Testing the Implementation of Function-focused Care in Assisted Living Settings.
Barbara Resnick, Marie Boltz, Elizabeth Galik and 4 others
PMID 33132018WHAT IT FOUND
In assisted living, a function-focused care program slowed resident functional decline over 12 months and increased resident participation in care activities.
It did not improve activity measured by monitors, so do not expect those changes.
Key findings
01At 12 months, Barthel Index scores declined 2.1 points in treatment residents and 9 points in control residents.
02At 12 months, residents in treatment sites performed 81% of function-focused care activities, while control residents performed 79%.
03Objective activity findings did not support effectiveness: the control group increased activity over time more than the treatment group.
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 resident sample was mostly white women from three states, and recruitment may have favored sites interested in physical activity. The total number of residents analysed is not stated in the supplied text. Many contextual factors were not measured, including staff numbers, turnover, state survey issues and payment differences. Direct care workers were not recruited as participants, so no demographic or work-related data are available about them. The intervention combined stakeholder meetings, environment and policy assessment, staff education, service-plan support, mentoring and weekly resources, so the contribution of any single component cannot be separated. The study deliberately limited outcomes and did not measure additional function or activity such as the six minute walk. Actigraphy had no wear-time diary and large missing data: 29% at baseline, 32% at four months, and 47% at 12 months. The treatment group had higher baseline physical activity than control, making it harder to show increases.
Declared interests
The publication type lists NIH extramural research support; the supplied text does not provide an author conflict-of-interest declaration.
The easy way to misread this
Do not conclude that this intervention increased residents' objective physical activity. The MotionWatch 8 findings did not support effectiveness, the control group increased activity over time more than the treatment group, and there was a large percentage of missing actigraphy data.