title: A randomized controlled trial for an individualized positive psychosocial intervention for the affective and behavioral symptoms of dementia in nursing home residents.
abstract: OBJECTIVE
  This randomized controlled study tested the effectiveness of individualized activities, led by certified nursing assistants (CNAs), to increase positive and reduce negative affect and behavior among nursing home residents with dementia.
  
  
  METHODS
  Nursing home residents with mild to advanced dementia (N = 180) were randomly assigned to usual care (UC, n = 93) or 1 of 2 experimental conditions. Residents in the attention control group (AC, N = 43) participated in standardized one-to-one activities with their CNAs. Individualized Positive Psychosocial Intervention (IPPI) participants (n = 44) received a CNA-led activity matched to their interests and ability. Outcomes were residents' positive and negative affect and verbal and nonverbal behavior.
  
  
  RESULTS
  The IPPI and AC groups experienced similar benefits-more pleasure, alertness, engagement, positive touch, and positive verbal behavior-compared with UC. The AC group displayed more anger, uncooperativeness, and very negative verbal behavior than UC or IPPI.
  
  
  CONCLUSIONS
  This study demonstrates the value of individualized activities for nursing home residents with dementia. In a stringent test, residents were happier and less angry during a customized intervention compared with a standardized intervention. Even brief individualized CNA-led activities bring pleasure to nursing home residents and constitute an effective strategy to enhance positive affect and engagement in persons with dementia.
authors.affiliation: Polisher Research Institute, Madlyn and Leonard Abramson Center for Jewish Life, North Wales, Pennsylvania. kvanhaitsma@abramsoncenter.org.
authors.forename: Kimberly S
authors.initials: KS
authors.lastname: Van Haitsma
authors.affiliation: VA Western NY Healthcare System, Batavia, New York.
authors.forename: Kimberly
authors.initials: K
authors.lastname: Curyto
authors.affiliation: Polisher Research Institute, Madlyn and Leonard Abramson Center for Jewish Life, North Wales, Pennsylvania.
authors.forename: Katherine M
authors.initials: KM
authors.lastname: Abbott
authors.affiliation: College of Nursing, University of Utah, Salt Lake City.
authors.forename: Gail L
authors.initials: GL
authors.lastname: Towsley
authors.affiliation: Spector Consulting, Bala Cynwyd, Pennsylvania.
authors.forename: Abby
authors.initials: A
authors.lastname: Spector
authors.affiliation: Polisher Research Institute, Madlyn and Leonard Abramson Center for Jewish Life, North Wales, Pennsylvania.
authors.forename: Morton
authors.initials: M
authors.lastname: Kleban
mesh_terms: D000342:Affective Symptoms / Q000209:etiology / Q000628:therapy; D000368:Aged; D000369:Aged, 80 and over; D001526:Behavioral Symptoms / Q000209:etiology / Q000628:therapy*; D003704:Dementia / Q000150:complications / Q000628:therapy*; D005260:Female; D006707:Homes for the Aged; D006801:Humans; D008297:Male; D008875:Middle Aged; D009735:Nursing Homes; D018802:Patient-Centered Care / Q000379:methods*; D011613:Psychotherapy / Q000379:methods*; D012720:Severity of Illness Index; D016896:Treatment Outcome
keywords: Activity intervention; Behavioral symptoms; Dementia; Nursing home; Positive and negative affect; Preferences; Randomized control trial