Examining Caregiver-Resident Communication and Apathy in Dementia in Nursing Homes During the COVID-19 Pandemic

Abstract This presentation shares lessons learned from conducting a study examining the impact of staff caregivers’ communication approach on apathy in residents with dementia in nursing homes. Due to COVID-19 restrictions, this study had to be paused and required major revisions to continue, which resulted in significant delays and increased expenses. Additionally, this study required in-person data collection and video recordings to capture staff caregivers’ communication with residents with dementia during caregiving activities. However, due to the pandemic, nursing home residents’ daily routines have been significantly changed, making it challenging to capture the nature of caregiver-resident interactions. Furthermore, using masks created unforeseen barriers for capturing communication between staff caregivers and residents including difficulties in identifying residents’ facial expressions, which are a vital component of assessing apathy. The presentation describes approaches to communication with founders, collaborators, and clinical sites and discusses strategies to recruit participants and conduct data collection.

functioning. Growth mindset, the belief in the malleability of intelligence and abilities, represents a related but distinct factor that has been widely studied in children and young adults' learning but less applied to the older adult population. Two studies investigated growth mindset, motivation, and cognitive functioning in a 3-month multi-skill learning intervention that incorporated weekly discussions on growth mindset and successful aging. Participants reported on their growth mindset, general pursuit of novel skill learning, and intrinsic motivation to learn, and completed a cognitive battery before, during, and after the intervention. Study 1 (n = 15, 67% female, M age = 68.67 years, SD age = 8.68, range 58-86) included both an experimental and control group and indicated that from pretest to post-test, intervention participants increased their growth mindset, while control participants did not. Study 2, which included a larger, all experimental sample (n = 28, 68% female, M age = 69.36 years, SD age = 7.00, range 58-86) revealed strong positive associations between growth mindset, pursuit of novel skill learning and intrinsic motivation. Further, participants showed a significant increase in growth mindset from pretest to post-test. Participants with higher preexisting growth mindset showed larger cognitive gains at post-test, although growth mindset change did not affect post-test change in cognitive functioning. These findings suggest that growth mindset may facilitate older adults' continued learning and cognitive gains, and they may complement older adult learning interventions.

CONDUCTING RESEARCH IN PERSONS WITH DEMENTIA DURING THE COVID-19 PANDEMIC: CHALLENGES AND STRATEGIES
Chair: Ying-Ling Jao Co-Chair: Diane Berish Discussant: Ann Kolanowski The COVID-19 pandemic has caused a health crisis for vulnerable older adults, physically and psychologically. Despite the urgent demand for clinical research for people with dementia, research activities are restricted due to the pandemic. This symposium will share the experiences of researchers conducting studies with older persons with dementia during the COVID-19 pandemic. The presenters share their strategies to overcome challenges at different stages of the study process during the pandemic. The research projects include work conducted in acute care, assisted living, nursing homes, and the community. The presentations include perspectives from different geographic areas and across countries in North America. The first presenter reports the challenges in continuing an ongoing research project, and shares strategies to engage stakeholders and plan a new protocol for recruitment and in-person data collection with residents with dementia in nursing homes. The second presenter reports on the barriers and facilitators of conducting an ongoing clinical trial with older adults with dementia across hospital and community settings and discusses strategies to meet project goals which include modifications to the protocol and analytic plan. The third presenter describes adaptations made to a study intervention designed to promote quality resident-staff interactions in assisted living and alterations to stakeholder engagement. The fourth presenter describes challenges and strategies to engage older adults with dementia via technology. The discussant will synthesize the findings across studies and highlight policy and research implications for the COVID-19 pandemic as well as other emergency situations. This presentation shares lessons learned from conducting a study examining the impact of staff caregivers' communication approach on apathy in residents with dementia in nursing homes. Due to COVID-19 restrictions, this study had to be paused and required major revisions to continue, which resulted in significant delays and increased expenses. Additionally, this study required in-person data collection and video recordings to capture staff caregivers' communication with residents with dementia during caregiving activities. However, due to the pandemic, nursing home residents' daily routines have been significantly changed, making it challenging to capture the nature of caregiver-resident interactions. Furthermore, using masks created unforeseen barriers for capturing communication between staff caregivers and residents including difficulties in identifying residents' facial expressions, which are a vital component of assessing apathy. The presentation describes approaches to communication with founders, collaborators, and clinical sites and discusses strategies to recruit participants and conduct data collection. The purpose of this study was to test the feasibility and preliminary efficacy of Promoting Positive Care Interactions (PPCI)-a four step intervention designed to establish positive care interactions between staff and residents with cognitive impairment or dementia in Assisted Living (AL). Initially designed as a traditional on-site intervention, PPCI was later transformed to be conducted remotely through webinar and virtual meetings due to challenges related to onsite engagement in AL during the COVID-19 pandemic. Additionally, the study adopted shorter timeline, a single group pretestposttest design, and limited recruitment to staff only; 17 care staff were recruited, and data was collected via online surveys and interviews. PPCI was successfully implemented as intended with considerable stakeholder engagement. Findings demonstrated feasibility and promising staff adoption of PPCI. Continued research is needed to optimize the quality of care interactions in AL and evaluate whether online approach to staff training can change staff behavior.

CLINICAL RESEARCH IN THE HOSPITAL DURING THE PANDEMIC: WHAT'S WORKED AND NOT WORKED?
Marie Boltz, 1 Ashley Kuzmik, 1 Irene Best, 1 and Jacqueline Mogle, 2 1. Pennsylvania State University,University Park,Pennsylvania,United States,2. Penn State University,University Park,Pennsylvania,United States Under normal conditions, the hospital setting presents multiple challenges to research with persons with dementia and their care partners. This presentation describes the additional barriers posed by the COVID-19 pandemic, as well as the strategies to meet those challenges, in a cluster randomized controlled trial that examines the efficacy of a nurse-family partnership to promote functional recovery of persons with dementia. In response to research restrictions, the research team altered their plan for recruitment, implementation of the intervention, data collection, and analytic approach. This presentation describes these alterations and discusses the plan to meet the aims of the project while meeting the requirements of the Institutional Review Board, accountability to the funder, and university regulations. Modifications in staffing patterns, staff training, and procedures will also be discussed, as well as the study timeline. Finally, strategies to maintain a positive attitude and productivity within the team will be discussed.

SUPPORTING PATIENT ENGAGEMENT IN DEMENTIA RESEARCH VIA TECHNOLOGY DURING THE COVID-19 PANDEMIC
Lillian Hung, 1 Sophie Yang, 1 Mario Gregorio, 2 and Alison Phinney, 1 1. University of British Columbia,Vancouver,British Columbia,Canada,2. Vancouver,British Columbia,Canada The COVID-19 pandemic brings challenges to patient partnerships in research. In-person research meetings with patient partners were prohibited. In this presentation, we outline specific issues we encountered in a patient-led dementia research project, which involved a literature review study and gathering community stakeholders to identify the top 10 local priorities in the development of a dementiafriendly community. We will describe how we found shared solutions to complete the project. In response to COVID, computers and training were provided for patient partners to maintain team connection, plan project activities, conduct team analysis, and host a community workshop in the lockdown time. The drastic shift to virtual research methods created barriers and opportunities for co-research with older people with dementia. Virtual meetings can generate inequities for those who do not have a computer and knowledge in videoconferencing. Practical strategies to overcome barriers to using virtual technologies will be explored.

COPING WITH COVID-19: CHALLENGES AND RESILIENCE
Chair: Lauren Mitchell Co-Chair: Lauren Mitchell Discussant: Daniel Mroczek COVID-19 has introduced unprecedented challenges for older adults. At the same time, older adults have adapted to meet the challenges of the pandemic. In this symposium, we explore a number of difficulties brought about by COVID-19, while also investigating the ways in which individual, social, and community resources and strengths have bolstered older adults' resilience through the pandemic. Paper 1 investigates family caregivers of older adults with dementia living in long-term residential care facilities, a group that has been especially heavily affected by the pandemic. Using longitudinal data spanning Fall 2017-Spring 2021, the authors estimate caregivers' trajectories of well-being pre-and-post pandemic. With an exceptionally large qualitative data sample, Paper 2 examines the influence of COVID-19 on older adults' neighborhood engagement. Thematic analysis has revealed diverse patterns of response to the pandemic, as well as community and personal characteristics that have facilitated older adults' coping and resilience. Papers 3 and 4 examine how older adults' personality traits may influence their responses and adjustment to the pandemic, each using assessments of personality taken before the pandemic. Specifically, Paper 3