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Management of apathy in nursing homes using a teaching program for care staff: the STIM‐EHPAD study
Author(s) -
Leone Elsa,
Deudon Audrey,
Bauchet Murielle,
Laye Mathilde,
Bordone Nathalie,
Lee JiHyun,
Piano Julie,
Friedman Leah,
David Renaud,
Delva Fleur,
Brocker Patrice,
Yesavage Jerome,
Robert Philippe Henri
Publication year - 2013
Publication title -
international journal of geriatric psychiatry
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.28
H-Index - 129
eISSN - 1099-1166
pISSN - 0885-6230
DOI - 10.1002/gps.3836
Subject(s) - apathy , dementia , psychology , intervention (counseling) , scale (ratio) , clinical psychology , medicine , psychiatry , nursing , cognition , disease , physics , quantum mechanics
Objective This study aimed to evaluate the effectiveness of a nursing home (NH) staff education to manage apathy in older individuals with a diagnosis of dementia. Methods Sixteen NHs agreed to participate, and 230 demented apathetic residents were randomly assigned to the reference group (RG) or the intervention group (IG). IG received a month of weekly 4‐h training. Qualitative evaluation was performed through interviews and questionnaires regarding work practices and knowledge about dementia. Quantitative evaluation was at baseline, at the end of the training program (week 4), and 3 months after the end of it with the use of the Neuropsychiatric Inventory (NPI), the Apathy Inventory, and two observation scales. Results In the qualitative evaluation, very few staff responded to the questionnaire. Concerning the difficulty that managing residents' behavioral symptoms presented, aggressiveness was ranked as the most difficult behavior to manage and apathy as the least difficult. In the quantitative evaluation, the results are as follows. NPI: the IG scores increased from baseline to week 4 more than the RG for symptoms belonging to the affective and the psychotic NPI item subgroup. Apathy Inventory: there was a significant decrease of the emotional blunting score dimension in the IG. Group Observation Scale: significant improvement was observed for the emotional blunting dimension in the IG only. Conclusions Apathy is rarely identified as a problem in NH. Emotional blunting was the only dimension sensitive to change. Failure to improve residents' level of interest could be explained by the difficulties encountered in accessing information regarding the subjects' personal interests. But it remains possible to modify residents' emotional reactivity and staff's perceptions of residents' behaviors and emotions. Copyright © 2012 John Wiley & Sons, Ltd.