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Randomized Controlled Trial
. 2021 Jul;22(7):1421-1428.e4.
doi: 10.1016/j.jamda.2020.12.020. Epub 2021 Jan 15.

A Cluster Randomized Controlled Trial Testing the Impact of Function and Behavior Focused Care for Nursing Home Residents With Dementia

Elizabeth M Galik  1 , Barbara Resnick  2 , Sarah D Holmes  2 , Erin Vigne  2 , Karen Lynch  2 , Jeanette Ellis  2 , Shijun Zhu  2 , Erik Barr  2
Affiliations
Randomized Controlled Trial

A Cluster Randomized Controlled Trial Testing the Impact of Function and Behavior Focused Care for Nursing Home Residents With Dementia

Elizabeth M Galik et al. J Am Med Dir Assoc. 2021 Jul.

Abstract

Objective: The purpose of this study was to test the effectiveness of the Function and Behavior Focused Care for the Cognitively Impaired (FBFC-CI) intervention on function, physical activity, and behavioral symptoms among nursing home residents with dementia, and to explore the adoption of the intervention at the facility level.

Design: This study was a clustered, randomized controlled trial with a repeated measures design that was implemented in 12 nursing homes randomized to either treatment (FBFC-CI) or educational control [Function and Behavior Focused Care Education (FBFC-ED)].

Setting and participants: Twelve nursing homes (6 treatment and 6 control) and 336 residents (173 treatment and 163 control) with moderate to severe cognitive impairment.

Measures: Outcomes included functional ability (Barthel Index), physical activity (actigraphy and survey), behavioral symptoms (Resistiveness to Care Scale, Cohen-Mansfield Agitation Inventory, Cornell Scale for Depression in Dementia), and psychotropic medication use.

Results: The participants were 82.6 (SD = 10.1) years of age, mostly female, and were moderate to severely cognitively impaired (Mini-Mental State Exam of 7.8, SD = 5.1). There was a significantly greater increase in time spent in total activity (P = .004), moderate activity (P = .012), light activity (P = .002), and a decrease in resistiveness to care (P = .004) in the treatment versus control group at 4 months. There was no change in mood, agitation, and the use of psychotropic medications. There was some evidence of adoption of the intervention at treatment sites.

Conclusions and implications: This study provides some support for the use of the FBFC-CI Intervention to increase time spent in physical activity and decrease resistive behaviors during care commonly noted among nursing home residents with moderate to severe cognitive impairment.

Keywords: Dementia; behavior; function; nursing home; physical activity.

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Conflict of interest statement

Conflicts of Interest: The authors have no financial or personal conflicts of interest.

Figures

Figure 1:
Figure 1:
Consort Diagram
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