Intervention program improves quality of life for people with dementia
IPPI program, developed in part by Scripps Gerontology Center researchers, trains nursing home staff to deliver brief, preference-based interactions to reduce emotional distress for residents living with dementia
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Published
Intervention program improves quality of life for people with dementia
•
Published
An intervention program developed and tested by researchers at ¾Ã¾ÃË®ÃÛÌÒ’s Scripps Gerontology Center and Pennsylvania State University has improved the quality of life for nursing home residents living with dementia, making them more alert, calm, and engaged while reducing emotional distress.
The Individualized Positive Psychosocial Interaction (IPPI) program is a nonpharmacological, behavioral intervention that trains care providers to engage people living with dementia in brief (e.g. 10-minute), personalized interactions two to three times weekly within their current workflow. Nursing homes implementing the program report residents were more alert and calm, engaged more in the community, exhibited positive behavior (both verbal and physical), and showed improved mood and outlook.
The details of the clinical trial that implemented this evidence-based program was recently accepted for in the Journal of the American Medical Directors Association (JAMDA).
Staff who conducted IPPIs reported that the program was a meaningful use of their time, residents wanted to participate in an IPPI again, and the interactions helped prevent escalation of emotional distress. Studies also show the program is cost-effective, especially for nursing homes with tighter budgets, as many communities already have necessary supplies and existing budgets cover any additional supplies needed.
People living with dementia can experience behavioral symptoms such as wandering, persistent vocalizations, and care refusal, as well as psychological symptoms including depression, anxiety, agitation, and aggression. Katherine Abbott, executive director of the Scripps Gerontology Center and professor of Sociology and Gerontology, explained these symptoms often occur because there’s an unmet need or preference and the resident can’t communicate what that unmet need is.
“If somebody is being physically aggressive while you’re trying to change their clothes, that’s not a behavior, that’s an emotional response,” Abbott said. “If someone is calling out ‘I want to go home. Where’s my family?’ They might be bored. What’s the emotion behind this response?”
The IPPI program uses preference-based, person-centered care as its guiding principle. Care providers use activities, daily schedules, and social preferences as part of each care plan, and supporting those preferences for daily living can promote physical, mental, and psychosocial wellbeing.
The program offers over 60 protocols that can align with an individual’s preferences, including taking care of clothes, doing one’s makeup, bathing, decorating one’s bedroom, gardening, photography, exercising, cooking, interacting with pets or animals, and listening to an audiobook. If a protocol isn’t listed, staff can create one to better match a resident’s preferences. Each protocol has a corresponding toolkit with instructions and conversation prompts.
“If we can understand a person’s preferences for how they want to live their life, those are actionable and concrete areas that staff providing those services can deliver, and so the service delivery can be aligned with that individual’s preferences,” Abbott said.
Ideally, nursing home residents would complete a Preferences for Everyday Living Inventory (PELI), a standardized questionnaire that documents their likes and dislikes, which care providers then use to develop individualized care plans. For residents living with dementia who cannot articulate their needs, that information may come from a family member or a care provider who will observe and learn what the resident’s preferences are.
, associate professor of Nursing and director of the Program for Person-Centered Living Systems of Care at Pennsylvania State University, started this research over 20 years ago while working in a nursing home as a researcher. Abbott began working with Van Haitsma in 2011 at the Polisher Research Institute in Pennsylvania. Although they eventually took university positions in separate states, they’ve continued to collaborate closely. Molly Noble, a research associate at Scripps, joined Van Haitsma and Abbott’s team three years ago.
The team has published more than 40 articles about person-centered, preference-based care. They published the first randomized control trial for the IPPI program in 2014 and an embedded pragmatic trial published in 2025. The team continues to present and provide implementation support to nursing home providers seeking to administer the IPPI program and improve residents’ quality of care.
Care providers who used the IPPI program suggested it could also help families, allowing them to communicate more effectively with their loved ones, develop a better understanding of dementia, adjust their expectations, and play a meaningful role in their loved one’s care. Abbott said the team submitted a grant proposal to test this adaptation called the IPPI-FAM, where speech language pathologists and occupational therapists would train family members on how to administer IPPIs to their relatives in a nursing home.
“People living with dementia deserve high quality care so they can experience a high quality of life. Professional staff care partners deserve to have the tools to deliver high quality care,” Abbott said.
High staff turnover rates across healthcare create a major barrier to expanding the IPPI program. When staff constantly changes and temporary staffing is needed, nursing homes lack the bandwidth for the program. However, Abbott’s studies show that when care providers engage in person-centered, preference-based care, staff have increased work satisfaction, which could lead to better retention.
More information about is available online.
The Individualized Positive Psychosocial Interaction (IPPI) program is a nonpharmacological, behavioral intervention that trains care providers to engage people living with dementia in brief (e.g. 10-minute), personalized interactions two to three times weekly within their current workflow. Nursing homes implementing the program report residents were more alert and calm, engaged more in the community, exhibited positive behavior (both verbal and physical), and showed improved mood and outlook.
The details of the clinical trial that implemented this evidence-based program was recently accepted for in the Journal of the American Medical Directors Association (JAMDA).
Staff who conducted IPPIs reported that the program was a meaningful use of their time, residents wanted to participate in an IPPI again, and the interactions helped prevent escalation of emotional distress. Studies also show the program is cost-effective, especially for nursing homes with tighter budgets, as many communities already have necessary supplies and existing budgets cover any additional supplies needed.
People living with dementia can experience behavioral symptoms such as wandering, persistent vocalizations, and care refusal, as well as psychological symptoms including depression, anxiety, agitation, and aggression. Katherine Abbott, executive director of the Scripps Gerontology Center and professor of Sociology and Gerontology, explained these symptoms often occur because there’s an unmet need or preference and the resident can’t communicate what that unmet need is.
“If somebody is being physically aggressive while you’re trying to change their clothes, that’s not a behavior, that’s an emotional response,” Abbott said. “If someone is calling out ‘I want to go home. Where’s my family?’ They might be bored. What’s the emotion behind this response?”
The IPPI program uses preference-based, person-centered care as its guiding principle. Care providers use activities, daily schedules, and social preferences as part of each care plan, and supporting those preferences for daily living can promote physical, mental, and psychosocial wellbeing.
The program offers over 60 protocols that can align with an individual’s preferences, including taking care of clothes, doing one’s makeup, bathing, decorating one’s bedroom, gardening, photography, exercising, cooking, interacting with pets or animals, and listening to an audiobook. If a protocol isn’t listed, staff can create one to better match a resident’s preferences. Each protocol has a corresponding toolkit with instructions and conversation prompts.
“If we can understand a person’s preferences for how they want to live their life, those are actionable and concrete areas that staff providing those services can deliver, and so the service delivery can be aligned with that individual’s preferences,” Abbott said.
Ideally, nursing home residents would complete a Preferences for Everyday Living Inventory (PELI), a standardized questionnaire that documents their likes and dislikes, which care providers then use to develop individualized care plans. For residents living with dementia who cannot articulate their needs, that information may come from a family member or a care provider who will observe and learn what the resident’s preferences are.
, associate professor of Nursing and director of the Program for Person-Centered Living Systems of Care at Pennsylvania State University, started this research over 20 years ago while working in a nursing home as a researcher. Abbott began working with Van Haitsma in 2011 at the Polisher Research Institute in Pennsylvania. Although they eventually took university positions in separate states, they’ve continued to collaborate closely. Molly Noble, a research associate at Scripps, joined Van Haitsma and Abbott’s team three years ago.
The team has published more than 40 articles about person-centered, preference-based care. They published the first randomized control trial for the IPPI program in 2014 and an embedded pragmatic trial published in 2025. The team continues to present and provide implementation support to nursing home providers seeking to administer the IPPI program and improve residents’ quality of care.
Care providers who used the IPPI program suggested it could also help families, allowing them to communicate more effectively with their loved ones, develop a better understanding of dementia, adjust their expectations, and play a meaningful role in their loved one’s care. Abbott said the team submitted a grant proposal to test this adaptation called the IPPI-FAM, where speech language pathologists and occupational therapists would train family members on how to administer IPPIs to their relatives in a nursing home.
“People living with dementia deserve high quality care so they can experience a high quality of life. Professional staff care partners deserve to have the tools to deliver high quality care,” Abbott said.
High staff turnover rates across healthcare create a major barrier to expanding the IPPI program. When staff constantly changes and temporary staffing is needed, nursing homes lack the bandwidth for the program. However, Abbott’s studies show that when care providers engage in person-centered, preference-based care, staff have increased work satisfaction, which could lead to better retention.
More information about is available online.
Established in 1809, ¾Ã¾ÃË®ÃÛÌÒ is located in Oxford, Ohio, with regional campuses in Hamilton and Middletown, a learning center in West Chester, and a European study center in Luxembourg. Interested in learning more about the Scripps Gerontology Center? Visit the website for more information.