IntroductionThe End-of-Life Namaste Care Program for People with Dementia, challenges the misconception that people with dementia are a ‘shell’; it provides a holistic approach using the five senses, which can provide positive ways of communicating and emotional responses. It is proposed Namaste Care can improve communication and the relationships families and friends have with the person with dementia. Previously used in care homes, this study is the first to explore the pioneering use of Namaste Care in people’s own homes.ObjectiveTo develop initial programme theories detailing if, how and under which circumstances Namaste Care works when implemented at home.DesignA qualitative realist approach following the RAMESES II guidelines was employed to understand not only whether Namaste Care has positive outcomes, but also how these are generated, for whom they happen and in which circumstances.SettingA hospice in the North East of England, operating in the community, through volunteers.ParticipantsProgramme theories were developed from three focus groups with volunteers implementing Namaste Care (n=8; n=8; n=11) and eight interviews with family carers (n=8).ResultsFour refined explanatory theories are presented: increasing engagement, respite for family carers, importance of matched volunteers and increasing social interaction. It was identified that while Namaste Care achieved some of the same goals in the home setting as it does in the care home setting, it could also function in a different way that promoted socialisation.ConclusionsNamaste Care provides holistic and personalised care to people with both moderate and advanced dementia, improving engagement and reducing social isolation. In the present study carers often chose to use Namaste Care sessions as respite. This was often linked to their frustration of the unavoidable dominance of task-focussed care in daily life. Individualised Namaste Care activities thus led to positive outcomes for both those with dementia and their carers.

IntroductionThe Namaste Advanced Demntia Care Programme is a holistic, novel approach based on the five senses, aimed at evoking an emotional response and providing positive ways of communicating with those who have advanced dementia (www.namastecare.com). Namaste has been utilised in care homes internationally (Simard and Volicer, 2010) yet use in the home setting has been scarce. A hospice in the North East of England has implemented Namaste in peoples’ homes through training and matching volunteers to families.AimTo begin to understand what works, for whom and in which circumstances when implementing Namaste Care in the home setting.MethodsA realist evaluation framework was utilised to develop initial programme theories about the use of Namaste in the home setting (Pawson and Tilley, 1997). The theories were developed through three realist focus groups with Namaste volunteers. Data was analysed using context-mechanism-outcome configurations (CMOC). The theories detail if, how and under which circumstances the Namaste Programme works.ResultsFour initial programme theories were developed which were focused around (1) the impact on the person (2) the use of Namaste in the home setting (3) family’s independent use of Namaste (4) the relationships between the person with dementia, the volunteer and the family.ConclusionDe-hospitalisation is a current policy driver (Foot et al., 2014); this public health approach works towards creating a community of care through engaging the family and community volunteers. The programme theories developed can now be tested in a larger scale study to further demonstrate the impact of Namaste in the home setting.References. Foot C, Sonola L, Bennett L, Fitzsimons B, Raleigh V, Gregory S. Managing quality in community health care services.The King’s Fund2014.. Pawson R, Tilley N.Realistic Evaluation,London Sage.. Simard J, Volicer L. Effects of Namaste Care on Residents Who Do Not Benefit From Usual Activities.American Journal of Alzheimer’s Disease & Other Dementias2010;25:46–50.