None listed
Conditions
Brief summary
This trial will offer family carers of people living with mixed or vascular dementia support in their own homes using both telephone and ipad technology to deliver an intervention that combines mental health support for the family carer with information about stroke, dementia and how to manage risk factors. Currently there is little known about how best to provide support for family carers of people living with vascular or mixed dementia over the telephone or using technology such as ipads/tablets. Family carers and people living with vascular or mixed dementia in the community are at risk of social isolation, mood disorders, and carer strain. Risk factors for vascular dementia are high blood pressure, diabetes, smoking and high cholesterol so it is important to avoid and control these risk factors to maintain functioning for as long as possible. Community awareness of dementia and management of behavioural symptoms is low. Face-to-face delivery of interventions can be hard to achieve and costly. With service providers introducing ipads for community clients who choose consumer directed care, there is the potential to utilise the new technology together with telephone support to provide a multi-modal support service in the carer’s own home.
Interventions
The 6-month intervention is a multi-component telephone call, a Google+ hangout setup on an ipad or tablet plus health promotion and dementia information on the tablet. Trained nursing and psychology therapists will conduct intervention contacts. The intervention will be tailored to individual carer/participant needs, will be conducted in sessions of up to 30 minutes per session, usually weekly and will be conducted approximately once per week for up to 12-weeks, followed by regular negotiated
The 6-month intervention is a multi-component telephone call, a Google+ hangout setup on an ipad or tablet plus health promotion and dementia information on the tablet. Trained nursing and psychology therapists will conduct intervention contacts. The intervention will be tailored to individual carer/participant needs, will be conducted in sessions of up to 30 minutes per session, usually weekly and will be conducted approximately once per week for up to 12-weeks, followed by regular negotiated calls (0-12) for a further three months. Participants will be provided with a Stroke Foundation information pack together with information about risk factors, knowledge of dementia and other educational resources on their ipad/tablet. The intervention will include psycho-education about dementia, counseling for mood disorders in the family carer and emotional support and education about risk factors. Participants will be counseled about health risk behavior including quarterly general practitioner visits, risk factor management and monitoring. Therapists will refer participants to appropriate health professionals where necessary. Therapists will liaise with health professionals, case managers and other health practitioners. Information will be provided on the ipad about contacts with relevant health professionals. Psychotherapy will be structured by assessment, diagnosis, formulation, implementation of formulation and evaluation of process, centered around behaviors of the care recipient and the carers thoughts feelings and and behavior. We will seek approval for all study intervention contacts between therapists and participants to be recorded. The investigators will review individual intervention contacts with each therapist at 1-week, 3-weeks and 6- weeks to ensure adherence to the study protocol.
Sponsors
Australian Catholic University (ACU)
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Educational / counselling / training
Masking
Blinded (masking used) (Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
1. Carer of a person with: (a). History of cognitive impairment associated with stroke. (b). Diagnosis of vascular dementia or mixed dementia. (c). Cognitive impairment as assessed by Psychogeriatric Assessment Scale. (d). Cognitive impairment associated with vascular dementia according to clinical judgement and imaging information obtained from consultant neurology referral. 2. Primary carer providing a minimum of 4-hours care per week.
Exclusion criteria
1. care recipient: (a). Alzheimer's Disease only. (b). Absence of vascular disease. (c). Life-expectancy less than study term. (d). Serious illness or comorbidities affecting study participation. (e) Likely transfer into high level care during study term. 2. Carer: (a). Serious illness affecting ability to participate in study procedures. (b). Cognitive impairment that would affect the ability to take part in study procedures.
Outcome results
None listed