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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

基本信息

批准号：
9977774
负责人：
MARK STEVEN LACHS
金额：
$ 74.3万
依托单位：
HEBREW HOME FOR THE AGED AT RIVERDALE
依托单位国家：
美国
项目类别：
财政年份：
2017
资助国家：
美国
起止时间：
2017-09-15 至 2022-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9977774
关键词：
Accidents Activities of Daily Living Address Affective Aggressive behavior Aging Alzheimer&apos s Disease Alzheimer&apos 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

项目摘要

This application proposes a cluster randomized trial to evaluate an innovative staff intervention targeting resident-to-resident elder mistreatment (R-REM) in 6 intervention and 6 control assisted living residences (ALRs). Data will be collected at baseline, 6- and 12-months. We define R-REM as negative and aggressive physical, sexual, or verbal interactions between residents, that in a community setting would likely be construed as unwelcome and have high potential to cause physical and/or psychological distress. R-REM is a serious behavioral problem that has a negative impact on the quality-of-life and physical well-being of residents with and without Alzheimer’s disease and related dementias living in congregate settings. The applicant team is uniquely positioned to conduct this project because of its expertise, multidisciplinary composition, and its previous successful collaborative efforts. Aim 1 (A1). Enhance staff knowledge of R-REM Aim 2 (A2). Enhance staff recognition, reporting and care planning related to R-REM Aim 3 (A3). Evaluate the impact of the staff intervention on resident falls, accidents and injuries and on quality of life using a prospective experimental design that derives information from five sources: (1) Resident interviews (2) Staff informants (3) Observational data (4) Chart and (5) Incident/accident report data. Primary Hypothesis: The frequency of falls, accidents and injuries will decrease in the intervention group, relative to the comparison group after implementation of the training intervention. Secondary Hypotheses: 1. Resident quality-of-life as measured by affective state will improve in the intervention group, relative to the comparison group after implementation of the training intervention. 2. Resident behavior problems will decline in the intervention group, relative to the comparison group after implementation of the training intervention. Resident behaviors will mediate the relationship between the intervention and the falls/accidents/injuries outcome. R-REM has been identified as an important problem in long-term care settings, and our earlier studies identified significant behavioral problems in these settings. However, to our knowledge no interventions targeted at staff have been proposed or tested. The proposed trial is thus timely and innovative. The results are likely applicable to the over 1.2 million residents of AL facilities. With the expected rapid growth in ALRs, and the growing trend to include residents with significant care needs and dementia-related behaviors, the project will serve an important role in improving the quality of care provided by staff.

本申请提出了一个集群随机试验来评估一个创新的员工干预目标