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The number of older Asians in the UK is increasing placing greater numbers at risk of developing dementia. The emerging need to address early diagnosis is especially prominent in areas where Asian communities are long established. This was the specific focus of a Dementia Collaborative Project in North West Kent. The project, working through a primary care practice, aimed to raise awareness of dementia and to facilitate early intervention and access to specialist dementia services. Using an evaluation methodology adopted by the Collaborative and working through a multiagency steering group, the pilot project successfully identified an appropriate primary care practice, established a link with a specially trained Asian nurse and devised a set of project materials. By inviting older Asian patients with memory problems to make an appointment with the nurse, and enclosing a culturally relevant information leaflet, older people were encouraged to come forward. Although the number of individual patients identified was small, the project outcomes include: significantly increased referral rates from black and minority ethnic communities to specialist services and greater awareness of dementia‐related issues in both primary care and Asian care services. Overall, the evaluation suggests that by engaging with a committed primary care practice it is possible to engage a hitherto marginal group of older people in early intervention in dementia and raise awareness about its benefits. That this approach underpins the development of a larger scale five year project in the same area additionally endorses its relevance for the mainstream population.

The purpose of this case study is to report and reflect on a recently completed five-year programme of research on dementia care and practice in England. This EVIDEM programme of research was specifically designed to influence services for people with dementia and their carers; several additional lessons emerged along the way that might shape broader research on ageing that includes older people and those who work with them.

This case study of the EVIDEM programme presents and discusses four lessons learned by the core research team – covering the implications of newly basing research inside the NHS, multi-disciplinary working across academic disciplines, communicating with diverse practitioners, and the impact of patient and public involvement on the research process. The paper reflects on communication between the NHS and academic communities, and the creation of new research capacity in dementia.

Collaborative working between academic disciplines is possible, given willing researchers and commitment to participating in frequent opportunities for dialogue and learning. In research in dementia these foundations are probably essential, given the growing scale of the problem and the small size of the research community, if we are to have a beneficial impact on people's lives. Lay expertise is a necessary ingredient of research programmes, not just for its co-design power, but for its ability to redesign projects when major problems arise.

This case study reports the subjective views of the research collaborators. While this raises the potential for bias, it offers an “insider” perspective of the research process and engagement in research leadership.

There are few reflections on research processes and management and this case study may be useful to academic researchers, to those working in the NHS with responsibility for research in different forms, and to older people's organisations who wish to hear of the value of older people's engagement in research advisory activity.

This paper aims to reports on an academic–industry service development innovation to advance the symptom monitor and track feature within the CogniCare app to support family carers of people living with dementia. Expert opinion from dementia care professionals identified key monitoring strategies for enhanced carer competence and confidence in the early identification of relevant symptoms that would help facilitate meaningful hospital/social care consultations.

A co-production approach between industry and academia included stakeholder representation from NHS Highland and Alzheimer Scotland. Dementia care experts validated items to be included for symptom monitoring and tracking using a newly developed A²BC²D²EF² framework as part of this project and recommended additional strategies for monitoring symptom change, including carer well-being.

Dementia care experts perceived the symptom monitoring and track feature to have the potential to support family carers with dementia care at home and foster a relationship-centred approach to dementia care to facilitate meaningful hospital/social care consultations.

The CogniCare app is the first platform of its kind that aims to support family carers to care for people living with dementia at home. This unique service development collaborative combined dementia and digital expertise to create innovative digital solutions for dementia care. The proposed monitoring and tracking feature is perceived by dementia care experts as a tool with the potential to enhance carer confidence and thus enable safe and effective dementia care within the home environment.

This paper aims to identify costs related to dementia care provision and explore how purpose-built environment investments can help control these costs and improve quality of life and clinical outcomes.

This research adopts a multi-method approach where the findings of a literature review drove the analysis of data obtained from the 115 pilot projects funded by the Department of Health England’s National Dementia Capital Investment Programme.

Under the UK Government’s new productivity challenge, it is fundamental to identify actions that provide value for money to prioritise policy and practice. This paper identifies healthcare spaces (e.g. bathroom) where the impact of the built environment on healthcare costs are most evident and building elements (e.g. lighting) to which these costs can be directly associated. The paper advocates the development of evidence and decision support tools capable of: linking built environment interventions to the healthcare costs; and helping the healthcare and social care sectors to develop effective and efficient capital investment strategies.

Further work needs to develop more systematic ways of rationalising proactive and timely built environment interventions capable of mitigating dementia (and older people) care cost escalation.

This research takes an innovative view on capital investment for care environments and suggests that appropriate built environment interventions can have a profound impact on costs associated with dementia care provision.

This paper summarises research funded by the EPSRC EQUAL programme from 2000 to 2003 to examine how neighbourhoods could be made dementia‐friendly. Design for dementia generally focuses on the internal environment of dementia care homes and facilities, but most people with dementia live at home. Unless they are able to use their local neighbourhoods safely, they are likely to become effectively housebound. There is also increasing awareness of the role the outdoor environment plays in the health, independence, well‐being and cognitive function of people with dementia. The research defined dementia‐friendly neighbourhoods as welcoming, safe, easy and enjoyable for people with dementia and others to access, visit, use and find their around. It identified six design principles: familiarity, legibility, distinctiveness, accessibility, comfort and safety. A number of recommendations for designing and adapting neighbourhoods to be dementia‐friendly arose from the research.

This study aims to systematically evaluate the impact and effectiveness of two early intervention services in NW Kent.

Data were gathered via evaluation questionnaires for both projects; these included quantitative post-intervention data and qualitative comments. Data on referrals to secondary care and a specialist third sector organisation were also collected for the primary care project.

Findings from the primary care project indicate that targeting a specific age cohort of patients can be effective in terms of: early identification of dementia-related concerns, the provision of support, appropriate referrals to secondary care, and increased referrals to a third sector dementia service. At the end of the project most practitioners felt they were better informed about dementia, more committed to facilitating early diagnosis, and had gained confidence in using a screening tool (the General Practitioner Assessment of Cognition Test). Evidence from evaluating the Carers Group suggests that attendance helped members manage emotional difficulties, increased understanding of dementia, and enhanced coping skills. They also felt less isolated and knew how to access support services.

The projects offer two models of intervention: how a proactive third sector agency can work with primary care professionals to enhance commitment to dementia case finding and the provision of group support to relatives of those in receipt of a recent dementia diagnosis.

The study provides insights into early intervention in dementia care how to evaluate impact of effectiveness.

The purpose of this paper is to assess the empirical support for the use of assistive technology in the care of people with dementia as an intervention to improve independence, safety, communication, wellbeing and carer support.

A total of 232 papers were identified as potentially relevant. Inclusion criteria were: studies published between 1995 and 2011, incorporated a control group, pre-test-post-test, cross sectional or survey design, type of interventions and types of participants. The 41 papers that met criteria were subjected to an assessment of their validity using the model provided by Forbes. Following the assessment seven papers were considered as strong, ten moderate and 24 weak. The review is presented around the following topics: independence, prompts and reminders; safety and security; leisure and lifestyle, communication and telehealth; and therapeutic interventions.

The literature exploring the use of assistive technologies for increasing independence and compensating for memory problems illustrate the problems of moving from the laboratory to real life. The studies are usually limited by very small samples, high drop-out rates, very basic statistical analyses and lack of adjustment for multiple comparisons and poor performance of the technology itself.

Research to date has been unable to establish a positive difference to the lives of people with dementia by the general use of the assistive technology reviewed here.

This study aims to describe the development and approach of a theory-informed social marketing intervention that aimed to promote respite for carers of people with dementia. Despite a high need for respite, carers of people with dementia are often low users of available respite services. The reasons for this are complex, including knowledge, attitudinal, behavioural and systemic barriers. In the context of an aging population, effective strategies to support respite use by carers of people with dementia are needed.

Via formative research, the authors gained an in-depth understanding of a hard-to-reach and vulnerable group (carers of people with dementia). The resulting intervention informed, persuaded and supported carers to rethink the use of respite addressing specific barriers to service use. The intervention was evaluated using a naturalistic effects model.

Carers of people with dementia who were exposed to community-level campaign activities and also self-selected to take part in tailored coaching showed improvements to their respite knowledge, attitudes and self-efficacy. Intention to use respite and levels of personal gain from caring also increased. In contrast, carers only exposed to informational activities experienced negative changes to their respite beliefs and their sense of role captivity.

Social marketing can be used to support carer respite knowledge, attitudes and service-use behaviours in carers of people with dementia. The case study highlights an untapped role for social marketers to work in partnership with health professionals to support improvements in aged care services.

To the best of the authors’ knowledge, this is the first known social marketing intervention promoting the use of respite to carers of people with dementia. Findings demonstrate that tailored support services are most effective in helping carers navigate and use respite services.

The independence and well-being of people with dementia can be significantly influenced by the design of the physical environments around them. Several assessment tools exist to evaluate the dementia design quality of existing residential aged care facilities but, to date, none have been formally identified as suitable for use during the design process. This paper aims to examine the feasibility of re-purposing existing post-occupancy tools for use during the design process, while mapping the influence of design stages on resulting dementia design quality.

Literature searches identified audit tools for residential aged care settings. After reliability screening, three tools were analysed in-depth, mapping their suitability for use during the design process.

The study confirmed that existing tools can be re-purposed for design stage use and identified that early design stages have a larger influence on overall dementia design quality than previously thought.

Non-English language publications were not reviewed. Searches may not have identified other existing audit tools for residential care environments.

The ability to assess proposals at key stages of design may help improve the dementia design quality of future residential aged care environments – potentially enhancing the lives of ever-larger numbers of people with dementia.

According to the authors’ knowledge, this is the first known paper to consider formal design-stage evaluation of dementia design quality and the first to identify the relative influence of key stages of design on the resulting dementia design quality.

The patient-centred management of people with cognitive impairment admitted to acute health care facilities can be challenging. The TOP5 intervention utilises carers’ expert biographical and social knowledge of the patient to facilitate personalised care. The purpose of this paper is to explore whether involvement of carers in the TOP5 initiative could improve patient care and healthcare delivery.

A small-scale longitudinal study was undertaken in two wards of one acute teaching hospital. The wards admitted patients with cognitive impairment, aged 70 years and over, under geriatrician care. Data for patient falls, allocation of one-on-one nurses (“specials”), and length-of-stay (LOS) over 38 months, including baseline, pilot, and establishment phases, were analysed. Surveys of carers and nursing staff were undertaken.

There was a significant reduction in number of falls and number of patients allocated “specials” over the study period, but no statistically significant reduction in LOS. A downward trend in complaints related to communication issues was identified. All carers (n=43) completing the feedback survey were satisfied or very satisfied that staff supported their role as information provider. Most carers (90 per cent) felt that the initiative had a positive impact and 80 per cent felt that their loved one benefitted. Six months after implementation of the initiative, 80 per cent of nurses agreed or strongly agreed that it was now easier to relate to carers of patients with cognitive impairment. At nine-ten months, this increased to 100 per cent.

Actively engaging carers in management of people with cognitive impairment may improve the patient, staff, and carer journeys, and may improve outcomes for patient care and service delivery.