Non-drug therapy: the first emergency trolley without drugs tested in nursing homes in France

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Korian and the Korian Institut de Bien Vieillir (optimal aging institute) are launching an experiment aimed at evaluating the effectiveness of the first “flash activities” trolley (without drugs) for dealing with acute behavioural disorders. This study is in keeping with the broader use of non-drug therapies (NDT) for elderly people with Alzheimer's disease and related disorders in Korian’s nursing facilities. The first non-drug emergency trolley was deployed in 40 skilled nursing facilities for the elderly (known as EHPADs in France) for six months. In parallel, the Korian Institut du Bien Vieillir set up a study designed to evaluate the impact of the trolley’s use.

A trial run in the field

Dr Didier Armaingaud, Korian’s Ethical, Medical and Quality Director in France, points out that this initial experiment represents the culmination of field work conducted by the medical teams on behavioural disorders, which are frequently encountered in the context of Alzheimer's and related pathologies.  “Korian deploys a personalized plan for each resident combining drug treatment, family and social activities and leisure-time activities.  On the basis of scientific findings and best field practices, we are setting up a pilot project in several facilities focused on non-drug therapies. The flash activities trolley, which is part of a more comprehensive therapy known as behaviour mediation therapy, is the first stage of this complete programme.

Objective of the flash activities trolley

Korian decided to create a “flash activities trolley” and deploy it across its facilities. The objective is to divert attention away from a negative stimulus (causing fear, stress or anxiety) and focus it on an enjoyable, recreational stimulus to address behavioural problems, once it has been determined that the cause of the behaviour is not somatic (i.e. pain, discomfort, urinary retention, fever, etc.) or when a rational explanation has no effect. It is similar to the continuously available emergency trolleys stationed in hospital corridors, and is equipped with materials for 11 flash activities to respond to emergency situations (agitation, wandering behaviour, aggression, violent opposition, delusional thinking and so on). The flash activities trolley can provide effective treatment for acute behavioural disorders.

 

Purpose and use of the flash activities trolley

It has been established that behavioural disorders are major symptoms of Alzheimer's disease and related pathologies and that they contribute to the patient’s loss of autonomy. There is now a therapeutic arsenal of non-drug therapies validated by referenced scientific studies, normally used in dedicated workshops.

“We wanted to experiment with using these therapies in a concentrated, continuously available manner, thus providing more effective alternatives when residents manifest behavioural problems. We are deploying these trolleys in 40 Korian skilled nursing facilities via a formalized, sustainable approach,” stresses Stéphane Hedont, who is in charge of non-drug therapies and approaches at Korian.

The first stage of a longer process

Dr Philippe Denormandie, Director of the Korian Institut du Bien Vieillir and Korian’s Deputy Managing Director, stresses that “in addition to field tests, we wanted to assess the trolley’s impact and use, through a study conducted by the Korian Institute, to determine the degree to which this new practice has been assimilated by our medical teams (physicians, nurses and psychologists) and also measure the new tool’s impact on residents.”

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