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Testing the Effect of Function‐Focused Care in Assisted Living
Author(s) -
Resnick Barbara,
Galik Elizabeth,
GruberBaldini Ann,
Zimmerman Sheryl
Publication year - 2011
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/j.1532-5415.2011.03699.x
Subject(s) - medicine , assisted living , gerontology , function (biology) , family medicine , biology , evolutionary biology
Objectives To develop and test the Function‐Focused Care in Assisted Living ( FFC ‐ AL ) intervention so as to alter the decline that older adults in AL experience. Design Cluster‐randomized controlled trial using repeated measures to test the effect of FFC ‐ AL . Setting Four AL facilities with at least 100 beds. Participants One hundred seventy‐one residents and 96 direct care workers ( DCWs ) were recruited. Ninety‐five of the DCWs were female (99%), and 59 were black (62%), with a mean age of 41.7 ± 13.8. The residents were mostly female (80%), white (93%), and widowed (80%), with a mean age of 87.7 ± 5.7. Intervention FFC ‐ AL included four components implemented by a research‐supported function focused‐care nurse ( FFCN ) and a site‐identified champion over a 12‐month period. Control sites were exposed to FFC education only. Measurements Outcomes for residents included psychosocial domains (mood, resilience, self‐efficacy, and outcome expectations for function and physical activity), function, gait and balance, and actigraphy. Outcomes for DCWs included knowledge, performance, and beliefs associated with FFC . Results DCWs in treatment sites provided more FFC by 12 months than those in control sites. Residents in treatment sites demonstrated less decline in function, a greater percentage returned to ambulatory status, and there were positive trends demonstrating more time in moderate‐level physical activity at 4 months and more overall counts of activity at 12 months than for residents in control sites. Conclusion Using a function‐focused approach in AL may help prevent some of the functional decline commonly noted in these settings.