Dementia in residential care: education intervention trial

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The DIRECT study aims to determine if education of General Practitioners (GPs) and Residential Care Staff can improve the quality of life (QOL) of people with dementia living in Residential Care Facilities (RCF). Our hypothesis is that a systematic educational intervention delivered to GPs and RCF staff will improve care delivery, leading to measurable improvements in the quality of life of residential care recipients. We hypothesise that education delivered to GPs will have additive effects to education delivered to RCF staff. Dementia is the leading cause of non-fatal disease burden among older Australians. Of people with dementia, nearly half live in RCF. There appears to be much scope to improve care, and thus QOL, for people with dementia living in residential facilities. However, the most effective way to translate knowledge regarding the components of high quality care into practice is uncertain and there is a paucity of Australian data to guide practice. Education of RCF staff is likely to be the cornerstone of improved care for recipients of residential care who have dementia. GPs also play a key-role in the care of older people living in RCF, including collaboration in the development of management plans, prescription of medications and initiation of health referrals. A detailed action research process with data collected from surveys, focus groups and pilots will be used to develop educational programmes for delivery to GPs and RCF staff. The primary outcome of the study will be quality of life of the people with dementia, assessed by themselves, their family carers and the staff looking after them. Several tools incorporating different sources of information will be used to assess QOL in a comprehensive fashion. Secondary outcomes will include knowledge among GPs and RCF staff regarding dementia, markers of quality care, participants’ sleep quality, and carer satisfaction. It is anticipated that the results will fill this current gap in evidence and will be of value to policy makers and stakeholders from the Residential Care Industry and Peak Community and General Practice bodies. The study results will have tangible implications for proprietors, managers and staff from the residential care sector and policy makers. The results have potential to directly benefit the quality of life of both patients and carers.