Nursing Home Resident Outcomes from the Res-Care Intervention

OBJECTIVES To test the effectiveness of a restorative care (Res-Care) intervention on function, muscle strength, contractures, and quality of life of nursing home residents, with secondary aims focused on strengthening self-efficacy and outcome expectations. DESIGN A randomized controlled repeated-measure design was used, and generalized estimating equations were used to evaluate status at baseline and 4 and 12 months after initiation of the Res-Care intervention. SETTING Twelve nursing homes in Maryland. PARTICIPANTS Four hundred eighty-seven residents consented and were eligible: 256 from treatment sites and 231 from control sites. The majority were female (389, 80.1%) and white (325, 66.8%); 85 (17.4%) were married and the remaining widowed, single, or divorced/separated. Mean age was 83.8 +/- 8.2, and mean Mini-Mental State Examination score was 20.4 +/- 5.3. INTERVENTION Res-Care was a two-tiered self-efficacy-based intervention focused on motivating nursing assistants and residents to engage in functional and physical activities. MEASUREMENTS Barthel Index, Tinetti Gait and Balance, grip strength, Dementia Quality-of-Life Scale, self-efficacy, and Outcome Expectations Scales for Function. RESULTS Significant treatment-by-time interactions (P <.05) were found for the Tinetti Mobility Score and its gait and balance subscores and for walking, bathing, and stair climbing. CONCLUSION The findings provide some evidence for the utility and safety of a Res-Care intervention in terms of improving function in NH residents.