An evaluation of a specialist multiagency home support service for older people with dementia using qualitative methods

Rothera, Ian; Jones, Rob; Harwood, Rowan H.; Avery, Anthony J; Fisher, Kate; James, Veronica; Shaw, Ian; Waite, Jonathan

doi:10.1002/gps.1841

Cited by 50 publications

(54 citation statements)

References 19 publications

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“…In contrast to findings that home care is often task-oriented and time-limited with care workers under pressure to complete their work against the clock, Rothera et al [55] found that the most effective forms of home care with the best outcomes are flexible in their design and responsive in their delivery.…”

Section: Resultsmentioning

confidence: 97%

“…In their view, single strand interventions (such as carer support groups) are less effective than multi-stranded interventions [31,80]. Rothera et al’s [55] work complements this by emphasising that flexible and individualised care at home is better than task-focused care. Ways to achieve this might include ways of managing risk that do not excessively constrain, and that involve carers [46].…”

Section: Resultsmentioning

confidence: 99%

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Evidence of what works to support and sustain care at home for people with dementia: a literature review with a systematic approach

et al. 2015

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BackgroundThis paper synthesises research evidence about the effectiveness of services intended to support and sustain people with dementia to live at home, including supporting carers. The review was commissioned to support an inspection regime and identifies the current state of scientific knowledge regarding appropriate and effective services in relation to a set of key outcomes derived from Scottish policy, inspection practice and standards. However, emphases on care at home and reduction in the use of institutional long term care are common to many international policy contexts and welfare regimes.MethodsSystematic searches of relevant electronic bibliographic databases crossing medical, psychological and social scientific literatures (CINAHL, IngentaConnect, Medline, ProQuest, PsychINFO and Web of Science) in November 2012 were followed by structured review and full-text evaluation processes, the latter using methodology-appropriate quality assessment criteria drawing on established protocols.ResultsOf 131 publications evaluated, 56 were assessed to be of ‘high’ quality, 62 of ‘medium’ quality and 13 of ‘low’ quality. Evaluations identified weaknesses in many published accounts of research, including lack of methodological detail and failure to evidence conclusions. Thematic analysis revealed multiple gaps in the evidence base, including in relation to take-up and use of self-directed support by people with dementia, use of rapid response teams and other multidisciplinary approaches, use of technology to support community-dwelling people with dementia, and support for people without access to unpaid or informal support.ConclusionsIn many areas, policy and practice developments are proceeding on a limited evidence base. Key issues affecting substantial numbers of existing studies include: poorly designed and overly narrowly focused studies; variability and uncertainty in outcome measurement; lack of focus on the perspectives of people with dementia and supporters; and failure to understanding the complexities of living with dementia, and of the kinds of multifactorial interventions needed to provide holistic and effective support. Weaknesses in the evidence base present challenges both to practitioners looking for guidance on how best to design and deliver evidence-based services to support people living with dementia in the community and their carers and to those charged with the inspection of services.Electronic supplementary materialThe online version of this article (doi:10.1186/s12877-015-0053-9) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 97%

Section: Resultsmentioning

confidence: 99%

Evidence of what works to support and sustain care at home for people with dementia: a literature review with a systematic approach

et al. 2015

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“…Around 25% people with dementia and their carers refuse home input when first offered (Brodaty et al, 2005) yet evidence from the US (Gaugler et al, 2005b) shows a correlation between early intensive input and delayed entry to care. Rothera et al (2008) echo this finding in the UK, whereas the provision of more traditional community support may be of limited benefit (Miller et al, 1999). A prospective Scottish Dementia Strategy provides an opportunity to develop a more intensive case management model including the early multidisciplinary assessment by all professionals likely to be involved in future care, the introduction of a comprehensive risk assessment in management procedure to ensure that only those at high risk are placed in institutional settings and the development of an advanced care plan to look at future needs including potential palliative care.…”

Section: Post-diagnosismentioning

confidence: 72%

Scottish dementia strategy editorial

Connelly

2010

Int J Geriat Psychiatry

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“…Rothera et al, 2008) or investigated the effectiveness of a single form of treatment (e.g. Orgeta et al, 2015).…”

Section: Discussionmentioning

confidence: 99%

Evaluating the effectiveness of different approaches to home support for people in later stage dementia: a protocol for an observational study

Chester

Clarkson

Hughes

et al. 2017

Int. Psychogeriatr.

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Background: Dementia is a major health problem with a growing number of people affected by the condition, both directly and indirectly through caring for someone with dementia. Many live at home but little is known about the range and intensity of the support they receive. Previous studies have mainly reported on discrete services within a single geographical area. This paper presents a protocol for study of different services across several sites in England. The aim is to explore the presence, effects and cost-effectiveness of approaches to home support for people in later stage dementia and their carers.

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An evaluation of a specialist multiagency home support service for older people with dementia using qualitative methods

Cited by 50 publications

References 19 publications

Evidence of what works to support and sustain care at home for people with dementia: a literature review with a systematic approach

Evidence of what works to support and sustain care at home for people with dementia: a literature review with a systematic approach

Scottish dementia strategy editorial

Evaluating the effectiveness of different approaches to home support for people in later stage dementia: a protocol for an observational study

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