Results from the multisite implementation of STAR-VA: a multicomponent psychosocial intervention for managing challenging dementia-related behaviors of veterans.
Dementia is often associated with challenging behaviors that can significantly impact the quality of life of individuals with dementia and pose great difficulty for long-term care staff. Antipsychotic medications, historically the mainstay approach for managing such behaviors, have increasingly been associated with limited efficacy and increased death risk with older dementia patients. In an effort to promote and realize the promise of nonpharmacological management of challenging dementia-related behaviors, the U.S. Department of Veterans Affairs (VA) health care system has developed and implemented STAR-VA, an interdisciplinary behavioral intervention for managing challenging dementia-related behaviors of veterans, in 17 VA nursing homes, as part of a pilot implementation initiative. Sixty-four veterans with challenging behaviors associated with dementia participated in the STAR-VA intervention coordinated by Mental Health Providers completing specialized training. Challenging behaviors clustered into 6 behavior types: resistance to care, agitation, violence/aggression, vocalization, wandering, and other. Results indicate that STAR-VA led to significant reductions in the frequency and severity of challenging dementia-related behaviors, with overall effect sizes of approximately 1. In addition, the intervention led to significant reductions in depression and anxiety. Overall, the results support the feasibility and effectiveness of STAR-VA for managing challenging dementia-related behaviors in veterans in real-world, nursing home settings.
Mental Health Services, U. S. Department of Veterans Affairs Central Office.
Bradley E
BE
Karlin
Serious Mental Illness Treatment Resource and Evaluation Center, Veterans Affairs Ann Arbor Healthcare System.
Stephanie
S
Visnic
Alzheimer's Disease and Memory Disorders Center, Department of Neurology, Baylor College of Medicine.
Jocelyn Shealy
JS
McGee
School of Nursing, University of Washington.
Linda
L
Teri
D000368:Aged; D001007:Anxiety / Q000628:therapy; D001526:Behavioral Symptoms / Q000209:etiology / Q000628:therapy*; D003704:Dementia / Q000150:complications / Q000534:rehabilitation*; D003863:Depression / Q000628:therapy; D006801:Humans; D017063:Outcome Assessment, Health Care; D010865:Pilot Projects; D011613:Psychotherapy / Q000379:methods*; D014481:United States; D014493:United States Department of Veterans Affairs; D014728:Veterans / Q000523:psychology*