Healthcare systems around the world, including within the United States, have long-established shortages of trained caregivers (WHO, 2016; Jones, Liu, Murfield, & Moyle, 2020). The American Health Care Association (2019) states that "the health care system has experienced a shortage of trained caregivers for critical roles for some time." This scarcity directly impacts the 45,800 Long-Term Care (LTC) communities throughout the U.S. (Harris-Kojetin et al, 2016).Concurrent with this staff shortage, more than half of LTC residents have some form of dementia (Alzheimer's Association,2019). These two issues create a serious public health concern, since dementia is associated with a variety of behavioral expressions, such as aggression, anxiety, and agitation (Cummings, 1997). Behavioral expressions of dementia can be successfully managed with the use of tailored, psychosocial interventions and communication support (Vernooij-Dassen etal., 2010; Fazio et al., 2018). Unfortunately, existing staff shortages make the facilitation of such interventions challenging. One powerful and often-overlooked approach to ameliorating staffing shortages involves the utilization of retired volunteers to facilitate interventions for persons with dementia (PWD). Based on the nearly universal love of music and a promising pilot study, the product to be developed and tested in this STTR will build upon the combined prior work of the Principal Investigators. Making Connections Thru Music (MCTM), an urgently needed product, will enable retired volunteers to facilitate an evidence-based music and discussion intervention with PWD. MCTM aims to improve engagement, enhance quality of life, and reduce behavioral expressions in PWD. The intervention will consist of two main components: (1) a comprehensive online training course for volunteers, which will provide a general overview of dementia, demonstrate effective communication strategies to use with PWD, and instruct volunteers to effectively facilitate MCTM sessions, and (2) an app containing a structured MCTM intervention protocol and toolkit, which will be the means by which volunteers facilitate MCTM. MCTM will be marketed to LTC communities. PHASE 1 SPECIFIC AIMS The 12-month Phase I project has the following Specific Aims: Â Aim 1: Improve and expand upon the MCTM training materials / curriculum and the MCTM intervention itself. Â Aim 2: Produce two MCTM prototype training modules. Â Aim 3: Produce a prototype of a MCTM tablet-based app. Â Aim 4: Conduct focus groups to examine feasibility and acceptability of the prototype training modules and app. PHASE II SPECIFIC AIMS The 24-month Phase II has the following Specific Aims. Â Aim 1: Finalize the MCTM online training course. Â Aim 2: Complete development of the MCTM tablet-based app. Â Aim 3: Conduct a Fidelity Trial of the MCTM intervention. In the Fidelity Trial, we will examine staff and volunteer adherence to the intervention, engagement/affect levels produced by volunteer- and staff-led MCTM sessions, and self-reported PWD satisfaction with MCTM.
Public Health Relevance Statement: Project narrative: An estimated 6.2 million Americans are currently suffering from Alzheimer's disease (AD); besides affecting the person with the condition, AD also presents a public health concern, due to the significant cost required to care for persons with dementia (PWD) and to the mental and physical stress placed upon caregivers. So, there is an urgent need for products and programs that improve the quality of life of PWD and reduce Behavioral Expressions. Additionally, the long term care industry is regularly afflicted by staffing shortages leading to reduced quality of care for PWD. Through the development and evaluation of an app that enables retired senior volunteers to lead a personalized music and discussion intervention with persons with dementia, the proposed project will help meet this need.
Project Terms: Affect, Elderly, advanced age, elders, geriatric, late life, later life, older adult, older person, senior citizen, Aggressive behavior, Aggression, Aging, Alzheimer's Disease, AD dementia, Alzheimer, Alzheimer Type Dementia, Alzheimer disease, Alzheimer sclerosis, Alzheimer syndrome, Alzheimer's, Alzheimer's disease dementia, Alzheimers Dementia, Alzheimers disease, Primary Senile Degenerative Dementia, dementia of the Alzheimer type, primary degenerative dementia, senile dementia of the Alzheimer type, Anxiety, Chronic Disease, Chronic Illness, chronic disorder, Communication, Communities, E-learning, computer-assisted instruction, computer-based education, computer-based instruction, computer-based learning, computer-based training, digital education, digital learning, eLearning, electronic learning, internet-assisted education, internet-based training, multimedia learning, on-line education, on-line learning, online education, online learning, technology-enhanced learning, virtual learning, web-based instruction, web-based training, Educational Curriculum, Curriculum, lesson plans, Mental Depression, depression, Elements, Feedback, Focus Groups, Health, Healthcare Systems, Health Care Systems, Health care facility, Health Facilities, Healthcare Facility, care facilities, Industry, Lead, Pb element, heavy metal Pb, heavy metal lead, Light, Photoradiation, Long-Term Care, extended care, longterm care, Love, Music, Music Therapy, Persons, Paper, pilot study, Pilot Projects, Public Health, QOL, Quality of life, Research, social role, Role, Stress, Tablets, Testing, Time, Training Activity, training module, United States, Use Effectiveness, Work, Caregivers, Care Givers, Agitation, Psychomotor Agitation, Psychomotor Excitement, Psychomotor Hyperactivity, Psychomotor Restlessness, Restlessness, Healthcare, health care, Blinded, Caring, base, improved, Site, Area, Phase, Evaluation, Training, mental, Psyche structure, satisfaction, Funding, Collaborations, programs, Protocol, Protocols documentation, Amentia, Dementia, psychosocial, American, experience, Structure, member, Self-Report, Patient Self-Report, QOC, Quality of Care, develop software, developing computer software, software development, Intervention Strategies, interventional strategy, Intervention, Institution, Adherence, Data, Caregiver instruction, care giver education, care giver instruction, care giver training, caregiver training, caregiver education, Small Business Technology Transfer Research, STTR, Principal Investigator, Development, developmental, Behavioral, cost, design, designing, aged, volunteer, prototype, evidence base, acceptability and feasibility, online version
