‘Knowing what makes them tick’: Motivating cognitively impaired older adults to participate in restorative care
ABSTRACT Nursing home residents with dementia represent a majority of the most functionally impaired individuals residing in nursing homes. Although many perceive this population as having little restorative potential, maintaining resident functional abilities for as long as possible helps to optimize quality of life and decrease caregiver burden. This study used a qualitative design with a focus group methodology to explore facilitators and barriers to engaging cognitively impaired residents in functional activities and exercise. A purposive sample of seven geriatric nursing assistants who were experts in dementia care participated in the study. Twenty-seven codes were reduced to three themes: (i) knowing what makes them tick and move; (ii) teamwork and utilizing resources; and (iii) barriers to restorative care. The study findings were used to revise the Restorative Care for the Cognitively Impaired Intervention and could direct future implementation of programmes in nursing home settings.
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ABSTRACT: Background and Purpose: This study examines the underlying factor structure of the Self-Efficacy for Functional Abilities (SEFA) scale among older adults in long-term care settings. Methods: A secondary analysis of SEFA data for 568 residents in 16 long-term care facilities was applied. The sample was randomly split into 2 subsamples. A 2-level exploratory and confirmatory factor analysis adjusting for clustering effect of facilities was used to identify and determine the factor structures respectively. Results: There were 1- and 2-factor models that were identified. Both models demonstrated acceptably mixed model fit. The 2-factor model had poor discriminant validity with high correlation between factors (r 5 .92, p < .001). The single-factor model was considered valid with moderate correlation with function (r 5 .301, p< .001). Conclusions: The SEFA scale demonstrated a unidimensional construct among older adults in long-term care settings. Future testing is needed among other older adult populations.Journal of Nursing Measurement 04/2015; 23(1):112-126. DOI:10.1891/1061-37188.8.131.52
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ABSTRACT: The objective of this study was to test the feasibility and impact of a 2-tiered motivational intervention, the Restorative Care Intervention for the Cognitively Impaired (Res-Care-CI), on nursing home residents with moderate to severe cognitive impairment. Single-group repeated measures study. Participants were 46 nursing home residents with moderate to severe cognitive impairment at a single nursing home designed for individuals with dementia. Descriptive data, the Barthel Index, the Physical Activity Survey in Long-Term Care, actigraphy, the Cornell Scale for Depression in Dementia, and the Cohen-Mansfield Agitation Inventory (short form). There was significant improvement in resident mood (F = 3.26, P = .02) and behavioral symptoms (F = 3.21, P = .04), but no significant change in physical function (F = 0.897, P = .43) or overall reported physical activity (F = 0.931, P = .43). There was a significant decrease in physical activity measured by actigraphy in 35 participants (F = 4.93, P = .005). Restorative care interventions were feasible to implement, and demonstrated improvements in mood and behavior, when used with nursing home residents with moderate to severe cognitive impairment.Journal of the American Medical Directors Association 10/2008; 9(7):516-22. DOI:10.1016/j.jamda.2008.04.013 · 4.78 Impact Factor