Calming Intervention for Behavioral Symptoms of Dementia

Behavioral symptoms of dementia (BSDs) such as restlessness, agitation, aggressive behavior, yelling, and nighttime awakenings, exhibited by more than 85% of nursing home residents, result in distress for the person with dementia (PWD) and fear and avoidance in caregivers. These behaviors tend not to respond well to medications. Costs upwards of $148 billion a year necessitate research in non-pharmacologial therapies that may alleviate these symptoms. Calming interventions (CALM), specifically therapeutic touch and the use of therapeutic communication skills, show a reduction in agitation and stress for PWD.  They may promote interpersonal “bonding” between residents and staff, strengthening relationships, decreasing staff burnout and turnover and improving the quality of care. This intervention can be inexpensively incorporated into a program of dementia care with minimal training costs and little capital expenditure, but their use is not currently part of the customary care provided to PWD.

Purpose: To test the effect and feasibility of incorporating the CALM protocol (which includes therapeutic touch and therapeutic communication skills) into the usual model of Assisted Living Facility (ALF) care for persons with dementia (PWD)

Methods: The study is being implemented in an Assisted Living Facility in Southern California. The intervention includes the CALM protocol, direct care staff (DCS) training  and implementation. Outcome measures include resident behavioral symptoms of dementia, and layered voice analysis, “bonding” between DCS and PWD, measured using urine oxytocin 30 min after treatment for DCS, layered voice analysis (LVA) to assess emotional change, mutuality between DCS and PWD, and DCS job satisfaction

 Results: This project is ongoing: Data Analysis  Paired t-tests will examine the change within the intervention group from baseline to post-intervention on DCS measures (oxytocin, LVA, knowledge, job satisfaction, and mutuality) and PWD measures (BSD, LVA)

Conclusion: we anticipate that an increase DCS oxytocin levels will result in increased job satisfaction, decreased staff turnover, and increased mutuality. Moreover, we anticipate that the resident will exhibit fewer behavioral symptoms and that both the resident and the DCS will exhibit decreased voice stress measured by layered voice analysis.