KCON professor spearheads $2.2 million NIH grant

Imagine the hallways within an assisted living or long-term care facility: long and lined with doors, often making one hallway indistinct from another. Now imagine attempting to navigate those hallways as a resident with dementia or Alzheimer's disease. 

Rebecca Davis, professor of nursing in the Kirkhof College of Nursing, spearheaded a $2.2 million grant from the National Institutes of Health to conduct an intervention study over five years, testing if visual cues will help residents effectively find their way.

This study advances Davis' research on wayfinding, the ability to find one's way. In 2013, Davis secured a NIH grant to conduct a study with senior citizens, some with Alzheimer's disease, testing how they found their way using a virtual reality environment and eye-tracking goggles. Her initial study began in 2008 and was funded by the John A. Hartford Foundation.

The current intervention study will be conducted in 12 long-term care facilities in West Michigan and Cleveland. 

Davis said her team will recruit nearly 140 people within the facilities for the study. "Six times over a year, they will be asked to find their way to certain places within their community," she said. Some facilities will have enhanced signs and decorative elements (like a large painting) added, others will incorporate signage and education, and a control group will have no enhancements.

The issue, Davis said, is many long-term care facilities were constructed to meet multiple needs of residents and, of course, to be aesthetically pleasing. "Signage is often hidden and designers are brought in to make the building look less institutional. A giant photo or large signs at the end of a hallway may not be eye-pleasing," she said.

For residents with dementia, not remembering how to get to the dining hall, for example, creates feelings of anxiousness and frustration, and can cause them to limit their life space, which Davis termed as the area where a person lives. 

"Staff at facilities recognize it as a huge problem, so they are very willing to participate in this study and see if their residents improve," Davis said. 

Davis and her team plan to see if changes in wayfinding and life space occur due to the interventions in the study, because over a year many people experience changes in their abilities. "One question we have is if we intervene with cues and education, will their wayfinding abilities get better or will they stay the same?" she said.

The grant Davis received was from NIH's National Institutes of Aging and is in the most prestigious category of funding, R01. It's the first time a Grand Valley researcher has secured R01 funding. 

Davis said R01 funding is desirable for clinical trials such as this one due to the complexity of the study. "We're really pleased to receive this. It's a very different study on how environmental changes can influence behavior, and it is in line with what nurses and other health care workers do to improve the quality of life for patients with dementia," she said.