The Enriched Opportunities Programme for people with dementia: A cluster-randomised controlled trial in 10 extra care housing schemes

Abstract

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The effective ingredients of social support at home for people with dementia: a literature review

“…Furthermore, many of the included studies used 'ideal type' interventions, including intensive service provision involving a range of professionals (all the UK studies), while the two Finnish studies applied health interventions to augment standard social care for people with dementia. In spite of their benefits, these types of intervention may be more costly to provide (Brooker et al, 2011) and financially unsustainable in the long term (Challis et al, 2002;Gladman et al, 2007). Such issues of cost are also relevant to the type of research design adopted and the different criteria used in determining the success of the intervention being evaluated.…”

“…Many references were excluded because they had an inadequate focus on social support at home for people with dementia (130). A further two studies (Brooker et al, 2011;Riordan and Bennett, 1998) were identified and added by the team. This was because they were considered to be relevant to the review.…”

“…For while policy recommendations have consistently supported the need for early diagnosis (All Party Parliamentary Group, 2014), the lack of availability of appropriate post diagnosis support is likely to undermine the goal of prompt intervention that such measures aim to promote. The review has also pointed to the likely benefits that arise from an integrated and multidisciplinary approach involving health and social care providers in the delivery and co-ordination of services (Brooker et al, 2011;Department of Health, 2015), thus reflecting the efficacy of an integrated approach to home care recently recommended by NICE (2016). If some or all of the above criteria are fulfilled in services provided to people with dementia living at home, evidence from this review suggests that their admission to residential or nursing home care might be delayed (Riordan & Bennett, 1998;Challis et al, 2002;Eloniemi-Sulkava et al, 2001Gaugler et al, 2005;Temple, Andel and Dobbs, 2010).…”

“…However, they do provide indications of what might, or might not, better enable such care to work at its best when unaugmented. For example, effective leadership and relevant staff training (Brooker et al, 2011), a systematic approach (Challis et al, 2002) and support for the principal carer (Riordan and Bennett, 1998), are all key enablers identified in the above studies.…”

“…Within this category, a randomised controlled trial by Brooker et al (2011) and two quasi-experimental studies (Riordan & Bennett, 1998;Challis et al, 2002), possibly, provided the strongest levels of evidence from the UK for this review. It is notable that all three of these studies involve augmentation significantly beyond what is generally provided by English social care support at home and the extent to which their results may be applicable to less intensive home care remains open to question.…”