Management of apathy in nursing homes using a teaching program for care staff: the STIM-EHPAD study

• Published in: International journal of geriatric psychiatry Vol. 28; no. 4; pp. 383 - 392
• Main Authors: Leone, Elsa, Deudon, Audrey, Bauchet, Murielle, Laye, Mathilde, Bordone, Nathalie, Lee, Ji-Hyun, Piano, Julie, Friedman, Leah, David, Renaud, Delva, Fleur, Brocker, Patrice, Yesavage, Jerome, Robert, Philippe Henri
• Format: Journal Article
• Language: English
• Published: Chichester, UK John Wiley & Sons, Ltd 01.04.2013; Psychology Press; Wiley Subscription Services, Inc
• Subjects: Aged; Aged, 80 and over; Aggressiveness; Alzheimer's disease; Apathy; Biological and medical sciences; Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases; Dementia; Dementia - nursing; Dementia - psychology; Dementia disorders; Effectiveness studies; Female; General aspects; Geriatric Nursing - education; Geriatric psychiatry; Geriatric psychology; Geriatrics; Health Knowledge, Attitudes, Practice; Humans; Male; Medical sciences; Neurology; Nursing Homes; Nursing Staff - education; Performance evaluation; Program Evaluation; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Qualitative Research; Surveys and Questionnaires; training program; France; Human; Long stay; Nervous system diseases; Nursing home for the aged; Alzheimer disease; Health care staff; Management; Care; Cerebral disorder; Educational program; Apathy; Gerontology; Central nervous system disease; Training program; Degenerative disease; Homes for the aged; Nursing home; Elderly; Psychiatry; Alzheimer's disease; nursing homes; Geriatrics
• ISSN: 0885-6230; 1099-1166
• DOI: 10.1002/gps.3836

ObjectiveThis study aimed to evaluate the effectiveness of a nursing home (NH) staff education to manage apathy in older individuals with a diagnosis of dementia. MethodsSixteen NHs agreed to participate, and 230 demented apathetic residents were randomly assigned to the reference group (RG) or the intervention group (IG). IG received a month of weekly 4‐h training. Qualitative evaluation was performed through interviews and questionnaires regarding work practices and knowledge about dementia. Quantitative evaluation was at baseline, at the end of the training program (week 4), and 3 months after the end of it with the use of the Neuropsychiatric Inventory (NPI), the Apathy Inventory, and two observation scales. ResultsIn the qualitative evaluation, very few staff responded to the questionnaire. Concerning the difficulty that managing residents' behavioral symptoms presented, aggressiveness was ranked as the most difficult behavior to manage and apathy as the least difficult. In the quantitative evaluation, the results are as follows. NPI: the IG scores increased from baseline to week 4 more than the RG for symptoms belonging to the affective and the psychotic NPI item subgroup. Apathy Inventory: there was a significant decrease of the emotional blunting score dimension in the IG. Group Observation Scale: significant improvement was observed for the emotional blunting dimension in the IG only. ConclusionsApathy is rarely identified as a problem in NH. Emotional blunting was the only dimension sensitive to change. Failure to improve residents' level of interest could be explained by the difficulties encountered in accessing information regarding the subjects' personal interests. But it remains possible to modify residents' emotional reactivity and staff's perceptions of residents' behaviors and emotions. Copyright © 2012 John Wiley & Sons, Ltd.