The Efficacy of Using Volunteers to Implement a Cognitive Stimulation Program in Two Long-Term Care Homes

Study Overview
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Brief Summary
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Many volunteers visiting seniors make socially-based friendly visits. This study investigated the efficacy of volunteers making visits focused on stimulating cognition. Participants were randomly assigned to either a friendly visit control group or a cognitive stimulation group. Seniors receiving stimulation visits made statistically significant improvement in memory abilities.

Detailed Description
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Older adults who maintain their cognitive skills and abilities are able to live more independently than those whose skills have deteriorated. The costs (money, time, personnel) associated with providing cognitive stimulation programs to residents in long-term care homes often prohibit the delivery of these programs. The present study explored the efficacy of using volunteers to administer a stimulation program in two long-term care homes. The program focused on stimulating reasoning, attention, and memory abilities using uncomplicated, pen-and-paper exercises. Thirty-six resident participants and 16 volunteer participants were randomly assigned to one of two parallel groups, either the control or stimulation group. For eight weeks, three times each week, control group participants met for standard friendly visits (casual conversation between a resident and volunteer) and stimulation group participants met to work through a variety of exercises meant to stimulate the cognitive abilities of residents. Results were analyzed using a 2-way ANOVA and indicated statistically significant Group x Time interactions for Verbal Memory (F(1, 33) = 7.92, p = .008), Non-Verbal Memory (F(1, 33) = 6.8, p = .014), Learning (F(1, 33) = 5.27, p = .028), and Verbal Fluency (F (1, 33) = 5.56, p = .024). Volunteers completed a post-study questionnaire which indicated that the volunteers in the stimulation group found their skills-based interactions more stimulating for residents. Given this showing of improved resident abilities, it is reasonable to assert that the study does demonstrate that a volunteer-administered, cognitive stimulation program can provide measurable gains in the cognitive abilities of older adults. Further studies concerning the role of volunteers in the maintenance of the cognitive abilities of older adults are recommended.

Official Title
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The Efficacy of Using Volunteers to Implement a Cognitive Stimulation Program in Two Long-Term Care Homes

Conditions
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Impaired Cognition, Geriatric Disorder, Learning Disorders, Age-Related Memory Disorders, Impairment of Attention

Intervention / Treatment
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* Other: Cognitive stimulation program
* Other: Standard Friendly Visit


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: 65 years and over living in a long-term care home normal or corrected visual and auditory acuity English proficiency not currently using de-stabilizing, psychotropic medication known to impair cognition ability and willingness to actively listen to and accurately follow 2-step instructions for at least 20 consecutive minutes

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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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Supportive Care
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Stimulation Group<br>Cognitive Stimulation Group: One-on-one (one volunteer visiting one resident at a time), stimulation-group residents and stimulation-group volunteers met 3 times each week, for 8 weeks, to work through a variety of memory, reasoning, and selective attention exercises. Each visit was 20 minutes in length. | Other: Cognitive stimulation program<br>* The stimulation program was composed of therapy- and education-based exercises which were specifically designed to stimulate reasoning, memory, and attention skills in adults.<br>|
| Active Comparator: Control Group<br>Standard Friendly Visit: Control-group residents and control-group volunteers, one-on-one, met for 8 weeks, 3 times each week, for friendly visits. Each visit was 20 minutes in length. | Other: Standard Friendly Visit<br>* Volunteers provided standard friendly visits to residents which included a friendly greeting and casual conversation about issues which interest the resident.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Test of Memory and Learning - Senior Edition (TOMAL-SE) | The TOMAL-SE was designed specifically for seniors and provides a thorough assessment, without being fatiguing (Reynolds & Vorees, 2012). The battery includes normative data for ages 55:0-89:11. It is a paper-based test and takes approximately 25-35 minutes to administer. It provides scores for the following indexes: Verbal Memory, Non-Verbal Memory, Delayed Memory, and Learning. | 10 weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II; Wechsler, 2011) | The WASI-II is designed to measure intelligence. The latest version, published in 2011, includes normative data for ages 6:0-90:11 years. The paper-based, two-subtest form includes the Vocabulary and Matrix Reasoning tests and provides an estimate of general cognitive ability. | 10 weeks |