title: PerCEN: a cluster randomized controlled trial of person-centered residential care and environment for people with dementia.
abstract: BACKGROUND
  There is good evidence of the positive effects of person-centered care (PCC) on agitation in dementia. We hypothesized that a person-centered environment (PCE) would achieve similar outcomes by focusing on positive environmental stimuli, and that there would be enhanced outcomes by combining PCC and PCE.
  
  
  METHODS
  38 Australian residential aged care homes with scope for improvement in both PCC and PCE were stratified, then randomized to one of four intervention groups: (1) PCC; (2) PCE; (3) PCC +PCE; (4) no intervention. People with dementia, over 60 years of age and consented were eligible. Co-outcomes assessed pre and four months post-intervention and at 8 months follow-up were resident agitation, emotional responses in care, quality of life and depression, and care interaction quality.
  
  
  RESULTS
  From 38 homes randomized, 601 people with dementia were recruited. At follow-up the mean change for quality of life and agitation was significantly different for PCE (p = 0.02, p = 0.05, respectively) and PCC (p = 0.0003, p = 0.002 respectively), compared with the non-intervention group (p = 0.48, p = 0.93 respectively). Quality of life improved non-significantly for PCC+PCE (p = 0.08), but not for agitation (p = 0.37). Improvements in care interaction quality (p = 0.006) and in emotional responses to care (p = 0.01) in PCC+PCE were not observed in the other groups. Depression scores did not change in any of the groups. Intervention compliance for PCC was 59%, for PCE 54% and for PCC+PCE 66%.
  
  
  CONCLUSIONS
  The hypothesis that PCC+PCE would improve quality of life and agitation even further was not supported, even though there were improvements in the quality of care interactions and resident emotional responses to care for some of this group. The Australian New Zealand Clinical Trials Registry Number is ACTRN 12608000095369.
authors.affiliation: Aged and Extended Care Nursing,Faculty of Health,University of Technology,Sydney,NSW,Australia.
authors.forename: Lynn
authors.initials: L
authors.lastname: Chenoweth
authors.affiliation: Faculty of Design,Architecture and Building,University of Technology Sydney,Sydney,NSW,Australia.
authors.forename: Ian
authors.initials: I
authors.lastname: Forbes
authors.affiliation: Dementia Training Study Centre,University of Wollongong,Wollongong,Australia.
authors.forename: Richard
authors.initials: R
authors.lastname: Fleming
authors.affiliation: Director Quality of Life Research Centre,University of Sydney,Sydney,NSW,Australia.
authors.forename: Madeleine T
authors.initials: MT
authors.lastname: King
authors.affiliation: Faculty of Health,University of Technology,Sydney,NSW,Australia.
authors.forename: Jane
authors.initials: J
authors.lastname: Stein-Parbury
authors.affiliation: Sydney Medical School,University of Sydney,Sydney,NSW,Australia.
authors.forename: Georgina
authors.initials: G
authors.lastname: Luscombe
authors.affiliation: Centre for Health Economics Research and Evaluation,University of Technology,Sydney,NSW,Australia.
authors.forename: Patricia
authors.initials: P
authors.lastname: Kenny
authors.affiliation: Faculty of Nursing and Midwifery,University of Sydney,Sydney,NSW,Australia.
authors.forename: Yun-Hee
authors.initials: YH
authors.lastname: Jeon
authors.affiliation: Centre for Health Economics Research and Evaluation,University of Technology,Sydney,NSW,Australia.
authors.forename: Marion
authors.initials: M
authors.lastname: Haas
authors.affiliation: School of Psychiatry,University of New South Wales,Sydney,Australia.
authors.forename: Henry
authors.initials: H
authors.lastname: Brodaty
mesh_terms: D000369:Aged, 80 and over; D003704:Dementia / Q000150:complications / Q000628:therapy*; D003863:Depression / Q000209:etiology; D004777:Environment; D005260:Female; D006801:Humans; D008297:Male; D057285:Precision Medicine / Q000379:methods*; D011595:Psychomotor Agitation / Q000209:etiology / Q000628:therapy; D011788:Quality of Life / Q000523:psychology; D012114:Residential Treatment / Q000379:methods*