Evaluating non-pharmacological approaches to nursing home dementia care: A protocol

Natalie E. Leland; Victoria Shier; Catherine Verrier Piersol; Cara Lekovitch; Jenny Martínez; Yuna H. Bae-Shaaw; Neeraj Sood; Claire Day; Paul Cass; Dominique Como; Carin Wong; Felicia Chew

Contemporary Clinical Trials Communications (Aug 2023)

Evaluating non-pharmacological approaches to nursing home dementia care: A protocol

Natalie E. Leland,
Victoria Shier,
Catherine Verrier Piersol,
Cara Lekovitch,
Jenny Martínez,
Yuna H. Bae-Shaaw,
Neeraj Sood,
Claire Day,
Paul Cass,
Dominique Como,
Carin Wong,
Felicia Chew

Affiliations

Natalie E. Leland: Department of Occupational Therapy, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA, USA; Corresponding author. University of Pittsburgh, Bridgeside Point I, 100 Technology Drive, Suite 350, Pittsburgh, PA, 15219.
Victoria Shier: University of Southern California, Los Angeles, CA, USA
Catherine Verrier Piersol: Department of Occupational Therapy, Jefferson College of Rehabilitation Sciences, Thomas Jefferson University, Philadelphia, PA, USA
Cara Lekovitch: Department of Occupational Therapy, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA, USA
Jenny Martínez: Department of Occupational Therapy, Jefferson College of Rehabilitation Sciences, Thomas Jefferson University, Philadelphia, PA, USA
Yuna H. Bae-Shaaw: University of Southern California, Los Angeles, CA, USA
Neeraj Sood: University of Southern California, Los Angeles, CA, USA
Claire Day: Alzheimer's Association Northern California and Northern Nevada Chapter, San Jose, CA, USA
Paul Cass: Department of Occupational Therapy, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA, USA; University of Southern California, Los Angeles, CA, USA; Department of Occupational Therapy, Jefferson College of Rehabilitation Sciences, Thomas Jefferson University, Philadelphia, PA, USA; Alzheimer's Association Northern California and Northern Nevada Chapter, San Jose, CA, USA
Dominique Como: Department of Occupational Therapy, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA, USA
Carin Wong: Department of Occupational Therapy, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA, USA
Felicia Chew: Department of Occupational Therapy, Jefferson College of Rehabilitation Sciences, Thomas Jefferson University, Philadelphia, PA, USA

Journal volume & issue: Vol. 34
p. 101161

Abstract

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Background: The COVID-19 pandemic has underscored the daily challenges nursing home (NH) staff face caring for the residents living with Alzheimer's Disease and Related Dementias (ADRD). Non-pharmacological approaches are prioritized over off-label medication to manage the behavioral and psychological symptoms of ADRD. Yet, it is not clear how to best equip NH staff and families with the knowledge and strategies needed to provide non-pharmacological approaches to these residents. Methods: This clustered randomized trial will compare team- and problem-based approaches to non-pharmacological ADRD care. The team-based approach includes core training for all NH staff using a common language and strategies to support continuity and sustainability. The problem-based approach capitalizes on the expertise of the professional healthcare providers to target issues that arise. A convergent mixed methods design will be used to examine (a) comparative effectiveness of the two approaches on long-term NH resident outcomes and (b) whether either approach is protective against the negative consequences of COVID-19. The primary outcome is the percentage of ADRD residents with off-label antipsychotic medication use, which will be evaluated with an intent-to-treat approach. Staff and family caregiver perspectives will be explored using a multiple case study approach. Conclusion: This trial will be the first-ever evaluation of team- and problem-based approaches to ADRD care across multiple NHs and geographic regions. Results can provide health system leaders and policymakers with evidence on how to optimize ADRD training for staff in an effort to enhance ADRD care delivery.

Published in Contemporary Clinical Trials Communications

ISSN: 2451-8654 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Medicine (General)
Website: https://www.journals.elsevier.com/contemporary-clinical-trials-communications/

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