Resident-to-Resident Elder Mistreatment Intervention for Dementia Care in Assisted Living

辅助生活中痴呆症护理中居民对居民虐待老人的干预措施

• 批准号: 10448041
• 负责人: MARK STEVEN LACHS
• 金额: $ 15.49万
• 依托单位: HEBREW HOME FOR THE AGED AT RIVERDALE
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-09-15 至 2023-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10448041
• 关键词: Accidents; Activities of Daily Living; Address; Affective; Aggressive behavior; Aging; Alzheimer' s Disease; Alzheimer' s disease related dementia; Area; Assisted Living Facilities; Awareness; Behavior; Behavior Disorders; Behavioral; Caring; Characteristics; Cluster randomized trial; Data; Data Reporting; Dementia; Discipline of Nursing; Disease; Distress; Doctor of Philosophy; Educational Intervention; Elder Abuse; Elderly; Experimental Designs; Focus Groups; Frequencies; Geriatrics; Gerontology; Goals; Impaired cognition; Individual; Injury; Intervention; Interview; Knowledge; Living Arrangement; Long-Term Care; Measurement; Measures; Mediating; Methodology; Minority; Movement; Nursing Homes; Outcome; Personal Satisfaction; Persons; Positioning Attribute; Prevalence Study; Problem behavior; Process; Professional Role; Public Health; Publishing; Quality of Care; Quality of life; Randomized; Reporting; Research; Risk; Role; Safety; Services; Source; Support System; Testing; Time; Training; Treatment Effectiveness; Vulnerable Populations; care systems; case finding; community setting; comorbidity; compare effectiveness; comparison group; dementia care; falls; group intervention; improved; informant; innovation; intervention program; multidisciplinary; pragmatic trial; prevent; prospective; psychologic; psychological distress; rapid growth; residence; response; social; staff intervention; statistics; treatment as usual; trend

7. Summary/ Abstract Proposed is an administrative supplement to the grant, Resident-to-Resident Elder Mistreatment (R-REM) Intervention for Dementia Care in Assisted Living. The proposed supplement address Covid-related behavioral and social outcomes both cross-sectionally (n=400) and longitudinally (n=200) by adding a Covid experiences module to an ongoing assessment. The parent study is a cluster randomized trial to evaluate an innovative staff intervention in assisted living residences (ALRs), and addresses the goal of comparing the effectiveness of treatments in managing behavioral disorders in people with Alzheimer’s disease and related disorders (ADRD). The proposed supplement addresses the goal of evaluating how social distancing requirements affect the care and well-being of vulnerable older adults in ALRs, including individuals with mild cognitive impairment and ADRD. Front line staff is ideally suited to inform intervention research and to serve as meaningful collaborators in promoting best practices, including those aimed at keeping residents engaged, such as technological interventions to enhance connections with music, art and social engagement with families. The proposed study addresses the following specific aims: Aim 1 (A1). Describe Covid-related experiences of fear, loneliness, engagement in isolation-mitigating technologies, care satisfaction, and environmental quality. Primary Aim (A2). Examine cross-sectionally and longitudinally the multivariate effects of Covid-related experiences (social isolation, loneliness, fear, stress) of residents on the outcomes of anxiety, depression and behavior, controlling for personal characteristics such as cognition, co-morbidity and physical function. Hypothesis: Covid-related experiences will contribute uniquely to negative outcomes; these effects will be mitigated (mediated) by technological and other interventions to reduce isolation and loneliness. Aim 3 (A3). Evaluate the impact on staff of Covid-related experiences in terms of heightened resident behavioral aggression, staff stress, burden, burnout as well as positive caregiver experiences. Social isolation due to COVID-19 social distancing restrictions in assisted living and other such settings may increase the risk of poor behavioral, cognitive, psychological and health outcomes. Identifying isolation- reducing interventions and examining their potential mediating role in ameliorating adverse outcomes is important, and has implications for future such catastrophic events. The results are likely applicable to the over 1.2 million residents of ALRs, many of whom have significant care needs and dementia-related behaviors. The proposed project is an important step in developing approaches and interventions for ameliorating and preventing social isolation in ALRs. Such interventions have the potential to improve quality of care, enhance resident safety and quality-of-life and reduce behavioral disorder associated with social isolation in general, in future crises, as well as during the current pandemic.

7.总结/摘要 拟议的是补助金的行政补充，居民对居民的老年人虐待（R-REM） 辅助生活中的痴呆症护理干预。拟议的补充说明了与Covid相关的行为 通过增加新冠肺炎经历，在横截面（n=400）和纵向（n=200）上评估社会结局 模块进行持续评估。母研究是一项随机分组试验，旨在评估一种创新的 工作人员干预辅助生活住宅（ALR），并解决了比较的有效性的目标 治疗阿尔茨海默病及相关疾病患者的行为障碍 （ADRD）.拟议的补充说明提出了评估社交距离要求如何 影响ALR中脆弱老年人的护理和福祉，包括轻度认知障碍者 损伤和ADRD。一线工作人员非常适合为干预研究提供信息， 有意义的合作者，以促进最佳做法，包括那些旨在保持居民参与， 例如技术干预，以加强与音乐，艺术和社会参与的联系， 家庭拟议的研究涉及以下具体目标： 目标1（A1）。描述与Covid相关的恐惧、孤独、参与隔离的经历-缓解 技术、护理满意度和环境质量。 主要目标（A2）。从横截面和纵向上检查Covid相关的多变量效应 居民的经验（社会孤立，孤独，恐惧，压力）对焦虑，抑郁和 行为，控制个人特征，如认知，共病和身体功能。 假设：与Covid相关的经历将唯一导致负面结果;这些影响将 通过技术和其他干预措施减轻（调解），以减少孤立和孤独。 目标3（A3）。评估Covid相关经历对工作人员的影响， 行为攻击，员工压力，负担，倦怠以及积极的照顾者经验。 在辅助生活和其他此类环境中，由于COVID-19社交距离限制而导致的社交隔离 可能会增加不良行为、认知、心理和健康结果的风险。识别隔离- 减少干预并检查其在改善不良结局中的潜在中介作用， 这一点很重要，并对未来此类灾难性事件产生影响。结果可能适用于 1.2 100万ALR居民，其中许多人有显著的护理需求和痴呆相关行为。的 拟议的项目是制定方法和干预措施以改善和 防止ALR中的社会隔离。这种干预措施有可能提高护理质量， 居民的安全和生活质量，并减少与社会隔离有关的行为障碍， 未来的危机，以及在目前的大流行病。