**2005 AGS Annual Meeting**

**Workshop Research Programs and Issues Series:**

**GRECC Research in Long Term Care Facilities to Improve Sleep and
Continence**

**Saturday, May 14: 11:15AM-12:45PM**

**[MODERATOR\'S INFORMATION]{.underline}**

Dennis H. Sullivan MD, MD

Director, GRECC

Geriatric Research, Education and Clinical Center

Central Arkansas Veterans Healthcare System

4300 West 7th St (182/LR)

Little Rock, AR 72205

Tel:501-257-2503

Fax: 501-257-2501

Email: sullivandennish@uams.edu

***[Program & Audience Overview :]{.underline}***

This workshop aims to feature cutting-edge research from the Veterans
Affairs Geriatric Research Education and Clinical Centers (GRECC). The
research presentation will focus on the long term care setting and two
common problems, that of sleep disorders and urinary incontinence. These
two problems are very common, often inadequately treated, and
potentially devastating conditions among older patients in extended care
settings. Each condition not only adversely affects the health and
quality of life of the older patient, they often add tremendously to the
burden of care and thus impact the health and quality of life of the
caregivers. This workshop will provide an overview of some of the latest
research dealing with the causes, consequences, and potential avenues of
treatment for these conditions and some of the obstacles to implementing
newer treatment strategies in the clinical setting. At the end of this
session, participants will be able to: (1) recite the high prevalence
and impact of insomnia and incontinence in extended care patients; (2)
identify some of the challenges of research on insomnia and incontinence
in extended care settings; (3) comprehend the strength of the evidence
for exercise, social activity, and other biobehavioral interventions for
improving sleep and continence in extended care patients; and, (4)
describe implications of this research for practice and future research.

***[Learning Objectives :]{.underline}***

1\. Develop a better understanding of the prevalence and impact of

insomnia and incontinence in extended care patients.

2\. Identify challenges for research on insomnia and incontinence

in extended care patients.

3\. Analyze the strength of the evidence for exercise, social activity,
and other biobehavioral interventions for improving sleep and continence
in extended care patients.

4\. Describe implications of this research for practice and

future research.

***[Outcomes :]{.underline}***

Participants will have an increased understanding of the

signficance of the problems of insomnia and incontinence in

extended care settings. They will understand the rationale and potential
benefits of biobehavioral interventions to improve outcomes for these
problems. Presenters will summarize relevant research and theoretical
issues related to the study of insomnia and incontinence in extended
care settings, present the results of original research, and invite
audience discussion.

**Title of Talk One :** Tailored Biobehavioral Interventions for Sleep
in Persons

with Dementia

Dr. Richards will provide an overview of sleep in persons with dementia
including potential causes and consequences of sleep problems and
possible approaches to improve sleep. This will include a discussion of
the findings from focus group assessments that indicate the consequences
of insomnia for persons with dementia and their caregivers and results
from a series of preliminary studies that identified daytime napping,
social and physical inactivity, and primary sleep disorders as causes
for insomnia. The talk will conclude by discussing the rationale for,
and results from a series of randomized controlled trials examining the
effects of various non-pharmacologic interventions to improve sleep in
nursing home residents with dementia

**Speaker\'s Name** :

Kathy Culpepper Richards, PhD, RN

Research Scientist and Professor

University of Arkansas for Medical Sciences

Central Arkansas Veterans Healthcare System

2200 Fort Roots Drive 3J/NLR

North Little Rock, AR 72114

Tel: 501-257-2044

Fax: 501-257-2501

Email: richardskathyc@uams.edu

Dr.Richards is funded by the National Institutes of Health and the VA
Health Services

Research and Development Program to conduct sleep research in persons
with

dementia. She is a Diplomate of the American Board of Sleep Medicine.

 

**Title of Talk Two : ** Sleep Disturbance in Post-Acute Rehabilitation

** **

Dr. Alessi will describe her work evaluating various subjective and
objective methods for assessing sleep/wake patterns and their
association with immediate functional outcomes in older adults
undergoing post-acute rehabilitation within both VA and non-VA
settings.  The results of a recent large prospective cohort study will
be presented that demonstrates that abnormal sleep patterns are common
in older people undergoing post-acute rehabilitation, some abnormalities
persist well beyond discharge, and impaired sleep may be associated with
poor functional recovery. 

** **

**Speaker\'s Name : **

Cathy Alessi MD, MD

Assoc. Dir Clinical Programs for GRECC

Geriatric Research, Education and Clinical Center

VA Greater Los Angeles Healthcare System

Sepulveda Ambulatory Care and Nursing Home Center

16111 Plummer Street

North Hills, CA 91343

Tel: 818-895-9311

Fax: 818-895-9519

Email: cathy.alessi@med.va.gov

** **

Dr. Alessi has conducted research on sleep in institutional settings for
the past 12 years. Her research findings regarding nonpharmacological
interventions on sleep in frail nursing home residents have made a
significant impact on the field.  She also brings significant clinical
expertise as a practicing geriatrician in a variety of clinical settings
for frail older veterans.

** **

**Title of Talk Three :** Functional Incidental Training: A Randomized,
Controlled, Crossover Trial in Veterans Administration Nursing Homes

Dr. Ouslander will present the rationale for and the potential benefits
of a rehabilitative intervention directed at continence, mobility,
endurance, and strength (Functional Incidental Training ("FIT")) in
frail older nursing home residents. He will describe the results of a
randomized controlled crossover trial conducted in 4 VA nursing homes
that tested the efficacy of the FIT intervention to improve urinary
continence, mobility, endurance, and strength. The talk will conclude
with a discussion of the challenges of implementing FIT in clinical
practice.

**Speaker\'s Name** :

Joseph Ouslander MD, MD

Director, Emory Center for Health in Aging

Geriatric Medicine and Gerontology

Wesley Woods Center of Emory University

1841 Clifton Rd. NE

Atlanta, GA 30329

Tel: 404-321-6111 ext. 6881

Fax: 404-728-6425

Email: jouslan@emory.edu

Dr. Ouslander is an experienced geriatrician who has a long history of
funded research on incontinence in frail elders. He is widely recognized
as an expert in the field and has published extensively.