title: A pilot study using "apps" as a novel strategy for the management of challenging behaviors seen in people living in residential care.
abstract: Many adults living in residential care will demonstrate challenging behaviors. Non-pharmacological strategies are recommended as first-line treatment. Using applications (apps) is a novel approach to managing these behaviors, and has yet to be assessed in this group. This paper describes a pilot study to test apps as a novel non-pharmacological strategy to manage challenging behaviors in adults living in residential care.
  
  
  
  A non-blinded, non-randomized crossover trial design was implemented which compared apps to a control situation and usual care to determine whether apps were able to decrease challenging behaviors. The primary outcome measure was the Neuropsychiatric Inventory (NPI) that measures the frequency and severity of these behaviors.
  
  
  
  Fifteen residents participated whose mean age was 78.5 years. There were a range of diagnoses and comorbidities, including dementia and schizophrenia. IPads were used as the medium for delivering the apps and residential care staff implemented the interventions. There was a significant decrease in the total NPI score using the apps intervention (10.6 points) compared to the control (17.7 points) and to usual care (21.1 points). There was positive qualitative feedback from the staff who were involved in the study, but they also cited barriers such as lack of confidence using the apps and lack of time.
  
  
  
  Although this was a small and limited study, results suggest that using apps may be a feasible and personalized approach to managing challenging behaviors. A more rigorous study design that includes larger sample sizes and staff training may enable further research and benefits in this area.
authors.affiliation: Academic Unit for Psychiatry of Old Age,Department of Psychiatry,The University of Melbourne,Melbourne,Australia.
authors.forename: Samantha M
authors.identifier: 0000-0002-4953-4500
authors.initials: SM
authors.lastname: Loi
authors.affiliation: NorthWestern Mental Health,Melbourne Health,Royal Melbourne Hospital,Melbourne,Australia.
authors.forename: Angela
authors.initials: A
authors.lastname: Mazur
authors.affiliation: NorthWestern Mental Health,Melbourne Health,Royal Melbourne Hospital,Melbourne,Australia.
authors.forename: David
authors.initials: D
authors.lastname: Huppert
authors.affiliation: NorthWestern Mental Health,Melbourne Health,Royal Melbourne Hospital,Melbourne,Australia.
authors.forename: Bernadette
authors.initials: B
authors.lastname: Hoy
authors.affiliation: NorthWestern Mental Health,Melbourne Health,Royal Melbourne Hospital,Melbourne,Australia.
authors.forename: Jodie
authors.initials: J
authors.lastname: Swan
authors.affiliation: Academic Unit for Psychiatry of Old Age,Department of Psychiatry,The University of Melbourne,Melbourne,Australia.
authors.forename: Nicola T
authors.initials: NT
authors.lastname: Lautenschlager
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001315:Australia; D034201:Computers, Handheld; D018592:Cross-Over Studies; D003704:Dementia / Q000523:psychology / Q000534:rehabilitation*; D005260:Female; D006282:Health Personnel / Q000193:education; D006707:Homes for the Aged; D006801:Humans; D008297:Male; D063731:Mobile Applications; D010865:Pilot Projects; D000066553:Problem Behavior; D011569:Psychiatric Status Rating Scales; D011597:Psychomotor Performance / Q000502:physiology; D011795:Surveys and Questionnaires
keywords: challenging behaviors; non-pharmacological; residential facilities; touchscreen technology