Abstract Paired PLIÉ (Preventing Loss of Independence through Exercise) is a behavioral intervention that integrates physical, mental and social activities into a multi-modal, group movement program for pairs of people with dementia and care partners. This process evaluation aimed to examine care partners’ observations and reactions to the Paired PLIE Program as part of a larger RCT. Three pairs completed up to 24 in-person classes and home practice (weekly handouts with themes for reflection and practice). Data included care partners’ daily written logs, weekly responses to home practice handouts, and emails received after program completion. Themes were categorized as physical, cognitive, and social/emotional based on prior work, and sub-themes were identified through an iterative, collaborative process. Physical functioning: care partners observed functional improvement and less symptomatic discomfort in both partners (e.g., dyad 3, week 9: “He could get up even without optimal chair and cushion.”) Cognitive functioning: care partners observed heightened engagement and focus in affected individuals (e.g., dyad 2, week 4: “He finished two crosswords completely (this was never done prior).”) Social/emotional functioning: care partners observed greater connection to the affected individual and lower stress in both partners (e.g., dyad 1, week 2: “…helped me relax and feel less stress.”) Two care partners noted that the PLIE program, especially the home practice component, added burden (e.g., dyad 3, week 9: “Neither of us was into doing more than [a] short time.”) For future groups, the home program will be revised and de-emphasized to maximize benefits and minimize burdens.

© 2015, Public Library of Science. All rights reserved.Background: Current dementia medications have small effect sizes, many adverse effects and do not change the disease course. Therefore, it is critically important to study alternative treatment strateg

Objectives: Preventing Loss of Independence through Exercise (PLIÉ) is a novel, integrative exercise program for individuals with dementia that combines elements of different conventional and complementary exercise modalities (e.g. tai-chi, yoga, Feldenkrais, and dance movement therapy) and focuses on training procedural memory for basic functional movements (e.g., sit-to-stand) while increasing mindful body awareness and facilitating social connection. This study presents analyses of qualitative data collected during a 36-week cross-over pilot clinical trial in 11 individuals.Methods: Qualitative data included exercise instructors written notes, which were prepared after each class and also following biweekly telephone calls with caregivers and monthly home visits; three video-recorded classes; and written summaries prepared by research assistants following pre-and post-intervention quantitative assessments. Data were extracted for each study participant and placed onto a timeline for month of observation. Data were coded and analyzed to identify themes that were confirmed and refined through an iterative, collaborative process by the entire team including a qualitative researcher (SA) and the exercise instructors.Results: Three overarching themes emerged: (1) Functional changes included increasing body awareness, movement memory and functional skill. (2) Emotional changes included greater acceptance of resting, sharing of personal stories and feelings, and positive attitude toward exercise. (3) Social changes included more coherent social interactions and making friends.Conclusions: These qualitative results suggest that the PLIÉ program may be associated with beneficial functional, emotional, and social changes for individuals with mild to moderate dementia. Further study of the PLIÉ program in individuals with dementia is warranted.

Introduction:Advance directives have traditionally been considered the gold standard for advance care planning. However, recent evidence suggests that advance care planning involves a series of multiple discrete behaviors for which people are in varying st