The Association Between Engagement in Activities of Daily Living and Care Interactions for Residents Living With Dementia.
Rachel McPherson, Barbara Resnick, Elizabeth Galik and 3 others
PMID 36730953WHAT IT FOUND
In nursing-home dementia care, residents who were actively engaged during care had higher-quality staff-resident interactions than passively engaged residents.
Most interactions were positive, but the study did not show engagement caused better care.
Key findings
01Residents who were actively engaged during care interactions had higher-quality interactions than residents who were passively engaged, after accounting for age, gender, cognition, comorbidities, and function.
02Most staff-resident interactions were positive: 42% positive social and 37% positive care.
03Most residents were actively engaged during the observed interactions (77%).
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This was a secondary analysis of baseline observations, not a randomized test of an intervention, so it cannot show that engaging residents caused better interactions. The sample came from a convenience sample of 55 nursing homes, and residents in hospice or short-term rehabilitation were excluded. The average cognitive impairment score was severe (mean BIMS 4.3), so the findings may not apply to residents with mild dementia. Most interactions were observed as positive, which the authors note may reflect social desirability because staff knew they were being observed. The model explained only 25% of the variation in interaction quality, so other factors such as staffing, stress, burnout, and staff dementia knowledge may matter. Resident engagement and interaction quality were rated by research evaluators, not by residents or families, and the analysis used listwise deletion.
The easy way to misread this
Do not conclude that helping residents become more actively engaged will improve care interactions or resident outcomes. The study found an association at baseline and did not test an engagement intervention.