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Effectiveness of Expanded Implementation of STAR-VA for Managing Dementia-Related Behaviors Among Veterans.

Publication ,  Journal Article
Karel, MJ; Teri, L; McConnell, E; Visnic, S; Karlin, BE
Published in: The Gerontologist
February 2016

Nonpharmacological, psychosocial approaches are first-line treatments for managing behavioral symptoms in dementia, but they can be challenging to implement in long-term care settings. The Veterans Health Administration implemented STAR-VA, an interdisciplinary behavioral approach for managing challenging dementia-related behaviors in its Community Living Center (CLCs, nursing home care) settings. This study describes how the program was implemented and provides an evaluation of Veteran clinical outcomes and staff feedback on the intervention.One mental health professional and registered nurse team from 17 CLCs completed STAR-VA training, which entailed an experiential workshop followed by 6 months of expert consultation as they worked with their teams to implement STAR-VA with Veterans identified to have challenging dementia-related behaviors. The frequency and severity of target behaviors and symptoms of depression, anxiety, and agitation were evaluated at baseline and at intervention completion. Staff provided feedback regarding STAR-VA feasibility and impact.Seventy-one Veterans completed the intervention. Behaviors clustered into 6 types: care refusal or resistance, agitation, aggression, vocalization, wandering, and other. Frequency and severity of target behaviors and symptoms of depression, anxiety, and agitation all significantly decreased, with overall effect sizes of 1 or greater. Staff rated both benefits for Veterans and program feasibility favorably.This evaluation supports the feasibility and effectiveness of STAR-VA, an interdisciplinary, behavioral intervention for managing challenging behaviors among residents with dementia in CLCs.

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Published In

The Gerontologist

DOI

EISSN

1758-5341

ISSN

0016-9013

Publication Date

February 2016

Volume

56

Issue

1

Start / End Page

126 / 134

Related Subject Headings

  • Veterans
  • United States Department of Veterans Affairs
  • United States
  • Retrospective Studies
  • Psychotherapy
  • Pilot Projects
  • Male
  • Humans
  • Homes for the Aged
  • Gerontology
 

Citation

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Chicago
ICMJE
MLA
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Karel, M. J., Teri, L., McConnell, E., Visnic, S., & Karlin, B. E. (2016). Effectiveness of Expanded Implementation of STAR-VA for Managing Dementia-Related Behaviors Among Veterans. The Gerontologist, 56(1), 126–134. https://doi.org/10.1093/geront/gnv068
Karel, Michele J., Linda Teri, Eleanor McConnell, Stephanie Visnic, and Bradley E. Karlin. “Effectiveness of Expanded Implementation of STAR-VA for Managing Dementia-Related Behaviors Among Veterans.The Gerontologist 56, no. 1 (February 2016): 126–34. https://doi.org/10.1093/geront/gnv068.
Karel MJ, Teri L, McConnell E, Visnic S, Karlin BE. Effectiveness of Expanded Implementation of STAR-VA for Managing Dementia-Related Behaviors Among Veterans. The Gerontologist. 2016 Feb;56(1):126–34.
Karel, Michele J., et al. “Effectiveness of Expanded Implementation of STAR-VA for Managing Dementia-Related Behaviors Among Veterans.The Gerontologist, vol. 56, no. 1, Feb. 2016, pp. 126–34. Epmc, doi:10.1093/geront/gnv068.
Karel MJ, Teri L, McConnell E, Visnic S, Karlin BE. Effectiveness of Expanded Implementation of STAR-VA for Managing Dementia-Related Behaviors Among Veterans. The Gerontologist. 2016 Feb;56(1):126–134.
Journal cover image

Published In

The Gerontologist

DOI

EISSN

1758-5341

ISSN

0016-9013

Publication Date

February 2016

Volume

56

Issue

1

Start / End Page

126 / 134

Related Subject Headings

  • Veterans
  • United States Department of Veterans Affairs
  • United States
  • Retrospective Studies
  • Psychotherapy
  • Pilot Projects
  • Male
  • Humans
  • Homes for the Aged
  • Gerontology