title: Function Focused Care for Assisted Living Residents With Dementia.
abstract: OBJECTIVE
  Assisted living (AL) residents with dementia require assistance with activities of daily living, encounter limited opportunities to engage in physical activity, and often exhibit challenging behavioral symptoms. The Function Focused Care Intervention for the Cognitively Impaired (FFC-CI) teaches and motivates direct care workers (DCWs) to engage residents with dementia in activities that optimize function and activity while minimizing behavioral symptoms. The purpose of this study was to test the impact of FFC-CI on function, physical activity, behavior, and falls.
  
  
  METHODS
  A cluster-randomized trial included 96 residents with dementia and 76 DCWs from 4 ALs. Generalized estimating equations were used to evaluate outcomes at 3 and 6 months.
  
  
  RESULTS
  There were no treatment by time differences with regard to resident behavior, mood, counts of physical activity based on actigraphy, falls, and function. There were significant increases in physical activity based on kilocalories burned (p = .001), time spent in physical activity based on survey results (p = .001), and time spent in repetitive behaviors, such as wandering (p = .01) among the control group over time. There were no treatment by time differences with regard to DCW beliefs, knowledge, or performance of FFC, except for less decline in job satisfaction among the treatment group (p = .002). Treatment fidelity with regard to delivery and receipt were poor due to high staff attrition in the treatment group (46% vs. 16%) and limited site support.
  
  
  CONCLUSIONS
  The findings from this study can be used to adapt future FFC intervention studies to improve treatment fidelity and optimize intervention efficacy.
authors.affiliation: Department of Organizational Systems and Adult Health, University of Maryland School of Nursing, Baltimore, Maryland. galik@son.umaryland.edu.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Galik
authors.affiliation: Department of Organizational Systems and Adult Health, University of Maryland School of Nursing, Baltimore, Maryland.
authors.forename: Barbara
authors.initials: B
authors.lastname: Resnick
authors.affiliation: Department of Organizational Systems and Adult Health, University of Maryland School of Nursing, Baltimore, Maryland.
authors.forename: Nancy
authors.initials: N
authors.lastname: Lerner
authors.affiliation: Department of Organizational Systems and Adult Health, University of Maryland School of Nursing, Baltimore, Maryland.
authors.forename: Margaret
authors.initials: M
authors.lastname: Hammersla
authors.affiliation: Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland.
authors.forename: Ann L
authors.initials: AL
authors.lastname: Gruber-Baldini
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000369:Aged, 80 and over; D040561:Assisted Living Facilities; D003704:Dementia; D005260:Female; D005851:Geriatric Nursing / Q000379:methods; D006282:Health Personnel / Q000193:education* / Q000523:psychology; D006801:Humans; D007588:Job Satisfaction; D008297:Male; D009043:Motor Activity; D017063:Outcome Assessment, Health Care; D018802:Patient-Centered Care / Q000379:methods*
keywords: Assisted living; Dementia; Function; Physical activity; Workforce issues