UNIVERSITY PARK, Pa. — Liza Behrens, assistant professor of nursing in the Ross and Carol Nese College of Nursing, received the 2025 Claudia J. Beverly Innovation Award from the National Hartford Center of Gerontological Nursing Excellence (NHCGNE) for her work developing DIGNITY, a program designed to help nursing home staff support autonomy for residents living with Alzheimer’s disease and related dementias while minimizing risk for healthcare related harms.
The Claudia J. Beverly Innovation Award honors NHCGNE members whose work demonstrates measurable improvements in the care, health outcomes or well-being of older adults. Named in honor of nurse leader and policy influencer Claudia J. Beverly, the award recognizes creativity, bold thinking and translational impact in gerontological nursing.
Behrens’ project, DIGNITY (Decision-making In aGing and demeNtIa for autonomY), helps nursing home staff honor the everyday choices of residents living with dementia, while protecting their health and safety.
These responsibilities can conflict in routine decisions, such as whether and when to bathe, what to eat and whether to use adaptive equipment like a walker. The COVID-19 pandemic offered a stark example, as nursing homes weighed infection risks against residents’ desire for social contact.
The DIGNITY program, which was developed in collaboration with more than 100 key stakeholders, gives nursing home teams a process for navigating these choices. Through an in-person training session, an intervention manual and biweekly coaching sessions, the program helps staff work with residents, families and nursing home leaders to identify preferences that may carry risk, assess possible harms and benefits, and develop care plans to support autonomy.
“My vision is for every resident to experience the highest level of person-centered care that supports their dignity, safety and well-being,” Behrens said. “DIGNITY offers nursing home staff a framework that supports autonomy while mitigating harm.”
Behrens and her team pilot tested DIGNITY in a 12-week cluster randomized controlled trial across four rural Pennsylvania nursing homes from November 2023 to January 2024, enrolling 52 staff members and 52 residents living with dementia. Residents in the DIGNITY group were more likely to report that their preferences were being met to their satisfaction than those in the control group and showed improvements in behavioral and psychological symptoms, including anxiety, mood and appetite. Staff in the DIGNITY group likewise demonstrated higher intent to honor resident preferences and greater confidence in addressing preferences that may involve risks for harm. While differences in staff outcomes should be interpreted cautiously given the small sample size, according to the team the direction and consistency of findings suggest clinically meaningful improvements in both resident and staff outcomes supporting further development of the intervention.
The project builds on Behrens’ broader research in person-centered nursing care. Her Preference-Based Person-Centered Risk Engagement Model, first published in 2020, has been used in multiple studies examining person-centered care in nursing homes and other long-term care environments.
The DIGNITY intervention has been presented at national, regional and international conferences, including the Gerontological Society of America Annual Scientific Meeting , the Eastern Nursing Research Society Scientific Sessions and most recently at the 23rd World Congress of the International Association of Gerontology and Geriatrics. Behrens also is preparing an NIH R01 application to support full-scale efficacy testing of DIGNITY.
“DIGNITY addresses a persistent challenge that nursing home staff face and empowers them to provide evidence-based, ethical care,” said Marie Boltz, associate dean of research and innovation, interim associate dean for graduate education, and the Elouise Ross Eberly and Robert Eberly Endowed Professor in the Ross and Carol Nese College of Nursing. “We are thrilled to see Liza receive national recognition for this important work.”