Improving Affect & Behavior in Assisted Living Residents

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DESCRIPTION (provided by applicant): This proposal develops a protocol for a multi-site effectiveness trial on a treatment to reduce affective and behavioral disturbance in Assisted-living (AL) residents with dementia. AL is rapidly becoming one of the most common methods of caring for demented older adults in long-term care. Over half of these residents are demented, and a significant number have affective and behavioral problems impeding their care and quality of life. Despite this, no empirically validated treatments to teach direct care staff how to care for these residents have been evaluated in a multi-site effectiveness trial. There is a tremendous public health need for such a trial to decrease the affective and behavioral disturbance experienced by AL residents with dementia. This study will develop a comprehensive standardized protocol to conduct and evaluate an intervention for AL staff to reduce the affective and behavioral problems of residents with dementia. This protocol will include: (1) a standardized procedure for conducting the treatment (including treatment manual and all materials necessary for treatment delivery); (2) methods for evaluating treatment fidelity, including assessment of treatment delivery, receipt, and enactment; (3) standardized measures of resident and staff outcomes, and (4) implementation procedures for web-based data collection and entry. This proposal will accomplish its goals in 3 phases. First, sites in three different states will collaborate to standardize the protocol to insure that it can be conducted systematically and reliably across sites. Second, a feasibility trial will be conducted to test the protocol. Across the three sites, 9 AL residences (each with 7-9 staff and 8-10 residents) will receive the intervention - two in-house workshops, four on-site consultations with direct care staff and two licensed staff sessions - and be assessed at baseline and post training. Treatment fidelity measures and resident and staff outcomes will be obtained at each residence. Resident outcomes will include depression, anxiety, behavioral problems and quality of life; staff outcomes will include job satisfaction, reaction to resident problems, skill, and turnover. Finally, the results of this trial will be used to develop a multi-site effectiveness trial on treatment to reduce affective and behavioral disturbance in AL residents with dementia.