Optimizing Care for Patients With Dementia
| Status: | Recruiting |
|---|---|
| Conditions: | Alzheimer Disease, Neurology |
| Therapuetic Areas: | Neurology |
| Healthy: | No |
| Age Range: | Any |
| Updated: | 2/7/2019 |
| Start Date: | March 15, 2018 |
| End Date: | December 2021 |
| Contact: | Natalie E Leland, PhD |
| Email: | NEL24@pitt.edu |
| Phone: | 412-383-3405 |
Optimizing Care for Patients With Dementia: A Comparison of Two Non-pharmacological Treatment Approaches
Of the 1.4 million nursing home (NH) residents in long term care facilities, more than half
have Alzheimer's disease or dementia. Due to changes in their familiar daily routines,
difficulty expressing their thoughts or asking for what they need, and overstimulation (such
as noise) or under stimulation (such as lack of activity), individuals with dementia often
display disruptive behaviors like resisting help or continually repeating the same phrases.
Medications are often prescribed to reduce agitation and aggressive behavior; however, these
medications may not be effective and can have a negative impact on the individual. Therefore,
families and other stakeholders strongly advocate the use of other types of approaches that
focus on minimizing the cause of the behavior. Two facility-based methodologies include the
transdisciplinary approach for integrated dementia care, which combines the expertise of all
NH staff, who work together to build a common language and approach for each resident, and
the multidisciplinary approach for problem-based dementia care, in which each staff member
conducts individual assessments and makes discipline-specific recommendations. While prior
research suggests that both of these facility-based approaches are useful, the circumstances
under which each approach is most effective are not clear. This project will prospectively
randomize 80 nursing homes to one of the two treatment arms to compare the effect of the
transdisciplinary approach versus the multidisciplinary approach.
This study will examine the difference between the two comparators with respect to facility
rates of medications dispensed to residents with dementia, leading to enhanced quality of
life for the resident.
This project is important because it will address a key clinical dilemma NH staff face as
they strive to optimize the use of alternative approaches to reduce disruptive behaviors in
residents with dementia. Transforming the quality of dementia care in NHs and enhancing the
quality of life of residents with dementia are high priorities for families and other
advocates.
have Alzheimer's disease or dementia. Due to changes in their familiar daily routines,
difficulty expressing their thoughts or asking for what they need, and overstimulation (such
as noise) or under stimulation (such as lack of activity), individuals with dementia often
display disruptive behaviors like resisting help or continually repeating the same phrases.
Medications are often prescribed to reduce agitation and aggressive behavior; however, these
medications may not be effective and can have a negative impact on the individual. Therefore,
families and other stakeholders strongly advocate the use of other types of approaches that
focus on minimizing the cause of the behavior. Two facility-based methodologies include the
transdisciplinary approach for integrated dementia care, which combines the expertise of all
NH staff, who work together to build a common language and approach for each resident, and
the multidisciplinary approach for problem-based dementia care, in which each staff member
conducts individual assessments and makes discipline-specific recommendations. While prior
research suggests that both of these facility-based approaches are useful, the circumstances
under which each approach is most effective are not clear. This project will prospectively
randomize 80 nursing homes to one of the two treatment arms to compare the effect of the
transdisciplinary approach versus the multidisciplinary approach.
This study will examine the difference between the two comparators with respect to facility
rates of medications dispensed to residents with dementia, leading to enhanced quality of
life for the resident.
This project is important because it will address a key clinical dilemma NH staff face as
they strive to optimize the use of alternative approaches to reduce disruptive behaviors in
residents with dementia. Transforming the quality of dementia care in NHs and enhancing the
quality of life of residents with dementia are high priorities for families and other
advocates.
Inclusion Criteria:
Eligible nursing home facilities will
- lack any existing dementia program targeting reduction of off-label psychotropic
medication use
- each serve >60 long-term care residents with Alzheimer's or dementia
- meet Center for Medicare & Medicaid Services' minimum requirements for NHs (e.g.,
meeting the mandated number of hours of staff training on dementia care, performing
regularly scheduled resident assessments).
Exclusion Criteria:
Facilities will be excluded if they have
- less than 60 long-stay residents
- an existing formal dementia care program in place
- an off-label psychotropic medication reduction program
- is located in a state that requires more than the Center for Medicare & Medicaid
Services' minimum for staff training requirements on the topic of dementia care
We found this trial at
1
site
4200 Fifth Ave
Pittsburgh, Pennsylvania 15260
Pittsburgh, Pennsylvania 15260
(412) 624-4141
Phone: 412-383-3405
University of Pittsburgh The University of Pittsburgh is a state-related research university, founded as the...
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