A Cluster Randomized Controlled Trial Testing the Impact of Function and Behavior Focused Care for Nursing Home Residents With Dementia.
Elizabeth M Galik, Barbara Resnick, Sarah D Holmes and 5 others
PMID 33454311WHAT IT FOUND
A nursing home program increased resident activity and reduced resistiveness to care at 4 months, but these gains disappeared by 12 months.
There were no improvements in daily function, mood, or agitation. The intervention requires ongoing staff mentoring to sustain changes.
Key findings
01The intervention significantly increased time spent in light, moderate, and total physical activity at 4 months, but not at 12 months.
02Residents in the treatment group showed a significant decrease in resistiveness to care at 4 months compared to the control group.
03There were no significant intervention effects on depressive symptoms, agitation, functional ability, or psychotropic medication use.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for RNs
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What it does not show
The study was slightly underpowered (336 participants vs 368 required). Significant attrition due to death (26%) and transfer limits generalizability. Baseline imbalances in education, cognition, and comorbidities required statistical adjustment. Only 12 nursing homes in a single state were included. Recruitment bias: only residents who could assent and have reachable proxies were included, excluding those with more severe behavioral symptoms. Subjective staff reports may have been biased by recall or by staff doing activities for residents rather than with them.
Declared interests
The authors have no financial or personal conflicts of interest. The study was supported by the National Institutes of Health.
The easy way to misread this
Do not assume the intervention leads to long-term functional improvement or reduced medication use. The benefits in activity and resistiveness to care were only significant at 4 months and disappeared by 12 months, and there was no change in daily living independence or psychotropic prescriptions.