None listed
Conditions
Brief summary
The "COPE" program is a structured program provided by occupational therapists for people with dementia and their carers. The program aims to improve independence and support the caregiver to manage stress and provide care. The program has been shown to be effective in a large randomised trial in the United States. However, neither the COPE program, nor similar evidence based occupational therapy programs for people with dementia have been translated into clinical practices. One of the main barriers is that these programs involve up to ten home visits; this is too resource intensive for many organisations and can not be delivered in the country. This project is a randomised controlled trial. The aim of this project is to compare two methods of delivering the COPE program: 1) traditional facetoface delivery, and 2) telehealth delivery. The content of the program will be the same but the method of delivery will be different. 174 participants will be randomised into the two groups of the trial and outcomes will be assessed at the end of intervention and at 9 months (following randomisation).
Interventions
Arm 1: Face-to-face delivery of a nonpharmacological program provided by an occupational therapist.
The intervention for both study groups will be based on the Care of Persons with Dementia in their Environments (COPE) intervention as described by Professor Laura Gitlin and colleagues. The COPE intervention incorporates environmental modification to decrease stressors, match the environment to the capabilities of the person with dementia and engage the person with dementia in daily activities. T
Arm 1: Face-to-face delivery of a nonpharmacological program provided by an occupational therapist. The intervention for both study groups will be based on the Care of Persons with Dementia in their Environments (COPE) intervention as described by Professor Laura Gitlin and colleagues. The COPE intervention incorporates environmental modification to decrease stressors, match the environment to the capabilities of the person with dementia and engage the person with dementia in daily activities. The therapist works with the person with dementia and their carer to identify key challenges and then problems solves using a collaborative approach and the use of skills building and role play. MATERIALS: The intervention will be delivered using the COPE Intervention Manual and the COPE Occupational Therapy Intervention Documentation Binder developed by Professor Gitlin and colleagues. The COPE Intervention Manual is complemented by prescriptions that provide specific strategies and advice for specific behavioural and psychological symptoms of dementia. The manual has been refined based on the learnings of the initial trial. Carers will also be provided with a loan copy of the book “A Caregiver’s Guide to Dementia” by Professor Gitlin and Dr Piersol. INTERVENTIONIST: The interventionist is a registered occupational therapist. The therapist will receive training in administering the COPE intervention and will be supported by the coordinating principal investigator who will discuss all cases with the therapist. MODE OF DELIVERY: In this study arm one will receive the intervention using the traditional face-to-face method of delivery. Up to ten visits over four months will take place in the person's home. The exact number of sessions and the frequency of sessions will be determined by the therapist based on the participant's treatment goals, progress and needs. Each session will last approximately 60 minutes. Fidelity will be examined by reviewing treatment notes of the treating therapist.
Sponsors
Flinders University
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Blinded (masking used) (Outcomes Assessor)
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Participants will be eligible for inclusion if they have a diagnosis of dementia or probable dementia and a score of <24/30 on the Mini Mental State Examination. Participants must require assistance with activities of daily living and have a carer/supporter who is able to participate in the videoconferencing intervention. The carer must report that they are having difficulty assisting the person to manage activities of daily living and/or behavioural and psychological symptoms of dementia. Caregivers must be willing to try a different approach to the usual model of care which is delivered face-to-face. There are no other specific inclusion/exclusion criteria for caregivers. People allocated to the telehealth group will be provided with training and support in using the telehealth technology whether that is using the videoconferencing software on their computer or tablet. Where the person is provided with a tablet to use within the study they will be trained in its use.
Exclusion criteria
Failure to meet the above criteria
Outcome results
None listed