RESUMEN

Resistance to care is among the most common behaviors exhibited by persons with dementia (PwD). Resistance to care is a barrier to safety and comfort of PwD and caregivers. Nonpharmacological interventions are recommended as first-line management. In the current study, 13 long-term care (LTC) residents aged 74 to 100 years with a history of behavioral and psychological symptoms of dementia (BPSD) were randomized to intervention (n = 7) and control (n = 6) groups. On Days 1 to 3, the intervention group received usual care plus exposure to MindfulGarden (MG), a novel digital calming device during morning and evening care, activities widely recognized as problematic for PwD and staff; the control group received usual care only. On Day 4, both groups were exposed to MG with verbal prompting. Trends in the data suggest that MG reduced BPSD and duration of care in the morning and may be a useful tool in management of resistance to routine care in PwD in LTC settings. [Journal of Gerontological Nursing, 47(11), 15-21.].

Asunto(s)

Demencia , Ansiedad , Cuidadores , Demencia/terapia , Humanos , Cuidados a Largo Plazo , Proyectos Piloto

RESUMEN

BACKGROUND: Behavioral and psychological symptoms of dementia (BPSD) exhibited by persons with dementia (PwD) in nursing home communal areas are generally managed by segregation and/or pharmacological interventions. OBJECTIVE: This study trialed MindfulGarden (MG), a novel digital calming device, in a Canadian nursing home. METHODS: Participants were 15 PwD (mean age = 87.67; 5m,10f; mean MMSE = 11.64±7.85). Each was observed by a research assistant (RA) for an average of 8-10 hours on two separate days. The RA followed them during time spent in communal areas of the nursing home including their unit's dining space, lounges, and corridors and spaces shared with other units (e.g., gym and gift shop) and documented any BPSD exhibited. Day-1 provided baseline data; on Day-2, residents were exposed to MG if nursing staff considered their BPSD were sufficiently intense or sustained to warrant intervention. Staff rated the impact as positive, neutral, or negative. RESULTS: On Day-1, 9 participants exhibited both aggressive and non-aggressive behaviors, 4 non-aggressive behaviors only, and 2 no BPSD. On Day-2, 7 exhibiting aggressive behaviors were exposed to MG. Staff reported MG as having distracting/calming effects and gave positive impact ratings to 6/13 exposures; there were no negative ratings. The most common aggressive BPSD on days of observation were pushing/shoving and screaming. CONCLUSION: MG may have value as a "psychiatric crash cart" in de-escalating agitation and aggression in care home settings.