Date of Award

12-2019

Degree Name

Doctor of Philosophy

Department

Interdisciplinary Health Sciences

First Advisor

Dr. Kieran Fogarty

Second Advisor

Dr. Jonathan VanGeest

Third Advisor

Steven Eberth

Keywords

Multisensory Stimulation Environment, clinical workforce, behavioral and psychological symptoms of dementia, dementia, psychotropic medication, memory care assisted living facility

Abstract

The use of Multisensory Stimulation Environments (MSSE) has grown increasingly more common in the United States (U.S.) as a nonpharmacological intervention for Behavioral and Psychological Symptoms of Dementia (BPSD). However, typical MSSE designs require a secluded room isolated from outside stimulation and demand direct supervision from the care provider during treatment. Due to projected shortages in the clinical workforce and the population of older adults on the rise, a study was designed to reveal the effectiveness of an open-floorplan MSSE to reduce the demand of care providers during the use of the MSSE while allowing subjects diagnosed with dementia to utilize the space independently for treatment.

The aim of this study was to investigate whether an open-floorplan MSSE design impacted episodes of BPSD, prevalence of falls, and psychotropic medication use in older adults diagnosed with dementia living in a Memory Care Assisted Living (MCAL) facility. This study also explored the impact an MSSE on employee turnover and staff engagement for those working within the MCAL unit.

An all-inclusive sample of 24 residents over 65-years-old with a diagnosis of dementia and living in an MCAL facility located in a metropolitan area of a Midwest state in the U.S. were analyzed by secondary medical chart review for the pre/post implementation impact of an open-floorplan MSSE design on BPSD, the prevalence of falls, and psychotropic medication use. The documented BPSD episodes, number of falls experienced by the MCAL residents, and the number of psychotropic medications administered were analyzed for a total of 6 months prior to the MSSE installation and 6 months following the MSSE installation. Additionally, a study population of 46 employees, staffed exclusively by the MCAL, was analyzed by turnover data and engagement survey results in this study.

Following the installation of the MSSE, the number of observed BPSD episodes changed from 17% pre-test to 10% post-test. Psychotropic dose reductions improved from 0% pre-test to 1.4% post-test. The employee turnover rate decreased from 41.8% pre-test to 12.9% post-test. In addition, the results revealed improvements in employee engagement outcomes and employee satisfaction measures.

The open-floorplan MSSE design utilized as a nonpharmacological intervention for BPSD was found to be effective in improving BPSD, psychotropic medication dose reductions, and employee turnover on the MCAL unit. Further analysis is recommended to determine impact of the open-floorplan MSSE on the administration of psychotropic medications and falls experienced by residents of an MCAL facility.

Access Setting

Dissertation-Open Access

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