Evidence-Base Support for I’m Still Here® Approach to Dementia Care
Impact
This page describes the evidence base for Hearthstone’s I’m Still Here® approach. This includes studies carried out by Hearthstone’s Research Division, articles by Hearthstone research staff, and other articles in the field supporting the approach.
The Impact Table summarizes the impact of Hearthstone’s I’m Still Here® programs and approaches on persons with dementia, as well as on family members, and members of staff. Data were obtained from a variety of sources, including NIH-funded studies, internal research on Hearthstone residents, literature reviews, and pre/post surveys with attendees of I’m Still Here® trainings.
Domains Impacted by Hearthstone’s Programs and Approaches
| Domain | Measure(s) | Sample(s) | Findings |
|---|---|---|---|
| Aggression (Any Type) | CMAI | 15 Special,Care Units (427 residents) | Residences that have fewer residents and have homelike qualities are correlated with reduced physical and/or verbal aggression |
| Aggression (Verbal) | CMAI | 15 Special Care Units (427 residents) | Residences with an appropriate sensory environment are correlated with reduced verbal aggression |
| Antipsychotic Use | % of Residents Taking Antipsychotics | Persons with dementia residing in a nursing home with staff trained on the I’m Still Here® Approach | Reduced percentage of participants taking antipsychotics after being trained on the I’m Still Here® Approach |
| Apathy | NPI-NH | Persons with dementia attending adult day centers and living at assisted living facilities and nursing homes | Reduction in apathy after regular participation in level-adjusted reading groups |
| Challenging Behaviors | CMAI | New Hearthstone residents | Reduction in challenging behaviors after living at Hearthstone for 3 months |
| Challenging Behaviors | CMAI | 15 Special Care Units (427 residents) | The use of private rooms that contain personal belongings is correlated with reduced challenging behaviors |
| Cognition | MMSE | Persons with late stage dementia residing in long term care | Improved cognition after regular participation in level-adjusted reading groups |
| Depression | GDS | Persons with dementia attending adult day centers and living at assisted living facilities and nursing homes, who also reported depression at baseline | Reduction in depressive symptoms after regular participation in level-adjusted reading groups |
| Depression | GDS | Persons with dementia attending adult day centers and living at assisted living facilities and nursing homes, who also reported depression at baseline | Reduction in depressive symptoms after taking part in two Scripted-IMPROV™ performances |
| Depression | MOSES | 15 Special Care Units (427 residents) | The presence of camouflaged exits and easily accessible exit controls for staff is correlated with reduced depression |
| Eating, Self-Performance | MDS | New Hearthstone residents | Increased independence with eating after living at Hearthstone for 3 months |
| Eating, Staff Assistance | MDS | New Hearthstone residents | Reduced reliance on staff with eating after living at Hearthstone for 3 months |
| Engagement | MPES | Hearthstone residents vs. similar sample of residents residing in a comparable long-term care facility | Higher levels of positive engagement for Hearthstone residents, as compared to residents at a similar type of residence |
| Engagement | MPES | Persons with dementia attending adult day centers and living at assisted living facilities and nursing homes | Higher levels of positive engagement and lower levels of negative engagement, as compared to standard programming, for persons who took part in Scripted-IMPROV™ performances |
| Engagement | MPES | Persons with dementia attending adult day centers and living at assisted living facilities and nursing homes | Higher levels of positive engagement and lower levels of negative engagement, as compared to standard programming, for persons who regularly took part in reading groups |
| Falls | Falls Per Month (on Average Over a Full Year) | Persons with dementia residing in a nursing home that was trained on the II’m Still Here® Approach | Reduced falls per month after being trained on the I’m Still Here® Approach |
| Pleasure | MPES | Persons with dementia attending adult day centers and living at assisted living facilities and nursing homes | Increase in pleasure, as compared to standard activities, for persons who took part in reading groups |
| Pleasure | MPES | Persons with dementia attending adult day centers and living at assisted living facilities and nursing homes | Increase in pleasure, as compared to standard activities, for persons who took part in Scripted-IMPROV™ |
| Psychiatric Problems | BEHAVE-AD | 15 Special Care Units (427 residents) | The use of private rooms that contain personal belongings is correlated with reduced psychiatric problems |
| Psychiatric Problems | BEHAVE-AD | 15 Special Care Units (427 residents) | Residences with an appropriate sensory environment are correlated with reduced psychiatric problems |
| Psychiatric Problems | BEHAVE-AD | 15 Special Care Units (427 residents) | Residences with appropriate walking paths are correlated with reduced psychiatric problems |
| Quality of Life | DEMQOL | New Hearthstone residents | Increase in quality of life after living at Hearthstone for 3 months |
| Quality of Life | DEMQOL | Persons with dementia attending adult day centers and living at assisted living facilities and nursing homes | Increase in quality of life after regular participation in reading groups |
| Quality of Life | DEMQOL | Hearthstone residents vs. similar UK/USA samples | Higher quality of life for Hearthstone residents, as compared to similar samples of residents in the US and the UK |
| Social Withdrawal | MOSES | 15 Special Care Units (427 residents) | The presence of several unique common spaces is correlated with reduced social withdrawal |
| Staff Utilization of Best Practices | I’m Still Here® Principles Checklist | Staff/Family Member Training Attendees | Increased use of I’m Still Here® principles after participation in I’m Still Here® trainings |
| Stigma | Zeisel Stigma Scale | Hearthstone residents vs. similar sample | Higher percentage of Hearthstone residents believe that persons with dementia “know who they are” and “can remember things,” as compared to a similar sample |
| Stigma | Zeisel Stigma Scale | Staff/Family Member Training Attendees | Reduced stigmatized beliefs after participation in an I’m Still Here® training |