Using video simulated presence to reduce resistance to care and increase participation of adults with dementia

Background: Cognitive and functional decline in dementia generally impairs performance of basic care activities. Staff assistanceduring these activities frequently results in confusion, anxiety, and distress, expressed through resistance to care (RTC).Methods: A single-system ABA withdrawal design (n ¼ 1) evaluated the effect of video-simulated presence (VSP) for decreasingRTC and increasing participation. A family member pre-recorded videos for use during episodes of RTC, in which the familymember spoke directly to the participant to encourage participation. Results: Introduction of the VSP significantly reduced RTCduring the basic care tasks of feeding and talking medication. This effect was reversed when the intervention was withdrawn.Participation increased following VSP, demonstrating clear trends toward clinical significance. Conclusions: This personcenteredintervention, based on VSP of a family member, provides encouraging results for reducing RTC and increasingparticipation of adults with dementia in basic care tasks.Keywordsactivities of daily living, dementia, resistance to care, participation, video-simulated presence