Delivering excellent care every day for people living with advanced dementia.
The Association for Dementia Studies has been awarded an implementation grant from the Alzheimer’s Society to carry out a 3 year project from 1st October 2016 to help UK-based care homes to provide better care for people with advanced dementia by an evidence based intervention that provides a practical, systematic approach to meet the physical, sensory and emotional needs of people living with advanced dementia.
Namaste is a multi-component intervention developed in the USA shown to reduce distress behaviours, pain, use of antipsychotics, hypnotics and depressive symptoms and inappropriate hospitalisation in people living with advanced dementia.
In this project evidence from research and practice in the UK to date will be synthesised to establish the optimal intervention. The a series of six implementation studies utilising Kotter’s 8-step process for change management will be undertaken in care homes posing different challenges (e.g. size, training, skill-mix). This will establish effectiveness and acceptability, including feedback from care homes, staff and people living with dementia and their families in addition to preliminary costing model.
The outcome will be an in-depth description of the optimal intervention in the form of a guidance manual together with expert practitioners who can mentor new programmes. The optimal intervention will then be ready to roll out across care homes with information about how to implement it successful, costs, staffing and resource use. This will include guidance on how to deal with common barriers e.g. competing priorities, lack of time, staff changes, engaging families and regulators.
An on-line “Community of Namaste Practice” will be built to gather feedback from multiple sites throughout the research. This will also be a major vehicle for generating and maintaining interest in implementation for further roll-out.
What do we already know?
Palliative care addresses the needs of people who are in the later stages of a disease or are approaching the end of their lives. Without proper palliative care, people with advanced dementia may experience unnecessary discomfort or have untreated pain. This can lead to distress, depression and changes in behaviour.
The Namaste Care programme was developed in the USA and focuses on enhancing quality of life through a range of physical, sensory and emotional care practices. These include improving pain management, ensuring proper nutrition, using music, aromatherapy and personalised nurturing communication with each individual. Early research indicates that this care programme could be beneficial for people who are in the advanced stages of dementia. It may help to alleviate symptoms such as agitation and reduce the use of medications such as antipsychotics.
What does this project involve?
The researchers aim to find out what aspects of the Namaste programme would be most effective for people with advanced dementia in care homes in the UK and how best to put the programme into practice. The research team will work with existing Namaste practitioners and 6 care homes implementing Namaste for the first time to find the best ways that the Namaste programme can be used successfully. This includes identifying things that help or hinder developing the programme in the care home and making sure that it is acceptable to people with dementia and their families.
How will this benefit people with dementia?
There is a need to better understand how to care for someone in the advanced stages of dementia to avoid any unnecessary distress, discomfort or pain. This study will allow researchers to understand what works well and what doesn’t when encouraging care homes to adopt complex but potentially effective methods of palliative care. If successful, using the Namaste programme may help to increase comfort and quality of life for people in the later stages of dementia.
The Research Team
- Professor Dawn Brooker PhD: Principal investigator:
- Caroline Baker (Co-applicant): Director of Dementia Care at Barchester Healthcare. has extensive experience of change management in dementia care
- Professor Darrin Baines (Co-applicant); Health economist who is well versed in modelling and statistical analysis, and economic evaluation.
- Roy and Ros Dibble (Co-applicants) are members of the Association for Dementia Studies LINK (Experts by Experience) group. Ros was a director of a large multi-national IT company based in the UK before contracting Alzheimers (Posterial Cortical Atrophy). Roy was Chief Executive of two government agencies.
University of Worcester research team
- Isabelle Latham, Senior Lecturer at ADS University of Worcester. Research Project management and care home data collection.
- Faith Wray, Research Associate investigating the application of Namaste Care in care homes in the UK
- Jennifer Bray, Research Assistant at ADS, University of Worcester. Survey design, data support and management.
- Mike Watts; Project Administration
In addition the following experts in the field have agreed to be involved
- Joyce Simard Associate Professor, University of Western Sydney Australia:
- Ladislav Volicer, MD, PhD, Professor, School of Aging Studies, University of South Florida;
- Min Stacpoole RN, MSc, Clinical Nurse Specialist in palliative care for people with dementia at St Christopher’s Hospice;
- John Killick, Director of Dementia Positive http://www.dementiapositive.co.uk
Briefing paper - Project overview
Launch of the Project
The project was formally launched at an event at the University of Worcester Arena on 9th November 2016
A copy of the PowerPoint presentation is here
For more information please contact us via firstname.lastname@example.org or 01905 542531.
Links to other organisations:
http://www.namastecare.com/ Joyce Simard
Dementia Positive - John Killick
An extract from the Alzheimer's Society Magazine - Living with Dementia -Feb 2015 on Namaste can be accessed here