Amber, a second-semester undergraduate research assistant, recently presented the article, “A Randomized Controlled Trial for an Individualized Positive Psychosocial Intervention for the Affective and Behavioral Symptoms of Dementia in Nursing Home Residents” (Van Haitsma et al., 2015).
Following Amber’s experience working in a nursing home, she found an interest in researching interventions for people with mental health disorders such as Dementia and Alzheimers. The person-centered model of care is based on recognizing the individual’s needs and preferences in caretaking. Self-Determination Theory (SDT) is a model of personality and motivation while the Broaden-and-Build Theory states that positive emotions widen an individual’s behavioral repertoire. There have also been findings within the research of modest effects of using non-pharmacological interventions such as music therapy to reduce behavioral symptoms of dementia. When planning these interventions, it is important to match the activity to skill level and interest.
With that, the purpose of this study specifically was to test the effectiveness of a preference-based activity intervention in nursing home residents with dementia. The researchers hoped to improve effect and behavioral engagement while reducing negative affect and negative behaviors. The authors hypothesized (1) One-to-one activity interventions will reduce residents’ negative affect, verbal, and nonverbal behaviors and (2) Individuals receiving the intervention will have increased instances of positive affect, verbal, and nonverbal behaviors. The sample had a mean age of 88.7 years with moderate to severe cognitive functional impairments and lived in the nursing unit for more than a month.
The participants were divided through random assignment into three groups: (1) Usual Care (UC), (2) Attention Control (AC) + UC and (3) Individualized Positive Psychological Intervention (IPPI). There was a 3 week treatment period where these interventions were applied.
The results showed that overall, the residents receiving IPPI showed the greatest benefit, followed by AC. The AC group showed benefits and more negative behavior. This may be due to the adverse effects standardized one-to-one interventions can have on highly vulnerable populations. Limitations of this study include the lack of diversity in the sample, the line-observation coding system (only observing one behavior state at a time rather than multiple), and the research assistant’s influence throughout the study. Amber also pointed out the issues involving researching individuals in assisted living facilities. Family members can be quite protective of their relatives during their later years in life. In an attempt to protect their loved ones, they sometimes refuse to consent to studies like this. Whether it is the harsh language calling it an experiment, or lacking trust in research it is a struggle to reach this population despite the good it can do. Amber hopes to address these concerns and reduce the stigma associated with researching elderly people.
Future directions of this study include replicating the study with a more diverse sample and the integration of other types of therapy such as CBT or mindfulness training. Amber will be able to use this knowledge and her interests to influence her future research plans regarding behavioral interventions, and cognitively impaired individuals with a diverse age range and population in mind. We are excited to see what Amber accomplishes!