For long-term care (LTC) residents, multiple barriers impede access to formal museum-based participa-tory art programming. Capitalizing on available technologies may circumvent common barriers and improve quality of life for those older adults even in the presence of dementia.
Targets:
A convenience sample of 31 older adults was recruited from the population of residents in one LTC facility.
Intervention:
ArtontheBrain, a web-based program, engages participants in activities centered on visual artwork, enabling users to learn about artists through activities, such as puzzles, storytelling, and group discussions.
Mechanisms of Action:
Researchers hypothesized that engagement with ArtontheBrain would benefit perceived quality of life in the domains of meaningful activity engagement and personal relationships and secondarily, improvements in functional performance, mood state, and cognitive performance may occur.
Outcomes:
Application of a quality of life survey pre and post ArtontheBrain intervention revealed significant improvements within the individual subsample for two activity options: engagement in enjoyable activities on weekends and evenings and explore new skills and interests. Total scores for the personal relationship scale had significant improvements post-intervention for the individual and group subsamples. The individual subsample demonstrated improvement in cognitive performance, which worsened for the group subsample. Mood and functional ability worsened for the entire sample.[
Research in Gerontological Nursing, 14
(5), 235–243.]
Prior research in geriatric medicine has shown that the use of antipsychotic medications by older people can result in significant adverse effects and increased mortality. This article focuses on the implementation of a methodology created by the Appropriate Use of Antipsychotics (AUA) collaborative, a project developed by the Senior Quality Leap Initiative (SQLI) in Canada, to reduce the use of antipsychotic medications among a population of older individuals at a long-term chronic hospital. The methodology included use of a variety of standardized AUA tools, the establishment of staff awareness and alignment, focused internal reporting with benchmarks, and collaborative teamwork with the use of person-centered care. Through this framework, the facility was able to reduce antipsychotic medication use from 22.0% to 14.9% over 2 years.
Achieving institutional goal of full, person-centered care was encumbered by an outdated structural “hospital model” at one long-term care facility that undertook building renovations, transforming long hallways into “neighborhood” of compact households. Quality of Life Survey and Long-term Care Minimum Data Set generated data at baseline and 1-year follow-up, comparing renovated(RU) and non-renovated unit(NRU) residents (n=36) to evaluate achievement of person-centered care. RU residents indicating they could “eat when I want” increased 75% to 81% at follow-up and decreased 17% for NRU residents. Sixty-seven percent of RU residents reported bathing “when they want” in contrast to 40% of NRU residents. Most RU residents agreed, “staff act on my suggestions.”More RU residents (68% vs 53%) agreed: “I spend time with other like-minded residents” and more RU residents (86% vs 43%) reported opportunity to explore new skills, interests. RU residents more often reported (50% vs 37%) “people ask for my help or advice.” Similar differences were observed with “it is easy to make friends here,” 67% RU residents responding affirmatively. RU residents reporting “feeling down” improved, moving from 46% to 50% disagreeing with this item with while increased number of NRU residents (18% to 22%) reported “feeling down” at follow-up.Improvement with independent performance of bed mobility, transfer, walking, and dressing among RU residents was observed while NRU residents had decreased percentages of independence. Evaluation of resident outcomes demonstrated improvement with personal choice, activities, personal relationships, functional independence and mood. Physical unit renovations appear to enhance implementation of person-centered care model.
ArtOn the Brain is a mobile application that incorporates art history education, play and socialization for older adults. This pilot project examined its health and social impact among long term care residents. A convenience sample of 48 residents, 60+ years, with borderline intact to moderate cognitive impairment were recruited. Residents with mild or better cognitive status used the app individually on a tablet while the remaining participated in therapist-led group sessions. One-hour intervention occurred twice weekly. Primary outcomes, health and well-being, were measured with 5Q-5D-5L and Warwick-Edinburgh Mental Well-being tools at baseline and after 6 weeks. Secondary outcomes were mood, cognition, function and overall satisfaction with activity options and personal relationships. Pre-post paired t-test analyses of data from EQ-5D-5L and Warwick tools did not show a significant difference. There were no notable declines with cognitive performance, functional ability and depression post-intervention. Four activity options and three personal relationship items had statistically significant improvements post-intervention. Activity options addressed engagement in enjoyable activities on weekends and evenings, and opportunity to, spend time with other like-minded residents and explore new skills, interests. Personal relationships items included engagement in activities helpful to others and having people to do things with. ArtOn the Brain is a novel application suitable for long term care residents. While 6 week intervention did not show improvement in overall health and well-being, there were significant improvements with residents’ reported engagement in activity options and improvement of personal relationships. Longitudinal evaluations are needed to examine changes in health status and well-being.
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