A Culturally Embedded, Adaptable Cognitive Intervention Activity for Older Adults with Dementia in Long-Term Care: A Mixed-Methods Feasibility Study

Abstract

Objectives To evaluate the feasibility, acceptability, and design principles of a culturally embedded, cognitively guided, modular tabletop cognitive activity for older adults with MCI or dementia in long-term care (LTC).Methods An exploratory sequential mixed-methods study in Taiwanese licensed LTC settings included 17 stakeholders and a 10-resident validation cohort with MCI or dementia. Feasibility was assessed by recruitment, retention, adherence, preparation time, social-validity indicators, directed content analysis, and observed distress and engagement during toolkit use.Results Across 189 observed difficulty events, cultural mismatch and ungraded cognitive demands accounted for 73.4% of engagement barriers. The modular framework comprised cultural resonance, stepped cognitive demand, and lowered operational barriers. Stakeholders judged it acceptable; prototype testing showed 100% recruitment and retention, high social validity, and reduced preparation time from 18.4 ± 3.2 to 2.5 ± 0.8 minutes (p < .001).Conclusions This culturally responsive modular toolkit appears feasible and acceptable for supporting cognitive activity programming in LTC and warrants further controlled testing.Clinical Implications LTC teams may enhance cognitive-stimulation activities by using culturally familiar, graded, low-preparation toolkits adaptable to resident abilities.