For many Kentuckians with dementia, medical interventions may seem like the only choice, but a new University of Kentucky study shows that prioritizing joy and engagement through enrichment activities is vital for the health of both residents and the caregivers who support them. This research highlights how advancing Kentucky's health care means looking beyond standard measures to support the holistic well-being of the aging population.
Researchers from the School of Music in the UK College of Fine Arts and the Sanders-Brown Center on Aging investigated how complementary and supportive care programs (CSCPs) - like animal interactions, music therapy and group games - affect life in four different Kentucky care facilities. To ensure privacy, exact locations were not provided, but the sites included a small rural nonprofit retirement community in a small town, a suburban for-profit memory care unit, and two sites located in midsize cities - a for-profit assisted living facility and a large nonprofit continuing care community.
The team found that although these programs significantly boost resident happiness and lower staff burnout, the current health care system has barriers that make it difficult for workers to document these positive impacts.
"So many measures seem very medically informed, but they seem to miss what the people actually doing the lion's share of the caregiving think about how people respond to the environment they're living in," said lead researcher Alaine E. Reschke-Hernández, Ph.D., an associate professor of music therapy in the School of Music and the Sanders-Brown Center on Aging.
The research team focused on the Kentucky health care system to understand how state-specific rules affect daily care. Through interviews, journals and site observations, they captured the reality of staff who often see residents "light up" during music or pet therapy but lack the time to record it due to top-down regulations that prioritize documenting negative medical incidents.
The qualitative multiple-case study, published in Alzheimer's & Dementia: Translational Research & Clinical Interventions, revealed a win-win scenario: residents engaged in these activities smiled more, moved their bodies and socialized better, which in turn lowered the overall stress of the care environment.
The study also found a benefit for the workforce: reduced stress.
"Care staff are in demanding roles and understanding that these programs also benefited them by alleviating their stress was a surprising result for me, and a hopeful one," said co-author Martina Vasil, Ph.D., an associate professor in the School of Music.
When residents are happily engaged, combative and exit-seeking behaviors decrease, which makes the staff's workload more manageable.
"I know what it's like to serve in a profession with high burnout (teaching), and care staff are similarly in a service role with high burnout rates," Vasil said.
The team, which included researchers with lived experience caring for family members with dementia, emphasized that these activities should be a standard part of care rather than an extra.
"The care of patients with neurodegenerative diseases like Alzheimer's and dementia should not be about lessening their decline alone - it should be enhancing their lives, too," said co-author Carson Woolums, a student researcher in the UK College of Medicine. "Focusing dementia care toward outcomes like meaning and connection helps reaffirm that people with dementia are still capable of rich, fulfilling emotional experiences."
"Complementary and supportive care programs can enhance person-centered care and the well-being of persons with dementia and the care staff who work with them," said co-author Emma King, a student researcher in the School of Music who conducted the site observations. "This study highlights the importance of sustainable policies that support care staff, who balance a variety of responsibilities in order to provide the best care possible."
Moving forward, the research team hopes these findings will serve as a catalyst for policy shifts within Kentucky's care facilities. By creating a framework for measuring quality-of-life interactions, UK aims to lead the way in transforming dementia care.
"I think some key points for anybody reading this would be to remember they're not patients, they're people with rich lives and memories and joy," Reschke-Hernández said. "It is really important to support both the people living with dementia and the people who care for them. Those two things are essential for high-quality dementia care."
The study was funded by the National Institutes of Health, the UK Office of the Vice President for Research and the UK College of Fine Arts.
Research reported in this publication was supported by the National Institute on Aging of the National Institutes of Health under Award Number P30AG072946. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
