Basket | Login | Register

 
 
 
 

P13. The MEETINGDEM Support Programme

Detailed programme and abstracts

DRÖES Rose-Marie, MEILAND Franka, EVANS Simon, BROOKER Dawn, CHATTAT Rabih, RYMASZEWSKA Joanna, FARINA Elisabetta, ORRELL Martin

Background: Transfer of evidence based care and support interventions from one country to another is not a matter of course. The JPND-MEETINGDEM project aimed to implement and validate the Dutch Meeting Centres Support Programme (MCSP) for community dwelling people with dementia and their family carers in other EU countries. This person-centred programme has been successfully implemented in 144 Meeting Centres in the Netherlands. Demonstrated benefits include high user satisfaction, reduced behavioural and mood problems, delayed nursing home admission and higher carer competence. Aim of the MEETINGDEM project was to see if MCSP could be successfully implemented in Italy, Poland and the UK and if comparable benefits would be achieved. In this session the aims, methods and results of the project will be presented and discussed. This session reports on the implementation, user feedback and effectiveness and cost-effectiveness of MCSP for the first time at an international conference.

Methods: First, in an exploration and preparation phase (M1-18) each country established an Initiative Group of relevant care, welfare, volunteer organizations, user representatives and local government to develop country-specific implementation plans. Next, (M19-36) MCSP was implemented in at least one region per country; Meeting Centres’ staff received training in methods of MCSP; a process evaluation was conducted by interviews with stakeholders to trace facilitators and barriers of implementation; the (cost-)effectiveness of MCSP compared to usual care was evaluated in a 7 months controlled trial regarding its impact on behaviour, mood and quality of life of people with dementia and carers’ sense of competence. Finally, a user evaluation was conducted.

Results: 13 Meeting Centres were successfully implemented (Italy-8, Poland-3, UK-2) according to country specific implementation plans. Dutch implementation tools were translated/adapted to country-specific requirements. The theoretical background and key features of MCSP and training for personnel were well adopted. All adaptations were recorded, as were reasons for adaptations, and a variety of facilitators and barriers of implementation were identified at a user, organizational and laws/regulations level. The effect study showed several benefits both for persons with dementia and carers. Overall, users in all countries were (very) satisfied with MCSP.

Conclusions: The adaptive implementation of MCSP in three EU countries appeared feasible and successful. Recommendations for further implementation of MCSP and transfer of evidence based interventions across the EU and beyond are made and discussed.

P13.1. Successful transfer of evidence based care across Europe: Results of the MEETINGDEM support programme for people with dementia and their carers in Italy, Poland and the UK

DRÖES Rose-Marie, MEILAND Franka, EVANS Simon, BROOKER Dawn, CHATTAT Rabih, RYMASZEWSKA Joanna, FARINA Elisabetta, ORRELL Martin

Background: Transfer of evidence based care and support interventions from one country to another is not a matter of course. The JPND-MEETINGDEM project aimed to implement and validate the Dutch Meeting Centres Support Programme (MCSP) for community dwelling people with dementia and family carers in other EU countries. This person-centred programme is offered in 144 Meeting Centres in the Netherlands. Demonstrated benefits include high user satisfaction, reduced behavioural and mood problems, delayed nursing home admission and higher carer competence. MEETINGDEM investigated if MCSP would work in Italy, Poland and UK, and if comparable benefits were achieved. In this session methods and results of the project will be discussed.

Methods: First, (M1-18) each country established an Initiative Group of care, welfare, volunteer and user organizations and local government, which developed country-specific implementation plans. Next, (M19-36) MCSP was implemented in at least one region per country; staff were trained; interviews held with stakeholders to trace facilitators/barriers of implementation; (cost-)effectiveness of MCSP compared to usual care was evaluated in a 7-months controlled trial on its impact on behaviour, mood and quality of life of people with dementia and carers’ sense of competence. A user evaluation was conducted.

Results: 13 Meeting Centres were successfully implemented (Italy-8, Poland-3, UK-2). Dutch implementation tools were translated/adapted to country requirements. The theoretical model, key features of MCSP and training for personnel were well adopted. All adaptations were recorded; a variety of facilitators/barriers of implementation were identified at a user, organizational and laws/regulations level. The study showed significant benefits both for persons with dementia and carers. In all countries users (incl. carers) were very satisfied with MCSP.

Conclusions: Implementation of MCSP in other EU countries appeared feasible and successful. Recommendations for further implementation of MCSP and transfer of evidence based interventions across the EU and beyond are discussed.

P13.2. Adaptive implementation of MCSP across Europe: What did we learn from the implementations in Italy, Poland and the UK?

MEILAND Franka, SAIBENE Francesca, EVANS Shirley, SZCZEŚNIAK Dorota, URBANSKA Katharzyna, GAMBORINI Giulia, SCOROLLI Claudia, FARINA Elisabetta, BROOKER Dawn, RYMASZEWSKA Joanna, CHATTAT Rabih, DRÖES Rose-Marie

Background: The Meeting Centres Support Programme (MCSP) originated in the Netherlands almost 25 years ago and multi-centre research proved its benefits (Dröes et al., 2000, 2004, 2006). Nowadays, 144 Meeting Centres exist in the Netherlands that offer combined person-centred psychosocial support to people with mild to moderately severe dementia and their family carers in socially integrated community centres. Within the framework of the JPND-MEETINGDEM project, MCSP has been adaptively implemented in three European countries: Italy, Poland and the UK. The method of adaptive implementation as well as the factors influencing the implementation of MCSP in these three European countries will be discussed.

Methods: A step-by-step procedure was designed to adaptively implement MCSP. Stakeholders were interviewed in each country about experienced facilitators and barriers to the implementation process. Data were analysed using the theoretical model of adaptive implementation (Meiland et al., 2004, 2005).

Results: The step-wise procedure was successfully followed in each country by an Initiative Group of stakeholders to establish new MCSP’s. Common facilitators to the implementation in all countries were: added value of MCSP over usual care, matching needs of the target group, suitable staff and management, enthusiasm of stakeholders. General barriers were: competition with existing care and welfare organizations and scarce funding. Also, differences between countries were found, e.g. related to time available to implement MCSP, and collaborations with other organisations.

Conclusions: Lessons were learned regarding implementation of this psychosocial intervention, such as: stepwise preparing a country specific implementation plan with initiative groups that elaborated on themes like: the target group, support programme, personnel, location, funding, PR; collaboration with relevant organisations in the region, thus allowing adaptations to meet the needs of the specific target group and region. Country-specific guides were developed to stimulate further successful implementation of MCSP in these countries and other countries across Europe.

P13.3. Effectiveness and cost-effectiveness of the meeting centres support programme for people living with dementia and their carers in Italy, Poland and the UK

EVANS Simon, BROOKER Dawn, EVANS Shirley, BRAY Jennifer, HENDERSON Cate, REHILL Amriptal, SAIBENE Francesca, SCOROLLI Claudia, SZCZESNIAK Dorota, D’ARMA Alessia URBANSKA Katarzyna, ATKINSON Teresa, FARINA Elisabetta, RYMASZEWSKA Joanna, CHATTAT Rabih, HENDRIKS Iris, MEILAND Franka, DRÖES Rose-Marie

Background: MEETINGDEM is a JPND funded project focussing on the Meeting Centres Support Programme (MCSP) that was developed and evaluated positively in the Netherlands. MEETINGDEM explored whether MCSP could be implemented in Italy, Poland and the UK with comparable benefits. 

Methods: 13 Meeting Centres were successfully implemented (Italy-8, Poland-3, UK-2). The effectiveness of MC in the three countries was compared to usual care (UC) by ANCOVAs in a 7 month pre-test/post-test controlled trial measuring behaviour (NPI), mood (CSDD), quality of life (DQoL, QOL-AD) of people with dementia and sense of competence (SSCQ) and loneliness (UCLA) of carers.  To calculate cost-effectiveness dyadic health, social and unpaid care costs were calculated, including Meeting Centre attendance costs.

Results: Pre/post data were collected from 85 people with dementia and 93 carers attending MCs and 74 people/carers receiving UC. Participants with dementia scored stage 3 to 5 on the GDS. MC participants showed significant positive effects for QoL (self-esteem, positive affect and feelings of belonging). Posthoc analyses showed depression decreased in the MC group but increased in UC. At baseline, MC participants felt they were receiving more help from family members than those in the UC group. Perceived levels of help reduced for MC group. While the number and severity of neuropsychiatric symptoms in MC was higher at baseline compared to UC, at 7 months this had decreased for MC and increased for UC. Carers distress reaction was higher at baseline and follow-up in the MC group, while MC carers reported reduced loneliness. The benefits of MC compared to UC were associated with additional costs. 

Conclusions: MC’s showed significant health and wellbeing benefits compared to UC, building on the evidence of effectiveness from the Netherlands. The benefits are associated with additional costs. Further investigation is needed to assess potential longer term savings of MCSP.

P13.4. Adaptations made to successfully implement the Meeting Centres Support Programme in other countries in Europe; results of the MeetingDem project

CHATTAT Rabih, EVANS Shirley, EVANS Simon, SZCZEŚNIAK Dorota, URBANSKA Katharzyna, GAMBORINI Giulia, SCOROLLI Claudia, FARINA Elisabetta, SAIBENE Francesca, BROOKER Dawn, RYMASZEWSKA Joanna, HENDRIKS Iris, MEILAND Franka, DRÖES Rose-Marie

Background: The adaptive implementation of the Meeting Centers Support Program (MCSP) in three European countries (IT, PL, UK), within the framework of the JPND-MEETINGDEM project, was based on the Dutch experience where more than 140 Meeting Centres were effectively implemented in the last two decades. The aim is to present what adaptations were made to successfully implement MCSP in Italy, Poland and the UK.

Methods: A step-wise procedure was applied. During the preparation of the implementation an initiative group of stakeholders, including care and welfare, public and non-profit, organizations involved in dementia care, was set up with the aim to develop an implementation plan in each country/region involved in the project. At the end of the implementation partners from the three countries were asked to report on a checklist the adaptations made to the original Dutch model regarding the components of MCSP and the implementation toolkit

Results: The main adaptations made were related to: 1- the access criteria to MCSP: some countries included people with Mild Cognitive Impairment in addition to people with mild to moderate dementia; 2- the flexibility in attendance for people with dementia and caregivers; 3- the opening days/hours which ranged from 2 to 3 days a week; 4- the content of the activity program like frequency and type of activities offered; 5- the recruitment and training of the staff with different backgrounds. 6- the governance of the MC and funding which had to comply with national/ regional regulations in terms of funding authorities, norms for staff recruitment and administrative aspects.

Conclusion: The results of the adaptation process show that the core elements of MCSP were maintained. We can conclude that the transfer of MCSP to other European countries was successful and feasible. Adaptations to the country culture and context proved necessary for effective implementation of MCSP in other countries.

P13.5. How do people with dementia and their caregivers in Italy, Poland and the UK evaluate the Meeting Centre Support Programme

RYMASZEWSKA Joanna, SZCZEŚNIAK Dorota, URBAŃSKA Katarzyna, BROOKER Dawn, EVANS Shirley, EVANS Simon, CHATTAT Rabih, SCOROLLI Claudia, FARINA Elisabetta, D’ARMA Alessia, SAIBENE Francesca Lea, MEILAND Franka, DRÖES Rose-Marie 

Background: The combined person-oriented Dutch Meeting Centres Support Programme (MCSP) (Dröes 2000, 2006) for people living with dementia and their caregivers was adaptively implemented in Italy, Poland and the United Kingdom in the JPND-MEETINGDEM project. Meeting Centres offer support based on the Adaptation–Coping Model (Dröes, 1991) describing adaptive tasks people have to deal with as a consequence of dementia and related support strategies. These form the theoretical framework for activities provided in the centres. An evaluation of MCSP among its users was conducted in the three countries.

Methods: A mixed methods explanatory design was used. Data collection took place after 3 and 6 months in 9 MCs in Italy, Poland and UK. 87/81 PwD and 81/84 caregivers completed a User Satisfaction Questionnaire. After 9 months in each country focus groups were organized, separately for users and caregivers, to receive in-depth feedback on MCSP.

Results: The number of users very satisfied with the activity program increased significantly over time (p<0.05) from 44,4% after 3 months to 58,1% after 6 months. The majority of caregivers (83,4%) reported feeling less burdened after 3 months of participation in MCSP (48.1% much less; 35.4% little less). After 6 months this number increased to 91% (p<0.04, 57.7% much less; 33.3% little less). Focus group analysis showed that in all countries/centres users’ ability in dealing with two adaptive tasks improved: maintaining an emotional balance and preserving a positive self-image.

Conclusions: The positive user evaluation of MCSP in Italy, Poland and UK confirms the results of previous research into MCSP in the Netherlands and shows that MCSP is a universal model that can help people living with dementia and their caregivers to increase their capacity to deal with the challenges caused by dementia and to stay emotionally in balance.

 

 
 

Last Updated: Monday 23 October 2017

 

 
  • Acknowledgements

    The 27th AE Conference in Berlin received funding under an operating grant from the European Union’s Health Programme (2014-2020). Alzheimer Europe and Deutsche Alzheimer Gesellschaft e.V. gratefully acknowledge the support of all conference sponsors.
  • European Union
  • Roche
 
 

Options