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To evaluate, by comparison with the classical method, the effectiveness of using the TNmP method in reducing the intensity or frequency of behavioral disorders in elderly people institutionalized in an institution.
Cognitive and psychological symptoms (CPS) are highly prevalent among dependent individuals with residual cognitive decline living in nursing homes (EHPAD). It is well established that personalized non-pharmacological therapies (PNPTs) play a major role in the management of CPS.
Traditionally, PNPTs are selected by geriatric nursing assistants according to the type of CPS and their knowledge of the resident, and are implemented in real time. The present project aims to describe and characterize a novel approach to the selection of PNPTs: the TNmP method, developed by Dr. Thierry Bautrant.
The TNmP method is based on an in-depth observation of behavioral disturbances and on a multidisciplinary decision-making process, with the objective of ensuring that the proposed PNPT is optimally adapted to the underlying psychiatric condition (anxiety, depression, apathy, or psychotic disorders) responsible for the behavioral symptoms. This approach takes into account the individual's life history and personality, personal preferences, and preserved physical and cognitive abilities (referred to as CHA: capacities, history, affinities).
To this end, healthcare professionals, under the supervision of their clinical leadership (physician, psychologist), meet on a weekly basis to discuss residents' cases. These meetings aim to identify the observed symptoms, determine their underlying causes, integrate the CHA framework, and select the most appropriate therapeutic intervention, including its practical modalities of implementation (who delivers the intervention, when, and how).
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| before/after study | Other | To evaluate the effectiveness of the TNmP method in reducing the intensity and/or frequency of behavioral disturbances by comparing two groups of centers (four using the conventional PNPT selection method and six using the TNmP method). |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| TNmP | Other | To evaluate the effectiveness of the TNmP method in reducing the intensity and/or frequency of behavioral disturbances by comparing two groups of centers (four using the conventional PNPT selection method and six using the TNmP method). |
| Measure | Description | Time Frame |
|---|---|---|
| Intensity or frequency of behavioral disorders | The primary outcome measure is to determine whether the use of the TNmP method is associated with greater effectiveness, compared with the conventional method, in reducing the intensity and/or frequency of agitation, resistance to care, or excessive wandering | At inclusion and 6 months after inclusion |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Valérie BRENIERE, Dr | Contact | 01 81 70 51 97 | valerie.breniere@univi.fr | |
| Fatima IZEDAREN | Contact | 0139637451 | fatima-zohra.izedaren@lpv.univi.fr |
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To evaluate the effectiveness of the TNmP method in reducing the intensity and/or frequency of behavioral disturbances by comparing ten groups of centers (four using the conventional PNPT selection method and six using the TNmP method).
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