Evidence map›Paper›PMID 27550398›Full record

ArticleJournal of the American Geriatrics Society2017

Informed Family Member Involvement to Improve the Quality of Dementia Care in Nursing Homes.

Jennifer Tjia, Celeste A Lemay, Alice Bonner, Christina Compher, Kelli Paice, Terry Field, Kathleen Mazor, Jacob N Hunnicutt, Kate L Lapane, Jerry Gurwitz

Open access · greenAbstract read
In one paragraph

Article in Journal of the American Geriatrics Society, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed
1.9field-weighted citation impact, top 11% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

11 citing papers in PubMed, 23 citations in OpenAlex.

  1. Trial
  2. Review
  3. Variations in State Essential Caregiver Programs for Nursing Homes During the COVID-19 Pandemic.Journal of applied gerontology : the official journal of the Southern Gerontological Society · 2025
    Article
  4. Article
  5. Article
  6. Article
  7. Article
  8. Article
  9. Article
  10. Reimagining Family Involvement in Residential Long-Term Care.Journal of the American Medical Directors Association · 2022
    Article
  11. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 3 institutions in 1 country.

Jennifer TjiaDivision of Epidemiology, Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts.
Celeste A LemayDepartment of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts.
Alice BonnerSchool of Nursing, Northeastern University, Boston, Massachusetts.
Christina CompherHealthcare Management Solutions, LLC, La Vergne, Tennessee.
Kelli PaiceDepartment of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts.
Terry FieldDepartment of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts.
Kathleen MazorDepartment of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts.
Jacob N HunnicuttDivision of Epidemiology, Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts.
Kate L LapaneDivision of Epidemiology, Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts.
Jerry GurwitzDepartment of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts.
University of Massachusetts Chan Medical School · USNortheastern University · USVA Tennessee Valley Healthcare System · US

Funding

iADAPT: Off-Label Use of Antipsychotics in the Nursing HomeR18HS019351 · AHRQ · UNIV OF MASSACHUSETTS MED SCH WORCESTER · PI GURWITZ, JERRY H · 2010 to 2010
$1.5M
In-hospital Antipsychotic Use among Elderly Patients Discharged to Nursing HomesR21AG046839 · NIA · UNIV OF MASSACHUSETTS MED SCH WORCESTER · PI LAPANE, KATE L · 2014 to 2015
$454k
AHRQ HHS R18 HS019351NIA NIH HHS R21 AG046839
6 · The paper itself

Abstract

objectivesTo describe the extent to which nursing homes engaged families in antipsychotic initiation decisions in the year before surveyor guidance revisions were implemented.

designMixed-methods study based on semistructured interviews.

settingU.S. nursing homes (N = 20) from five CMS regions (III, IV, VI, VIII, IX).

participantsFamily members of nursing home residents (N = 41). MEASUREMENTS: Family member responses to closed- and open-ended questions regarding involvement in resident care and antipsychotic initiation. Two researchers used a content analytical approach to code open responses to themes of family involvement in behavior management, decision-making, knowledge of risks and benefits, and informed consent.

resultsFifty-four percent of family members felt highly involved in decisions about behavior management. Forty-two percent recalled being asked how to manage resident behavior without medication, and 17% recalled receipt of information about antipsychotic risks and benefits. Sixty-six percent felt highly involved in the process of initiating antipsychotic medication; 24% reported being asked for input into the antipsychotic initiation decision and knowing before the antipsychotic was started.

conclusionUnder existing federal regulations but before guidance revisions were implemented in 2013, more than 40% of families reported being involved in nonpharmacological behavior management of family members, but fewer than one in four reported being involved throughout the entire antipsychotic prescribing process. Interventions that standardize family engagement and promote adherence to existing federal regulations are needed. This discussion builds on these findings to weigh the policy options of greater enforcement of existing regulations versus enactment of new legislation to address this challenging issue.

Indexed as

Decision MakingFamilyNursing HomesProfessional-Family RelationsAntipsychotic AgentsBehavior ControlDementiaFemaleHumansInterviews as TopicMaleMiddle AgedQuality of Health CareThird-Party ConsentUnited StatesAntipsychotic Agentsantipsychoticsdementiafamily involvementnursing homeoff-label

Identifiers

PMID27550398
PMCPMC5258777
OpenAlexW2517620499

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.