Enhancing Quality of Life for Nursing Home Residents

Study Overview
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Brief Summary
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Many persons with dementia exhibit behaviors that caregivers find difficult to manage. The purpose of this study is to test the effectiveness of individualized recreational activities for reducing agitation and passivity in persons with dementia.

Detailed Description
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Most persons with dementia exhibit behavioral symptoms, such as agitation and passivity, at some time in the course of their illness. These behaviors are a source of caregiver burden and often precipitate nursing home placement. There are a number of drugs that can be used to treat these behaviors, but they are costly and have serious adverse effects in a sizable number of people. Non-drug interventions, such as recreational activities, are recommended as the first line of treatment for behavioral symptoms. However, we don't know which activities are most effective for individual residents. The one size fits all approach has not been very effective. We are testing an approach that individualizes activities for residents based on their personality style of interest and functional level. We anticipate that this approach will be more effective for reducing behavioral symptoms than routine activities given to all residents. Consenting residents are assessed for personality and functional level and are videotaped during a baseline period and during activities so we can reliably measure behaviors, affect and engagement.

Official Title
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A Prescription for Enhancing Resident Quality of Life

Conditions
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Alzheimer's Disease

Intervention / Treatment
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* Behavioral: Activity matched to interest
* Behavioral: Activity matched to function
* Behavioral: Activity matched to both interest and function


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: English speaking; diagnosis of dementia; a willing informant who knows the subject well and who can provide past personality and other data; a stable dose of any psychoactive drug from pre-baseline through final observation; and presence of agitation or passivity. Exclusion Criteria: delirium or an unstable medical condition; history of Parkinson's disease, Huntington's disease, seizure disorder, stroke, alcoholism, drug abuse, head trauma with loss of consciousness, or psychiatric illness preceding the onset of memory loss; severe vision or hearing impairment; and receiving a new psychoactive medication within the past 30 days.

Ages Eligible for Study
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Minimum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Diagnostic
Allocation: Randomized
Intervention Model: Single Group Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: 1<br> | Behavioral: Activity matched to interest<br>* Recreational activities are tailored to subject's style of interest<br>|
| Experimental: 2<br> | Behavioral: Activity matched to function<br>* Recreational activities are tailored to subjects physical and cognitive functioning<br>|
| Experimental: 3<br> | Behavioral: Activity matched to both interest and function<br>* Recreational activities are tailored to both style of interest and physical and cognitive functioning.<br>|
| No Intervention: 4<br>Recreational activities are not tailored to either style of interest or function | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Agitation |  | During activity intervention, random times outside of activity intervention (during the intervention period), and one week post intervention period | 
| Passivity |  | During activity intervention, random times outside of activity intervention (during the intervention period), and one week post intervention period | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Mood |  | During activity intervention, random times outside of activity intervention (during the intervention period), and one week post intervention period | 
| Affect |  | During activity intervention, random times outside of activity intervention (during the intervention period), and one week post intervention period | 
| Engagement |  | During activity intervention, random times outside of activity intervention (during the intervention period), and one week post intervention period |