Improving the Rehabilitation Process

Study Summary

A major challenge in care of persons with dementia is that illness and hospitalizations can lead to significant decreases in functional abilities. Maintaining functional abilities as high as possible is a key goal in dementia care, because persons are able to function optimally despite cognitive problems and engage in more preferred and enjoyable activities. Functional decline can be ameliorated through rehabilitation, building strength, balance and functional competencies. People with dementia, however, may not able to engage fully in rehabilitation due to their cognitive problems. They may not understand the therapist's instructions and may be fearful of what the therapist is trying to do. The proposed study will test the efficacy of a multifunctional interactive computer system, the IN2L, that uses video and audio to engage people more fully in rehabilitation. Music and videos elicit and sustain responses that contribute to rehabilitation goals such as increasing balance or strength. With the IN2L, audio and video material that matches the preferences and past experience of the person in rehabilitation can be selected. While this approach shows promise with rehabilitation patients generally, it has particular potential for application with persons with dementia. Specifically, when Physical or Occupational Therapists (PT and OT) are not able to engage a person with dementia in rehabilitation tasks using verbal instructions and explanations, they may be able to involve the person using audio and video stimuli that draw upon abilities that have remained intact despite the disease. To determine the efficacy of IN2L, the study will use a quasi-experimental design that compares rehabilitation patients with dementia seen at two comparable facilities operated by Presbyterian Senior Care Network. In one facility, the Willows, OT and PT currently use IN2L. In the comparison facility, (Southmont), OT and PT do not currently have access to IN2L. This type of design is opti

Primary Outcome

Measures change in engagement in therapy from the beginning to the end of rehabilitation. Scores range from 0--no engagement to 5--excellent engagement. Higher scores indicate a better outcome. There are no subscales.

Interventions

• DEVICE IN2L computer system