Pilot Testing Decision Making in Aging and Dementia for Autonomy Program in Nursing Homes

The purpose of this study is to adapt, pilot test, and evaluate the feasibility, acceptability, and preliminary effectiveness of DIGNITY (Decision-making In aGing and demeNtIa for auTonomY) for Preference-Based Care in Nursing Homes as a new evidence-based intervention to support nursing home staff to safely honor care and activity preferences of residents' living with dementia in rural, typically under resourced nursing home communities.

Inclusion Criteria for Nursing Homes:Located in rural Pennsylvania per the Rural Health Information Hub54Administrator articulates commitment to delivering person-centered careNH has a dedicated dementia care unit and/or a total bed capacity of 100 beds or moreNH has the capacity to participate in the study activities for the term of the study as determined by nursing home leadershipNH has a dedicated quality improvement/safety team that meets regularlyNH has a stable internet connectivity for program deliveryExclusion Criteria:Nursing Home does not meet inclusion criteria.Convenience sampling will be used to recruit nursing home staff and residents within nursing homes.Inclusion criteria for Nursing Home Staff:18 years or olderEmployed by the participating nursing home for at least 6 monthsFluent in written and spoken EnglishProvides and/or influences direct care delivery to older adults with dementiaInclusion criteria for Residents:Resides in nursing home study site for at least 3 monthsEnglish speakingDocumented diagnosis of Alzheimer's disease or related dementia (ADRD)Have a stated preference that nursing home staff indicated poses a risk to their health and/or safetyProvides consent/assent to be enrolled