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Home | The Res-Care-AL Intervention Study
The Res-Care-AL Intervention Study
Researchers at the University of Maryland, led by Barbara Resnick and Sheryl Zimmerman, conducted a randomized controlled trial to test Function Focused Care – Assisted Living (FFC-AL), an intervention designed to maintain and improve function, physical activity, muscle strength, psychosocial outcomes (efficacy expectations and life satisfaction) and decrease adverse events (pain, falls and hospitalizations) among assisted living residents. FFC-AL was implemented by a research Function Focused Care Nurse (FFCN). The FFCN worked with the intervention sites 15 hours per week for the first 6 months of the 12-month intervention, 8 hours a week for the next 3 months, and 4 hours a week for the final 3 months of the intervention. To assure sustainability of the function focused care philosophy, each treatment site identified a facility champion who worked with the FFCN, learned the implementation process, and helped to institutionalize function focused care within the community. Working with the facility champion, the FFCN implemented the four components of the intervention: (I) Environment and Policy/Procedure Assessments; (II) Education; (III) Developing Function Focused Goals; and (IV) Mentoring and Motivating. Four assisted living communities were randomly assigned to treatment (FFC-AL) or to placebo control (FFC-education only). A total of 171 residents and 96 direct care workers (DCW) were followed for 12 months. Based on observations of care interactions, DCWs in treatment sites provided more function focused care by 12 months than those in the control sites. Residents in treatment sites demonstrated fewer declines in function and spent more time in moderate level physical activity at 4 months and more overall counts of activity at 12 months when compared to residents in control sites. There were no differences in muscle strength, falls, pain, life satisfaction or efficacy expectations between the groups. There were, however fewer transfers to the hospital among those in the treatment sites. There was evidence of dissemination and implementation of FFC-AL within the sites that endured beyond the study period (e.g, policy and environmental changes). The study findings suggest that using a FFC-AL approach may help to prevent some of the persistent functional decline commonly noted in these communities, increase time spent in physical activity, and decrease the need for acute care transfers.