions for neuropsychiatric symptoms (NPS) of dementia in long-term care (LTC) settings; 2.) Recruit and train volunteers using the VALID program and pilot test the volunteer-led program with 20 individuals with Alzheimer's disease and NPS in a LTC facility in Kingston; and, 3.) Evaluate the effects of the VALID program on the symptoms of NPS, patient quality of life, volunteer's experience, and LTC staff stress.
Interventions
BEHAVIORALVolunteers Adding Life in Dementia (VALID) Program
The VALID intervention will consist of 2 phases. First, volunteers will complete an assessment involving recording of a Life Story for each patient participant. This will include information on the patient's psychosocial history, occupational history, hobbies, interests and preferred activities using information from the LTC medical record and interviews with the patient and family members. Based on this information, a variety of potential psychosocial interventions will be developed for the individual with the assistance of the recreation therapist at the LTC. The second phase will involve implementation of the VALID intervention. Each individual with dementia will receive personalized pleasant activities for a minimum session of 30 minutes at a frequency of 3 times per week. One volunteer will complete the Life Story assessment and up to 3 volunteers may be involved with implementing the VALID program for each resident.
Sponsors
Queen's University
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
65 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* diagnosis of Alzheimer's disease or related forms of dementia * significant symptoms of agitation as measured by a Cohen-Mansfield Agitation Inventory (CMAI) total score of \>39 * in nursing home for at least 30 days * presence of a caregiver or substitute decision maker willing to consent to treatment * no changes in psychotropic medications in the 2 weeks preceding enrolment in study
Exclusion criteria
* depressive symptoms presenting risk * physically aggressive behavior posing safety risk to others * uncontrolled pain * currently receiving palliative care * medically unstable with life expectancy of \< 6 months * currently awaiting transfer to another LTC facility or hospital.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Change in Cohen-Mansfield Agitation Inventory (CMAI) score | Baseline and 12 weeks |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Remission of neuropsychiatric symptoms | Baseline and 12 weeks | CMAI score \<40 |
| Change in Neuropsychiatric Inventory (NPI) score | Baseline and 12 weeks | — |
| Change in depression symptoms (Cornell Depression in Dementia Rating Scale) | Baseline and 12 weeks | — |
| Dementia Quality of Life (DemQoL) Scale | Baseline and 12 weeks | — |
| Clinically significant reduction in agitation | Baseline and 12 weeks | 30% reduction in CMAI score |
| Use and dose of required medication | Baseline and 12 weeks | — |
| Short form health survey | Baseline and 12 weeks | Volunteer quality of life |
| Change in Modified Nursing Care Assessment Scale score | Baseline and 12 weeks | Assessing nursing stress. |
| Clinical Global Impression of Change (CGI-C) | Baseline and 12 weeks | — |
Countries
Canada
Outcome results
None listed