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

DomainMeasure(s)Sample(s)Findings
Aggression
(Any Type)
CMAI15 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)
CMAI15 Special Care Units
(427 residents)
Residences with an appropriate sensory environment are correlated with reduced verbal aggression
Antipsychotic Use% of Residents Taking AntipsychoticsPersons with dementia residing in a nursing home with staff trained on the I’m Still Here® ApproachReduced percentage of participants taking antipsychotics after being trained on the I’m Still Here® Approach
ApathyNPI-NHPersons with dementia attending adult day centers and living at assisted living facilities and nursing homesReduction in apathy after regular participation in level-adjusted reading groups
Challenging BehaviorsCMAINew Hearthstone residentsReduction in challenging behaviors after living at Hearthstone for 3 months
Challenging BehaviorsCMAI15 Special Care Units
(427 residents)
The use of private rooms that contain personal belongings is correlated with reduced challenging behaviors
CognitionMMSEPersons with late stage dementia residing in long term careImproved cognition after regular participation in level-adjusted reading groups
DepressionGDSPersons with dementia attending adult day centers and living at assisted living facilities and nursing homes, who also reported depression at baselineReduction in depressive symptoms after regular participation in level-adjusted reading groups
DepressionGDSPersons with dementia attending adult day centers and living at assisted living facilities and nursing homes, who also reported depression at baselineReduction in depressive symptoms after taking part in two Scripted-IMPROV™ performances
DepressionMOSES15 Special Care Units
(427 residents)
The presence of camouflaged exits and easily accessible exit controls for staff is correlated with reduced depression
Eating, Self-PerformanceMDSNew Hearthstone residentsIncreased independence with eating after living at Hearthstone for 3 months
Eating, Staff AssistanceMDSNew Hearthstone residentsReduced reliance on staff with eating after living at Hearthstone for 3 months
EngagementMPESHearthstone residents vs. similar sample of residents residing in a comparable long-term care facilityHigher levels of positive engagement for Hearthstone residents, as compared to residents at a similar type of residence
EngagementMPESPersons with dementia attending adult day centers and living at assisted living facilities and nursing homesHigher levels of positive engagement and lower levels of negative engagement, as compared to standard programming, for persons who took part in Scripted-IMPROV™ performances
EngagementMPESPersons with dementia attending adult day centers and living at assisted living facilities and nursing homesHigher levels of positive engagement and lower levels of negative engagement, as compared to standard programming, for persons who regularly took part in reading groups
FallsFalls 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® ApproachReduced falls per month after being trained on the I’m Still Here® Approach
PleasureMPESPersons with dementia attending adult day centers and living at assisted living facilities and nursing homesIncrease in pleasure, as compared to standard activities, for persons who took part in reading groups
PleasureMPESPersons with dementia attending adult day centers and living at assisted living facilities and nursing homesIncrease in pleasure, as compared to standard activities, for persons who took part in Scripted-IMPROV™
Psychiatric ProblemsBEHAVE-AD15 Special Care Units
(427 residents)
The use of private rooms that contain personal belongings is correlated with reduced psychiatric problems
Psychiatric ProblemsBEHAVE-AD15 Special Care Units
(427 residents)
Residences with an appropriate sensory environment are correlated with reduced psychiatric problems
Psychiatric ProblemsBEHAVE-AD15 Special Care Units
(427 residents)
Residences with appropriate walking paths are correlated with reduced psychiatric problems
Quality of LifeDEMQOLNew Hearthstone residentsIncrease in quality of life after living at Hearthstone for 3 months
Quality of LifeDEMQOLPersons with dementia attending adult day centers and living at assisted living facilities and nursing homesIncrease in quality of life after regular participation in reading groups
Quality of LifeDEMQOLHearthstone residents vs. similar UK/USA samplesHigher quality of life for Hearthstone residents, as compared to similar samples of residents in the US and the UK
Social WithdrawalMOSES15 Special Care Units
(427 residents)
The presence of several unique common spaces is correlated with reduced social withdrawal
Staff Utilization of Best PracticesI’m Still Here® Principles ChecklistStaff/Family Member Training AttendeesIncreased use of I’m Still Here® principles after participation in I’m Still Here® trainings
StigmaZeisel Stigma ScaleHearthstone residents vs. similar sampleHigher percentage of Hearthstone residents believe that persons with dementia “know who they are” and “can remember things,” as compared to a similar sample
StigmaZeisel Stigma ScaleStaff/Family Member Training AttendeesReduced stigmatized beliefs after participation in an I’m Still Here® training