A PRESCRIPTION FOR ENHANCING RESIDENT QUALITY OF LIFE

描述（由申请人提供）：居住在我国养老院的150万人中，大多数是患有痴呆症的老年人，这使他们面临健康状况不佳和生活质量下降的风险。需要驱动的行为，如躁动和被动，在90%的痴呆症患者中都有表现，并导致许多不良的健康结果，包括情绪功能不良、身体功能下降、使用克制、社会孤立和虐待风险增加。在需求驱动的痴呆妥协行为模型（NDB）中，这些行为被概念化为未满足需求触发的早期行为模式的保留残余。

DESCRIPTION (provided by applicant): The majority of the 1.5 million individuals who reside in our nation's nursing homes are elderly persons with dementias that place them at risk for poor health outcomes and diminished quality of life. Need driven behaviors, such as agitation and passivity, are exhibited by 90% of residents with dementia, and account for many poor health outcomes, including poor emotional functioning, decline in physical functioning, use of restraint, social isolation and increased risk of abuse. In the Need-driven Dementia compromised Behavior model (NDB) these behaviors are conceptualized as preserved remnants of earlier behavioral patterns that are triggered by unmet needs. Recreational activities tailored to the skill level and interests of residents hold promise as management strategies for agitation and passivity, but there has been no systematic examination of the treatment components (skill level and interest) that are hypothesized to result in therapeutic outcomes. Until recently, no theoretical framework that addressed nursing home residents' needs related to skill level and interests was available. The primary aim of this study is to test the efficacy of recreational activities derived from the NDB model in reducing agitation and passivity and improving engagement, affect and mood in nursing home residents with dementia. These recreational activities will be individually tailored to match the resident's skill level (cognitive ability and physical functioning) and interests (personality). The NDB-derived activities meet needs by addressing three important causes of need-driven behaviors: impaired cognitive ability, impaired physical functioning and premorbid personality. This study will be a randomized clinical trial with repeated measures, in which 140 residents will be randomly assigned to one of four groups for a 3-week intervention. Measures of agitation and passivity, engagement, affect and mood will be taken before and after interventions. It is hypothesized that residents who receive the NDB-derived intervention will exhibit significantly less agitation, less passivity, greater engagement, more positive affect and more positive mood than residents who receive the match to skill only, match to interest only, or control intervention. This study holds promise for improving quality of life for nursing home residents with dementia by using theoretically based activities to respond to their needs.