Implementation of Function Focused Care for Acute Care Using the Evidence Integration Triangle

Abstract

Background: The purpose of this study was to test the impact of Function Focused Care for Acute Care Using the Evidence Integration Triangle (FFC-AC-EIT) on hospitalized patients living with dementia.

Methods: This was a clustered randomized clinical trial including 12 hospitals from two states and 455 patients living with dementia. Hospitals were randomized to FFC-AC-EIT versus FFC Education Only. The mean age of the participants was 82.5 (SD = 8.5), the majority were women (62.6%), White (65.3%), married (64.4%), and had 3.0 (SD = 2.4) comorbidities. Outcome measures included the Barthel Index; the Physical Activity Survey, the Confusion Assessment Method Short Form (CAM-S), the Neuropsychiatric Inventory (NPI), and the Pain Assessment in Advanced Dementia.

Results: At discharge, both groups improved in function and physical activity, patients in the intervention group had less increase in pain than those in the control group (β = -0.58, 95% confidence interval [95% CI] (-0.89, -0.26), p < 0.001). There were no group differences in behavioral symptoms or delirium. At 1 month post-discharge there was a significant improvement in function (β = 5.55, 95% CI [0.36, 10.75], p = 0.036) and physical activity (β = 3.07, 95% CI [1.87, 4.28], p < 0.001).

Conclusions: Exposure to information about function focused care may help staff in acute care settings maintain and increase function and physical activity for older patients living with dementia during the hospital stay and help facilitate an increase in function and physical activity after discharge.

Keywords: dementia; function; physical activity.