Implementation effectiveness of psychosocial and environmental care practices in assisted living

Psychosocial and environmental care practices are recommended to address behavioral expressions in persons with dementia, but their use has been limited partly because guidance is lacking regarding implementation. In response, we developed a simple how-to guide of evidence-based protocols for aromatherapy, natural light, familiar music, and robotic pets; trained staff in four assisted living (AL) communities to use the practices; provided materials; met with them regularly; and evaluated fidelity, facilitators and barriers to implementation, and staff knowledge, attitudes, and self-efficacy. After two months, staff reported more familiarity, confidence, and use; barriers such as difficulty locating supplies and task-focused staff with limited time; and staff champion facilitators. Notable differences were identified across communities, suggesting that just as care to individuals must be person-centered, practices embraced by communities must fit that community. Through strategic adoption, successful implementation is possible. The how-to guide is appropriate for AL, nursing homes, and persons' own homes. (c) 2020 Elsevier Inc. All rights reserved.

Automated summary

A simple how-to guide of evidence-based care practices was developed, and staff in four assisted living communities were trained, with the effectiveness and challenges of implementation evaluated. After two months, staff reported increased familiarity, confidence, and use of the practices, along with barriers such as difficulty locating supplies. Significant differences were found across communities, suggesting the need for tailored practices based on community characteristics.