Implementing Montessori approaches after training: A mixed methods study to examine staff understanding and movement toward action.

This paper uses Normalization Process Theory (NPT) to examine staff impressions of Montessori-based program training and implementation at Veterans Affairs Community Living Centers (VA CLCs; nursing homes). We conducted a mixed-methods evaluation of Montessori Approaches to Person-Centered Care (MAP-VA) at eight VA CLCs. Trainings were conducted as either a live virtual course or a pre-recorded asynchronous class.

Increase in blood pressure precedes distress behavior in nursing home residents with dementia.

Background: Distress behaviors in dementia (DBD) likely increase sympathetic nervous system activity. The aim of this study was to examine the associations among DBD, blood pressure (BP), and intensity of antihypertensive treatment, in nursing home (NH) residents with dementia.

Methods: We identified long-stay Veterans Affairs NH residents with dementia in 2019-20 electronic health data.

Factors Related to Higher and Lower Performance and Adherence in STAR-VA Program Sustainment in Department of Veterans Affairs (VA) Community Living Centers (CLCs).

Objectives: We identify factors associated with sustainment of an intervention (STAR-VA) to address distress behaviors in dementia (DBD), guided by the Organizational Memory Knowledge Reservoir (KR) framework, compared across 2 types of outcomes: (1) site performance improvement on a clinical outcome, the magnitude of change in levels of DBD, and (2) self-rated adherence to STAR-VA core components, a process outcome.

Design: We used a cross-sectional sequential explanatory mixed methods design guided by the Organizational Memory Framework.

Setting And Participants: We selected 20 of 79 sites that completed STAR-VA training and consultation based on rankings on 2 outcomes-change in an indicator of DBD and reported adherence to STAR-VA core components.

An MDS 3.0 Distressed Behavior in Dementia Indicator (DBDI): A Clinical Tool to Capture Change.

Background/objectives: Persons with dementia frequently demonstrate distress behaviors in dementia (DBD), associated with poorer outcomes. This study aimed to create a measure of DBD from routinely administered Minimum Data Set (MDS 3.0) behavior section items that demonstrated sensitivity to change, for evaluation of intervention efforts for VA Community Living Center (CLCs) residents exhibiting DBD.

Preference Consistency: Veteran and Non-Veteran Nursing Home Resident Self-Reported Preferences for Everyday Living.

Understanding patient preferences is core to person-centered care. The consistency of everyday preference reporting was assessed comparing responses of Veteran (VA) and non-VA nursing home (NH) residents on the Preferences for Everyday Living Inventory (PELI) at baseline and 5 to 7 days later. Non-VA NH residents demonstrated higher perfect agreement than VA residents (66% vs.

Identifying barriers to culture change: A qualitative analysis of the obstacles to delivering resident-centered care.

A growing number of healthcare organizations have moved from traditional, institutional nursing home models to ones that emphasize culture change, or resident-centered care (RCC). In 2006, the Department of Veterans Affairs (VA) began implementing a number of changes to VA nursing homes, now called (CLCs), to provide veterans with a more resident-centered and homelike environment. This study aimed to understand the barriers CLC staff face when delivering RCC.

Development of the Knowledge of Dementia Competencies Self-Assessment Tool.

Competent dementia care requires caregivers with specialized knowledge and skills. The Knowledge of Dementia Competencies Self-Assessment Tool was developed to help direct care workers (DCWs) assess their knowledge of 7 dementia competencies identified by the Michigan Dementia Coalition. Item selection was guided by literature review and expert panel consultation.

The consistency of self-reported preferences for everyday living: implications for person-centered care delivery.

Preferences are the expression of an individual's basic psychosocial needs and are related to care outcomes. The current study tested the consistency of 87 individuals' everyday preferences over 1 week, comparing responses of nursing home residents (n = 37; mean age = 82) and university students (n = 50; mean age = 20). Participants completed the Preferences for Everyday Living Inventory at baseline and 5 to 7 days later.

"It Depends": Reasons Why Nursing Home Residents Change Their Minds About Care Preferences.

Purpose Of The Study: Understanding and honoring preferences are fundamental in the promotion of well-being for frail elders. This study aims to understand and describe nursing home residents' perspectives on why the importance of their preferences may change in daily care.

Design And Methods: Secondary data analyses of cognitive interviews with 39 cognitively capable nursing home residents regarding their importance of preferences for everyday living were completed.

A randomized controlled trial for an individualized positive psychosocial intervention for the affective and behavioral symptoms of dementia in nursing home residents.

Objectives: This randomized controlled study tested the effectiveness of individualized activities, led by certified nursing assistants (CNAs), to increase positive and reduce negative affect and behavior among nursing home residents with dementia.

Method: Nursing home residents with mild to advanced dementia (N = 180) were randomly assigned to usual care (UC, n = 93) or 1 of 2 experimental conditions. Residents in the attention control group (AC, N = 43) participated in standardized one-to-one activities with their CNAs.

The preferences for everyday living inventory: scale development and description of psychosocial preferences responses in community-dwelling elders.

Purpose Of The Study: Assessing preferences for daily life is the foundation for person-centered care delivery. This study tested a new measure, the Preferences for Everyday Living Inventory (PELI), with a large sample of community-dwelling older adults. We sought to evaluate the tool's convergent and divergent validity, identify the most commonly held preferences within the sample, and explore relationships between gender and race and strength of preferences.