Management of apathy in nursing homes using a teaching program for care staff: the STIM-EHPAD study.
OBJECTIVE
This study aimed to evaluate the effectiveness of a nursing home (NH) staff education to manage apathy in older individuals with a diagnosis of dementia.


METHODS
Sixteen NHs agreed to participate, and 230 demented apathetic residents were randomly assigned to the reference group (RG) or the intervention group (IG). IG received a month of weekly 4-h training. Qualitative evaluation was performed through interviews and questionnaires regarding work practices and knowledge about dementia. Quantitative evaluation was at baseline, at the end of the training program (week 4), and 3 months after the end of it with the use of the Neuropsychiatric Inventory (NPI), the Apathy Inventory, and two observation scales.


RESULTS
In the qualitative evaluation, very few staff responded to the questionnaire. Concerning the difficulty that managing residents' behavioral symptoms presented, aggressiveness was ranked as the most difficult behavior to manage and apathy as the least difficult. In the quantitative evaluation, the results are as follows. NPI: the IG scores increased from baseline to week 4 more than the RG for symptoms belonging to the affective and the psychotic NPI item subgroup. Apathy Inventory: there was a significant decrease of the emotional blunting score dimension in the IG. Group Observation Scale: significant improvement was observed for the emotional blunting dimension in the IG only.


CONCLUSIONS
Apathy is rarely identified as a problem in NH. Emotional blunting was the only dimension sensitive to change. Failure to improve residents' level of interest could be explained by the difficulties encountered in accessing information regarding the subjects' personal interests. But it remains possible to modify residents' emotional reactivity and staff's perceptions of residents' behaviors and emotions.
Memory Center of Nice (Centre Mémoire de Ressources et de Recherche), Centre Hospitalier Universitaire de Nice, France. leone.e@chu-nice.fr
Elsa
E
Leone
Audrey
A
Deudon
Murielle
M
Bauchet
Mathilde
M
Laye
Nathalie
N
Bordone
Ji-Hyun
JH
Lee
Julie
J
Piano
Leah
L
Friedman
Renaud
R
David
Fleur
F
Delva
Patrice
P
Brocker
Jerome
J
Yesavage
Philippe Henri
PH
Robert
D000368:Aged; D000369:Aged, 80 and over; D057565:Apathy; D003704:Dementia / Q000451:nursing* / Q000523:psychology; D005260:Female; D005851:Geriatric Nursing / Q000193:education*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D009735:Nursing Homes; D009740:Nursing Staff / Q000193:education*; D015397:Program Evaluation; D036301:Qualitative Research; D011795:Surveys and Questionnaires