OA25 The namaste care programme can enrich quality of life for people with advanced dementia and those who care for them without additional resources

Stacpoole, Min; Thompsell, Amanda

doi:10.1136/bmjspcare-2015-000906.25

Cited by 9 publications

(8 citation statements)

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“…The majority were descriptive accounts of Namaste Care rather than research studies. Of the seven research studies, three included some before-and-after data, 22,44,45 three were qualitative [46][47][48] and one (reported in three papers) 27,29,49 used an action research approach. Only five studies 21,22,27,44,45 presented data on resident outcomes.…”

Section: Phasementioning

confidence: 99%

“…Further details of the Namaste Care studies are listed in additional file 3 of Bunn et al 32 With respect to research design, the 86 papers reported: l 17 evidence reviews (not Namaste Care) [51][52][53][54][55][56][57][58][59][60][61][62][63][64][65][66][67][68] l 59 papers reporting 51 primary studies (not Namaste Care) l 10 papers reporting 8 Namaste Care studies. 22,27,29,[44][45][46][47][48]50,130 REALIST REVIEW OF NAMASTE CARE AND OTHER MULTISENSORY INTERVENTIONS NIHR Journals Library www.journalslibrary.nihr.ac.uk…”

Section: Phasementioning

confidence: 99%

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A group intervention to improve quality of life for people with advanced dementia living in care homes: the Namaste feasibility cluster RCT

Froggatt

Best

Bunn

et al. 2020

Health Technol Assess

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Background People with advanced dementia who live and die in nursing homes experience variable quality of life, care and dying. There is a need to identify appropriate, cost-effective interventions that facilitate high-quality end-of-life care provision. Objectives To establish the feasibility and acceptability to staff and family of conducting a cluster randomised controlled trial of the Namaste Care intervention for people with advanced dementia in nursing homes. Design The study had three phases: (1) realist review and (2) intervention refinement to inform the design of (3) a feasibility cluster randomised controlled trial with a process evaluation and economic analysis. Clusters (nursing homes) were randomised in a 3 : 1 ratio to intervention or control (usual care). The nature of the intervention meant that blinding was not possible. Setting Nursing homes in England providing care for people with dementia. Participants Residents with advanced dementia (assessed as having a Functional Assessment Staging Test score of 6 or 7), their informal carers and nursing home staff. Intervention Namaste Care is a complex group intervention that provides structured personalised care in a dedicated space, focusing on enhancements to the physical environment, comfort management and sensory engagement. Main outcome measures The two contender primary outcome measures were Comfort Assessment in Dying – End of Life Care in Dementia for quality of dying (dementia) and Quality of Life in Late Stage Dementia for quality of life. The secondary outcomes were as follows: person with dementia, sleep/activity (actigraphy), neuropsychiatric symptoms, agitation and pain; informal carers, satisfaction with care at the end of life; staff members, person-centred care assessment, satisfaction with care at the end of life and readiness for change; and other data – health economic outcomes, medication/service use and intervention activity. Results Phase 1 (realist review; 86 papers) identified that a key intervention component was the activities enabling the development of moments of connection. In phase 2, refinement of the intervention enabled the production of a user-friendly 16-page A4 booklet. In phase 3, eight nursing homes were recruited. Two homes withdrew before the intervention commenced; four intervention and two control homes completed the study. Residents with advanced dementia (n = 32) were recruited in intervention (n = 18) and control (n = 14) homes. Informal carers (total, n = 12: intervention, n = 5; control, n = 7) and 97 staff from eight sites (intervention, n = 75; control, n = 22) were recruited over a 6-month period. Recruitment is feasible. Completion rates of the primary outcome questionnaires were high at baseline (100%) and at 4 weeks (96.8%). The Quality of Life in Late Stage Dementia was more responsive to change over 24 weeks. Even where economic data were missing, these could be collected in a full trial. The intervention was acceptable; the dose varied depending on the staffing and physical environment of each care home. Staff and informal carers reported changes for the person with dementia in two ways: increased social engagement and greater calm. No adverse events related to the intervention were reported. Conclusions A subsequent definitive trial is feasible if there are amendments to the recruitment process, outcome measure choice and intervention specification. Future work In a full trial, consideration is needed of the appropriate outcome measure that is sensitive to different participant responses, and of clear implementation principles for this person-centred intervention in a nursing home context. Trial registration Current Controlled Trials ISRCTN14948133. Funding This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 24, No. 6. See the NIHR Journals Library website for further project information.

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Section: Phasementioning

confidence: 99%

Section: Phasementioning

confidence: 99%

A group intervention to improve quality of life for people with advanced dementia living in care homes: the Namaste feasibility cluster RCT

Froggatt

Best

Bunn

et al. 2020

Health Technol Assess

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“…There is evidence that Namaste Care can increase social interaction, reduce the severity of behavioural and physical symptoms such as agitation [ 8 , 10 , 11 ] and, potentially, lead to cost savings via a reduction in the use of psychotropic medication [ 12 , 13 ]. Qualitative evidence also suggests it can increase family and staff satisfaction with care [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

Improving living and dying for people with advanced dementia living in care homes: a realist review of Namaste Care and other multisensory interventions

et al. 2018

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BackgroundSeventy percent of people with advanced dementia live and die in care homes. Multisensory approaches, such as Namaste Care, have been developed to improve the quality of life and dying for people with advanced dementia but little is known about effectiveness or optimum delivery. The aim of this review was to develop an explanatory account of how the Namaste Care intervention might work, on what outcomes, and in what circumstances.MethodsThis is a realist review involving scoping of the literature and stakeholder interviews to develop theoretical explanations of how interventions might work, systematic searches of the evidence to test and develop the theories, and their validation with a purposive sample of stakeholders. Twenty stakeholders - user/patient representatives, dementia care providers, care home staff, researchers -took part in interviews and/or workshops.ResultsWe included 85 papers. Eight focused on Namaste Care and the remainder on other types of sensory interventions such as music therapy or massage. We identified three context-mechanism-outcome configurations which together provide an explanatory account of what needs to be in place for Namaste Care to work for people living with advanced dementia. This includes: providing structured access to social and physical stimulation, equipping care home staff to cope effectively with complex behaviours and variable responses, and providing a framework for person-centred care. A key overarching theme concerned the importance of activities that enabled the development of moments of connection for people with advanced dementia.ConclusionsThis realist review provides a coherent account of how Namaste Care, and other multisensory interventions might work. It provides practitioners and researchers with a framework to judge the feasibility and likely success of Namaste Care in long term settings. Key for staff and residents is that the intervention triggers feelings of familiarity, reassurance, engagement and connection.Study registrationThis study is registered as PROSPERO CRD42016047512Electronic supplementary materialThe online version of this article (10.1186/s12877-018-0995-9) contains supplementary material, which is available to authorized users.

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“…The primary aim of the program is to improve the quality of life of people with advanced dementia by focusing on a meaningful connection with them, which might result in positive effects in people with dementia and their family caregivers. Studies reported that Namaste Care successfully improves the quality of life of people with advanced dementia and their family caregivers without extra healthcare costs [11][12][13]. Despite the fact that these studies have estimated costs and effects associated with Namaste Care, no full economic evaluation has been performed yet.…”

Section: Introductionmentioning

confidence: 99%

Cost-effectiveness of the Namaste care family program for nursing home residents with advanced dementia in comparison with usual care: a cluster-randomized controlled trial

Alili

Smaling

Joling

et al. 2020

BMC Health Serv Res

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Background: Dementia is a progressive disease that decreases quality of life of persons with dementia and is associated with high societal costs. The burden of caring for persons with dementia also decreases the quality of life of family caregivers. The objective of this study was to assess the societal cost-effectiveness of Namaste Care Family program in comparison with usual care in nursing home residents with advanced dementia. Methods: Nursing homes were randomized to either Namaste Care Family program or usual care. Outcome measures of the cluster-randomized trial in 231 residents included Quality of Life in Late-Stage Dementia (QUALID) and the Gain in Alzheimer Care Instrument (GAIN) for family caregivers over 12 months of follow-up. Health states were measured using the EQ-5D-3L questionnaire which were translated into utilities. QALYs were calculated by multiplying the amount of time a participant spent in a specific health state with the utility score associated with that health state. Healthcare utilization costs were estimated using standard unit costs, while intervention costs were estimated using a bottom-up approach. Missing cost and effect data were imputed using multiple imputation. Bootstrapped multilevel models were used after multiple imputation. Cost-effectiveness acceptability curves were estimated.

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OA25 The namaste care programme can enrich quality of life for people with advanced dementia and those who care for them without additional resources

Abstract: Where there was good leadership and adequate clinical care, the Namaste Care programme supported compassionate care and enhanced quality of life for people with advanced dementia at the end of their lives. No additional resources were required.

Cited by 9 publications

References 0 publications

A group intervention to improve quality of life for people with advanced dementia living in care homes: the Namaste feasibility cluster RCT

A group intervention to improve quality of life for people with advanced dementia living in care homes: the Namaste feasibility cluster RCT

Improving living and dying for people with advanced dementia living in care homes: a realist review of Namaste Care and other multisensory interventions

Cost-effectiveness of the Namaste care family program for nursing home residents with advanced dementia in comparison with usual care: a cluster-randomized controlled trial

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