Excessive unoccupied time precipitates agitated behaviors in nursing home (NH) residents with AD and greatly increases caregiver burden. Therapeutic recreational activity intervention studies have shown that activities can fill unoccupied time, produce positive affect, and significantly decrease agitation among NH residents with AD. Tailoring these activities has been critical to meet individual needs and promote engagement in activities due to residents'wide-ranging cognitive and functional abilities. However, nursing homes may need to house hundreds of various activities to meet individual needs and train staff for activity prescription and implementation. These requirements are burdensome for nursing homes and prevent the therapeutic use of recreational activities for NH residents with AD. There is an urgent need for therapeutic activity interventions that are easily accessible, feasible, and effective in managing agitation in residents with AD. A therapeutic use of computers represents great potential to make activities easily accessible and tailored to the specific needs of persons with AD because of its unique features of interactivity, multi-sensory stimulation, immediate feedback, multiple repetitions on demand, and easy modifications of speed and level of cognitive challenge. Adaptive accessories such as a track ball or touch screen have made computerized activities user-friendly for elders with limited physical function. However, the therapeutic effects of computer activities on persons with AD are largely unknown since researchers have not examined these effects systematically. Therefore, this proposed study will build on knowledge from previous therapeutic activity intervention studies in AD and examine the initial efficacy of a Therapeutic Computer Activity Intervention (TCAI) on decreasing agitation in nursing homes residents with mild-to-moderate dementia associated with AD. The study will use a within-subject quasi-experimental design with repeated measures on engagement, affect, and agitation. A sample of 40 elders will participate in computerized activities matched to their cognitive and physical ability for 6 weeks (5 days a week for up to 30 minutes per day). Using a standardized videotape-recording protocol, data collection will occur at baseline, treatment, and one-week follow-up. A mixed model ANOVA (time as a repeated factor) will be used to assess changes in agitated behaviors.
Tak, Sunghee H; Kedia, Satish; Tongumpun, Tera Marie et al. (2015) Activity Engagement: Perspectives from Nursing Home Residents with Dementia. Educ Gerontol 41:182-192 |