Occupational therapy and people with dementia in care homes.
Occupational therapy (Health aspects)
Nursing homes (Management)
Dementia (Care and treatment)
Dementia (Patient outcomes)
|Author:||Wenborn, Jennifer Lindsey|
|Publication:||Name: British Journal of Occupational Therapy Publisher: College of Occupational Therapists Ltd. Audience: Academic Format: Magazine/Journal Subject: Health Copyright: COPYRIGHT 2011 College of Occupational Therapists Ltd. ISSN: 0308-0226|
|Issue:||Date: July, 2011 Source Volume: 74 Source Issue: 7|
|Topic:||Event Code: 200 Management dynamics Computer Subject: Company business management|
|Product:||Product Code: 8050000 Nursing & Rest Homes; 8366000 Homes for Aged NAICS Code: 623 Nursing and Residential Care Facilities; 623312 Homes for the Elderly SIC Code: 8051 Skilled nursing care facilities; 8052 Intermediate care facilities; 8059 Nursing and personal care, not elsewhere classified|
|Geographic:||Geographic Scope: United Kingdom Geographic Code: 4EUUK United Kingdom|
Background: Lack of activity within care homes decreases quality of
life. Staff often lack the knowledge and skills to provide meaningful
activity at an appropriate level for residents with dementia.
Aim: To assess if occupational therapy intervention for people with dementia in care homes improves quality of life.
Study 1: The validity and reliability of the Pool Activity Level (PAL) checklist was assessed. A survey of activity providers demonstrated good content validity. When completed with 60 people with dementia, it showed: strong criterion, construct and concurrent validity with other measures; good internal consistency; and adequate interrater and test-retest reliability.
Study 2: This was a matched pair design cluster randomised controlled trial. Eight care homes (n = 104 residents) received the intervention, and eight (n = 106) continued usual care. The intervention comprised: environmental assessment; education sessions and individual coaching for staff who used the PAL checklist to assess and provide meaningful activities with two residents each. Primary outcome was quality of life. Measures were completed at baseline; 4 and 12 weeks postintervention. Assessors were blinded to allocation and intervention content. Data from 159 residents at final follow-up were analysed by intention to treat. Quality of life, cognition, dependency declined; challenging behaviour increased; and symptoms of depression and anxiety reduced significantly in both groups. Multi-level modelling, adjusted for baseline, found no significant differences between groups on the primary outcome (quality of life) or other outcome measures.
Conclusion: Compliance to the intervention programme varied, so not all residents received enhanced activity provision. Homes with strong management commitment reported better quality of life for their residents. Future studies should consider alternative implementation and programme fidelity strategies, and more sensitive outcome measures to capture fully the potential impact of occupational therapy interventions. [Author abstract]
Jennifer Lindsey Wenborn
University College London, 2010. PhD.
|Gale Copyright:||Copyright 2011 Gale, Cengage Learning. All rights reserved.|