Strategies to engage older adults with behavioral and psychological symptoms of dementia in exercise: A multiple case study.
Fang Yu, Susan Greimel, Kaitlin Kelly and 1 others
PMID 28720243WHAT IT FOUND
Three people with dementia and behavioral symptoms attended 83% to 100% of exercise sessions.
Staff managed agitation by learning each person's triggers, using distraction, and framing instructions as shared rules. Strategies that worked for one person often failed for another.
Key findings
01Participants with dementia and behavioral symptoms achieved high attendance rates (83% to 100%) in an exercise program when staff used person-centered strategies.
02Strategies to manage behavioral symptoms were highly individualized; for example, answering repetitive questions patiently worked for one participant, while distraction and small rewards were needed for another.
03For a participant resistant to instruction, framing exercise steps as mandatory rules for the staff member rather than personal orders improved compliance.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study includes only three cases, so the strategies described may not generalize to other patients or symptom profiles. Participants were selected from a larger trial, which may introduce bias. The study reports on adherence and management strategies, not on the clinical benefits of the exercise itself. Data on strategies were collected from the exercise interventionists, who were also the ones delivering the care, potentially introducing observer bias.
Declared interests
The study was supported by the National Institute on Aging (grant 1R01AG043392–01A1). No other conflicts of interest are declared in the provided text.
The easy way to misread this
Do not conclude that these specific strategies guarantee high adherence in all patients with dementia. The paper shows that what worked for one person often failed for another, emphasizing the need for individualized trial and error rather than a standard protocol.