Montessori Assessment in Restorative Nursing in Dementia

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DESCRIPTION (provided by applicant): The purpose of this study is to develop and test a new assessment tool to be used by nursing home staff with the goal of more effectively implementing restorative nursing and activities programming with nursing home residents with moderate to advanced dementia. The ability to assess persons with moderate to advanced dementia in long-term care is critical for developing plans of care, especially if such plans are to focus on rehabilitative rather than mere palliative care. Yet few assessment instruments provide information that guides care providers who wish to develop interventions for these residents. This study will develop and test the Myers-Menorah Park/Montessori-Based Assessment System (MMP/MAS). The study will be conducted in three phases: (1) field testing the "alpha version" of the MMP/MAS, which has shown promise in a small-scale demonstration project, to determine its reliability and validity; (2) creating the MMP/MAS "beta version", refining its administration and scoring, establishing inter-rater reliability between research staff and nursing staff, and developing protocols for linking the MMP/MAS assessments to restorative nursing programs and plans of care for residents; and (3) testing the effects of implementation of the MMP/MAS by nursing staff in three nursing homes, using experimental and control nursing units, with measures of treatment fidelity, multiple outcome measures on long-term care residents, and measures of staff satisfaction, willingness to continue implementation of MMP/MAS, and recommendations for improving it. At the end of this study, the MMP/MAS will have reached the point where it can be implemented in a large-scale, multi-site effectiveness study. This future study will determine if the utilization of the MMP/MAS by care-delivering staff at a large number of facilities can produce more effective plans of care, restorative nursing, and activities programming for long-term care residents with moderate to advanced dementia, thus leading to improved quality of life for this population.