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Can a tailored exercise and home hazard reduction program reduce the rate of falls in community dwelling older people with cognitive impairment: protocol paper for the i-FOCIS randomised controlled trial

Background: The rate of falls in community dwelling older people with cognitive impairment (CI) is twice that of a cognitively intact population, with almost two thirds of people with CI falling annually. Studies indicate that exercise involving balance and/or a home hazard reduction program are effective in preventing falls in cognitively intact older people. However […]

Targeting and managing behavioral symptoms in individuals with dementia: a randomized trial of a nonpharmacological intervention

Objectives: To test the effects of an intervention that helps families manage distressing behaviors in family members with dementia.; Design: Two-group randomized trial.; Setting: In home.; Participants: Two hundred seventy-two caregivers and people with dementia.; Intervention: Up to 11 home and telephone contacts over 16 weeks by health professionals who identified potential triggers of patient […]

The cost-effectiveness of a nonpharmacologic intervention for individuals with dementia and family caregivers: the tailored activity program

Objectives: To evaluate cost-effectiveness of the Tailored Activity Program (TAP) for individuals with dementia and family caregivers.; Design: Cost-effectiveness study of a two-group randomized controlled trial involving 60 patients-caregiver dyads randomized to intervention or wait-list control.; Setting: Participants’ homes in Philadelphia region.; Participants: Caregivers were aged ≥ 21 years, lived with patients, and provided ≥ […]

The Tailored Activity Program to reduce behavioral symptoms in individuals with dementia: feasibility, acceptability, and replication potential

Purpose: The Tailored Activity Program (TAP) is a home-based occupational therapy intervention shown to reduce behavioral symptoms and caregiver burden in a randomized trial. This article describes TAP, its assessments, acceptability, and replication potential.; Design and Methods: TAP involves 8 sessions for a period of 4 months. Interventionists identify preserved capabilities, previous roles, habits, and […]

Translation of a dementia caregiver intervention for delivery in homecare as a reimbursable Medicare service: outcomes and lessons learned

Purpose: families of dementia patients receiving skilled homecare do not receive supportive services. We evaluated whether a proven intervention, Environmental Skill-building Program (ESP), which reduces caregiver burden and enhances skills managing patient functioning, can be integrated into homecare practices of occupational therapists (OTs) and reimbursed through Medicare Part B.; Design and Methods: a 2-year translational […]

A multidimensional home-based care coordination intervention for elders with memory disorders: the maximizing independence at home (MIND) pilot randomized trial

Objectives: To assess whether a dementia care coordination intervention delays time to transition from home and reduces unmet needs in elders with memory disorders.; Design: 18-month randomized controlled trial of 303 community-living elders.; Setting: 28 postal code areas of Baltimore, MD.; Participants: Age 70+ years, with a cognitive disorder, community-living, English-speaking, and having a study […]

A biobehavioral home-based intervention and the well-being of patients with dementia and their caregivers: the COPE randomized trial

Context: Optimal treatment to postpone functional decline in patients with dementia is not established.; Objective: To test a nonpharmacologic intervention realigning environmental demands with patient capabilities.; Design, Setting, and Participants: Prospective 2-group randomized trial (Care of Persons with Dementia in their Environments [COPE]) involving patients with dementia and family caregivers (community-living dyads) recruited from March […]

A non-pharmacologic approach to address challenging behaviors of Veterans with dementia: description of the tailored activity program-VA randomized trial

Background: Behavioral symptoms accompanying dementia are associated with increased health care costs, reduced quality of life and daily functioning, heightened family caregiver burden, and nursing home placement. Standard care typically involves pharmacologic agents, but these are, at best, modestly effective, carry serious risks, including mortality, and do not address behavioral symptoms families consider most distressful […]