6 Replies to “Resident in Late – Stage Dementia Exercising at a Fitness Center – A Case Study”

  1. It’s nice to know that under the right conditions with the right person assisting, that people in this situation can improve their overall health. Since her aggressive behavior and struggles with hygiene were discussed, I wish the case study discussed any outcomes in these areas due to her improved health.

  2. Thanks for your note Mike. You are raising an interesting point. The study, however, did not examine the effects of the resident’s improved physical function (due to her participation in the fitness center) on her engagement in “aggressive” behaviors and behaviors that compromised her hygiene. This was a qualitative study that used unstructured observation as the primary data collection strategy (as opposed to quantitative study methods that often use structured instruments that are designed to capture measurable outcomes and enable to conduct comparisons across different care situations). It would be interesting to examine this issue in future research as establishing empirical evidence to support the link you are suggesting could have significant practical implications for improving the care of residents with similar conditions and behaviors.

    That being said, several staff members, review of staff behavioral log, and my unstructured observations indicated that when this resident was meaningfully engaged in a group activities (such as pet therapy or music therapy) and when staff members engaged her in one-to-one supportive interactions, she was much less likely to engage in these behavioral expressions. However, when the activities were not planned well or delivered skillfully (such as when she was allowed to sit next to a resident with whom she didn’t get along), you could certainly see “aggressive” behaviors (such as when she was speaking loudly and repetitively next to this resident who was known not to tolerate it).

    When staff members anticipated the times when she was inclined to engage in behaviors that compromised her hygiene (such as during early morning hours inside her bedroom/bathroom) and proactively supervised and assisted her BEFORE she was able to engage in these behaviors, they were often successful in preventing these behaviors (consistent with the principle of Anticipatory Care Approach; term coined by Prof. Christine Kovach).

    By contrast, during times when she was left on her own for significant periods, she frequently engaged in behaviors that compromised her hygiene, she tended to become anxious, and was engaged in altercations with other residents.

    Hope this addresses your question.

    For more information about this aspect of the study, I invite you and others to read my article:

    Caspi, E. (2014). Does self-neglect occur among older adults with dementia when unsupervised in Assisted Living? An exploratory, observational study. Journal of Elder Abuse and Neglect, 26(2), 123-149.

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