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P3: Psychosocial interventions

Detailed programme, abstracts and presentations

P3: Psychosocial interventions

P3.1. Understanding the causes and solutions for crises in dementia

ORRELL Martin, TOOT Sandeep, LEDGERD   Ritchard

Many people with dementia and their carers experiences crises with the common consequence of a breakdown in care and the potential for hospital admission. The consequences of this can be that the person with dementia is no longer able to be supported in their own place which can result in a permanent loss of their home and long term admission to a nursing home.  This usually means quality of life is lower and costs are higher, even though with the right support they could potentially be maintained at home for considerably longer. Little is known about the precise causes of crisis and even less about the best measures to manage them. A series of studies are presented which look at the risk factors for and the precipitants of crisis from the point of view of family carers, staff, and the people with dementia themselves, and related work identifies the best methods for the prevention of crises and the most useful ways to intervene and prevent admissions. Methods include systematic reviews, focus group studies, a national survey and consensus methods. The results showed that falls, infection and delirium were highly rated as risks factors for crises. Carers and people with dementia rated aggression as less important but severity of memory impairment as much more important than staff did. Education and support for family carers and home care staff was highly valued. Well trained home care staff, communication equipment, emergency contacts and access to respite were highly valued for managing crises. In conclusion, understanding potential crisis situations and interventions to support people with dementia and their carers is critical to providing effective support.

P3.2. Online training of carers of people with dementia; evaluation results of the European STAR training portal

MEILAND Franka, HATTINK Bart, VAN DER ROEST Henriëtte, KEVERN Peter, ABIUSO Francesca, BENGTSSON Johan, GIULIANO Angele, DUCA Annalise, SANDERS Jennifer, BASNET Fern,  NUGENT Chris, KINGSTON Paul, DRÖES Rose-Marie

Background: A shortage is expected of professionals available to care for the growing number of people with dementia. As a result, untrained informal carers and volunteers will increasingly provide care. To promote effective care in dementia and avoid carer overburdening, carers need to become properly skilled. To address this need, a multilingual e-learning portal has been developed and evaluated within the European STAR project. The final results of the evaluation of the STAR training portal will be presented.

Methods: A randomised  controlled  trial  was  performed  among  142  informal  carers, volunteers and professional carers in the Netherlands and the UK. Online standardised questionnaires were used at baseline and after two-four months.

Intervention: The training portal consisted of eight modules, two of which were deemed to be of a basic level and six additional modules at intermediate and advanced levels. The experimental group had access to the STAR training and online peer and expert communities for  support and  information exchange. The control group received access to the STAR training portal after the research had ended.

Measurements: Outcome measures were: user-friendliness, usefulness and impact of the STAR training portal on knowledge, attitudes and approaches of carers regarding dementia, empathy, quality of life, burden and carers’ sense of competence.

Results: The STAR training portal was rated positively by all user groups for user-friendliness and usefulness. Significant positive effects (large effect sizes) were found on person-centred care approaches (ADQ) and empathy (IRI). In the same group, however, there was a significant reduction in sense of competence (SSCQ) (medium effect size).

Conclusion: Training through the STAR portal is considered a useful, user friendly e-learning method for dementia carers and has provided significant positive effects on carer attitudes and empathy. The STAR training is now available online and is being disseminated to other countries over the world.

P3.3. Woodlands & forests as places of mental well-being for people with dementia

COOK Mandy

This is a PhD research study.  Evidence has emerged regarding the beneficial effects of being within green spaces, including woodlands and forests, for people with a range of mental health conditions.  In recent years, there has been a growing awareness that people with dementia should have the necessary environmental support and freedom to access the outdoors.  This study fulfils a research need by focusing on people with early-stage dementia living at home.  It provides a detailed and critical insight into the meaning and use of the specific setting of woodlands and forests and how these spaces can contribute to positive mental well-being and broader community belonging.  This presentation shows the results of a pilot programme of activities based in an urban woodland setting for people with early-stage dementia.

Main findings

  • The woodland activity programme provides an overwhelmingly positive experience for people with early-stage dementia, offering meaningful experiences which contribute to the well-being and feelings of self-worth.  
  • The woodland activity programme offers a viable and potentially more effective alternative to traditional therapeutic interventions, such as reminiscence therapy (involving the discussion of past experiences) and reality orientation (presenting information about time, place or person to help a person to understand their surroundings and situation) for people with early-stage dementia. 
  • The woodland activity programme helps people with early-stage dementia and their carers to remain active and connected within the community, enabling them to maintain their independence for as long as possible.  
  • The woodland activity programme provides support for carers.
  • The woodland environment provides a ‘library’ of resources and stimulation for people with dementia.  
  • An ‘end of the road’ approach to people with dementia is no longer acceptable.  We need to explore more ways of providing care with an emphasis on empowerment and maintaining the best possible quality of life.

P3.4. Spreading the word: multiplication of best practice in carer support through a new apprentice scheme in reminiscence arts in dementia care and evaluation of this scheme

SCHWEITZER Pam, JANECKOVA Hana

Summary:Last year, the European Reminiscence Network developed a training and apprenticeship scheme to spread the word concerning the effectiveness of reminiscence in dementia care in supporting the central relationship between family carer and cared-for. This new apprenticeship scheme, which aims to train more workers in a fully tested and very positive intervention, is being piloted across ten EU countries all following the same pattern and leading to a certification in group facilitation of the “Remembering Yesterday, Caring Today” project.

Apprentices in each country attend an initial 2-day training course, then participate in at least 6 of 10 weekly practical sessions with families affected by dementia. They gain experience in running some of the activities themselves and then work in small teams to deliver entire sessions themselves. They receive feedback from experienced group leaders and from one another. The written work component of the apprenticeship measures their level of reflective practice and new learning against an agreed marking scheme. The first 20 apprentices have completed their course in the UK, almost all of them freelancers with a community arts background who intend to develop the work with new families in different parts of the country. Across the partner countries 100 apprentices have been accredited. 

We are now extending the scheme, with at least two more groups of apprentices, to ensure there are more people able to deliver this highly effective intervention in the future.

In this paper, we shall quote from the recorded experience of the apprentices and reflect on the idea of accrediting an internationally shared intervention, showing how modifications to the programme have enabled it to succeed in different countries, and how project partners with different backgrounds (eg Alzheimer Societies, day centres, care support projects, community arts projects) have interpreted the brief while staying true to the spirit of the project. We shall also share information concerning evaluation of this project.

P3.5. Naturall4DEM: results of a qualitative pilot study into personalized nature based interventions for people with dementia

GERRITSEN Debby, VAN VLIET Deliane, HENDRIKS Iris, DRÖESRose-Marie

Background: For people with dementia, nature and outdoor spaces can provide a stimulating environment with exposure to light and sensory experiences as well as engagement in pleasant activities. Being in nature is often either not available for nursing home residents with dementia or underused despite easy access to it. Outdoor spaces (gardens, parks) often are available -also for home dwelling persons with dementia-, but their use must be further improved.

Aim: 1) investigate the views of persons with dementia on the importance of nature and outdoor spaces for their quality of life (QoL); 2) create a checklist of what people experience as important for their QoL in nature and outdoor spaces; 3) develop several nature/outdoor space wellbeing-interventions for people with dementia, especially for persons with behaviour and mood problems; 5) pilot-test these interventions, investigating possible effects and feasibility.

Method: Focus-group interviews and semi-structured interviews with persons with dementia were conducted. The interventions were pilot-tested and evaluated by 15 persons with dementia. Feasibility was also studied, by interviewing professionals in dementia care.

Results: We identified various aspects of nature and outdoor spaces that people with dementia consider important for their well-being/QoL, e.g. health (fresh air, exercise) and rest (relaxing, silence, getting calm). Based on these, a checklist linking QoL-domains to nature/outdoor activities was developed to inventory what activities a person with dementia could undertake. Subsequently, a decision tree tool for person-centered nature interventions was created. The tool was presented to professionals caregivers and persons with dementia and adapted according to their feedback.

Momentarily, a pilot-study is conducted into the person-centered nature interventions for people with behaviour and mood problems (n=15) in day-care centers and nursing homes in three regions of the Netherlands.

Conclusion: The pilot-study ends May 2015. Results on effects and feasibility of the interventions are presented at the conference.

 

 
 

Last Updated: Monday 28 September 2015

 

 
  • Acknowledgements

    The 25th AE Conference in Ljubljana received funding under an operating grant from the European Union’s Health Programme (2014-2020). Alzheimer Europe and Spominčica gratefully acknowledge the support of all conference sponsors.
  • European Union
  • Roche
  • SCA Global Hygiene
 
 

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