Community-engaged intervention mapping for developing the DIGNITY program: Supporting decision-making in aging and...

Area of Science:

• Gerontology
• Dementia Care Research
• Healthcare Intervention Development

Background:

• Person-centered care enhances well-being for nursing home (NH) residents with Alzheimer's disease and related dementias (ADRD).
• Resident autonomy, such as independent outdoor access, is often limited by safety concerns in NH settings.
• A need exists for strategies to help NH staff balance resident safety with autonomy.

Purpose of the Study:

• To develop the Decision-making In aGing and demeNtIa for autonomy (DIGNITY) intervention.
• To support shared decision-making and promote preference-congruent dementia care in NHs.
• To codesign a multilevel, theory-informed program with NH stakeholders.

Main Methods:

• Utilized the Community-Engaged Intervention Mapping (CEIM) Model for intervention development.
• Engaged 53 NH stakeholders through focus groups and engagement sessions.
• Incorporated stakeholder feedback for six key refinements to the DIGNITY program.

Main Results:

• The DIGNITY intervention was refined based on stakeholder input regarding manual formatting, communication, staff roles, decision-making capacity, and implementation factors.
• The final intervention comprises a structured manual, decision-making tools, and a training/coaching program.
• The program aims to assist NH staff in respecting resident preferences while managing perceived risks.

Conclusions:

• DIGNITY is a novel intervention developed with stakeholders to support preference-based dementia care in rural NHs.
• Future research is needed to evaluate the feasibility and acceptability of the DIGNITY intervention.
• Further studies should assess the intervention's impact on staff attitudes and resident outcomes.