None listed
Conditions
Brief summary
COPE is an evidence -based non-pharmacological program developed by Professor Laura Gitlin from John Hopkins University. COPE is proven effective in reducing dependency and engagement of the person with dementia, and in improving carer wellbeing in a randomised trial in the US. The program uses occupational therapy skills with complimentary nursing skills, centring the needs of both the carer and the person with dementia. This implementation research project aims to integrate the COPE intervention within existing health and aged care systems in Australia. The project will examine facilitators and barriers at therapist, organisation and policy levels, explore funding models and building in features of sustainability. There will be a process evaluation (interviews, focus groups and observation) and a cost-benefit evaluation (questionnaires and data collection forms) included in the research project. The final output for the project will be an Implementation Strategies Document to influence policy and address how COPE can be rolled out wide-scale.
Interventions
Face-to-face delivery of 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 collab
Face-to-face delivery of 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. METHOD: Intervention will be delivered by community based registered Occupational Therapists with their existing clients. Face-to-face visits occur in participant's home or in acute rehabilitation settings (where necessary) with the person with dementia and caregiver together. Number of visits will vary from three to ten, upon discretion of the therapist based on extend of difficulties and success of intervention. Length of visits will be one to two hours, as required. 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. Adherence to the program protocol will be monitored with intervention logs including length of visit, resources used, strategies discussed and assessments conducted. A Fidelity Assessment tool has also been developed for this study and will be completed by therapists within six months of first implementing COPE. Coaching meetings, with up to 6 therapists at a time together with a master trainer, will be conducted every 3 months to discuss difficult cases. 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.
Sponsors
Flinders University
Study design
Allocation
Non-randomised trial
Intervention model
Single group
Primary purpose
Treatment
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Eligible participants with dementia will have a diagnosis of probable dementia, or a Mini-Mental State Examination (MMSE) score less than 24 (or equivalent score on a comparable tool such as the MOCA); and live in the community with or nearby a family caregiver. Eligible caregivers provide regular oversight or care to a person with dementia
Exclusion criteria
Caregivers who are under 18 years of age will be excluded from the dyad questionnaire and interview components of the study. Failure to meet the above criteria
Outcome results
None listed