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Yet staff often restrict preferences—such as independent time outdoors—by labeling them “risky.” DIGNITY (Decision making in aging and dementia for autonomy) targets shared decision-making to balance perceived health and safety risks with residents’ autonomous choices, especially in under-resourced rural settings, using a multi-site cluster randomized pilot.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/balancing-autonomy-and-safety-developing-and-pilot-testing-dignity-program-in-rural-nursing-homes/421952/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/balancing-autonomy-and-safety-developing-and-pilot-testing-dignity-program-in-rural-nursing-homes/421952.png","ImageObject",300,407,{"name":92,"@type":93},"Stanford","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-02","2026-09-28",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",11,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"What problem does the DIGNITY program address in rural nursing homes?","Question",{"text":113,"@type":114},"It addresses the tension between staff-perceived health and safety risks and residents’ right to make autonomous choices, especially when preferences like independent outings are restricted.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"What is DIGNITY (Decision making in aging and dementia for autonomy)?",{"text":118,"@type":114},"DIGNITY is an innovative risk management program designed to support shared decision-making strategies through a staff-focused behavioral intervention.",{"name":120,"@type":111,"acceptedAnswer":121},"What does the symposium present about the study and the program?",{"text":122,"@type":114},"It presents preliminary results from a multi-site cluster randomized controlled pilot, including stages of co-design, implementation, acceptability/feasibility, plus development of intervention rationale, manuals/tools, community engagement findings, and a case study.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},421952,1790759281,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":14,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":24,"preview_page_count":4},2336477552062,"https://ap-avatar.wpscdn.com/davatar_994ba38a5ba835b3df7d355c54d3ed8d","602 Innovation in Aging, 2025, Vol. 9, No. S2  \nAbstract citation ID: igaf122.2066  \nBALANCING AUTONOMY AND SAFETY: DEVELOPING AND PILOT TESTING DIGNITY PROGRAM IN RURAL NURSING HOMES  \nChair: Liza Behrens  \nCo-Chair: Marie Boltz  \nPerson-centered care that honors individual preferences enhance the health and well-being of nursing home (NH) residents living with Alzheimer’s disease and related dementias (ADRD). However, preferences such as going outside independently are often seen as “risky”by NH staff and subsequently restricted. There is an urgent need for shared decision-making strategies to help NH staff balance perceived health and safety risks with the residents’right to make autonomous choices, particularly in under-resourced rural NH communities.This symposium will present the preliminary results of a multi-site cluster randomized controlled pilot study to co-design with key stakeholders  \nInnovation in Aging, 2025, Vol. 9, No. S2 603  \n(Stage 1a), implement, and assess (Stage 1b) the acceptability and feasibility of an innovative risk management program: DIGNITY (Decision making in aging and dementia for autonomy). The first presentation will describe the early development of DIGNITY intervention, establishing the rationale and theoretical underpinnings of the staff-focused behavioral intervention. The second presentation will highlight the program manual and tool development within formal consultation with a community advisory board from the perspective of an attending physician. The third presentation will present results from community engagement studios with rural NH stakeholders from the perspective of a NH leader. The fourth presentation will share a case study implementing the DIGNITY process in a risky preference situation commonly encountered in all NH communities. Finally, the session will conclude with a fifth presentation reporting acceptability, feasibility, and preliminary efficacy of implementing DIGNITY within four rural NH communities.","cbCaipgGxi8eXWVE","https://ap.wps.com/l/cbCaipgGxi8eXWVE","pdf",1086528,"English","# Symposia Overview\n## Shared decision-making to balance autonomy and safety\n## Development of the DIGNITY intervention\n## Program manual and tool development\n## Community engagement studios\n## Case study applying DIGNITY in a risky preference situation\n## Acceptability, feasibility, and preliminary efficacy across rural NHs","[{\"question\":\"What problem does the DIGNITY program address in rural nursing homes?\",\"answer\":\"It addresses the tension between staff-perceived health and safety risks and residents’ right to make autonomous choices, especially when preferences like independent outings are restricted.\"},{\"question\":\"What is DIGNITY (Decision making in aging and dementia for autonomy)?\",\"answer\":\"DIGNITY is an innovative risk management program designed to support shared decision-making strategies through a staff-focused behavioral intervention.\"},{\"question\":\"What does the symposium present about the study and the program?\",\"answer\":\"It presents preliminary results from a multi-site cluster randomized controlled pilot, including stages of co-design, implementation, acceptability/feasibility, plus development of intervention rationale, manuals/tools, community engagement findings, and a case study.\"}]","BALANCING AUTONOMY AND SAFETY - Developing and Pilot Testing DIGNITY Program in Rural Nursing Homes | PDF",1790625901]