Further enabling care at home for people living with dementia

There are three steps to the intervention; each one is implemented by the Further Enabling Care at Home nurse. This nurse needs to be experienced in the care of people living with dementia and the support of their family carers and requires a background in acute care for people living with dementia with medical comorbidities. A two-day training course is also provided to familiarise the nurse with the Further Enabling Care at Home program protocols. This training is face-to-face and one-on-one; it is provided by up to three members of the investigating team with relevant expertise and covers (a) structure of the Further Enabling Care at Home program, (b) assessing caregivers' support needs, (c) identifying existing services and how these may be accessed, and (d) record keeping. First the Further Enabling Care at Home nurse contacts the carer by telephone within 6-10 days of the discharge from hospital of the person living with dementia (ie, the care recipient). This contact is for the nurse to make a telephone appointment – during the following week - for establishing and addressing the carer’s support needs. Immediately following this, preliminary, call the nurse provides the carer with a copy of the Carer Support Needs Assessment Tool(1) to be used during the next appointment, so that the carer has time to reflect upon the questions. This first call takes approximately 10-15 minutes. Second, the nurse telephones at the appointed time and administers the Carer Support Needs Assessment Tool(1), also addressing up to three needs identified as priorities by the carer - guiding the carer’s access to appropriate existing services. This step is supported by the Further Enabling Care at Home manual, developed during an earlier study.(2) This appointment can be expected to take at least 30 minutes and may take longer or need to involve ‘call backs’. Finally, at two time points – 4 weeks after the discharge and 8 weeks after the discharge -the nurse telephones to check the carer’s access to services as planned, advising of alternative strategies if access has proved problematic. Each of these two sessions can be expected to last for approximately 15 minutes. Adherence to these steps will be examined as part of process evaluation, which will also inform calculation of costs of the intervention. Each contact will be recorded in a database that records the timing of the contact with respect to the discharge date, the length of the contact, and services recommended/accessed. Barriers to/facilitators of service access will also be recorded. 1. Ewing G, Grande G. The Carer Support Needs Assessment Tool (CSNAT) for end-of-life care practice at home: A qualitative study. Palliative Medicine. 2013;27(3):244-56. 2. Toye C, Moorin R, Slatyer S, Aoun S, Parsons R, Hill, K. Protocol for randomised controlled trial of an outreach support program …BMC Geriatr June 25 2015; 15:70