Function Focused Care for Assisted Living Residents With Dementia

Area of Science:

• Gerontology
• Dementia Care
• Clinical Interventions

Background:

• Assisted living (AL) residents with dementia often require significant assistance, have limited physical activity, and display challenging behaviors.
• The Function Focused Care Intervention for the Cognitively Impaired (FFC-CI) aims to improve function and activity while reducing behavioral symptoms in this population.

Purpose of the Study:

• To evaluate the impact of the FFC-CI on function, physical activity, behavior, and falls in AL residents with dementia.

Main Methods:

• A cluster-randomized trial involving 96 residents with dementia and 76 direct care workers (DCWs) across 4 AL facilities.
• Outcomes were assessed at 3 and 6 months using generalized estimating equations.

Main Results:

• No significant differences were observed in resident behavior, mood, actigraphy-measured physical activity, falls, or function between groups.
• The control group showed significant increases in physical activity (kcal burned, survey time) and repetitive behaviors (wandering).
• Direct care worker knowledge and performance of FFC did not differ, though the intervention group experienced less decline in job satisfaction. Treatment fidelity was poor due to high staff attrition and limited site support.

Conclusions:

• The FFC-CI, as implemented, did not yield significant improvements in resident outcomes.
• Findings suggest a need to adapt future FFC intervention studies to enhance treatment fidelity and optimize efficacy, particularly addressing staff attrition and site support.