# Reducing Behavioral and Psychological Symptoms of Dementia (BPSD) for Acutely-Ill Persons with Alzheimers Disease and Related Dementias via Patient Engagement Specialists

> **NIH NIH R21** · FEINSTEIN INSTITUTE FOR MEDICAL RESEARCH · 2020 · $210,997

## Abstract

Project Summary/Abstract
Persons with Alzheimer’s Disease and Related Dementias (ADRD) currently account for 3.2 million hospital
admissions per year and have over three times more hospitalizations than those without cognitive impairment.
Yet, hospital caregivers are currently ill-prepared to manage patients with ADRD, with less than 5% reporting
mandatory dementia care training. Three-quarters of hospitalized persons with ADRD display Behavioral and
Psychological Symptoms of Dementia (BPSD), associated with functional and cognitive decline, increased
resource consumption, institutionalization, premature death, and caregiver burden. The overall objective of this
project is to test the preliminary efficacy of an innovative model of care, the PES-4-BPSD, for reducing BPSD
by empowering Patient Engagement Specialist (PES) to deliver dementia care for acutely-ill patients with
ADRD. Traditionally, mental health assistants with training in crisis-prevention techniques provide care to
psychiatric patients. On the intervention unit, these mental health assistants, as PES, purposefully engage
patients with BPSD. In our pilot study, we found that patients with cognitive impairment admitted to the PES
unit were significantly less likely to require constant observation, chemical and physical restraints, suggesting
improved management of BPSD. Our central hypothesis is that the PES-4-BPSD intervention will improve the
ability of PES to create an “enabling” milieu that addresses the factors leading to BPSD and improves the
experience of hospital caregivers. Guided by a social-ecological framework, the PES-4-BPSD model
incorporates: dementia education and training, environmental modifications-cohorting, increased staffing-PES,
and staff support. Our multidisciplinary research team is well-positioned to accomplish the following aims: Aim
1: Determine the preliminary efficacy of the PES-4-BPSD intervention for reducing BPSD during hospitalization
and Aim 2: Evaluate whether dementia care training improves the perceived ability of PES staff (intervention)
and nurse assistant staff (control) to care for hospitalized persons with ADRD. For Aim 1, we will conduct a
non-randomized preliminary efficacy trial of the PES-4-BPSD intervention enrolling N=158 patients (79 control
and 79 intervention). The primary outcome will be the presence (through a multi-modal approach) of BPSD
during hospitalization using the Neuropsychiatric Inventory-Questionnaire (NPI-Q). In Aim 2, we will use survey
methodology in a repeated measures design to evaluate within and between-group differences in attitudes,
experience, and satisfaction toward managing patients with ADRD. Measures will be completed at baseline
(T1), immediately following training (T2), and at end of the intervention period (T3). In response to the 2017
NIA Workshop, “Innovating the Next Generation of Dementia and Alzheimer's Disease Care Interventions”, this
proposal will be the first to study an innovative model of car...

## Key facts

- **NIH application ID:** 9996803
- **Project number:** 5R21NR018500-02
- **Recipient organization:** FEINSTEIN INSTITUTE FOR MEDICAL RESEARCH
- **Principal Investigator:** Liron Danay Sinvani
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $210,997
- **Award type:** 5
- **Project period:** 2019-08-15 → 2022-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9996803

## Citation

> US National Institutes of Health, RePORTER application 9996803, Reducing Behavioral and Psychological Symptoms of Dementia (BPSD) for Acutely-Ill Persons with Alzheimers Disease and Related Dementias via Patient Engagement Specialists (5R21NR018500-02). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/9996803. Licensed CC0.

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