The Specialized Early Care for Alzheimer’s method of caring for people with dementia: an investigation of what works and how

Abstract

Background and rationale SPECAL is a model of care for people with dementia based on a novel conceptualisation of memory and how this changes in dementia. Carers adapt their communication style to prevent distress and promote well‐being for the person with dementia. However, there is limited scientific evidence on the effectiveness of SPECAL. Aim This study explored mechanisms of SPECAL through a qualitative enquiry with family carers. Method Semi‐structured interviews were conducted with family carers who had been coached in SPECAL and applied its principles and practices. Thematic analysis was applied. Findings All participants had found SPECAL helpful in caring for a person with dementia. The core themes of this positive experience were empathy, harmony and resilience. Synthesis of these themes contributes to a proposed model of the mechanisms of SPECAL. Conclusion In applying SPECAL, carers gained an empathetic insight to the feelings of the person with dementia. This empathy leads to a more harmonious environment, which enhances the carer’s resilience.

Improving well-being in dementia care for clients and carers

“…As the care workers in this study showed, the SPECAL method can be learned quickly, and research to date suggests that it makes a positive contribution to quality of life for people with dementia and those who care for them (McCrae et al, 2019;Riachi, 2018;Pritchard and Dewing, 2001). The challenge for public mental health is how these techniques could be used at scale and in other environments.…”

“…The challenge for public mental health is how these techniques could be used at scale and in other environments. SPECAL was developed in a small community hospital with family caregivers (James, 2008) and requires a team approach (McCrae et al, 2019), so adapting SPECAL for people with dementia in a large care home might be problematic. However, the growing adoption of conversational techniques, such as not contradicting a person with dementia and not asking open questions (Alzheimer's Society, 2020b; Alzheimer's Association, 2020) suggest that the SPECAL method may have had influence beyond the domiciliary environment.…”

“…Known particularly for its "three golden rules"do not ask direct questions, listen to the person with dementia and do not contradict (James, 2008) -SPECAL has gained popularity among family carers, but is still under-researched in institutional settings (McCrae et al, 2019). The "three golden rules" are predicated on a desire to avoid creating situations where the client feels embarrassed at their loss of recall or that they are out of step with what is going on around them.…”

The Effectiveness and Characteristics of Communication Partner Training Programs for Families of People With Dementia: A Systematic Review

“…Future studies could attempt meta-analysis within subsections of data that have more consistent homogeneity, particularly with frequently used outcome measures. In addition, this study only included intervention studies/protocols and did not include other studies that reviewed or described interventions and their outcomes (e.g., McCrae et al, 2020 ). Reporting bias may further be present as only studies that were published in English were included due to pragmatic reasons.…”