Resident-to-Resident Elder Mistreatment Intervention for Dementia Care in Assisted Living

Resident-to-resident elder mistreatment (R-REM) is a significant problem in long-term services and support settings (LTSS), and likely to cause physical and or psychological distress. The proposed project tests an intervention developed for use by LTSS staff. As such, it represents an important step in the process of developing approaches for ameliorating and preventing R-REM in assisted living residences which house residents with dementia and related behavioral disorders, and is thus likely to have significant public health impact.

Study Overview

• Status: Completed
• Conditions: Assisted Living, Resident to Resident Elder Mistreatment
• Intervention / Treatment: Other: R-REM training

• Study Type: Interventional
• Enrollment (Actual): 930
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • New York
    • Bronx, New York, United States, 10471
      • Hebrew Home at Riverdale

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult; Older Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• all long term residents residing at each facility at baseline, for those unable to consent, proxy consent will be sought

Exclusion Criteria:

• residents receiving hospice care,
• facilities will have the option to exclude individuals for selected reasons, (e.g., severe psychosis)

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Prevention
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: R-REM training; 3 module training for frontline staff in assisted living facilities related to recognizing and management of resident-to-resident elder mistreatment	Other: R-REM training; three training modules for front-line long-term care staff to aid in recognition, management and reporting of R-REM
No Intervention: Usual Care; Usual care arm

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Falls, Accidents, and Injuries	Impact on falls, accidents, and injuries as measured by incident reports	Six months before baseline through twelve month follow-up

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Affect	Impact on participant affect as measured by the Feeling Tone Questionnaire (FTQ). A 16-item scale with a theoretical range of 0-32. Higher score indicates lower affect (depressed direction).	Baseline, 6- and 12- month follow-up

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Staff Knowledge Module 1	Module 1: Recognizing R-REM 10-item knowledge test related to recognizing resident-to-resident elder mistreatment The potential (theoretical) total score range is 0-10 with a higher score indicating more knowledge (better outcome)	Pre and post training evaluation: Immediately before and immediately after training
Staff Recognition, Reporting and Care Planning of Resident-to-resident Elder Mistreatment Events	Statistical Analysis 1: Count of participants with events reported by the staff through the informant interview measure Statistical Analysis 2: Count of events reported through the Behavior Recognition Documentation Sheets (BRDS)	baseline through 1-year follow-up
Staff Knowledge Module 2	Module 2: Management of R-REM 10-item knowledge tests The potential (theoretical) range is 0-10 with a higher score indicating more knowledge (better outcome)	Administered immediately before and immediately after training was provided

Collaborators and Investigators

• Sponsor: Hebrew Home at Riverdale
• Collaborators: National Institute on Aging (NIA); Weill Medical College of Cornell University; Cornell University
• Investigators: Principal Investigator: Jeanne A Teresi, PhD, EdD, Research Division, Hebrew Home at Riverdale

Publications and helpful links

General Publications

• Teresi JA, Silver S, Ramirez M, Kong J, Eimicke JP, Boratgis GD, Meador R, Schultz L, Lachs MS, Pillemer KA. Resident-to-resident elder mistreatment (R-REM) intervention for direct care staff in assisted living residences: study protocol for a cluster randomized controlled trial. Trials. 2020 Aug 12;21(1):710. doi: 10.1186/s13063-020-04580-z.

Study record dates

Study Major Dates

• Study Start (Actual): June 22, 2018
• Primary Completion (Actual): June 5, 2023
• Study Completion (Actual): June 5, 2023

Study Registration Dates

• First Submitted: December 8, 2017
• First Submitted That Met QC Criteria: December 22, 2017
• First Posted (Actual): December 26, 2017

Study Record Updates

• Last Update Posted (Actual): March 30, 2025
• Last Update Submitted That Met QC Criteria: March 28, 2025
• Last Verified: March 1, 2025

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Mental Disorders; Neurocognitive Disorders; Dementia
• Other Study ID Numbers: 952; 5R01AG057389 (U.S. NIH Grant/Contract)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: To be determined

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No