Making dementia programming outcome driven

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Making dementia programming outcome driven

Posted on January 26, 2015

The goal of programming and life enrichment is to help residents live their highest quality of life – no matter their interests, background, life stories and abilities. For programming to support optimal wellness in residents, it needs to establish engagement opportunities that match realistic goals for each individual. Measuring outcomes of activities, whether they are positive or negative, is important to evaluate the quality of care provided. It can help optimize what is offered to better answer the needs of each individual. To qualify these goals, one should focus on outcomes that are:

  1. Clinically valuable
  2. Validated
  3. Measureable
  4. Repeatable

Here are some examples of outcomes that programming and life enrichment could work to improve on and/or increase the frequency of:

  • Mood – Depression and apathy are typical companions of dementia. Focusing on improving moods has been shown to increase the quality of life of residents
  • Socialization – Capturing programming attendance and supporting group activities helps residents engage in a crucial wellness dimension, while providing measurable data for the staff.
  • Engagement – If attendance is the quantity measure of programming, the level of engagement (are participants active, passive, refusing programming…) is the quality factor and shows the effectiveness of the sessions.
  • ADLs – The ability to perform activities of daily living is a direct correlation to quality of life. Programs that encourage a resident’s independence is a central key of person centered care.

Here are examples of outcomes that programming and life enrichment could work to reduce and/or decrease the frequency:

  • Anti-psychotic drug usage – Meaningful, person centered programming has been proven to be the most effective non-pharmacological way to avoid unacceptable behaviors. Its effectiveness should be tracked by measuring the use of psychotic drugs before the programming and then over time, the reduction in anti-psychotics after exposure to the programming.
  • Behaviors – People with dementia develop behavioral and psychological symptoms including wandering, restlessness, aggression, delusions, hallucinations, apathy and sleep disturbances. The cost of managing behavioral and psychological symptoms of dementia (BPSD) has been shown to cost more than $4,000 per resident per year.
  • Falls: It has been documented that people with dementia are four to five times more likely to experience falls than older people without significant cognitive impairment. Beyond the inappropriate use of anti-psychotic drugs that can cause imbalance, dementia engagement has a direct impact on falls by reducing behaviors and keeping the individual busy. Therefore, dementia engagement should be used as part of any anti-fall strategy.