Alzheimer’s disease or related dementia are a major cause of death in the United States. While effective interventions have been developed to deliver palliative care to nursing home residents with ADRD, little work has identified effective interventions to reach assisted living (AL) residents with dementia.
118 AL residents with dementia from 10 different ALs in Florida participated. A pilot study using a cluster-randomized trial was conducted, with six sites randomized to receive a palliative care educational intervention for staff (N =23) to deliver care to residents; four sites were usual care. The feasibility of the intervention was assessed by examining recruitment, retention and treatment fidelity at 6 months. Cohen’s d statistic was used to calculate facility level treatment effect sizes on key outcomes (documentation of advance care planning discussions, hospice admission, and documentation of pain screening).
The intervention proved feasible with high ratings of treatment fidelity. The intervention also demonstrated preliminary evidence for efficacy of the intervention, with effect sizes for the treatment group over .80 for increases in documentation of ACP discussions compared to the control group. Hospice admissions had a smaller effect size (.16) and documentation of pain screenings had no effect.
The pilot results suggest that the intervention shows promise as a resource for educating and empowering AL staff on implementing person-centered palliative care delivery to persons with dementia in assisted living. a larger, fully powered randomized trial Is needed to test for its efficacy.

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