Kimberly Van Haitsma

• PhD in Clinical Psychology
• Professor (Full) at Pennsylvania State University

Background and Objectives The purpose of this paper is to describe the pre-implementation process utilized to identify potential substantive barriers and facilitators to implementing the Individualized Positive Psychosocial Interaction (IPPI) across 9 nursing home communities prior to recruitment for an embedded pragmatic clinical trial. Research...

Background and Objectives Little work has explored how pragmatic data (i.e., usual care delivery data) can be used as an indicator of preference-based care delivery in nursing homes (NH) and how we can link these data to health of NH residents. The Preference Match Tracker (PMT) uses electronic medical records data to track the number of recreation...

Objectives: Little is known about how preference-based care impacts nursing home (NH) residents' well-being over time. The Preference Match Tracker (PMT) objectively tracks the number of recreation activities NH residents attend that match their important preferences. We explored how PMT data were linked to residents' depressive symptoms over time...

INTRODUCTION Differences in adaptive strategies used by individuals and families living with dementia have the potential to impact day‐to‐day well‐being. The Living Well Inventory for Dementia (LWI‐D) is a new measure to capture these strategies and to illuminate new options to support families living with dementia. The Quality of Day Scale (QODS)...

Nursing Home (NH) leaders are challenged to deliver quality person-centered care (PCC), despite the COVID-19 transition to an endemic phase. This study aimed to describe NH leadership perspectives on preparing and maintaining quality care during the transition point between the COVID-19 pandemic and endemic to identify how best to support NHs in ba...

Understanding modification motive can help improve intervention protocols and future implementation efforts. The core components of the IPPI that should not be modified include that staff approach one-to-one resident interactions with a positive intent, use good communication skills, and base interactions on a preferred activity of the resident liv...

The Individualized Positive Psychosocial Interaction (IPPI) is an evidence-based program that supports engaging people living with dementia and their care partners in the nursing home (NH). IPPIs are brief, one-to-one, preference-based activities to improve well-being and decrease behavioral and psychological symptoms of dementia. The purpose of th...

Purpose The current study explored the association of nursing home (NH) residents' demographic and clinical attributes and NH characteristics with resident-reported satisfaction with NH communities. Method Pearson correlations and multiple linear regression were used to test the association of demographic and clinical attributes of residents and N...

Objectives: The study evaluated the feasibility of implementing Dementia Collaborative Coaching (DCC) into the routine workflow of speech-language pathologists (SLPs) working in nursing homes (NHs). DCC is an intervention delivered by SLPs to train nursing assistants (CNAs) in communication strategies to support people living with dementia (PLWD)....

Objectives: This study assessed the readiness of The Individualized Positive Psychosocial Interaction (IPPI) program in the nursing home (NH) setting from the perspective of NH providers implementing the IPPI. The evidence-based IPPI program is designed to help remediate distress and improve mood for residents living with dementia. NH staff are tr...

Background and Objectives The Individualized Positive Psychosocial Interaction (IPPI) Program is an adaptable, evidence-based intervention. IPPI trains nursing home care partners to engage residents living with moderate to severe dementia in preference-based, one-to-one interactions using emotion-focused communication. We sought to understand provi...

Purpose To understand direct care workers' perceptions of the impact of implementing a person-centered communication tool, Preference for Activity and Leisure (PAL) Cards, into care. Method PAL Cards provide at-a-glance information about a nursing home (NH) resident's background and important preferences for activities and leisure. As a quality im...

Background Persons living with Alzheimer’s disease and related dementia (ADRD) in nursing homes (NH) are often excluded from conversations about their health/safety. These omissions impinge on personhood and the rights to have care preferences heard and honored. While persons with ADRD maintain the ability to communicate their preferences long afte...

There are 200+ tested interventions for care partners (family, friends, and fictive kin) of people living with dementia (PLWD). But these interventions do not systematically cover relevant settings. Nor do these interventions affect all relevant outcomes that matter to people and healthcare systems. We present an evidence map of settings and outcom...

The National Institute on Aging Alzheimer's Disease/Alzheimer's Disease and Related Dementias Research Implementation Milestones emphasize the need for implementation research that maximizes up-take and scale-up of evidence-based dementia care practices across settings, diverse populations, and disease trajectories. Organizational readiness for imp...

Objectives: The current study aimed to develop and preliminarily validate an initial version of an instrument to assess the leisure activity preferences of people receiving adult day services (ADS). Methods: Based on previously conducted concept mapping steps, we identified 12 clusters of preferences for leisure activities. We adopted the structure...

Introduction: Sexual wellness plays a crucial role in an individual's quality of life, interpersonal relationships, and self-concept, particularly among older adults residing in residential aged care facilities, including those with dementia. However, there is currently a limited person-centered approach to understanding the unique preferences of e...

Objectives: The Individualized Positive Psychosocial Interaction (IPPI) is a non-pharmacological, person-centered, intervention for nursing home (NH) residents living with moderate to severe dementia. The purpose of this study was to assess the pragmatic implementation of the IPPI by leveraging Ohio's Nursing Home Quality Improvement Program (QIP)...

Ageing and dementia affect many aspects of life, including intimate relationships, sex and sexual expression. Older people, including those living with dementia, can have sexual relationships and form new ones. Their sexual and physical health, quality of life, and psychological well-being can be improved by respecting their intimacy and sexuality...

Despite the importance of person-centered measurement -- and that numerous research instruments are now available to measure person-centeredness -- there are no tools to evaluate the extent to which existing research instruments themselves are developed consistent with principles of person-centeredness. The PC-MET (Person-Centered Measure Evaluatio...

Background Differences in adaptive strategies used by individuals living with dementia have the potential to impact wellbeing. Two new measures were developed using human-centered design to capture daily adaptive strategies and outcomes. The Living Well Inventory for Dementia (LWI-D) and the Quality of Day Scale (QODS) capture important aspects of...

Nursing home (NH) residents living with dementia (residents) commonly experience behavioral symptoms during mealtime that negatively impact nutrition and function. Residents may not receive optimal, person-centered mealtime care (PCMC) due to multilevel factors. PCMC training that teaches staff to actively engage residents in eating is a prioritize...

Person-Centered Care (PCC) involves individuals in their care planning and decision-making. Measuring PCC is crucial in identifying the adequacy of PCC dimensions, which can then be used to promote quality of care and life, yet a comprehensive review of evidence on PCC measurement tools in long-term service and support settings (LTSS) is lacking. O...

Currently it is unknown what people receiving adult day services (ADS) understand as leisure and the activities they prefer remain unknown. To address these gaps, we investigated the understanding of leisure of people receiving ADS. We conducted semistructured interviews with 15 people receiving ADS in Germany. Interviews were analyzed using reflex...

Background and Objectives: Providing preferred leisure activities appears to be an important approach to support and empower people receiving adult day services (ADS) allowing them to age in place. To provide the conceptualization for a preference instrument, we actively involved people receiving ADS in exploring the content and structure of their...

Background: Adult day services (ADS) are a preferred care environment for people with dementia living at home. Providing preferred leisure activities in ADS centers appears to be an important approach to support and empower people receiving ADS to age healthy and in place. Currently, no specific instrument exists to assess their preferences for lei...

Background: The Preferences for Everyday Living Inventory (PELI) is a person-centered care (PCC) tool that uncovers/honors older adults' important preferences. PCC implementation in nursing homes (NHs) often requires additional resources, such as staff time. We explored if PELI implementation is associated with NH staffing levels. Methods: Using NH...

There is an emerging call for new strengths-based measures to guide research, care, and support for persons living with Alzheimer's disease and related dementias. Person-centered interventions have demonstrated a positive impact in global quality of life, but many promising approaches lack strengths-based measures with sufficient sensitivity to doc...

Seven self-care behaviors—healthy coping, healthy eating, being active, taking medication, monitoring, reducing risk, and problem-solving—are recommended for individuals with diabetes to achieve optimal health and quality of life. People newly diagnosed with type 2 diabetes may find it challenging to learn and properly incorporate all of these self...

Background and Objectives Person-centered care practices are essential to providing high-quality care for nursing home (NH) residents. A key component of implementing person-centered care is the assessment and fulfillment of residents’ preferences. However, few NHs consistently assess and implement residents’ preferences into care. From 2015 to 201...

Introduction Community-based care such as adult day services (ADS) are preferred by people with dementia. ADS offers the opportunity to support the health and social needs of their clients and provide respite to family members, contributing to a stable care situation at home. The psychological needs of humans according to the self-determination-the...

Persons living with dementia (PLWD) in nursing homes (NH) are often left out of care conversations about their health and safety. These omissions impinge on their personhood and rights to have care preferences heard and honored. PLWD maintain the ability to communicate values and preferences long after their decision-making abilities are affected b...

Implementation efforts of evidence-based practices focusing on the nursing home setting remain understudied. The purpose of this study was to explore the role of the Consolidated Framework for Implementation Research (CFIR) inner setting domain on the implementation of PAL Cards. Monthly qualitative interviews (n=50) with project champions (n=16) w...

Background The CFIR Process domain can be used to evaluate practices that are associated with successful or unsuccessful implementation. The purpose of this study was to understand the processes that led to successful implementation of the PAL Card QIP during the height of the pandemic from the provider champion’s perspective. Methods Qualitative...

Background New measures are needed that can provide a holistic approach to capturing salient outcomes contributing to quality of life in dementia. Purpose: To use human centered design to develop, prototype and evaluate new positive psychosocial measures for persons living with dementia Methods This project used a conceptual framework of human cen...

Understanding the barriers and facilitators of an intervention can inform implementation efforts. The purpose of this study was to understand the characteristics associated with the PAL Card intervention that led to successful implementation in nursing home (NH) settings. Qualitative telephone interviews were conducted with n=11 NH champions who co...

The way we respond emotionally to others can impact how we provide care. Emotional intelligence is vital for care team members whose entire day involves interacting with other people. We have developed an interactive, online, self-paced course for people providing care to others with the specific goal of increasing awareness of emotions and helping...

Technological advances, such as telehealth, have been used to manage the multiple chronic conditions that impact over 25% of the US adult population. Technology-assisted communication (TAC) can help to bridge the gap in effective management of health conditions in the community by patients, informal caregivers, and healthcare providers, while empha...

Preferences for Activity and Leisure (PAL) Cards are a communication tool designed to alert nursing home staff to important resident preferences. This study explored the role of nursing home provider champions implementing (PAL) Cards in their community. Champions (n=35) created PAL Cards for 15-20 residents. A total of 88 monthly interviews were a...

The Ohio Department of Medicaid added the PELI as one of five quality incentive points used to determine Medicaid per diem reimbursement rates with the goal of improving person-centered care among Ohio’s nursing homes (NHs). The purpose of this study was to explore if the degree of PELI implementation had an impact on quality as defined by deficien...

The COVID-19 pandemic introduced many societal changes, including the need to use technology to communicate with healthcare providers. For many this was a new form of communication. This study examines (1) who older adults identified as healthcare providers and (2) reflected on how communications with formal healthcare providers changed during the...

Organizational readiness for implementation refers to the collective willingness and efficacy of people, processes, and internal and external contexts within study sites to implement an intervention; it is a salient consideration when planning and conducting embedded pragmatic trials. This paper examines the conceptual and theoretical underpinnings...

Champions are crucial to successful intervention implementation; however, as an area of research champions have only recently begun to gain empirical focus. The purpose of this study was to identify the barriers and facilitators regarding champion qualities using the domain “Characteristics of the Individual” from CFIR. Qualitative interviews were...

This was the third time replicating the Preferences for Activity and Leisure (PAL) Card quality improvement project, but the first conducted entirely during the height of the pandemic. Nursing home providers attempted n=174 PAL Cards and completed n=166 (96%). Feedback from surveys with n=68 staff who came in daily contact with residents (e.g., 26%...

Emotion-focused communication can improve the delivery of care for long-term care recipients, especially individuals' living with dementia. The purpose of this manuscript is to describe the process of translating the Emotion-Focused Communication Training (EFCT) for long-term care staff from an in-person workshop to an online program and evaluate i...

The diagnosis of type 2 diabetes initiates a new health-illness transition. However, little is known about the immediate support that people need to successfully cope with this diagnosis. This qualitative study explored the experiences and immediate support needed at the point of diagnosis among individuals with type 2 diabetes. The findings sugges...

Introduction: Community-based care such as adult day services (ADS) are preferred by people with dementia. ADS offers the opportunity to support the health and social needs of their clients and provide respite to family members, contributing to a stable care situation at home. The psychological needs of humans according to the self-determination-th...

Objectives The purpose of this study is to expand on previous work testing the relationship between person-centered care (PCC) and quality outcomes in the nursing home (NH) setting. We explore if the Preferences for Everyday Living Inventory (PELI) implementation is a predictor of NH quality, as defined by deficiencies. Design Secondary data analy...

The Checklist for Evidence of Person-Centered Care Approaches for Behavioral and Psychological Symptoms of Distress (BPSD) in Care Plans was developed to assess the person-centeredness of care plans for nursing home residents living with behavioral and psychological symptoms associated with dementia. The purpose of the current study was to evaluate...

Nursing homes (NHs) are challenged to consistently deliver person-centered care (PCC), or care based on residents' values and preferences. NH staff associate certain resident preferences with risk. However, there are limited evidence-based person-centered risk management strategies to assist NH staff with risky resident preferences. The purpose of...

Importance Assisted living (AL) is the largest provider of residential long-term care in the US, and the morbidity of AL residents has been rising. However, AL is not a health care setting, and concern has been growing about residents’ medical and mental health needs. No guidance exists to inform this care. Objective To identify consensus recommen...

Background Nursing homes (NHs) are required to provide person-centered care, efforts often folded into broader culture change initiatives. Despite the known benefits of culture change, it is difficult to measure. This study aims to assess the criterion validity of the Preferences for Everyday Living Inventory (PELI) Implementation Indicator with ot...

Background: Nursing education influences medication administration practices, which involve clinical decision making and risk perceptions. Method: This mixed-methods concurrent nested study explored the relationship among knowledge, personality traits, and self-efficacy related to medication administration error in fourth-year, prelicen-sure nur...

Nursing home (NH) providers would benefit from adopting evidence-based measures for gathering and utilizing resident preference information in their daily care activities. However, providers face barriers when implementing assessment tools used to promote person-centered care (PCC). Although Agile methodology is not commonly used in NH settings, th...

Long-term stability of nursing home (NH) residents’ everyday preference remains unknown. We examined 1-year stability in reports of importance of 34-recreational activity preferences (8-MDS 3.0 Section F items; 26- Preferences for Everyday Living Inventory-NH items) by NH residents ( N = 161). We examined mean differences on demographic and clinica...

The Centers for Medicare and Medicaid Services mandate the provision of person-centered care (PCC), but there is limited evidence on how PCC impacts nursing home (NH) residents' care experiences. This study examined the relationship between n = 163 NH residents' ratings of satisfaction with care related to their preferences and their satisfaction w...

In residential care communities (CCs), implementation strategies can improve the use of person-centered approaches for residents' behavioral symptoms of distress. We examined staff perceptions of how well their organizational goals for achieving person-centered care (PCC) were met following implementation of the strategy, Evidence Integration Trian...

Purpose Preference assessment is integral to person-centered treatment planning for older adults with communication impairments. There is a need to validate photographs used in preference assessment for this population. Therefore, this study aimed to establish preliminary face validity of photographs selected to enhance comprehension of questions f...

Background and Objectives Behavioral and psychological symptoms of dementia (BPSD) commonly occur in persons living with dementia Bright light (BL) interventions have shown some positive impact on BPSD. Ambient lighting is a more efficient approach to delivering BL with better compliance and less staff workload than individual-based lighting interv...

Considering the preferences for everyday living of older people with various care needs across different care settings is important in nursing care. Currently, there is no systematic overview of the various instruments, and it is unclear what instruments exist, and which preferences they measure. We systematically searched for studies in the electr...

At the time of this writing, at least 186,000 nursing home (NH) residents and staff have succumbed to coronavirus disease 2019 (COVID-19; AARP, 2021), and countless others have suffered the mental anguish of limited visits from family and isolation. The massive gap between well-resourced NHs and NHs in poor communities, often made up of residents a...

Objectives The Preferences for Everyday Living Inventory (PELI-NH) assesses psychosocial preferences of nursing home (NH) residents. This study explored the association of race with importance ratings of self-dominion preferences (i.e., preferences for control). Methods PELI-NH interviews were conducted with 250 NH residents. Tests of mean differe...

Background: Instruments to identify and assess pref- erences for everyday living are important tools for health professionals. For research purposes, they appear equally es- sential, for example, to develop new care approaches based on the preferences of the older adults. So far, it seemed un- known which instruments already exist to identify and a...

Identifying preference of older adults supports person-centred care. The most sophisticated instrument is the preference for everyday living inventory (PELI). The PELI has been translated into German language and tested in different care settings. For people who experience difficulties communicating their preference the PELI has been combined with...

Effective management of the perceived risks associated with delivering preference-based person-centered care (PBPCC) is historically challenging for nursing home staff. Existing research lacks the granularity needed to guide clinicians who fear negative health and safety outcomes for residents. This study examined direct-care nursing staff percepti...

This study aimed to explore the perceptions of stakeholders (site champions, administrators, and front-line, social service, and activity staff) regarding the EIT-4-BPSD implementation strategy, including its utility, and the barriers and facilitators to implementation in real-world settings. A process evaluation included qualitative data from focu...

Photo-supported verbal assessments have shown to improve comprehension and expression of choices by older adults living with cognitive-communication challenges. The purpose of this study was to assess content validity (CV) of photographs used to supplement the Preferences for Everyday Living Inventory-Nursing Home (PELI-NH) from the perspective of...

Background The Preferences for Everyday Living Inventory assists nursing home (NH) providers in assessing residents’ preferences and can be used to make Preferences for Activity and Leisure (PAL) Cards, which are personalized 5x7 laminated cards that reflect a resident’s recreation and leisure preferences. We sought to understand the barriers and f...

Recruitment of residents in the EIT-4-BPSD study required that residents have evidence of at least one behavioral symptom noted by staff in the past month. Even with this inclusion criteria 25% of the sample had no behavioral symptoms at baseline based on the Cornell Scale for Depression in Dementia, the Cohen-Mansfield Agitation Inventory, the Res...

The purpose of this study was to test the reliability and validity of the Pain Assessment in Advanced Dementia (PAINAD) and particularly consider whether or not this measure was invariant when used among the Black and White residents. Baseline data from an implementation study testing that included a sample of 553 residents, 30% of who were Black,...

Objectives The purpose of this study was to expand on prior work testing invariance on several depression measures in community-based older adults and explore the psychometric properties and evidence of invariance between racial groups based on the Cornell Scale for Depression in Dementia. Design This was a descriptive measurement study. Setting...

Aim The purpose of this study was to explore and describe pre-licensure nursing students’ perceptions of risk for medication administration errors in fourth-year baccalaureate student nurses from three campuses at a large X university. Background Medication administration errors continue to be a significant safety concern in healthcare settings. P...

Background: With the increase in Black nursing home residents, racial and ethnic disparities in quality of care have been raised. Purpose: The purpose of this study was to evaluate racial disparities in care and outcomes over 12 months. Methods: This was a secondary data analysis using data from the Evidence Integration Triangle for Behavioral...

Introduction Leisure activities appear to be an important factor in maintaining and improving health in old age. To better understand what people want to do when visiting an adult day service (ADS), it is important to systematically assess their preferences. Currently, there is no instrument for assessing preferences for leisure activities for peop...

Background Behavioral and psychological symptoms of distress in dementia (BPSD) are major drivers of poor quality of life, caregiver burden, institutionalization, and cost of care in nursing homes. The Evidence Integration Triangle (EIT)-4-BPSD in nursing homes was a pragmatic Hybrid III trial of an implementation strategy to help staff use evidenc...

Introduction Consideration of the preferences for everyday living of older people with various care needs is a prerequisite for person-centred and evidence-based nursing care. Knowledge of and respect for these preferences by nursing staff are associated with better care outcomes for older people with various care needs. To assess preferences in a...

Background: This study evaluated the association between age, sex, comorbidities, cognition, and administration of opioids with pain and the impact of all of these variables plus function, agitation, resistiveness to care, and depression on quality of life among residents in nursing home with severe dementia. Design: This was a descriptive study...

Objectives:Emotional expressions in late-stage dementia have traditionally been studied within a deficit paradigm. Moving the narrative of the dementia trajectory from a solely negative pathological experience to one that acknowledges the potential for positive experiences aligns with international recommendations for living well with dementia. The...

Objectives To outline development of the Intimacy and Sexuality Expression Preference (ISEP) tool that elicits preferences for the expression of intimacy and sexuality of older people, living with and without dementia, in residential aged care. Methods Using two rounds of the Delphi technique involving 14 panelists, tool items were evaluated for i...

Person-centered care (PCC) in nursing homes is an elusive organizational goal that has attracted the attention of pay-for-performance (P4P) programs. P4P programs are used to incentivize providers to improve the quality of care delivered. However, P4P programs have both overarching policy initiatives (big “P”) that must incorporate an implementatio...

Background Federal regulations stipulate that behavioral interventions be used for behavioral and psychological symptoms of distress in dementia (BPSD). Care community staff have difficulty implementing these approaches. Purpose This study tested an implementation strategy, the Evidence Integration Triangle for BPSD (EIT-4-BPSD), for assisting sta...

Objectives: The purpose of this quality improvement project was to evaluate the implementation of a person-centered communication tool in nursing homes (NH). The Preferences for Activity and Leisure (PAL) Cards were developed to communicate residents’ preferences for activities across care team members. Methods: Providers were recruited to assess r...

The purpose of this study was to consider gender differences in depressive symptoms, agitation, resistiveness to care, physical function, and use of psychotropic medications in older adults with moderate to severe dementia in nursing homes. Sixty-seven nursing homes and 889 residents from two states were included. The majority of the participants w...

The purpose of the current study was to describe gender differences in the quality of interactions between nursing home residents with behavioral and psychological symptoms of dementia and staff. Data from the Evidence Integration Triangle for Behavioral and Psychological Symptoms of Dementia (EIT-4-BPSD) implementation study were used for the curr...

The coronavirus disease 2019 (COVID-19) has challenged the way nursing homes deliver person-centered care (PCC). Preferences for Activity and Leisure (PAL) Cards are a tool to communicate residents' important preferences to staff. Monthly interviews (N = 32) were conducted with champions who were conducting a PAL Card quality improvement project in...

Person-centered care (PCC) is the standard for the delivery of long-term services and supports (LTSS). In this article, we summarize the state of the science on meaningful outcomes and workforce development and discuss what is needed to ensure that person-centered LTSS becomes a universal reality. These 2 themes are intimately related: the dementia...

Background and Purpose The purpose of this study was to test the reliability and validity of the Quality of Interaction Survey (QuIS) using a quantification scoring approach. Methods Baseline data from the Evidence Integration Triangle for Behavioral and Psychological Symptoms of Dementia (EIT-4-BPSD) study was used. Results A total of 553 reside...

Background: Behavioral and psychological symptoms of distress in dementia (BPSD) are major drivers of poor quality of life, caregiver burden, institutionalization, and cost of care in nursing homes. The Evidence Integration Triangle (EIT)-4-BPSD in nursing homes was a pragmatic Hybrid III trial of an implementation strategy to help staff use eviden...

This study described current use and predictors of psychotropics among residents with moderate to severe cognitive impairment. This was a secondary data analysis using baseline data from the first 341 residents in an ongoing trial. Predictive measures included age, gender, race, depressive symptoms, agitation, resistiveness to care, depression, cog...