Background Dementia care staff working in long‐term care settings are often exposed to a variety of complex situations that can be emotionally challenging, and a lack of adequate support and limited training opportunities may contribute to high levels of staff turnover in this area. Good‐quality training may be beneficial for improving the quality of care provided, and in improving staff confidence and morale. This systematic review aimed to establish how dementia care home staff perceived their own competence and confidence in relation to the care they deliver, whether there are any specific interventions that improve these feelings, and whether feeling more competent and confident impacts on care delivery. Method A search of the literature focusing on staff perceptions of competence and confidence identified 14 873 studies. Following the removal of duplicates and papers that did not meet the inclusion criteria, 19 studies were included in the review and subject to quality assessment. Results Studies varied in terms of quality and design, and were categorised as either intervention or non‐intervention studies. Four studies found a significant increase in feelings of competence and confidence following intervention, although many studies did not statistically analyze their data. The most successful interventions seemed to be those that involved practical support alongside education, and non‐intervention studies highlighted the importance of specific dementia and palliative care training with regard to feelings of competence and confidence. Conclusion Teaching alone may not be an adequate method of training dementia care staff, and the most successful interventions were those where practical support was also provided. Most studies suggested that improvements in competence and confidence also had benefits for care delivery and staff wellbeing. More research needs to be done using validated outcome measures and with competence and confidence as the primary aim.

This study aimed to explore the impact of carer stressors (neuropsychiatric symptoms of dementia, level of independence in activities of daily living, hours of caring per week), demographic factors (carer age, relationship with the person with dementia, dementia type, dementia severity, number of years since diagnosis and cohabitation status) and psychological inflexibility on depression and anxiety in family carers of people with dementia. Eighty-nine family carers with a mean age of 69.13 years old completed self-reported and interview-based questionnaires. Participants were primarily female family members aged 65 years or older looking after a person with severe Alzheimer's disease. Two final regression models (Depression model R 2 =.43; Anxiety model R 2 =.43) demonstrated that psychological inflexibility (β=.52) and the number of hours devoted to caregiving (β=.23) had a significant impact on carer depression, while psychological inflexibility was the only significant independent predictor of carer anxiety (β=.55). The findings demonstrated psychological inflexibility to be a common factor explaining mental health problems in this population even after controlling for other variables known to have an impact. Acceptance and Commitment Therapy (ACT) may be beneficial for concomitantly treating depression and anxiety in this population. Considering that fifty-two per cent of participants responded that they devote more than 41 hours to caregiving per week, a non-traditional face to face approach such as online ACT may have potential in future research. Future studies should also explore the suggested models in understudied subgroups of carers (e.g., carers of early-onset dementia, carers of people with early-stage dementia).

Purpose Including the views of service users, carers and clinical staff when prioritising health research can ensure future projects are meaningful and relevant to key stakeholders. One National Health Service Foundation Trust in England, UK undertook a project to identify the top 10 research priorities according to people with experience using or working in services for dementia and older adult mental health. The paper aims to discuss these issues. Design/methodology/approach Service users with dementia and mental health difficulties; informal carers, family and friends of service users; clinical staff working in the Trust. Participants were surveyed for research ideas. Ideas were processed into research questions and checked for evidence. Participants were then asked to prioritise their personal top 10 from a long list of research questions. A shortlist of 26 topics was discussed in a consensus workshop with a sample of participants to decide on the final top 10 research priorities. Findings A total of 126 participants provided 418 research ideas, leading to 86 unique and unanswered research questions. In total, 58 participants completed interim prioritisation, 11 of whom were invited to the consensus workshop involving service users, carers and clinical staff. The final top 10 priorities were dominated by topics surrounding care, psychosocial support and mental health in dementia. Research limitations/implications Future research from the Trust and collaborating organisations can use these results to develop relevant projects and applications for funding. Originality/value This project has demonstrated the possibility of including key stakeholders in older adult mental health research priority setting at the local level.

Purpose The purpose of this paper is to understand how dementia is represented within current UK Recovery College courses and how people with dementia are involved with such courses. Design/methodology/approach A scoping survey was developed with seven multiple choice questions. Information was collected to find out: How many Colleges are currently offering dementia courses; have previously offered courses or plan to start offering courses; how they have developed their courses; who delivers them; who can attend; and how long courses have been running. Individual Recovery Colleges could leave contact details if they were interested in collaborating on future research projects. UK Recovery Colleges were identified using a published list (Anfossi, 2017) supplemented with internet searching. 86 e-mail messages were sent to Recovery Colleges inviting Leads/Managers to complete the survey through an electronic link. Findings Of the 28 (32.6 per cent) Recovery Colleges who completed the survey, 11 reported to be currently offering dementia courses, while eight planned to start doing so. Six Recovery Colleges stated they were not currently offering dementia courses, have not done so previously and have no current plans to. Research limitations/implications The survey results indicate variability in provision of UK Recovery College courses for people with dementia, and raise further questions about the way the courses are used, their acceptability and usefulness. Originality/value This service evaluation highlights the variability in what is offered, which is an important step in understanding the current service provision.

Background Nurse prescribers (NPs) in memory services have a potentially important role in alleviating the burden of dementia on health care, but they require continuing professional development (CPD) specific to their scope of practice. Aims To inform development of CPD workshops for mental health NPs working in memory services, a review of the literature was undertaken regarding role and CPD issues of this professional group. Design and Methods Healthcare databases were searched using defined search terms alongside lateral searches. Study characteristics were extracted systematically, with results grouped thematically in the style of a narrative review. Reporting followed the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses, adapted for current methods (see Supporting Information File S1). Results and Discussion Nine articles specifically addressing nurse prescribing in memory services were found. Studies from broader areas were drawn upon. Considerable variation was found for how the role of memory service NPs might be defined, due in part to variation in characteristics of memory services. NPs, other clinical staff and patients have provided positive feedback to the introduction of the role in memory services and elsewhere. However, concerns around prescribing cautiousness of NPs were apparent. Little clinical or economic outcome data were found to compare opinions and experiences to, with none for NPs in memory services. Literature addressing CPD issues for NPs in memory services was nonexistent. Studies from surrounding areas suggest a problem with availability of CPD opportunities for nurse prescribers. Conclusion This review highlights the paucity of literature for this area of inquiry, particularly for clinical, economic and other patient outcome data. Relevance to Clinical Practice Variation in the little existing evidence suggests development of CPD opportunities should spend time understanding issues at the local level. The gap in the literature in this area may impact policy decisions in the UK and elsewhere.

BackgroundUndertaking co-production as a power-sharing way to improve mental health dementia services remains uncommon, suggesting opportunities to apply knowledge from lived experience of people with dementia, may often be missed. One barrier is stigma, assuming people with progressive cognitive impairment cannot manage this level of participation, support peers nor offer a “valid” perspective.PurposeThis paper shares knowledge gained from a service evaluation that explored various experiences of a person with dementia, their family supporter and mental health staff, involved in co-producing a course about “living well” with dementia, within a mental health Recovery College.DesignA qualitative, case study approach used semi-structured interviewing and inductive thematic analysis.FindingsCo-production activities generated a shared sense of positivity, pride and privilege, highlighting positive effects in breaking down the “them and us” barriers common in traditional healthcare professional-service user relationships. Each individual had both something to offer and something to gain during the process. Staff identified challenges in the co-production process; in that balancing all the voices during meetings could be complex at times, and the process overall required considerable time commitment.ConclusionTaking part in co-production at an appropriate level and with peer support is a relational activity seen to be valuable in powerfully, yet gently, challenging stigma and assumptions around dementia. Findings show that while the process of co-production requires time and dedication, there is overall value in involving people living with dementia both in co-production and in peer support. This provided a straightforward and beneficial means to inclusively improve post-diagnosis support and care quality within a memory service.