Feasibility and acceptability of NIDUS-professional, a training and support intervention for homecare workers caring for clients living with dementia: a cluster-randomised feasibility trial

Cooper, Claudia; Zabihi, Sedigheh; Akhtar, Amirah; Lee, Teresa; Isaaq, Abdinasir; Le Novere, Marie; Barber, Julie; Lord, Kathryn; Rapaport, Penny; Banks, Sara; Duggan, Sandra; Ogden, Margaret; Walters, Kate; Orgeta, Vasiliki; Rockwood, Kenneth; Butler, Laurie T; Manthorpe, Jill; Dow, Briony; Hoe, Juanita; Hunter, Rachael; Banerjee, Sube; Budgett, Jessica; Duffy, Larisa

doi:10.1093/ageing/afae074

Cited by 3 publications

References 31 publications

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A process evaluation of the NIDUS-Professional dementia training intervention for UK homecare workers

Kelleher,

Windle,

Randell

et al. 2024

Age and Ageing

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Introduction This process evaluation was conducted in parallel to the randomised controlled feasibility trial of NIDUS-Professional, a manualised remote dementia training intervention for homecare workers (HCWs), delivered alongside an individualised intervention for clients living with dementia and their family carers (NIDUS-Family). The process evaluation reports on: (i) intervention reach, dose and fidelity; (ii) contexts influencing agency engagement and (iii) alignment of findings with theoretical assumptions about how the intervention might produce change. Methods We report proportions of eligible HCWs receiving any intervention (reach), number of sessions attended (dose; attending ≥4/6 main sessions was predefined as adhering), intervention fidelity and adherence of clients and carers to NIDUS-Family (attending all 6–8 planned sessions). We interviewed HCWs, managers, family carers and facilitators. We integrated and thematically analysed, at the homecare agency level, qualitative interview and intervention recording data. Results 32/141 (23%) of eligible HCWs and 7/42 (17%) of family carers received any intervention; most who did adhered to the intervention (89% and 71%). Intervention fidelity was high. We analysed interviews with 20/44 HCWs, 3/4 managers and 3/7 family carers, as well as intervention recordings involving 32/44 HCWs. All agencies reported structural challenges in supporting intervention delivery. Agencies with greater management buy-in had higher dose and reach. HCWs valued NIDUS-Professional for enabling group reflection and peer support, providing practical, actionable care strategies and increasing their confidence as practitioners. Conclusion NIDUS-Professional was valued by HCWs. Agency management, culture and priorities were key barriers to implementation; we discuss how to address these in a future trial.

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A process evaluation of the NIDUS-Professional dementia training intervention for UK homecare workers

Kelleher,

Windle,

Randell

et al. 2024

Age and Ageing

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Systematic policy and evidence review to consider how dementia education and training is best delivered in the social care workforce, and how policy does or can enable its implementation in England

Delray,

Banerjee,

Zabihi

et al. 2024

Preprint

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BackgroundVery many social care clients have dementia, but few social care workers receive dementia-specific training.ObjectiveTo systematically review dementia training interventions for social care, review past policies and hold stakeholder workshops considering how future policy can support quality dementia training in social care.MethodsWe searched electronic databases, November 2015 to February 2024, including studies describing dementia training and support interventions for social care workers, assessing risk of bias with the Mixed Methods Appraisal Tool. We reviewed English policies January 2015 to April 2024 to identify social and policy contexts relevant to dementia training. We consulted home care and care home stakeholders regarding how findings could inform future policy.ResultsWe included 56 studies (50 in care homes, 6 in home care). There was good quality evidence that dementia training interventions in care homes that engaged staff “champions” to integrate practice-based learning reduced agitation, neuropsychiatric symptoms and antipsychotic prescribing and improved life quality of residents with dementia. One study found this approach was cost-effective. In home care, evidence was limited; group training was valued, and improved staff sense of dementia care competence in one study. We identified 27 policies and related documents; and consulted 18 stakeholders. Stakeholders supported mandatory dementia training but considered implementation very challenging in current economic contexts.ConclusionsWe found strong evidence for dementia training in care homes, but a relative lack of research in home care. Policy options identified to implement evidence require investment, which could deliver substantial savings across health and social care.

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Exploring the Impact of Cognitive Dysfunction During Recurrent Depression in a Sample of Mid‐to‐Older Age British South Asians: A Qualitative Study

Akhtar,

Shafiq,

Parveen

et al. 2024

Psychiatric Ment Health Nurs

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IntroductionDepression is a major public health issue, increasing the risk of comorbidities. Some people with depression experience cognitive dysfunction, which can persist even after symptomatic recovery. British South Asians are at greater risk of developing depression and are less likely to seek treatment. It is important to understand their experience of subjective cognitive dysfunction in depression and how best to support them.AimsThis study explored subjective experience of cognitive dysfunction during recurrent depression, in a sample of 12 British South Asians aged between 45 and 60 years.MethodsWe conducted semi‐structured interviews to explore cognitive dysfunction during recurrent depression. We analysed the data using thematic analysis.ResultsDifficulties in attention and concentration resulted in lower quality of social relationships, including not feeling present and social isolation. Learning new information was difficult, thus impacting productivity. Participants found it difficult to engage in enjoyable activities that promoted brain health. The emotional, physical and spiritual impact negatively impacted on quality of life.DiscussionCognitive strategies used in therapies could improve brain health and functional recovery in people living with depression.ImplicationsMental health nurses play a pivotal role in providing culturally appropriate information and strategies for managing cognitive dysfunction in recurrent depression.

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Feasibility and acceptability of NIDUS-professional, a training and support intervention for homecare workers caring for clients living with dementia: a cluster-randomised feasibility trial

Cited by 3 publications

References 31 publications

A process evaluation of the NIDUS-Professional dementia training intervention for UK homecare workers

A process evaluation of the NIDUS-Professional dementia training intervention for UK homecare workers

Systematic policy and evidence review to consider how dementia education and training is best delivered in the social care workforce, and how policy does or can enable its implementation in England

Exploring the Impact of Cognitive Dysfunction During Recurrent Depression in a Sample of Mid‐to‐Older Age British South Asians: A Qualitative Study

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