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O2‐14‐04: From Continence to Incontinence in Nursing Home Care: The Influence of a Dementia Diagnosis
Author(s) -
Wagg Adrian S.,
Hunter Kathleen F.,
Poss Jeff W.,
Estabrooks Carole
Publication year - 2016
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1016/j.jalz.2016.06.476
Subject(s) - dementia , minimum data set , medicine , urinary incontinence , odds ratio , quality of life (healthcare) , nursing homes , depression (economics) , urinary continence , gerontology , nursing , disease , surgery , prostate , cancer , economics , macroeconomics , prostatectomy
Background:Apathy associated with dementia is linked to accelerated physical and mental decline. Research suggests that environmental and social stimulation can increase purposeful engagement and, thus, reduce apathy. In 2014, Vanderbilt’s Center for Quality Aging conducted a prospective, longitudinal pilot evaluation over 12 months in one Belmont Village Senior Living’s Circle of Friends (COF) program: a 7-day-per-week program conducted by trained staff that includes all-day structured activities in five areas: aerobic/weight exercises; 6 domains of cognitive functioning; heart-healthy diet; and social connections. Performance-based neuropsychological instruments and standardized observations showed that COF participants spent significantly more time engaged in purposeful activities (no apathy) relative to a control group. In addition, COF participants showed maintenance of cognitive functioning in some domains. This 2015 follow-up study evaluated COF across all 23 Belmont Village buildings, comparing COF apathy/no apathy with a sample of assisted living residents. Methods:This was a quantitative study administered across 23 Belmont Village Assisted Living facilities, comparing activity participation in a structured, 7-day per week, whole brain fitness ( Circle of Friends) program for residents with mild to moderate dementia (MMSE 11 to 26). The Circle (N 1⁄4 499) was compared to a nonenrolled group of Assisted Living residents ( N1⁄4 176). High activity participation was defined as No Apathy, or four or more hours of purposeful activities per day. Mild Apathy was 1 to 3 activities or less than half a day and Apathy was none or sporadic participation. The study took place in March, 2015. Circle residents and controls were assessed by trained Belmont Village staff on standardized neuropsychological instruments measuring cognitive functioning. Daily activity participation was recorded by activity leaders on attendance sheets for the month of March. Results: No Apathy: 74% COF; 29% Controls; Mild Apathy: 14% COF; 32% Controls; Apathy: 10%COF; 35%Controls (p< .0001).Conclusions:The next steps will involve, in March 2016, a one-year, longitudinal comparison, including activity participation and cognitive functioning for both groups plus a comparison of behaviors and medications.