The best evidence for minimizing resistance-to-care during assisted personal care for older adults with dementia in nursing homes: a systematic review.

Abstract

Review question/objective Objective To determine the effectiveness of interventions in minimizing resistance-to-care behaviors during assisted personal care for nursing home residents with dementia. Review Questions • What interventions are effective for reducing the frequency and intensity of resistance-to-care behaviors during assisted personal care activities (i.e. mealtime assistance, toileting, mouth care, morning care and shower/bathing) for nursing home residents with dementia? • What interventions are effective for reducing the frequency and intensity of resistance-to-care behaviors for overall daily personal care activities for nursing home residents with dementia? Inclusion criteria Types of participants Older adults with dementia, aged over 55 years with the formal diagnosis of dementia. Only studies which focus on persons who live in residential aged care facilities (nursing homes) will be considered. Older adults with any dementia type will be included but HIV-related dementia will be excluded as the challenges posed by this patient group are different. Nursing staff and formal caregivers will be also included if they provide daily personal care for nursing home residents with dementia. Types of intervention Any intervention will be considered if the intervention aims to reduce resistance-to-care behaviors of nursing home residents with dementia. Types of outcomes The types of outcome measures will be frequency and intensity of resistance-to-care behavior during personal care. Outcomes related to caregivers will not be considered (e.g. the competency or perceptions of caregivers). Comparator Usual care