Costs of a Staff Communication Intervention to Reduce Dementia Behaviors in Nursing Home Care

Area of Science:

• Gerontology
• Health Services Research
• Behavioral Science

Background:

• Behavioral symptoms in dementia often lead to nursing home placement.
• Managing these symptoms increases staff burden and costs by an estimated 30%.
• The CHAT study demonstrated that improved staff communication, specifically reducing "elderspeak," decreased "resistiveness to care" (RTC) behaviors.

Purpose of the Study:

• To evaluate the cost-effectiveness of the CHAT intervention.
• To assess the intervention's impact on reducing "elderspeak" communication and resident RTC behaviors.

Main Methods:

• Process-based costing was used in eleven nursing homes from 2011-2013.
• Staff wages were analyzed pre- and post-intervention.
• An incremental cost-effectiveness analysis determined costs per unit reduction in elderspeak and RTC.

Main Results:

• A 1% reduction in elderspeak costs $6.75 per staff member.
• A 1% reduction in RTC costs $4.31 per resident, assuming staff care for two residents with RTC.
• Costs are influenced by baseline levels of elderspeak/RTC and participant numbers.

Conclusions:

• The cost-effectiveness of reducing elderspeak and RTC varies with baseline behaviors and intervention scale.
• The 3-session CHAT training program is a cost-effective strategy.
• CHAT improves dementia care by reducing resident "resistiveness to care" behaviors.