Persons with Alzheimer's disease (AD) and dementia of the Alzheimer's Type (DAT) often reside in nursing homes and frequently exhibit debilitating behaviors of agitation, aggressiveness, screaming, wandering and repetitive actions. The purpose of this study is to test the effectiveness of three levels of a nursing intervention on altering the dysfunctional behaviors of elderly nursing home residents diagnosed with AD or DAT. The conceptual framework is based on Hall and Buckwalter's (1987) Progressively Lowered Stress Threshold (PLST). The PLST model will be used to guide the testing of the intervention. The three levels of the intervention are: 1) video respite, which was designed to engage the demented elderly person thereby intervening in the dysfunctional behavior, and two commonly used interventions; 2) taking the resident for a walk; and 3) talking to the resident about the resident's family members. The latter two interventions were identified as commonly used interventions by CNAs and RNs who work in the four study site nursing homes.
The specific aims of this study are: 1. Test three levels of a nursing intervention on the management of dysfunctional behaviors (engagement time) of demented elderly nursing home residents. 2. Examine the differences in engagement scores for each level of intervention by gender and ethnicity of the participants. A quasi-experimental design will be used to compare the effects of the three levels of intervention on engagement time. The three levels of intervention will be randomly assigned to residents diagnosed with dementia and the engagement time will be recorded (Specific Aim 1). Four ethnically diverse nursing homes and a minimum of 52 elderly residents will participate. Two-way ANOVAS will be used to test the main and interaction effects of the intervention, ethnicity and gender. Congruent with the aging of the US population is an increasing number of elderly persons in nursing homes with dementia. However, there are few meaningful interventions to assist nursing home caregivers to manage the demanding and often destructive behaviors associated with dementia. The significance of this nursing intervention is that the video respite intervention has the potential to become a cost-effective procedure that effectively manages behavioral problems in demented elderly people.
