Using Video Simulated Presence to reduce resistance to care and increase participation of adults with dementia

Background: Cognitive and functional decline in dementia generally impairs performance of basic care activities. Staff assistance during these activities frequently results in confusion, anxiety, and distress, expressed through resistance to care (RTC). Methods: A single-system ABA withdrawal design (n = 1) evaluated the effect of video-simulated presence (VSP) for decreasing RTC and increasing participation. A family member pre-recorded videos for use during episodes of RTC, in which the family member spoke directly to the participant to encourage participation. Results: Introduction of the VSP significantly reduced RTC during the basic care tasks of feeding and talking medication. This effect was reversed when the intervention was withdrawn. Participation increased following VSP, demonstrating clear trends toward clinical significance. Conclusions: This person-centered intervention, based on VSP of a family member, provides encouraging results for reducing RTC and increasing participation of adults with dementia in basic care tasks.

[1]  J M Kendall,et al.  Designing a research project: randomised controlled trials and their principles , 2003, Emergency medicine journal : EMJ.

[2]  J. Cohen-Mansfield,et al.  Characterization of Family-Generated Videotapes for the Management of Verbally Disruptive Behaviors , 2000 .

[3]  P. Reed,et al.  Literature review: Intervention research on caring for people with dementia in assisted living and nursing homes , 2008 .

[4]  S. Harris,et al.  Single-subject research in rehabilitation: a review of studies using AB, withdrawal, multiple baseline, and alternating treatments designs. , 1997, Archives of physical medicine and rehabilitation.

[5]  J S Peak,et al.  Using simulated presence therapy with people with dementia , 2002, Aging & mental health.

[6]  K. Barnes Book Review: Evaluating Clinical Change: Strategies for Occupational and Physical Therapists , 1986 .

[7]  J. Cohen-Mansfield,et al.  Management of verbally disruptive behaviors in nursing home residents. , 1997, The journals of gerontology. Series A, Biological sciences and medical sciences.

[8]  S. Mercer,et al.  Improving dressing behavior in cognitively impaired nursing home residents. , 1997, Nursing research.

[9]  R. Mathews,et al.  Using family-style meals to increase participation and communication in persons with dementia. , 2002, Journal of gerontological nursing.

[10]  S Zhan,et al.  Single subject research designs for disability research , 2001, Disability and rehabilitation.

[11]  J. Cohen-Mansfield,et al.  Nonpharmacologic interventions for inappropriate behaviors in dementia: a review, summary, and critique. , 2004, The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry.

[12]  A. Mackinnon,et al.  THE PSYCHOGERIATRIC ASSESSMENT SCALES (PAS): FURTHER DATA ON PSYCHOMETRIC PROPERTIES AND VALIDITY FROM A LONGITUDINAL STUDY OF THE ELDERLY , 1997, International journal of geriatric psychiatry.

[13]  Gwendolyn de Geest The relation between the perceived role of family and the behavior of the person wiht dementia , 2003 .

[14]  M. Kaas,et al.  Resistance to care. , 1996, Journal of gerontological nursing.

[15]  P. A. Clifford,et al.  Dementia, pain, depression, behavioral disturbances, and ADLs: toward a comprehensive conceptualization of quality of life in long‐term care , 2004, International journal of geriatric psychiatry.

[16]  D. O'Connor,et al.  A comparison of two treatments of agitated behavior in nursing home residents with dementia: simulated family presence and preferred music. , 2007, The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry.

[17]  Anne Birge James,et al.  Activities of daily living and instrumental activities of daily living , 2009 .

[18]  P. Sloane,et al.  Assisting cognitively impaired nursing home residents with bathing: effects of two bathing interventions on caregiving. , 2006, The Gerontologist.

[19]  P. Woods,et al.  Simulated presence therapy: using selected memories to manage problem behaviors in Alzheimer's disease patients. , 1995, Geriatric nursing.

[20]  David Ames,et al.  Psychosocial treatments of behavior symptoms in dementia: a systematic review of reports meeting quality standards , 2009, International Psychogeriatrics.

[21]  W. L. Ooi,et al.  Evaluation of Simulated Presence: A Personalized Approach to Enhance Well‐Being in Persons with Alzheimer's Disease , 1999, Journal of the American Geriatrics Society.

[22]  K. Ottenbacher,et al.  Evidence-Based Practice: Methods to Evaluate Individual Patient Improvement , 2001, American journal of physical medicine & rehabilitation.

[23]  S. Dean,et al.  Aged Care Residential Facility and Family Interface: A Training Program for Staff , 2009 .

[24]  S. Deyoung,et al.  Decreasing aggressive, agitated, or disruptive behavior: perticipation in a behavior management unit. , 2002, Journal of gerontological nursing.

[25]  Richard Cheston,et al.  Simulated presence therapy, attachment and separation amongst people with dementia , 2007 .

[26]  A. Hurley,et al.  Development and testing of the Resistiveness to Care Scale. , 1999, Research in nursing & health.

[27]  D. Barlow,et al.  Single Case Experimental Designs: Strategies for Studying Behavior Change , 1976 .

[28]  S. Zimmerman,et al.  Resident contact with family and friends following nursing home admission. , 2001, The Gerontologist.

[29]  M. Law,et al.  Participation in the occupations of everyday life. , 2002, The American journal of occupational therapy : official publication of the American Occupational Therapy Association.

[30]  J. Cohen-Mansfield,et al.  Conceptualization of Agitation: Results Based on the Cohen-Mansfield Agitation Inventory and the Agitation Behavior Mapping Instrument , 1997, International Psychogeriatrics.

[31]  Christianna S. Williams,et al.  Characteristics associated with lower activity involvement in long-term care residents with dementia. , 2005, The Gerontologist.

[32]  Jessica I Zetteler,et al.  Effectiveness of simulated presence therapy for individuals with dementia: A systematic review and meta-analysis , 2008, Aging & mental health.

[33]  S. Miller,et al.  Audio presence intervention for decreasing agitation in people with dementia. , 2001, Geriatric nursing.

[34]  J R Hodges,et al.  Activities of daily living in frontotemporal dementia and Alzheimer disease , 2007, Neurology.

[35]  S. Brown,et al.  Evaluating interventions for people with severe dementia: Using the Positive Response Schedule , 1999 .

[36]  R. Woods,et al.  Strain in nursing care of people with dementia: Nurses’ experience in Australia, Sweden and United Kingdom , 2008, Aging & mental health.

[37]  N. Tabak,et al.  Interventions used by nursing staff members with psychogeriatric patients resisting care. , 2002, International journal of nursing studies.

[38]  M. Larsson,et al.  'Patient participation' in everyday activities in special care units for persons with dementia in Norwegian nursing homes. , 2010, International journal of older people nursing.

[39]  A. Mackinnon,et al.  The cognitive decline scale of the psychogeriatric assessment scales (PAS): longitudinal data on its validity , 2001, International journal of geriatric psychiatry.

[40]  S. Luther,et al.  Agitation and resistiveness to care are two separate behavioral syndromes of dementia. , 2007, Journal of the American Medical Directors Association.

[41]  Alan E. Kazdin,et al.  Research Design in Clinical Psychology , 2021 .

[42]  J. Cohen-Mansfield,et al.  Bathing: a framework for intervention focusing on psychosocial, architectural and human factors considerations. , 2007, Archives of gerontology and geriatrics.

[43]  D. Christison Assessment strategies. , 2007, Nursing standard (Royal College of Nursing (Great Britain) : 1987).

[44]  T. Perrin The Positive Response Schedule for Severe Dementia , 1997 .

[45]  C. Iglesias,et al.  A system of patient classification in long-term psychiatric inpatients: Resource Utilization Groups T-18 (RUG T-18). , 2005, Journal of Psychiatric and Mental Health Nursing.

[46]  Marcia S. Marx,et al.  Engaging nursing home residents with dementia in activities: The effects of modeling, presentation order, time of day, and setting characteristics , 2010, Aging & mental health.