(P27) Meaningful Activity Engagement for Assisted Living Residents with Dementia

Introduction/Objective: Engagement in meaningful activity is beneficial for assisted living residents with dementia. The purpose of this study was to pilot test a theory-based approach, Meaningful Activity for Managing Behavioral Symptoms of Distress (MAC-4-BSD). MAC-4-BSD focuses on increasing engagement in meaningful activity while decreasing behavioral symptoms among assisted living residents with dementia. The intervention is theoretically based using the Social Ecological Model and Social Cognitive Theory and includes four components: 1) Assessment of the environment and policies; 2) Staff education; 3) Assessment of resident preferences and goals for meaningful activity; 4) Mentoring and motivating staff and residents. It was hypothesized that residents exposed to MAC-4-BSD will demonstrate increased meaningful activity engagement, improved quality of life, and reduced behavioral symptoms at 4 months compared to those exposed to education only.

Design/Methodology : Using a cluster randomized controlled trial with repeated measures design, this study included 73 residents with dementia from 5 assisted living settings. Residents were eligible for the study if they were ≥55 years old, lived in a participating community, and screened positive for dementia based on the Saint Louis University Mental Status exam (SLUMS) and AD8 Dementia Screening Interview. Residents were excluded if they were enrolled in hospice, admitted for short term respite, or had a significant neurological condition not related to Alzheimer’s disease or related dementia. Resident outcomes were evaluated at baseline and 4 months post-intervention and included residents’ engagement in meaningful activity (Engagement in Meaningful Activities Survey), behavioral symptoms (brief Neuropsychiatric Inventory Questionnaire), and quality of life (Quality of Life-Alzheimer’s disease). Descriptive statistics were used to describe the sample and evaluate feasibility. Linear mixed models were used to determine preliminary effectiveness of the MAC-4-BSD approach.

Results: Most participants were female (n=54, 74%), and White (n=64, 88%) with a mean age of 85 years (SD=8.2). The MAC-4-BSD intervention was feasible to implement with the sample of assisted living residents with moderate to severe dementia. At four months, preliminary effectiveness was demonstrated based on increased engagement in meaningful activity (b=7.69, p=.005), improved quality of life (b=3.74, p=.03), and decreased number of behavioral symptoms (b=-1.83, p=.037) among those exposed to MAC-4-BSD versus the control group.

Conclusion/Discussion : These findings demonstrate that MAC-4-BSD can be effectively implemented to facilitate meaningful activity engagement for residents with dementia in assisted living. Ongoing research is needed to evaluate the long-term sustainability of the MAC-4-BSD approach in assisted living and other post-acute and long-term care settings.