Meaningful Activity for Long-Term Care Residents With Dementia: A Comparison of Activities and Raters.

Purpose of the Study: Engagement in meaningful activities is associated with positive outcomes for persons with dementia, yet studies demonstrating quantitative evidence for which activities can be considered meaningful are lacking. We investigated MemPics™, a program designed to promote meaningful activity for individuals with dementia through engagement and cognitive stimulation. It was compared with other recreation activities offered in U.S. long-term care facilities to determine whether MemPics™ was rated as having more meaningful activity from both the perspectives of participants and recreation staff. Design and Methods: Long-term care residents with mild to moderate dementia that met eligibility criteria were randomly assigned to an activity group (treatment, control). Participants completed 2 sessions of either the experimental or control group activity with facility recreation staff. Both participants and staff rated each activity in terms of meaningfulness following each session. Results: Of the enrolled participants (N = 126), study analyses were based on the 94 participants (n = 48 treatment and n = 46 control; M age = 82.98±9.63) who completed the activity sessions. Compared to the control group activities, MemPics™ had significantly higher participant and staff ratings of meaningfulness. Scores between the 2 rater types were significantly different, with staff reporting higher meaningful activity than participants. Further support for MemPics™ was found in exit survey responses from participating staff. Implications: We discuss the merits and shortcoming of this study, the utility of MemPics™ for providing meaningful engagement in long-term care residents with mild to moderate dementia, and ideas for future research.

Predicting Off-Label Antipsychotic Medication Use in a Randomly Selected Nursing Home Sample Based on Resident and Facility Characteristics.

Reducing off-label antipsychotic medication use for behavioral and psychological symptoms of dementia (BPSD) in nursing home residents has been a centerpiece of government regulation, but without insight into utilization differences based on resident and facility characteristics. To examine whether resident and facility characteristics can predict off-label antipsychotic medication treatment for BPSD, residents prescribed antipsychotic medication (N = 216) from 17 Maryland nursing facilities were randomly selected. Based on physician diagnoses, 59.7% of participants were taking off-label antipsychotic medications for BPSD. Hierarchical logistic regression results suggest that dementia level (indicated by Brief Cognitive Assessment Tool scores) and age, but not facility characteristics, significantly predict greater likelihood of using off-label antipsychotic medications for BPSD. Having moderate-severe dementia was associated with more than a four-fold increase in off-label antipsychotic medication use for BPSD. Off-label use of antipsychotic medications for BPSD remains high, especially for older nursing home residents with more severe dementia, indicating that more targeted reduction approaches are needed. [Res Gerontol Nurs. 2016; 9(6):257-266.].