Building on Preserved Capabilities of People Living With a Neurocognitive Disorder: Participatory Action Research for the Implementation of Cognitive Strategies in a Seniors’ Residence

The capability of people to engage in meaningful activities declines with the progression of major neurocognitive disorders. Cognitive strategies can help them pursue such activities, thus maintaining their dignity. They build on procedural memory and implicit retrieval, both preserves abilities, to automate the correct action sequences during learning, with repetition and while providing cues. However, few studies have implemented cognitive strategies especially in seniors' residences. Thus, the feasibility of their implementation remains unknown. This study aims to document the facilitators and barriers to the implementation of cognitive strategies with people living with neurocognitive disorders housed in a private seniors' residence. This participatory action research included training and coaching to allow care staff to integrate personalized cognitive strategies with nine residents. Qualitative interviews with 20 care staff and a focus group with 2 managers were conducted. Key facilitators identified included personalized approach rooted in life history, team awareness and engagement, alignment with organizational values, and a calm, home-like environment. Barriers included the rapid progression of neurocognitive disorder symptoms related to comorbidities, staff shortages and turnover, and disparities between organizational decisions and clinical practice. The results showed encouraging avenues to integrate cognitive strategies in long-term care settings when the care team is supported by adequate training and coaching.