Meaningful Engagement and Quality of Life among Assisted Living Residents with Dementia

患有痴呆症的辅助生活居民的有意义的参与和生活质量

• 批准号: 10447092
• 负责人: Candace Lynn Kemp
• 金额: $ 68.65万
• 依托单位: GEORGIA STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-09-30 至 2024-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10447092
• 关键词: Activities of Daily Living; Address; Advocate; Age; Alzheimer' s Disease; Anxiety; Area; Assisted Living Facilities; Behavioral; Caring; Communities; Data; Data Analyses; Data Collection; Dementia; Dementia caregivers; Dimensions; Disease; Education; Environment; Ethnic Origin; Fees; Gender; Goals; Health; Healthcare; Individual; Influentials; Interview; Knowledge; Lead; Learning; Location; Mediation; Mental Depression; Mental Health; Methodology; Methods; Modeling; Nursing Homes; Participant; Perception; Personal Satisfaction; Persons; Physical Function; Physical environment; Policies; Policy Maker; Public Health; Public Health Practice; Quality of Care; Quality of life; Race; Recommendation; Religion; Research; Research Personnel; Resources; Site; Social Environment; Socioeconomic Status; Stimulus; Time; Training; Training and Education; Translating; Visit; Work; cognitive function; community living; community-level factor; cost; dementia care; ethnographic method; expectation; experience; informal care; informal caregiver; innovation; insight; policy implication; prevent; programs; residence; social; theories; Activities of Daily Living; Address; Advocate; Age; Alzheimer' s Disease; Anxiety; Area; Assisted Living Facilities; Behavioral; Caring; Communities; Data; Data Analyses; Data Collection; Dementia; Dementia caregivers; Dimensions; Disease; Education; Environment; Ethnic Origin; Fees; Gender; Goals; Health; Healthcare; Individual; Influentials; Interview; Knowledge; Lead; Learning; Location; Mediation; Mental Depression; Mental Health; Methodology; Methods; Modeling; Nursing Homes; Participant; Perception; Personal Satisfaction; Persons; Physical Function; Physical environment; Policies; Policy Maker; Public Health; Public Health Practice; Quality of Care; Quality of life; Race; Recommendation; Religion; Research; Research Personnel; Resources; Site; Social Environment; Socioeconomic Status; Stimulus; Time; Training; Training and Education; Translating; Visit; Work; cognitive function; community living; community-level factor; cost; dementia care; ethnographic method; expectation; experience; informal care; informal caregiver; innovation; insight; policy implication; prevent; programs; residence; social; theories

PROJECT SUMMARY/ABSTRACT Meaningful engagement is a critical dimension of quality of care and quality of life for persons living with dementia. Defined broadly as participation in individual and group activity, engagement has implications for well-being, mental health, and cognitive and physical function and shows promise as a non-pharmacological strategy for addressing anxiety, depression, and behavioral expressions. For residents in assisted living (AL), which is an increasingly popular care setting for persons with dementia, engagement also can prevent or delay relocation to costly and less-preferred nursing home settings, but represents a significant challenge. Although our work shows that most AL residents are embedded in care convoys (i.e. networks) comprised of formal and informal care partners who support their daily activities, opportunities for meaningful engagement are neither universally nor consistently available, especially for those with dementia. Evidence points to the importance of meaningful engagement for persons living with dementia, but also to potential barriers. Despite the significant public health, practice, and policy implications, unknown is what constitutes meaningful engagement and how to best promote it as across dementia type and level of functional ability. The overall goal of this five-year study is to identify best care practices aimed at recognizing, creating, and maintaining optimal meaningful engagement opportunities for persons with dementia that enhance their quality of life. Our specific aims are: 1) To learn what constitutes meaningful engagement in the lives of AL residents with dementia, including how it is perceived and negotiated by care partners; 2) To understand the intersecting factors that promote and constrain meaningful engagement opportunities and experiences in the lives of persons with dementia in AL; and 3) To determine strategies that promote meaningful engagement opportunities and experiences for persons living with dementia. This study will use ethnographic methods, including participant observation, informal and formal interviewing, and record review in 12 AL settings that vary by key individual-, residence-, and local community-level factors, collecting data in three 1-year periods involving 4 sites each. Seventy-five residents with different types of dementia and of varying levels of functional ability and diverse in gender, age, race and ethnicity, and socioeconomic position, will be purposively selected and studied along with the informal and formal care partners. Grounded Theory Method will guide data collection and analysis, which will provide significant insight into residents’ meaningful engagement opportunities and experiences, including connections to quality of life. The study will support the National Alzheimer’s Plan and its call to optimize care quality and support persons living with dementia and their care partners by advancing knowledge of engagement, including how to assess its quality in the dementia context, and identifying best care practices that lead to optimal meaningful engagement among persons with dementia.

项目摘要/摘要 有意义的参与是与与之相处的人的护理质量和生活质量的关键维度 失智。广泛定义为参与个人和小组活动，参与对 幸福感，心理健康以及认知和身体机能，并显示出非药理学的希望 解决焦虑，抑郁和行为表达的策略。对于辅助生活（AL）的居民， 对于患有痴呆症患者的越来越受欢迎的护理环境，参与也可以预防或延迟 搬迁到昂贵且偏爱的护士家庭环境中，但这是一个重大挑战。虽然 我们的工作表明，大多数AL居民都嵌入了护理车队（即网络）正式和 支持他们日常活动的非正式护理伙伴，有意义的参与机会都不是 普遍也不一致，特别是对于患有痴呆症的人。证据指出的重要性 对患有痴呆症的人的有意义的参与，也对潜在的障碍。尽管很重要 公共卫生，实践和政策影响，未知是构成有意义的参与以及如何 最好地将其作为痴呆症类型和功能水平促进它。这项五年研究的总体目标 是确定旨在认识，创造和维持最佳有意义的最佳护理实践 痴呆症患者的订婚机会，可以增强其生活质量。我们的具体目的是：1） 了解什么构成有意义的痴呆症居民生活的有意义的参与，包括如何 由护理伙伴感知和谈判； 2）了解促进和 限制AL痴呆症患者生活中有意义的参与机会和经验； 3）确定促进有意义的参与机会和经验的策略 患有痴呆症的人。这项研究将使用人种学方法，包括参与观察， 非正式和正式的访谈，并在12个AL设置中记录审查，这些设置因关键个人，居住 - 以及当地社区级别的因素，在三个1年内收集数据，涉及4个站点。七十五 具有不同类型痴呆症和功能能力不同的居民，性别，年龄，潜水员 种族和种族以及社会经济地位通常将被选中，并与 非正式和正式护理伙伴。接地理论方法将指导数据收集和分析，这将 对居民的有意义的参与机会和经验，包括 与生活质量的联系。该研究将支持国家阿尔茨海默氏症的计划及其呼吁优化护理 通过促进知识，质量和支持痴呆症及其护理伴侣的人 参与度，包括如何在痴呆症中评估其质量，并确定最佳护理实践 这导致痴呆症患者之间的最佳有意义的参与。