Elizabeth Galik1, Barbara Resnick2, Nancy Lerner2, Margaret Hammersla2, Ann L Gruber-Baldini3. 1. Department of Organizational Systems and Adult Health, University of Maryland School of Nursing, Baltimore, Maryland. galik@son.umaryland.edu. 2. Department of Organizational Systems and Adult Health, University of Maryland School of Nursing, Baltimore, Maryland. 3. Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland.
Abstract
PURPOSE OF THE STUDY: Assisted living (AL) residents with dementia require assistance with activities of daily living, encounter limited opportunities to engage in physical activity, and often exhibit challenging behavioral symptoms. The Function Focused Care Intervention for the Cognitively Impaired (FFC-CI) teaches and motivates direct care workers (DCWs) to engage residents with dementia in activities that optimize function and activity while minimizing behavioral symptoms. The purpose of this study was to test the impact of FFC-CI on function, physical activity, behavior, and falls. DESIGN AND METHODS: A cluster-randomized trial included 96 residents with dementia and 76 DCWs from 4 ALs. Generalized estimating equations were used to evaluate outcomes at 3 and 6 months. RESULTS: There were no treatment by time differences with regard to resident behavior, mood, counts of physical activity based on actigraphy, falls, and function. There were significant increases in physical activity based on kilocalories burned (p = .001), time spent in physical activity based on survey results (p = .001), and time spent in repetitive behaviors, such as wandering (p = .01) among the control group over time. There were no treatment by time differences with regard to DCW beliefs, knowledge, or performance of FFC, except for less decline in job satisfaction among the treatment group (p = .002). Treatment fidelity with regard to delivery and receipt were poor due to high staff attrition in the treatment group (46% vs. 16%) and limited site support. IMPLICATIONS: The findings from this study can be used to adapt future FFC intervention studies to improve treatment fidelity and optimize intervention efficacy.
RCT Entities:
PURPOSE OF THE STUDY: Assisted living (AL) residents with dementia require assistance with activities of daily living, encounter limited opportunities to engage in physical activity, and often exhibit challenging behavioral symptoms. The Function Focused Care Intervention for the Cognitively Impaired (FFC-CI) teaches and motivates direct care workers (DCWs) to engage residents with dementia in activities that optimize function and activity while minimizing behavioral symptoms. The purpose of this study was to test the impact of FFC-CI on function, physical activity, behavior, and falls. DESIGN AND METHODS: A cluster-randomized trial included 96 residents with dementia and 76 DCWs from 4 ALs. Generalized estimating equations were used to evaluate outcomes at 3 and 6 months. RESULTS: There were no treatment by time differences with regard to resident behavior, mood, counts of physical activity based on actigraphy, falls, and function. There were significant increases in physical activity based on kilocalories burned (p = .001), time spent in physical activity based on survey results (p = .001), and time spent in repetitive behaviors, such as wandering (p = .01) among the control group over time. There were no treatment by time differences with regard to DCW beliefs, knowledge, or performance of FFC, except for less decline in job satisfaction among the treatment group (p = .002). Treatment fidelity with regard to delivery and receipt were poor due to high staff attrition in the treatment group (46% vs. 16%) and limited site support. IMPLICATIONS: The findings from this study can be used to adapt future FFC intervention studies to improve treatment fidelity and optimize intervention efficacy.
Authors: Elizabeth Galik; Barbara Resnick; Erin Vigne; Sarah Dee Holmes; Victoria Nalls Journal: J Am Med Dir Assoc Date: 2016-10-21 Impact factor: 4.669
Authors: Barbara Resnick; Elizabeth Galik; Marie Boltz; Erin Vigne; Sarah Holmes; Steven Fix; Shijun Zhu Journal: West J Nurs Res Date: 2018-03-21 Impact factor: 1.967
Authors: Barbara Resnick; Sheryl Zimmerman; Joseph Gaugler; Joseph Ouslander; Kathleen Abrahamson; Nicole Brandt; Cathleen Colón-Emeric; Elizabeth Galik; Stefan Gravenstein; Lona Mody; Philip D Sloane; Kathleen Unroe; Hilde Verbeek Journal: J Am Geriatr Soc Date: 2022-02-23 Impact factor: 5.562
Authors: Barbara Resnick; Marie Boltz; Elizabeth Galik; Steven Fix; Sarah Holmes; Shijun Zhu; Erik Barr Journal: J Am Geriatr Soc Date: 2020-10-23 Impact factor: 5.562
Authors: Barbara Resnick; Ann Kolanowski; Kimberly Van Haitsma; Elizabeth Galik; Marie Boltz; Jeanette Ellis; Liza Behrens; Nina M Flanagan; Karen J Eshraghi; Shijun Zhu Journal: Res Nurs Health Date: 2018-02-27 Impact factor: 2.228
Authors: Ian D Cameron; Suzanne M Dyer; Claire E Panagoda; Geoffrey R Murray; Keith D Hill; Robert G Cumming; Ngaire Kerse Journal: Cochrane Database Syst Rev Date: 2018-09-07