Testing the Effect of Function-Focused Care in Assisted Living

• Autores: Barbara Resnick, Elizabeth Galik, Ann L. Gruber-Baldini
• Localización: Journal of the American Geriatrics Society, ISSN 0002-8614, Vol. 59, Nº. 12, 2011, págs. 2233-2240
• Idioma: inglés
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• Resumen

  • Objectives: To develop and test the Function-Focused Care in Assisted Living (FFC-AL) intervention so as to alter the decline that older adults in AL experience.

    Design: Cluster-randomized controlled trial using repeated measures to test the effect of FFC-AL.

    Setting: Four AL facilities with at least 100 beds.

    Participants: One hundred seventy-one residents and 96 direct care workers (DCWs) were recruited. Ninety-five of the DCWs were female (99%), and 59 were black (62%), with a mean age of 41.7 ± 13.8. The residents were mostly female (80%), white (93%), and widowed (80%), with a mean age of 87.7 ± 5.7.

    Intervention: FFC-AL included four components implemented by a research-supported function focused-care nurse (FFCN) and a site-identified champion over a 12-month period. Control sites were exposed to FFC education only.

    Measurements: Outcomes for residents included psychosocial domains (mood, resilience, self-efficacy, and outcome expectations for function and physical activity), function, gait and balance, and actigraphy. Outcomes for DCWs included knowledge, performance, and beliefs associated with FFC.

    Results: DCWs in treatment sites provided more FFC by 12 months than those in control sites. Residents in treatment sites demonstrated less decline in function, a greater percentage returned to ambulatory status, and there were positive trends demonstrating more time in moderate-level physical activity at 4 months and more overall counts of activity at 12 months than for residents in control sites.

    Conclusion: Using a function-focused approach in AL may help prevent some of the functional decline commonly noted in these settings.