A person‐centred team approach targeting agitated and aggressive behaviour amongst nursing home residents with dementia using the Senses Framework

Abstract

Purpose The increase in agitated or aggressive behaviour amongst nursing home residents with dementia is a challenging problem. Such behaviour causes stress for both resident and caregiver. Many non‐pharmacological interventions have been studied, but these interventions disregard the resident's unfulfilled needs and are executed by a single, designated caregiver. This study tests a non‐pharmacological intervention, applied by the entire team and based on the resident's underlying needs. Design A pretest and post‐test interventional study design was used, in which 65 residents with dementia who expressed agitated or aggressive behaviour. Data were collected from December 2016 until March 2017. Methods The ABC method and the Senses Framework were used to assign residents to either therapeutic touch, group music sessions or a meaningful individual activity. All staff members applied the interventions. Data were collected by use of the Neuropsychiatric Inventory‐Nursing Home version (NPI‐NH) and the Cohen‐Mansfield Agitation Inventory (CMAI). Results The frequency of aggression, loss of decorum, depression and the severity of aggression decreased for all three interventions. However, the overall severity of fear also increased. The overall prevalence of agitated of residents decreased for the therapeutic touch, group music sessions and individual activities. Conclusions This study shows the possibilities of designing individualised interventions on the Senses Framework and the ABC method for addressing agitated and aggressive behaviour amongst nursing home residents with dementia. The framework presented in this study should be further explored. Implications for practice A team‐based approach is effective to reduce agitated or aggressive behaviour amongst nursing home residents.

Continuing education interventions about person-centered care targeted for nurses in older people long-term care: a systematic review

“…E: n = 11 dyads C: n = 8 dyads A: n = 19 dyads * Video recorded material code by Person-Centered Behavior Inventory and Global Behavior Scale [ 58 ] * Relationship between residents and CNAs measured by Resident Satisfaction Index 27- items and Subscale of the Maslach Burnout Inventory “Personal Accomplishment” 8-items [ 59 ] and Mutuality Scale 15-items [ 60 ] Cornelison et al [ 61 ], 2019, USA A multi-arm, pre-post intervention study JBI = 6 To evaluate how nursing homes, perceive their adoption of person-centered care practices across seven domains and how these perceptions change in response to an eductional intervention embedded in a statewide program, Promoting Excellent Alternatives in Kansas nursing homes Staff teams from nursing homes: E: n = (Pre-adopters) 82 C: n = (Adopters) 86 A: n = 168 * Kansas Culture Change Instrument 68 -items in 7 dimensions Fossey et al [ 62 ], 2006, United Kingdom Cluster randomised controlled tria JBI = 8 To assess effectiveness of a training and support intervention for nursing home staff in reducing the proportion of residents with dementia who are prescribed neuroleptics. Residents in nursing homes E: n = 176 C: n = 170 * Cohen-Mansfield Agitation Inventory [ 40 ] * Dementia Care Mapping (DCM) * Medication charts Gillis et al [ 63 ], 2019, Belgium Pre-posttest design, without control group JBI = 6 To test a person-centred team approach for addressing agitated or aggressive behaviour amongst nursing home residents with dementia. Residents in nursing home n = 65 * Neuropsychiatric Inventory – Nursing Home Version (NPI-NH) 12 symptoms * Cohen-Mansfield Agitation Inventory (CMAI) 29 items Hoeffer et al [ 64 ], 2006, USA Randomized controlled trial with crossover design JBI = 9 To test the efficacy of two person-centered care-based bathing interventions to improve caregiving behavior during bathing.…”

“…Person-centred team-based approach is effective to reduce agitated or aggressive behaviour amongst nursing home residents. OP = + Gillis et al [ 63 ] 2019 - Individual communication plans - Dementia care workshop - Support system, for nurses - 4-h workshop - Support by experts Residents mood and daily functioning were assessed at baseline and 10 weeks after the care providers were instructed in using the communication plans. Care providers’ attitudes, satisfaction, and burden were assessed at baseline and 10 weeks following the workshop.…”

“…Nurses reported increased knowledge about meeting the needs of people with dementia and organizational culture change experiences and next of kin were also satisfied with these changes and quality of care [ 69 ]. Also, positive effects on care providers’ mood, burden [ 67 ] and residents’ behaviour were reported [ 63 ].…”

“…Four studies did not report any positive outcomes from the continuing education interventions [ 50 , 55 , 61 , 68 ]. There were quite several studies that did not follow the reporting guidelines, in which case the primary and secondary measures and outcomes were not clearly mentioned [ 42 , 44 , 46 – 50 , 57 , 61 , 63 , 64 , 67 , 69 , 74 , 75 ].…”

Living With Cognitive Impairment in China: Exploring Dyadic Experiences Through a Person-Centered Care Lens

“…Fostering the experience of these six senses can be conceptualized as foundational to the well-being of PWCI and their care partners (Ryan et al, 2008). Current studies show that Senses Framework provides practical guidance for support relationship-centered care in managing aggressive behaviors among nursing home residents with dementia (Gillis et al, 2019) and in the end of life care for those with advanced dementia (Watson, 2019).…”