Citation

Karel MJ, Teri L, McConnell E, Visnic S, Karlin BE. Gerontologist 2015; 56(1): 126-134.

Affiliation

Education Development Center, Inc., New York, New York. School of Nursing, Bouvé College of Health Sciences, Northeastern University, Boston, Massachusetts.

Copyright

(Copyright © 2015, Oxford University Press)

DOI

10.1093/geront/gnv068

PMID

26185155

Abstract

PURPOSE OF THE STUDY: Nonpharmacological, psychosocial approaches are first-line treatments for managing behavioral symptoms in dementia, but they can be challenging to implement in long-term care settings. The Veterans Health Administration implemented Staff Training in Assisted Living Residences (STAR)-VA, an interdisciplinary behavioral approach for managing challenging dementia-related behaviors in its Community Living Center (CLCs, nursing home care) settings. This study describes how the program was implemented and provides an evaluation of Veteran clinical outcomes and staff feedback on the intervention. DESIGN AND METHODS: One mental health professional and registered nurse team from 17 CLCs completed STAR-VA training, which entailed an experiential workshop followed by 6 months of expert consultation as they worked with their teams to implement STAR-VA with Veterans identified to have challenging dementia-related behaviors. The frequency and severity of target behaviors and symptoms of depression, anxiety, and agitation were evaluated at baseline and at intervention completion. Staff provided feedback regarding STAR-VA feasibility and impact.

RESULTS: Seventy-one Veterans completed the intervention. Behaviors clustered into 6 types: care refusal or resistance, agitation, aggression, vocalization, wandering, and other. Frequency and severity of target behaviors and symptoms of depression, anxiety, and agitation all significantly decreased, with overall effect sizes of 1 or greater. Staff rated both benefits for Veterans and program feasibility favorably. IMPLICATIONS: This evaluation supports the feasibility and effectiveness of STAR-VA, an interdisciplinary, behavioral intervention for managing challenging behaviors among residents with dementia in CLCs.

Language: en