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.