scholarly journals Clinical effectiveness of the START (STrAtegies for RelaTives) psychological intervention for family carers and the effects on the cost of care for people with dementia: 6-year follow-up of a randomised controlled trial

2019 ◽  
Vol 216 (1) ◽  
pp. 35-42 ◽  
Author(s):  
Gill Livingston ◽  
Monica Manela ◽  
Aidan O'Keeffe ◽  
Penny Rapaport ◽  
Claudia Cooper ◽  
...  
Keyword(s):  
Health Research ◽  
Psychological Intervention ◽  
Care Home ◽  
Clinical Effectiveness ◽  
Cost Of Care ◽  
Research Centre ◽  
Family Carers ◽  
People With Dementia ◽  
The Impact

BackgroundThe START (STrAtegies for RelaTives) intervention reduced depressive and anxiety symptoms of family carers of relatives with dementia at home over 2 years and was cost-effective.AimsTo assess the clinical effectiveness over 6 years and the impact on costs and care home admission.MethodWe conducted a randomised, parallel group, superiority trial recruiting from 4 November 2009 to 8 June 2011 with 6-year follow-up (trial registration: ISCTRN 70017938). A total of 260 self-identified family carers of people with dementia were randomised 2:1 to START, an eight-session manual-based coping intervention delivered by supervised psychology graduates, or to treatment as usual (TAU). The primary outcome was affective symptoms (Hospital Anxiety and Depression Scale, total score (HADS-T)). Secondary outcomes included patient and carer service costs and care home admission.ResultsIn total, 222 (85.4%) of 173 carers randomised to START and 87 to TAU were included in the 6-year clinical efficacy analysis. Over 72 months, compared with TAU, the intervention group had improved scores on HADS-T (adjusted mean difference −2.00 points, 95% CI −3.38 to −0.63). Patient-related costs (START versus TAU, respectively: median £5759 v. £16 964 in the final year; P = 0.07) and carer-related costs (median £377 v. £274 in the final year) were not significantly different between groups nor were group differences in time until care home (intensity ratio START:TAU was 0.88, 95% CI 0.58–1.35).ConclusionsSTART is clinically effective and this effect lasts for 6 years without increasing costs. This is the first intervention with such a long-term clinical and possible economic benefit and has potential to make a difference to individual carers.Declarations of interestG.L., Z.W. and C.C. are supported by the UCLH National Institute for Health Research (NIHR) Biomedical Research Centre. G.L. and P.R. were in part supported by the National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care (CLAHRC) North Thames at Bart's Health NHS Trust. The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health. Z.W. reports during the conduct of the study; personal fees from GE Healthcare, grants from GE Healthcare, grants from Lundbeck, other from GE Healthcare, outside the submitted work.

P4-345: THE LONG-TERM CLINICAL EFFECTIVENESS OF START (STRATEGIES FOR RELATIVES) FOR FAMILY CARERS OF PEOPLE WITH DEMENTIA AND THE EFFECTS ON COST OF CARE

2014 ◽  
Vol 10 ◽  
pp. P914-P915
Author(s):  
Gill Livingston ◽  
Martin Knapp ◽  
Barber Julie ◽  
Claudia Cooper ◽  
Penny Rapaport ◽  
...  
Keyword(s):  
Clinical Effectiveness ◽  
Cost Of Care ◽  
Family Carers ◽  
People With Dementia

scholarly journals Are we allowed to visit now? Concerns and issues surrounding vaccination and infection risks in UK care homes during COVID-19

2021 ◽  
Author(s):  
Clarissa Marie Giebel ◽  
Kerry Hanna ◽  
Jacqueline Cannon ◽  
Paul Marlow ◽  
Hilary Tetlow ◽  
...  
Keyword(s):  
Scientific Evidence ◽  
Care Home ◽  
Home Visitation ◽  
Control Measures ◽  
Care Homes ◽  
Family Carers ◽  
Care Home Staff ◽  
The Uk ◽  
The Impact

Background: Vaccination uptake in the UK and increased care home testing are likely affecting care home visitation. With scant scientific evidence to date, the aim of this longitudinal qualitative study was to explore the impact of both (vaccination and testing) on the conduct and experiences of care home visits. Methods: Family carers of care home residents with dementia and care home staff from across the UK took part in baseline (October/November 2020) and follow-up interviews (March 2021). Public advisers were involved in all elements of the research. Data were analysed using thematic analysis. Results: Across 62 baseline and follow-up interviews with family carers (n=26; 11) and care home staff (n=16; 9), five core themes were developed: Delayed and inconsistent offers of face-to-face visits; Procedures and facilitation of visits; Frustration and anger among family carers; Variable uptake of the COVID-19 vaccine; Misinformation, education, and free choice. The variable uptake in staff, compared to family carers, was a key factor seemingly influencing visitation, with a lack of clear guidance leading care homes to implement infection control measures and visitation rights differently. Conclusions: We make five recommendations in this paper to enable improved care home visitation in the ongoing, and in future, pandemics. Visits need to be enabled and any changes to visiting rights must be used as a last resort, reviewed regularly in consultation with residents and carers and restored as soon as possible as a top priority, whilst more education needs to be provided surrounding vaccination for care home staff.

scholarly journals 210 - Are visits allowed? The impact of the COVID-19 pandemic on care home visitation and care delivery in the UK

2021 ◽  
Vol 33 (S1) ◽  
pp. 12-13
Author(s):  
Clarissa Giebel ◽  
Kerry Hanna ◽  
Jacqueline Cannon ◽  
Hilary Tetlow ◽  
Paul Marlow ◽  
...  
Keyword(s):  
Research Team ◽  
Care Delivery ◽  
Care Home ◽  
Family Members ◽  
Care Homes ◽  
Family Carers ◽  
Care Home Staff ◽  
The Uk ◽  
The Impact

Background:COVID-19 has caused the sudden closure of care homes to the outside world, to stem the virus from infecting some of the most vulnerable groups of people – older adults residing in care homes. With very little knowledge to date, we aimed to explore the impact of COVID-19 on care provision and visits in care homes from staff and family members’ perspectives.Methods:Care home staff and family carers of people living with dementia (PLWD) across the UK were recruited via convenience sampling and participated via telephone or Zoom. Participants took part in a semi-structured remote interview. Baseline data were collected between October and November 2020, and follow-up interviews were collected throughout March 2021. Anonymised transcripts were analysed separately by two research team members using thematic analysis, with codes discussed and themes generated jointly, supported by research team input.Results:42 participants (26 family carers and 16 care home staff) took part in the baseline interviews, and 20 purposefully sampled participants (11 family carers and 9 care home staff) were followed up. Prior to vaccination roll out in the UK, at baseline, family carers expressed concern about a lack of clear guidance throughout the pandemic, with care homes delivering care differently and disparities noted in the levels and types of visiting allowed for family members. Lack of communication between care homes and family members, but also government and care homes, led to family carers feeling excluded and concerned about the well-being of their relative. Data on follow-up interviews are still being analysed.Conclusions:This is the first empirical evidence to show how the pandemic has caused severe difficulties in providing adequate care for care home residents, with not only residents, but also care home staff and family carers being negatively affected. Follow-up data will shed light onto the impact of vaccination and eased visitation rights put in place since March 2021 on care delivery and connections between family carers and residents.

scholarly journals Personality and Dementia: an Approach to Differential Profile of the Caregiver

2011 ◽  
Vol 1 (3) ◽  
pp. 85-94
Author(s):  
Elena de Andrés-Jiménez ◽  
Rosa Mª Limiñana-Gras ◽  
Encarna Fernández-Ros
Keyword(s):  
Relevant Information ◽  
Personality Profile ◽  
Family Carers ◽  
Psychological Variables ◽  
People With Dementia ◽  
The Family ◽  
Study Population ◽  
The One ◽  
The Impact

The aim of this study is to determine the existence of a characteristic personality profile of family carers of people with dementia. The correct knowledge and use of psychological variables which affect the carer, helps to promote appropriate actions to mitigate the impact of care and improve the carer’s quality of life and likewise the one of the person cared for. The study population consists of 69 family carers of people with dementia, members of various associations and care centers. The results allow us to identify a characteristic personality profile for these carers and it reveals a specific psychological working in this sample, although we cannot directly relate it with the tasks of caring for people with this disease, this profile gives us very relevant information to pay more attention to the needs of this group. Moreover, the analysis of personality styles depends on the sex of the family carer, showing, once again, that the woman is in a situation of most vulnerability.

scholarly journals 409 - Trends in Involvement, Perceived Role, Role Overload and Self-efficacy of Family Carers of People with Dementia in Care Homes

2020 ◽  
Vol 32 (S1) ◽  
pp. 125-125
Author(s):  
Marleen Prins ◽  
Bernadette Willemse ◽  
Marlous Tuithof ◽  
Henriëtte van der Roest ◽  
Anne Margriet Pot
Keyword(s):  
Self Efficacy ◽  
Care Home ◽  
Care Homes ◽  
Role Overload ◽  
Family Carers ◽  
Change Over Time ◽  
Person Centered Care ◽  
People With Dementia ◽  
Centered Care ◽  
Over Time

IntroductionThe quality of long-term care provided to people with dementia (PwD) in care homes can be improved by implementing person-centered care. Family carers of PwD living in care homes are an important part of person-centered care. However, they often experience high levels of burden, even when a family member with dementia lives in a care home. This study examines trends in the involvement of family carers and their perceived role, role overload and self-efficacy.MethodsData from the Living Arrangements for People with Dementia study, a cross-sectional monitoring study that evaluates developments in care for PwD in care homes in the Netherlands, with four measurement cycles between 2008-2017 was used. Data from the three most current measurement cycles were used, with respectively 144, 47 and 49 participating care homes and 888, 392 and 401 participating family carers. Family involvement was measured by the number of hours per week that family carers visited the PwD and the type of activities they undertook. Perceived caregiving role was measured with the Family Perceptions of Caregiving Role instrument. We used the Self-Perceived Pressure by Informal Care to measure role overload and a 37-item questionnaire was used to measure self-efficacy. We investigated the changes over time (e.g., measurement cycles) of these measures.ResultsThe number of hours that family carers visited the PwD did not change over time. However, there was a trend towards an increase in the variety of activities they undertook. Their perceived caregiving role did not change over time. Self-efficacy of family carers increased over time and they reported more feelings of role overload.ConclusionsDuring the past decade, there has been an increasing trend towards family carers doing more diverse activities with PwD in carer homes. Family carers did feel more competent in their caring role, although their feelings of role overload also increased. Continuing attention is therefore needed for the psychological well-being of family carers after a person with dementia moves to a care home.

scholarly journals A digital meal nutritional score may influence food choices in a workplace restaurant: A pilot study

2020 ◽  
Vol 79 (OCE2) ◽  
Author(s):  
Daniela Prozorovscaia ◽  
Emma Jacquier ◽  
Florent Dudan ◽  
Suttipong Mungkala ◽  
Hilary Green
Keyword(s):  
Food Choices ◽  
Research Centre ◽  
Dietary Recommendations ◽  
Workplace Education ◽  
Lunch Break ◽  
Education Campaign ◽  
Behaviour Changes ◽  
Nutritional Score ◽  
The Impact

AbstractIntroductionFood choice is complex. Digital nutrition applications are emerging to help decisions about food choices. Nestlé's Meal Nutritional Score (MNS) is a number between 0 and 100 that provides a measure of the extent to which a meal meets US dietary recommendations. The objective was to evaluate if the MNS influences food choices in a workplace restaurant.Materials and MethodsA workplace education campaign ran over two weeks in order to introduce the MNS to employees. This was done during the lunch break at the entrance to the cafeteria of Nestlé's research centre, which serves around 250 hot meals at lunchtime every day. Employees choose between a typical Western meal, a healthy meal and a vegetarian meal. During the campaign, and for three weeks afterwards, LED screens displayed the MNS for the three different types of meal, every day. Employees’ voluntary feedback on the MNS was collected using a closed-ended questionnaire. Descriptive analyses were done for the scores and sales of each type of meals for one week before the education campaign, immediately after the campaign and three weeks later. Data are reported as mean ± 1 standard deviation.ResultsFeedback was obtained from 152 employees, of whom 96% said the MNS helped them to understand the nutritional balance of the meals, and 38% said the MNS influenced their meal choices. The MNS scores pre-campaign, post-post campaign and 3 weeks later were 52 ± 14, 50 ± 16 and 56 ± 11 for the Western meal; 54 ± 14, 62 ± 6 and 67 ± 6 for the healthy meal and 64 ± 11, 57 ± 14 and 57 ± 12 for the vegetarian meal, respectively. The percentage of sales pre-campaign, post-post campaign and 3 weeks later were 48 ± 10%, 43 ± 9% and 33 ± 9% for the Western meal; 25 ± 10%, 30 ± 8% and 36 ± 10% for the healthy meal, and 27 ± 4%, 27 ± 4% and 30 ± 8% for the vegetarian meal, respectively.DiscussionThe number of people selecting the healthy meal, which usually had the best score, increased during the three weeks following the education campaign, suggesting that the MNS positively influences food choices. The MNS may also help chefs to design more nutritionally balanced meals. Longer-term follow up is necessary to evaluate if these are sustained behaviour changes as well as to test the impact of the MNS in a different workplace environment.

The biopsychosocial (BPS) model of dementia as a tool for clinical practice. A pilot study

2016 ◽  
Vol 28 (7) ◽  
pp. 1079-1089 ◽  
Author(s):  
Catherine Revolta ◽  
Martin Orrell ◽  
Aimee Spector
Keyword(s):  
Quality Care ◽  
Preliminary Evidence ◽  
Sense Of Competence ◽  
Positive Attitudes ◽  
People With Dementia ◽  
Within Subjects ◽  
Treatment Plans ◽  
Practical Tool ◽  
The Impact

ABSTRACTBackground:Equipping staff with the skills to provide high quality care in dementia is essential. The Biopsychosocial (BPS) model of dementia (Spector and Orrell, 2010) is a practical tool designed to encourage staff to develop personalized interventions and treatment plans for people with dementia. This feasibility study aimed to examine the impact of training staff to use the BPS model on skills of formulation, attitude towards dementia and sense of role competence.Method:A within-subjects design was used. Thirty-seven staff working in dementia care across a community mental health team (CMHT), inpatient wards, and residential care homes were trained to use the BPS model. Outcomes were measured at baseline, post-training, and four week follow-up.Results:The ability of staff to understand, formulate, and develop interventions for people with dementia increased significantly following training. There were small, non-significant improvements in positive attitudes, and sense of competence following training. Staff also reported that training improved their understanding of biological and psychosocial factors in dementia.Conclusions:This study provides preliminary evidence that training staff to use the BPS model can lead to improvements in their ability to understand and develop interventions for people with dementia. Further research would be required to draw firm conclusions about its effectiveness.

scholarly journals Living in a care home during COVID-19: a case study of one person living with dementia

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Ian Davies-Abbott ◽  
Catrin Hedd Jones ◽  
Gill Windle
Keyword(s):  
Study Design ◽  
Single Case ◽  
Care Home ◽  
Care Homes ◽  
Single Case Study ◽  
Content Type ◽  
Case Study Design ◽  
People With Dementia ◽  
The Impact

Purpose This paper aims to understand the lived experience of a person living with dementia in a care home during the COVID-19 pandemic. It responds to the absence in research of the voices of people with dementia living in care homes during the pandemic. Design/methodology/approach The paper adopts a single case study design applied thematic analysis to semi-structured interview data to discover the experiences of one person living with dementia in a care home during a period of lockdown. Findings Five themes reveal how the participant responded to the practical and emotional challenges of the pandemic: autonomy; fears; keeping connected; keeping safe and other people living with dementia. These themes highlight the participant’s ability to adapt, accept and dispute lockdown restrictions, revealing considerable insight into their situation. Research limitations/implications The pandemic has restricted access to care homes, which informed the single case study design. This approach to the research may restrict the generalisability of the findings. Other researchers are encouraged to include the voices of people with dementia living in care homes in further studies. Practical implications Implications for practice, presented in this paper, promote quality psychosocial approaches when health-care workers engage with people living with dementia during periods of restricted activity. Originality/value Unlike other studies about the impact of the pandemic on care homes, this paper explores the experience of the pandemic in care homes from the perspective of a person living with dementia.

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