A5028830256- Dementia and Cognitive Impairment Research
- Geriatric Care and Nursing Homes
- Mental Health and Patient Involvement
- Palliative Care and End-of-Life Issues
- Health Systems, Economic Evaluations, Quality of Life
- Intergenerational Family Dynamics and Caregiving
- Schizophrenia research and treatment
- Health disparities and outcomes
- Innovations in Medical Education
- Healthcare Quality and Management
- Family Caregiving in Mental Illness
- Empathy and Medical Education
- Healthcare Decision-Making and Restraints
- Ethics in Clinical Research
Oxford Health NHS Foundation Trust
2015-2020
Churchill Hospital
2018
University College London
2015
University of Hull
2015
Bangor University
2015
Alzheimer's Society
2015
Background Agitation is a common, challenging symptom affecting large numbers of people with dementia and impacting on quality life (QoL). There an urgent need for evidence-based, cost-effective psychosocial interventions to improve these outcomes, particularly in the absence safe, effective pharmacological therapies. This study aimed evaluate efficacy person-centred care intervention incorporating antipsychotic review, WHELD, QoL, agitation, use living nursing homes, determine its cost....
Objective: This study evaluated the impact of antipsychotic review, social interaction, and exercise, in conjunction with person-centered care, on use, agitation, depression people dementia living nursing homes. Method: A cluster-randomized factorial controlled trial two replications was conducted 16 U.K. All homes received training care. Eight were randomly assigned to a interaction intervention, an exercise intervention for 9 months, most more than one intervention. The primary outcome...
Background Very few interventional studies have directly examined the impact of treatment approaches on health-related quality life (HRQL) in people with dementia. This is particular importance therapies to address behavioural symptoms, where HRQL often severely affected. Methods Analysis within WHELD cluster randomised factorial study 16 UK care homes examining person-centred combination antipsychotic review, social interaction and exercise interventions. analysed through DEMQOL-Proxy....
Psychosocial person-centred interventions are considered best practice for addressing complex behaviours and care needs such as agitation anxiety, improving the quality of life people with dementia in homes. Dementia Care Mapping (DCM™) is an established development tool process aimed to help home staff deliver more care. To date, few studies have evaluated efficacy DCM™ found mixed results. These results suggested be outcome intervention implementation, which may impacted by a range...
The quality of care for people with dementia in homes is concern. Interventions that can improve outcomes are required.To investigate the clinical effectiveness and cost-effectiveness Dementia Care Mapping™ (DCM) reducing agitation improving living homes, versus usual care.A pragmatic, cluster randomised controlled trial an open-cohort design, follow-up at 6 16 months, integrated analysis process evaluation. Clusters were not blinded to allocation. primary end point was completed by staff...
Up to 90 % of people living with dementia in care homes experience one or more behaviours that staff may describe as challenging support (BSC). Of these agitation is the most common and difficult manage. The presence associated fewer visits from relatives, poorer quality life social isolation. It recommended treated through psychosocial interventions. Dementia Care Mapping™ (DCM™) an established, widely used observational tool practice development cycle, for ensuring a systematic approach...
Objectives The study aims to understand the factors that care home staff felt enabled or hindered them in continuing use well‐being and health for people with dementia (WHELD) psychosocial approach their investigate whether there was sustained activity 9 12 months after ended. Methods This qualitative is part of a wider clinical trial, which demonstrated effectiveness intervention on quality life outcomes neuropsychiatric symptoms residents. Forty‐seven within nine homes United Kingdom...
Background The effective management of agitation and other neuropsychiatric behavioural symptoms in people with dementia is a major challenge, particularly care home settings, where severity higher there limited training support for staff. There evidence the value staff use psychosocial approaches; however, no intervention currently exists that combines these elements into an fit purpose settings based on from randomised controlled trial. Objective objective was to develop evaluate complex...
Objectives: To contribute to improvements in the design and delivery of intervention research care homes by adopting a collaborative approach that listens experiences home staff who had participated clinical trial aimed at optimising evaluating psychosocial package for people with dementia.Methods: Qualitative study involving focus group discussions (FGDs) 41 across 6 UK. Inductive thematic analysis was used identify themes interpret data.Results: Three overarching emerged as influential:...
Purpose The purpose of this paper is to report on a service evaluation competency-based dementia training programme for clinicians establish its value in improving their knowledge and confidence care explore any resulting changes practice. Design/methodology/approach Mixed method quantitative qualitative data, using rating scales focus group discussions (FGDs), were collected. Wilcoxon signed-rank test was used analyse the responses thematic analysis FGDs undertaken identify staff...
Objectives This study explored the experiences of a range health and social care professionals employed in role trainer/coaches to support home staff implement psychosocial intervention for residents living with dementia. It aimed identify factors which are pertinent these roles, context cascade model training. Method A focus group was convened involving dementia supervisors who had worked on Well-being Health people Dementia randomised control trial. Twelve participants their preparedness...
Objectives Agitation is common and problematic in care home residents with dementia. This study investigated the (cost)effectiveness of Dementia Care Mapping™ (DCM) for reducing agitation this population.Method Pragmatic, cluster randomised controlled trial cost-effectiveness analysis 50 homes, follow-up at 6 16 months stratified randomisation to intervention (n = 31) control 19). Residents dementia were recruited baseline 726) 261). Clusters not blinded allocation. Three DCM cycles...
Policy and practice guidelines recommend person-centred care to support people live well with dementia in long-term care. Therefore, staff working settings need be trained awareness However, the access to, content of reach training across can varied. Data on current ongoing form an important component data gathered usual research studies, particular clinical trials within no suitable assessment tools are available measure availability, reach. This paper describes development a audit tool...
Conducting trials in care homes is complex on multiple levels. Here we focus recruitment issues surrounding: a) home selection to participate research, b) and involvement of participants fulfilling various roles (residents, relatives, staff), c) consent the context Mental Capacity Act, d) scheduling researcher time undertake processes across homes. To ensure generalizability results, EPIC were selected form a stratified random sample known sampling frame. This was done by first defining...
Dementia Care Mapping (DCM) is a practice development tool, used internationally, for facilitating delivery of person-centred dementia care in formal settings. Four previous exploratory controlled studies on the efficacy DCM home settings, have delivered mixed results. The EPIC trial, subsequently, aimed to assess clinical effectiveness and cost reducing agitation residents with dementia. was multi-centre, pragmatic, cluster randomised trial follow-up at 6- 16-months, 50 UK homes 987...
Background: This trial investigated the (cost) effectiveness of Dementia Care Mapping (DCM™) for reducing agitation in care home residents with dementia compared to usual (DCM™ EPIC trial).