SOCAV, a nurse-led program promoting self-direction in nursing homes: a longitudinal mixed-methods pilot study

Abstract Background This study evaluates the impact of the SOCAV program on promoting self-direction of individuals with dementia in nursing homes and examines the behavioral changes in care staff when trained and coached to implement the program. SOCAV is a longitudinal training and coaching intervention designed to enhance person-centered care and support self-direction in individuals with dementia. Methods This mixed-methods longitudinal pilot study was conducted in two long-term care units and one day activity center of a nursing home. Participants included 61 individuals with dementia, 48 caregivers, and 85 care staff members. Qualitative data were collected from reflective coaching diaries, while quantitative data were gathered using the Canadian Occupational Performance Measure (COPM) from the perspectives of individuals with dementia, their caregivers, and care staff. Results Thematic analysis revealed four positive changes in care staff: acceptance of reflective coaching, focus on self-direction, improvement in communication and interaction, and enhanced team collaboration. Statistically significant improvements in COPM performance and satisfaction were observed in individuals with dementia, as reported by all stakeholders, providing quantitative validation of the observed behavioral changes adopted by the care staff. Initial resistance from staff, linked to fears of criticism and discomfort with change, diminished through supportive peer coaching and emphasis on positive experiences. Conclusions The SOCAV program was associated with meaningful improvements in care staff attitudes and behaviors that support self-direction among individuals with dementia. Key facilitators, including peer coaching, team cohesion, and the realization of staff impact on residents’ self-direction, were instrumental in establishing these changes. Future research is needed to assess potential benefits of the SOCAV program in other settings and populations.