Abstract
BackgroundPreventing Loss of Independence through Exercise (PLIÉ) is an integrative group movement program developed for adults with mild-to-moderate dementia attending day programs. However, many older adults with dementia ultimately require assistance with their activities of daily living and become residents in nursing homes or other long-term care facilities with their complex comorbidities and unique needs. We conducted a post-implementation evaluation of PLIÉ at a San Francisco Veterans Affairs (VA) nursing home to assess reach and effectiveness among residents, staff, and family members who participated in ≥ 1 PLIÉ class from 9/2018 to 6/2019.MethodsPost-implementation number of classes offered and mean attendance; anonymous satisfaction surveys (5-point Likert scales); qualitative content analysis of open-ended survey responses and clinical progress notes.ResultsForty-five PLIÉ classes were offered over 9 months. Residents attended an average of 13 ± 12 classes with an average class size of 14 residents, 4 staff members, and 2 family members. Most survey respondents rated the program overall as “very good” or “excellent” (100 % residents, n = 15; 87 % staff, n = 14; 100 % family members, n = 8). Respondents reported improvements in themselves and/or others in four domains: (1) physical, (2) psychological, (3) social, and (4) cognitive. Physical improvements among veterans included mobility, strength, and energy. Psychological improvements included feelings of happiness/well-being, enjoyment, and self-empowerment. Social improvements included connection, social skills, and social support. Cognitive improvements included engagement, communication ability, and focus/attention. Responses were similar among resident, staff, and family member surveys and clinical progress notes. Participants frequently reported improvements in multiple domains (e.g., “The veterans are more alert and engaged, many are smiling and laughing.”). Negative comments were primarily related to logistics, suggesting that the class occur more frequently.ConclusionsPLIÉ was successfully implemented in a VA nursing home with high attendance and satisfaction among residents, staff, and family members. Participants reported clinically meaningful physical, psychological, social, and cognitive benefits. Other long-term care facilities could potentially benefit from implementing PLIÉ to increase quality of life in residents with dementia.
Highlights
Preventing Loss of Independence through Exercise (PLIÉ) is an integrative group movement program developed for adults with mild-to-moderate dementia attending day programs
Disruptive and challenging behavioral symptoms often prevent the placement of veterans with dementia in community long-term care settings because they may pose health or safety risks to themselves or others, and those with the most severe symptoms are often cared for by nursing homes run by the Department of Veterans Affairs (VA), which are called Community Living Centers (CLCs)
We first conducted semi-structured interviews with key stakeholders, including VA national and local leaders, local clinical providers, community partners, veterans with dementia, and caregivers to learn about the status of VA care for veterans with dementia and unmet needs for CLC residents with dementia
Summary
Preventing Loss of Independence through Exercise (PLIÉ) is an integrative group movement program developed for adults with mild-to-moderate dementia attending day programs. Many older adults with dementia require assistance with their activities of daily living and become residents in nursing homes or other long-term care facilities with their complex comorbidities and unique needs. 48 % of nursing home residents across the United States have Alzheimer’s or other dementias, and 61 % of PWD in nursing homes have moderate or severe cognitive impairment [2]. Disruptive and challenging behavioral symptoms often prevent the placement of veterans with dementia in community long-term care settings because they may pose health or safety risks to themselves or others, and those with the most severe symptoms are often cared for by nursing homes run by the Department of Veterans Affairs (VA), which are called Community Living Centers (CLCs)
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