None listed
Conditions
Brief summary
This project evaluates an innovative model involving the delivery of psychological interventions by mental health trainees (MHTs) to residents with mild to moderate dementia. Interventions are provided to residents over 6 months (approximately 20 face-to-face sessions). Training in understanding dementia is also provided to their caregivers (family and friends) and to facility staff. In addition, caregivers are invited to join a monthly support group. Hence, the treatment involves a systemic approach involving residents, their caregivers and facility staff. Using a cluster-randomised controlled trial, this project compares the effectiveness of the model over and above usual practice, for improving depression and anxiety levels in residents with dementia.
Interventions
The intervention condition involving the Wellbeing Clinic is tri-focal.
First, up to 20 face-to-face sessions (30 - 50 minutes each session, once a week approximately) will be provided to residents on a one-on-one basis by mental health trainees. Consistent with evidence based protocols for improving mood in older adults with dementia (Meeks et al., 2008; Stanley et al., 2013), family caregivers and/or staff will be invited to attend approximately 50% of these sessions. Interventions will inclu
The intervention condition involving the Wellbeing Clinic is tri-focal. First, up to 20 face-to-face sessions (30 - 50 minutes each session, once a week approximately) will be provided to residents on a one-on-one basis by mental health trainees. Consistent with evidence based protocols for improving mood in older adults with dementia (Meeks et al., 2008; Stanley et al., 2013), family caregivers and/or staff will be invited to attend approximately 50% of these sessions. Interventions will include behavioural strategies for improving mood, relaxation techniques for reducing anxiety, cognitive strategies for modifying unhelpful automatic beliefs and reminiscence strategies for priming valued self-representations and memories. Interventions will be matched to residents’ goals and cognitive capacity. The intervention protocol is formalized within a treatment manual, and is based on the works of Meeks et al, Stanley et al., and Bhar (2017). Second, a structured training and support program will be provided to family caregivers. A 2-hour training program will be co-designed by AAV, SUT and the steering committee to provide family caregivers with an understanding of dementia and of methods for interacting positively with the care recipient. In addition, family caregivers will be invited to join a caregiver support group program, held monthly for 2 hours each month, for 6 months, at the facility, which will provide further support to reduce caregiver distress and improve their sense of competency in interacting with their family members living with dementia. The support group program is based on narrative and normative practices, and is formalized by a program protocol. The training workshop is designed by Dementia Australia. The workshop is described in https://www.dementia.org.au/learning/centre-for-dementia-learning/edie-educational-dementia-immersive-experience. Third, a 3-hour workshop will be provided on-site to facility staff, designed to improve staff knowledge about dementia and competence in interacting with residents living with dementia. This workshop is designed by Dementia Australia, as described in https://www.dementia.org.au/learning/centre-for-dementia-learning/edie-educational-dementia-immersive-experience.
Sponsors
Associate Professor Sunil Bhar
Study design
Allocation
Randomised controlled trial
Intervention model
Single group
Primary purpose
Treatment
Masking
Blinded (masking used) (Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
Residents are eligible to participate if they: 1. are currently 65 years or older. 2. are currently living in residential aged care facilities 3. are diagnosed with dementia (major neurocognitive disorder, according to the Diagnostic and Statistical Manual of Mental Disorders, fifth edition [DSM 5]), 4. have within the six months been found to have mild to moderate cognitive impairment as defined as a score between 24 and 10 on the mini-mental state examination (MMSE) or the equivalent on the Psychogeriatric Assessment Scale Cognitive Impairment Scale (PAS-CIS) – 4 to 15 inclusive 5. have within the past year been found to have clinically significant levels of depression as indicated by a minimum of 7 on the Cornell Scale for Depression in Dementia (CSDD) or 11 on the Rating Anxiety in Dementia (RAID) Family/friend caregivers will be eligible to participate if they are 1. nominated by the resident or legal proxy as an important source of care for the resident 2. are at least 18 years old, and 3. can communicate in English 4. willing to participate in project activities Facility staff will be eligible to participate if they are 1. nominated by the resident, legal proxy or unit manager/clinical as an important source of care for the resident 2. are at least 18 years old, and 3. can communicate in English 4. willing to participate in project activities
Exclusion criteria
Residents with limited capacity to communicate verbally in English (due to a lack of English language proficiency as assessed by facility or research staff) or who are unable to complete study procedures due to health conditions (e.g., resident is physically unwell, highly distressed)(as assessed by facility or research staff) will not be eligible to participate in the study.
Outcome results
None listed