Dementia Programme Effectiveness in Long-Term Care

Abstract

Objective. To examine the effectiveness of dementia programmes and report factors related to programme outcomes. To describe the characteristics which placed hostel residents at risk for nursing home placement and to measure changes in dependencies and impairments over 2 years. Design. Longitudinal, quasi‐experimental using in situ resident groups matched on resident and facility characteristics. Setting. Australian hostels for the elderly. Subjects. 587 residents (programme group N=184, comparison group N=162, frail groups N}=241). Measures. Mini‐Mental State Examination, Geriatric Depression Scale and staff‐rated indices of functioning, including activities of daily living, problem behaviours, psychiatric symptomology and health status, were used to monitor changes in resident characteristics. Time to nursing home placement was another outcome measure. Results. Residents in hostel dementia programmes remained significantly longer than those in the comparison group (2.5 months over 2 years) before exit to a nursing home. Quality of life for residents in dementia programmes was enhanced through higher levels of social contact with relatives and lower reported levels of depressive symptoms. Conclusions. Dementia programmes worked, but the reasons why were more difficult to establish. The programmes did not appear to modify the capacities of residents by slowing rates of decline. Dementia programmes provided specialist (non‐personal care) staff focusing on the social and emotional needs of residents. These staff provided appropriate, targeted activities for residents with dementia, had a clearly defined role directed exclusively to these residents and felt directly responsible for them. Dementia programmes produced a system effect. They increased the capacity of hostels to care for residents with dementia for longer periods, before admission to a nursing home. © 1997 John Wiley & Sons, Ltd.

How do staff influence the quality of long-term dementia care and the lives of residents? A systematic review of the evidence

“…We also look at potentially adjustable within-facility staff variables, such as level of emotional support for staff, the way shifts are organized, staff ratios, but not at broad facility level variables such as type of unit (for example Special Care Units (SCU) vs. nursing home), which is not an accurate enough variable and is an area already heavily reviewed with equivocal results (e.g. Rosewarne et al, 1997a;Chappell and Reid, 2000). We do look at relevant care characteristics sometimes associated with SCUs, if measured, but our interest is in what staff actually do rather than the broad label applied to where they do it.…”

Effects of Supporting Community‐Living Demented Patients and Their Caregivers: A Randomized Trial

“…Several types of interventions, such as counseling, training programs, and therapeutic group meetings, that have been organized for caregivers have resulted in prolonged community care 13–15 . Although several dementia programs have been implemented resulting in some improvements in patients' functional abilities 16,17 or behavioral complications, 18 no randomized studies have as yet examined the effects of support interventions directed at both demented patients and their caregivers in an effort to prolong the period of community care. We undertook such a study to determine whether community care of demented patients can be prolonged through a 2‐year support program based on nurse case management 19…”

Monash and King's Pharmacy Education Symposium 2007 9-11 July 2007 Prato, Italy

“…Bridging the gap between student learning and professional practice: Evaluation of interprofessional learning programs Abstract: Interprofessional education has encouraged collaborative practice and improved patient health outcomes (Rosewarne, 1997).…”