Effect of an Intervention on Health in Older Care Home Residents

The Physical and Psychosocial Effects of a Whole Systems Wellness Intervention for Older Adults Living in Care Homes: A Feasibility Study

Care home residents spent 79% of their time being sedentary. Reduced physical activity and lack of mental stimulation causes general weakness and frailty in older adults that can result in increased healthcare needs. It is important that care home residents spend their time being both physically and psychosocially engaged.

This study aims to investigate the effect of a wellness programme on physical and psychosocial wellbeing in older adults living in care homes. Through this process this study will assess the feasibility of implementing the programme and collecting data in care home settings.

There are two main groups of participants, 1) care home residents and 2) care home staff.

Care home residents will have data collected at three time points. The first time point will be before the intervention (baseline) in the care home setting. The second time point will be three months after the intervention has been delivered. The third time point will be 6 months after the intervention has been delivered.

The following measurements will be conducted:

1. Measuring hand grip strength by having to grip a device as firmly as possible and measurements will be taken,
2. Answering questionnaires about quality of life, daily routine, appetite, thoughts about wellness activities the participants have participated in,
3. Wearing a little 'match box-like' device (that measures daily movements and sleep patterns) for 7 consecutive days.

Care home staff will be invited to participate in a focus group discussion 6 months after the intervention. Hence, this research will aim to understand the impact of a wellness programme that incorporates physical and psychosocial components that targets the holistic wellbeing of older adults.

Study Overview

• Status: Withdrawn
• Conditions: Frail Elderly Syndrome; Frailty; Sedentary Behavior; Life Style Induced Illness; Lifestyle, Sedentary
• Intervention / Treatment: Other: Wellness programme provided by Oomph! Wellness company

Detailed Description

The following potential issues have been identified:

1. This feasibility study is being carried out in older adults living in care homes. Older adults are considered to be vulnerable population by the definition of the World Health Organisation.

2. This study involves residents with cognitive impairment who may not be able to give consent for themselves to take part in the study. To overcome these issues, the research team is very mindful not to exclude residents with cognitive impairment who otherwise are able to participate in the Wellness activities. Th investigators will strictly adopt the Dewing process of gaining consent for older adults with cognitive impairment which involves ongoing consent monitoring. The investigators have followed the guidelines of Mental Capacity Act 2005 and designed participant information sheets and consulted declaration form who could consent on the participant's behalf (consultee). If consent is not obtained, the participant will not be recruited into the study. The consultee will be able to withdraw consent at any time in the study. Any visible distress observed during participation (eg. use of handgrip dynamometer & accelerometer) will be recorded and the participant will be withdrawn from the study.

   Participants will also be regularly reminded that they can choose to withdraw from the study at any point, without any explanation and that care received would not be affected or compromised due to this study.

3. All data collected will be stored on password protected computers and/or the BU secure server and will be handled in accordance with the General Data Protection Regulation 2018 and Data Protection Act 2018. Data will only be accessed by the investigator and the supervisor, and the participant's identity will be anonymised using a coding system.

   Conflict of Interest:

4. There will be no conflict of interest in the study.

• Study Type: Interventional
• Phase: Not Applicable

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 65 years and older (OLDER_ADULT)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: All

Description

Inclusion Criteria (care home residents):

• Residents' Age: 65 years of age and older living in a care home, and
• Have no cognitive impairment or in case of cognitive impairment have a score of more than 14 on the Montreal Cognitive Assessment (MOCA) screening (Nasreddine et al 2005) and who are able to provide consent or have next-of-kin/relatives/ friends who can give consent on their behalf.

Inclusion criteria (care home employee):

• All full time care home employees and part-time employees who work in the care home on a long-term basis and interact with the care home residents

Exclusion criteria (care home residents):

• 65 years of age and above residents who score less than 14 on the MOCA screening will have moderate to severe cognitive impairment as they may not be able to follow the intervention and tests, or
• with physical or neurological condition that impedes the usage of the hand grip dynamometer, or
• with skin contraindications to wearing an accelerometer, or
• Known to have a diagnosis of severe dementia or other health conditions that contraindicate their participation in the study, or
• residents with cognitive impairment where English is not primary language as screening test is language sensitive, or
• residents who are registered blind with or without mild cognitive impairment

Exclusion criteria (care home employees):

• Part time employees who work on an ad hoc basis and only have intermittent/minimal interaction with care home residents

Study Plan

How is the study designed?

Design Details

• Primary Purpose: OTHER
• Allocation: NA
• Interventional Model: SINGLE_GROUP
• Masking: NONE

Number of Arms

1

Arms and Interventions

Participant Group / Arm

Intervention / Treatment

OTHER: Single arm study; This study only contains one arm

Other: Wellness programme provided by Oomph! Wellness company; The Oomph! wellness programme empowers older adults to lead a full life for life. It focuses on building an individual-centred programme that consists of a varied exercise and activity plans including days out. All of these, aims in improving the physical and psychosocial wellness in older adults. This intervention is a three day training session for care home staff to understand and learn how to facilitate care activities within their care home.; Other Names: Oomph! Wellness

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Accelerometer(Actigraph)	To measure the level of physical activity	Pre-intervention for 7 days
Accelerometer(Actigraph)	To measure the level of physical activity	3 months post-intervention
Accelerometer(Actigraph)	To measure the level of physical activity	6 months post-intervention
Barthel Index	To measure the independence in performing activities of daily living	Pre-intervention
Barthel Index	To measure the independence in performing activities of daily living	3 months post-intervention
Barthel Index	To measure the independence in performing activities of daily living	6 months post-intervention
Hand grip dynamometer	To measure their grip strength by using their hands to grip the dynamometer	Pre-intervention
Hand grip dynamometer	To measure their grip strength by using their hands to grip the dynamometer	3 months post-intervention
Hand grip dynamometer	To measure their grip strength by using their hands to grip the dynamometer	6 months post-intervention
Simplified Nutritional Appetite Questionnaire (SNAQ)	Self-administered questionnaire that will measure appetite levels	Completed pre-intervention
Simplified Nutritional Appetite Questionnaire (SNAQ)	Self-administered questionnaire that will measure appetite levels	Completed 3 months post-intervention and 6 months post intervention
Simplified Nutritional Appetite Questionnaire (SNAQ)	Self-administered questionnaire that will measure appetite levels	Completed 6 months post-intervention
EQ-5D-5L questionnaire	self-administered questionnaire that will measure quality of life	Completed pre-intervention
EQ-5D-5L questionnaire	self-administered questionnaire that will measure quality of life	Completed 3 months post-intervention and 6 months post intervention
EQ-5D-5L questionnaire	self-administered questionnaire that will measure quality of life	Completed 6 months post-intervention
Focus group discussion for care home staff	this will be a guided discussion facilitated by the researcher to understand the feasibility of implementing personalised interactive exercises & activities in a care home	Conducted at the 6 month timeline of data collection

Collaborators and Investigators

• Sponsor: Bournemouth University
• Collaborators: Royal Bournemouth and Christchurch Hospitals NHS Foundation Trust; Oomph! Wellness; Solent University
• Investigators: Study Director: Jane Murphy, Professor of Nutrition

Publications and helpful links

General Publications

• Bradshaw SA, Playford ED, Riazi A. Living well in care homes: a systematic review of qualitative studies. Age Ageing. 2012 Jul;41(4):429-40. doi: 10.1093/ageing/afs069. Epub 2012 Jun 7.

Study record dates

Study Major Dates

• Study Start (ANTICIPATED): July 1, 2020
• Primary Completion (ANTICIPATED): January 1, 2021
• Study Completion (ANTICIPATED): April 1, 2022

Study Registration Dates

• First Submitted: May 21, 2020
• First Submitted That Met QC Criteria: December 2, 2020
• First Posted (ACTUAL): December 9, 2020

Study Record Updates

• Last Update Posted (ACTUAL): December 9, 2020
• Last Update Submitted That Met QC Criteria: December 2, 2020
• Last Verified: December 1, 2020

More Information

Terms related to this study

• Keywords: physical activity; older adults; elderly; care home; psychosocial activity; care home staff; care home residents
• Additional Relevant MeSH Terms: Pathologic Processes; Frailty
• Other Study ID Numbers: 276089

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: Individual participant data are strictly confidential and will not be accessed by researcher. This will be assessed by care home staff.

Drug and device information, study documents

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