None listed
Conditions
Brief summary
We hypothesise that an Allied Health Assistant supporting people who have a mild to moderate diagnosis of dementia to complete six sessions of a personalised, goal-directed intervention will result in them maintaining or improving their overall wellbeing, improve their quality of life and have an impact on their likelihood to have falls, require hospitalisation or enter residential aged care. SPICE at Home draws on elements of a multicomponent, multidisciplinary personalised and goal-directed intervention, SPICE, which has demonstrated promising results in improving and maintaining wellbeing in people with mild to moderate dementia when delivered in a group setting. The SPICE at Home intervention will be a pilot trial to test the feasibility and effectiveness of a fully powered trial. We will explore the perceived benefits of the intervention through both quantitative and qualitative data collection and analysis of participants who received the intervention.
Interventions
SPICE at Home is a complex intervention designed to support people with mild to moderate dementia and their care partners through personalised, goal-directed interventions. The Occupational Therapist will use the Canadian Occupational Performance Measure (COPM) to identify priority goals and guide the development of the intervention. If indicated, participants will receive an assessment from a Physiotherapist to incorporate physical components into their goals. The initial consultation will be 1
SPICE at Home is a complex intervention designed to support people with mild to moderate dementia and their care partners through personalised, goal-directed interventions. The Occupational Therapist will use the Canadian Occupational Performance Measure (COPM) to identify priority goals and guide the development of the intervention. If indicated, participants will receive an assessment from a Physiotherapist to incorporate physical components into their goals. The initial consultation will be 1-2 hours and aims to gather the information required to design a personalised intervention. The Occupational Therapist and as needed, Physiotherapist, will collaborate to develop a personalised intervention plan, which will be referred to the Allied Health Assistant for implementation. The Occupational Therapist will break down overarching goals into smaller, achievable goals for each session, considering safety risks and individual goals. The six sessions will be scheduled over up to 12 weeks, depending on the participant's goals and appropriate intensity. Each session will be up to 90 minutes in duration and will be adaptable based on the pre-prepared goals and interventions. Each session will commence with a standardised cognitive stimulation exercise for the purpose of familiarity. Each session will aim to consolidate and build upon the previous sessions. A resource pack, created by the Allied Health Assistant, will be provided to the participants at the completion of the intervention. This pack will include step-by-step guides with pictures, person-specific instructions, and visual cues to promote ongoing maintenance of the goals achieved during the intervention. Fidelity to the intervention will be achieved through the development of a manual with a guide around the structure for each session for the Allied Health Assistant, Occupational Therapist, and Physiotherapist to be guided by. Activities that are related to occupational performance will be developed by the occupational therapist. Examples of activities that may be included are as follows: - Self-care activities (E.g., engaging in gardening, or putting on music and dancing to it) - Leisure activities (E.g., engaging in a board game or forest bathing) - Productivity activities (E.g., folding and putting away laundry) - Social engagement (E.g., planning and attending a coffee catch-up with a friend) - Physical activity (E.g., going for a planned walk or exercise routine) - Meaningful occupation (E.g., helping prepare a shopping list for a meal) - Cognitive activity (E.g., engaging in completion of a puzzle or developing a journal of the person’s life) Activities that are related to mobility and exercise will be developed by the physiotherapist where identified as being related to one of the person's goals or when clinically necessary. All activities will be delivered by the allied health assistant with clinical supervision and guidance from the occupational therapist and/or physiotherapist. The sessions will be delivered over a minimum period of 6 weeks and a maximum period of 12 weeks. The decision for delivery over 6 or 12 weeks will be person-centred and driven by the participant and not dependent on the actual activity.
Sponsors
University of Canberra Hospital
Study design
Allocation
Non-randomised trial
Intervention model
Single group
Primary purpose
Treatment
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
- Able to consent to participation - Dementia diagnosis (any type) by a health professional - A rating of 0.5-2 on the Clinical Dementia Rating Scale (CDR) - People with a CDR of 2 will be required to be supported by a care partner or supporter who will be present at each session - Be willing, interested, and able to participate in six sessions and consent to home visits - ACT resident - Participants must be experiencing challenges relating to living with dementia in the community, including: • Living alone, socially isolated, or without support of a family member or care partner and/or • With a care partner or family members who are experiencing challenges supporting the person to be engaged in their home and/or • Do not currently have reliable transport to access health or community services
Exclusion criteria
- Not able to consent - No formal dementia diagnosis (any type) - CDR score of 0 or 3 - Significant changed behaviours and unable to engage with allied health professionals - Non-ACT resident - Already accessing and satisfied with community supports (e.g., have a support/case worker in place, social support for respite, attend day respite regularly)
Outcome results
None listed