title: Testing the effect of function-focused care in assisted living.
abstract: OBJECTIVE
  To develop and test the Function-Focused Care in Assisted Living (FFC-AL) intervention so as to alter the decline that older adults in AL experience.
  
  
  METHODS
  Cluster-randomized controlled trial using repeated measures to test the effect of FFC-AL.
  
  
  METHODS
  Four AL facilities with at least 100 beds.
  
  
  METHODS
  One hundred seventy-one residents and 96 direct care workers (DCWs) were recruited. Ninety-five of the DCWs were female (99%), and 59 were black (62%), with a mean age of 41.7 ± 13.8. The residents were mostly female (80%), white (93%), and widowed (80%), with a mean age of 87.7 ± 5.7.
  
  
  METHODS
  FFC-AL included four components implemented by a research-supported function focused-care nurse (FFCN) and a site-identified champion over a 12-month period. Control sites were exposed to FFC education only.
  
  
  METHODS
  Outcomes for residents included psychosocial domains (mood, resilience, self-efficacy, and outcome expectations for function and physical activity), function, gait and balance, and actigraphy. Outcomes for DCWs included knowledge, performance, and beliefs associated with FFC.
  
  
  RESULTS
  DCWs in treatment sites provided more FFC by 12 months than those in control sites. Residents in treatment sites demonstrated less decline in function, a greater percentage returned to ambulatory status, and there were positive trends demonstrating more time in moderate-level physical activity at 4 months and more overall counts of activity at 12 months than for residents in control sites.
  
  
  CONCLUSIONS
  Using a function-focused approach in AL may help prevent some of the functional decline commonly noted in these settings.
authors.affiliation: School of Nursing, University of Maryland, Baltimore, Maryland 21201, USA. resnick@son.umaryland.edu
authors.forename: Barbara
authors.initials: B
authors.lastname: Resnick
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Galik
authors.forename: Ann
authors.initials: A
authors.lastname: Gruber-Baldini
authors.forename: Sheryl
authors.initials: S
authors.lastname: Zimmerman
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000369:Aged, 80 and over; D040561:Assisted Living Facilities; D005260:Female; D005851:Geriatric Nursing / Q000379:methods; D006801:Humans; D008297:Male; D009043:Motor Activity; D018802:Patient-Centered Care