Effects of an Intervention Approach Based on the Meanings of Vocal Behaviours in Older People Living with a Major Neurocognitive Disorder: A Pilot Study

Abstract

Effets d'une démarche d'interventions basée sur les sens des comportements vocauxEffets d'une démarche d'interventions basée sur les sens des comportements vocaux de personnes âgées vivant avec un trouble neurocognitif majeur : une étude pilote de personnes âgées vivant avec un trouble neurocognitif majeur : une étude pilote Abstract Introduction: Vocal behaviours (VB) are frequent in long-term care facilities (LTCF) and have many negative consequences. Interventions to decrease VB have limited clinical impact. Objective: This pilot study aimed to provide preliminary evidence on the effects of an intervention approach based on the meanings of VB in older people living with a neurocognitive disorder in LTCF. Methods: A mixed methods action research study was used. Fourteen triads (n=43) made up of an older person who manifested VB, a family member, and formal caregivers were included. An approach based on the meanings of VB was implemented in five LTCF. Semistructured interviews took place with some participants. Tools were used at four-time points to measure five variables: the frequency of VB, the well-being of older people, the perceived disruptiveness of VB, the partnership-based decision-making and the empowerment felt by family and formal caregivers. Results: The approach improved the perception of family and formal caregivers toward older people. This led to habit changes that influenced positively the frequency of VB and the well-being of older people. Formal and family caregivers also perceived VB as less disturbing and felt more empowered relatively to VB. The attitude of formal caregivers toward families evolved positively. No other changes were noted on partnership-based decisionmaking. Discussion and conclusion: This study indicates the potential of this approach to improve the well-being of older people who manifested VB, their families, and formal caregivers. This approach could be implemented in LTCF, tested and adapted for other behaviours.

An Action Research to Optimize the Well-Being of Older People in Nursing Homes: Challenges and Strategies for Implementing a Complex Intervention

“…Some of the strategies we had anticipated were effective, and other new ones were developed with participant feedback. Although it was impossible to eliminate all constraints, adjustments to the strategies made it possible to implement the approach and obtain positive results for the well-being of older people, their families, and formal caregivers (Bourbonnais et al, 2019; Bourbonnais et al, 2017).…”

“…The pilot study presented here aimed to assess strategies useful in implementing a complex intervention based on the meanings of screams of older people living in NHs with ADRD. The preliminary effects of this approach are presented elsewhere (Bourbonnais et al, in press; Bourbonnais et al, 2017).…”

Conditions and ethical challenges that could influence the implementation of technologies in nursing homes: A qualitative study

“…Our proposed app could include an intervention approach based on the meanings of responsive behaviours developed by one of the authors (AB). This approach guides the care process by identifying individualised interventions based on partnership decision‐making between family and formal caregivers (Bourbonnais, Lalonde, & Lavallée, ). It could also be adapted for fall prevention and management.…”