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Ireland’s Health Service Executive publishes implementation evaluation of Dementia Post-diagnostic Support Scheme

Saturday 30 November 2019

To increase staff capacity to deliver dementia post-diagnostic supports (PDS) and to make them more equitably available, the Irish National Dementia Office (NDO) recently ran a PDS grant scheme. The scheme is part of a broader dementia post-diagnostic programme of work which supports the implementation of the National Dementia Strategy. Following a review of the literature, the grant scheme focused on three interventions - cognitive stimulation therapy (CST), cognitive rehabilitation (CR) therapy and psychoeducational (PE) interventions. An open competition was held and grants covering staff costs were awarded; with a geographical spread across the country. An independent evaluation of the PDS Grant Scheme focused on issues related to: intervention implementation; the subjective impact of interventions for participants; and how these programmes address the post-diagnostic care/support gap.  

Data was collected between January and June 2019, across 17 sites implementing 19 PDS interventions:

  • The number of people participating, across 7 CST programmes was 89 people with dementia (not applicable for carers)
  • The number of people participating, across 6 CR programmes was 80 people with dementia and 64 family carers
  • The number of people participating, across 6 PE programmes was 63 people with dementia and 63 family carers
  • The total number of people with dementia participating in the 19 programmes was 232 and the total number of family carers participating was 127

The findings show that implementation was impacted by the:

  • confluence of staff experience, skills, readiness and know-how;
  • choice of intervention - adopting an existing intervention or developing a new one;
  • embeddedness of staff within their organisation and within the wider health system;
  • management support;
  • local context e.g. level of demand among people with dementia;
  • need for ongoing supervision, mentoring and feedback for less experienced staff. 

The vast majority of participants rated interventions very positively. They particularly welcomed the focus on social interaction and peer support within group interventions e.g. CST and CR. For group CR it was also more cost effective. Further investigation is needed to assess efficacy where there were adaptations to existing models, specifically in the case of CST, where all grant sites made changes. Evidence on the impact of PE is less well established. Developing new PE programmes took significant time and resources; requiring high levels of expertise. Although the “Next Steps Guidance Document on Psychoeducational Programmes”, was an important and practical tool to guide programme development. As a result of the evaluation findings, all grant sites that wished to continue their programmes into 2020, have received co-funding to do so. The findings are also informing the content of a National Dementia Post-diagnostic Framework for Ireland. For more information about the PDS programme contact emer.begley@hse.ie

The evaluation report is also available to download:

https://www.understandtogether.ie/Training-resources/Helpful-Resources/Publications/An-Evaluation-of-the-HSE-s-National-Dementia-Post-Diagnostic-Support-Grant-Scheme-2019-.pdf

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