UNIVERSITY PARK, Pa. — Up to 90 percent of nursing home residents with dementia exhibit behavioral and psychological symptoms that include aggression, agitation, depression, anxiety, apathy and hallucinations. These symptoms put patients at risk for inappropriate medication use, reduced function and increased social isolation, among other negative health outcomes. Two Penn State College of Nursing faculty members hope to reduce those risks by implementing a new approach to managing these symptoms, called “EIT-4-BPSD.”
Ann Kolanowski, professor of nursing, and Kimberly Van Haitsma, associate professor of nursing, are two of three multiple principal investigators (MPIs) on a $2.26 million National Institutes of Health grant to implement and test EIT-4-BPSD, a strategy using behavioral approaches to reduce behavioral and psychological symptoms of dementia (BPSD) and improve quality of life for nursing facility residents with dementia.
“Behavioral approaches are endorsed as the first line of treatment, and their effectiveness is supported through clinical trials,” Kolanowski said. Working with MPI Barbara Resnick from the University of Maryland, she and Van Haitsma aim to evaluate the model in terms of both effectiveness and cost.
“This study will add critical knowledge about implementation of effective interventions in nursing facilities and serve as a model with potential for wide dissemination,” Van Haitsma said. “In addition, it will demonstrate how facilities can implement person-centered dementia care with the ultimate goal of decreasing BPSD and enhancing quality of life.”
The Centers for Medicare and Medicaid Services (CMS) National Partnership to Improve Dementia Care in Nursing Homes requires that person-centered behavioral approaches be used to deliver care for residents with dementia. To advance the aims of the partnership, the team previously developed a Nursing Home Toolkit, a comprehensive collection of resources for behavioral approaches to addressing BPSD. The toolkit is based on a theoretically based four-step approach guided by a framework called the Evidence Integration Triangle (EIT), which influences care practice through evidence and key stakeholders.
“EIT includes participatory implementation processes, practical evidence-based interventions, and pragmatic measures of progress,” noted Kolanowski. The EIT framework was merged with the toolkit resources to develop EIT-4-BPSD, the intervention that will be tested with this project.
“Our goal is to demonstrate that EIT-4-BPSD enables nursing home staff to reduce BPSD using behavioral approaches while optimizing function, preventing adverse effects, and improving quality of life for residents,” added Van Haitsma.