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

7.摘要/摘要 建议对住院老人虐待补助金(R-REM)进行行政补充 辅助生活中痴呆症护理的干预。建议的补充剂针对Covid相关行为 以及通过添加Covid体验的横向(n=400)和纵向(n=200)的社会结果 模块到正在进行的评估。母研究是一项整群随机试验，旨在评估一项创新的 辅助生活住宅(ALR)中的工作人员干预，并解决了比较有效性的目标 阿尔茨海默病及相关疾病患者行为障碍的治疗方法 (ADRD)。拟议的补编涉及评估社会距离要求如何 影响ALR中脆弱老年人的护理和福祉，包括轻度认知障碍的个人 损害和ADRD。一线工作人员非常适合为干预研究提供信息，并担任 在推广最佳做法方面有意义的合作者，包括那些旨在保持居民参与的做法， 例如技术干预，以加强与音乐、艺术和社会参与的联系 家人。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、隔离的经历--缓解 技术、护理满意度和环境质量。 主要目标(A2)。横断面和纵向检验Covid相关的多变量效应 居民的经历(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、合并症和身体功能。 假设：与Covid相关的经历将独特地导致负面结果；这些影响将 通过减少孤立和孤独的技术和其他干预措施来缓解(调解)。 目标3(A3)。从住院人数增加的角度评估与Covid相关的经历对工作人员的影响 行为攻击性、员工压力、负担、职业倦怠以及积极的照顾者经历。 新冠肺炎导致的社会孤立辅助生活和其他类似环境中的社交距离限制 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- 减少干预措施并检查其在改善不良后果方面的潜在中介作用 这很重要，并对未来此类灾难性事件产生影响。这一结果很可能适用于 ALR的120万居民，其中许多人有重大的护理需求和痴呆症相关行为。这个 拟议的项目是制定方法和干预措施的重要一步，以改善和 防止ALR中的社会孤立。这种干预措施有可能改善护理质量，增强 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，以及在当前的大流行病期间。

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.