Care homes

Care-homes-banner

If you are interested in finding out more about the following projects or exploring new opportunities for research in care homes please contact Isabelle Latham: i.latham@worc.ac.uk

 

Namaste Care Intervention UK

 

Joyce_Simard_web_page_picture

Delivering excellent care every day for people living with advanced dementia.

 namaste logoAS

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

Collaborators

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 

Briefing paper - Project overview

Namaste Care UK 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

Contact us

For more information please contact us via dementia@worc.ac.uk or 01905 542531.

Links to other organisations:

St Christopher's Hospice

Namaste Care

Dementia Positive  

Alzheimer's Society

An extract from the Alzheimer's Society Magazine - Living with Dementia - Feb 2015 on Namaste can be accessed here 

 

Admiral Nurses roles in care home

ADS worked with the Orders of St John Care Trust to evaluate the "My Home Life Admiral Nurse" role in Orders of St John Care Trust care homes. It is unusual for care home organisations to employ Admiral Nurses directly and so an exploration of the impact of such a role was important.

The project was funded by the Orders of St John Care Trust and the Burdett Trust, and was completed in January 2015.

A copy of the project summary is also available.

A copy of the report is here

The findings of this research can also be found in the following publication:

Latham, I., Evans, S., Atkinson, T., and Elliot, V. (2015) Admiral Nursing in Care Homes. Journal of Dementia Care, 23 (6). pp. 26-29. ISSN 1351-8372

Anchor iPad evaluation

Study reveals iPads have ‘substantial potential’ to improve quality of life for people living in care homes

  • The Association for Dementia Studies at the University of Worcester has carried out the largest study of its kind to understand how iPads can be used to enhance quality of life for people with dementia
  • In the first systematic roll-out of iPads in care homes, Anchor has introduced tablets to 63 of its care homes across England
  • Findings demonstrate the benefits of introducing and using touchscreen technology in care settings
  • Good practice guide published to share findings

 A copy of the full report can be found here

Evaluation of the keys to care resource

 

residents_and_relatives_association

The Residents and Relatives Association commissioned the Association for Dementia Studies to evaluate the use and impact of its Keys to Care resource. Funded by Comic Relief this six-month project looked at the ways in which the resource is being used and the impact it has had across three different care providers.

The final report was completed in February 2016 and is available here.

If you have any questions regarding this evaluation, please contact us on 01905 542531 or via email at dementia@worc.ac.uk

PIECE-dem

 PANICOA_rdax_557x311

How can I tell you what's going on here?

PIECE-dem: an observational framework focussing on the perspective of residents with advanced dementia.

PIECE-dem was developed by ADS as part of the PANIOCA (Prevention of Abuse and Neglect in the Institutional Care of Older Adults) programme. PANICOA is a joint-funded research initiative between the Department of Health and Comic Relief which is designed to enhance the dignity of older people in institutional settings. PIECE-dem is an observational process that illuminates the experience of those people with advanced dementia and high levels of need, who are most vulnerable in long-term care settings. PIECE-dem is an acronym for:

 

PIECE-dem

 

For a brief overview of the PIECE-dem process, please see our project summary. 

PIECE-dem was used in the final PANICOA project, CHOICE (see below). ADS is developing PIECE-dem further so that it can be used by practitioners to assist them in assessing the experience of their most vulnerable residents. This will take the form of an instruction manual and accompanying training course. For more information contact dementia@worc.ac.uk

PIECE-dem documents

PIECE-dem flyer PDF

PIECE-dem Final Report PDF

 

CHOICE project

 

 PANICOA_rdax_557x311

 

Care Home Organisations Implementing Cultures for Excellence (CHOICE)

The CHOICE project was funded by the Department of Health and Comic Relief, and was the final project of the UK-wide PANICOA (Prevention of Abuse and Neglect in the Institutional Care Of Older Adults) programme. The aim of CHOICE was to examine the links between organisational cultures and the care experiences of older people living in residential and nursing care.

ADS worked in partnership with the University of East Anglia, University of Stirling and Cardiff University to carry out 12 in-depth case studies of care homes across the UK. Positive and negative care experiences of older people in long-term care were analysed in relation to the contexts and cultures in which they occurred. The case studies used observations, interviews and documentary collection to analyse the individual circumstances and organisational cultures, contexts and practices most likely to encourage or inhibit the provision of high-quality care. The starting point of each case study was an in-depth observation over a 2-day period using the PIECE-dem framework, which was developed by ADS in an earlier PANICOA research programme.

A copy of the final project report can be found here. The findings of this project showed 7 elements of positive care cultures that made a difference to residents quality of life. These findings are integrated into all of our education and consultancy work and are discussed in detail within the latest edition of  Person-Centred Dementia Care: 2nd Edition: Making Services Better with the VIPS Framework by Dawn Brooker and Isabelle Latham - copies of which can be ordered here at books and resources.

The findings of this project are also discussed in the following publication:

Killett, A., Bowes, A., Brooker, D., Burns, D., Kelly, F., La Fontaine, J., Latham, I., O’Neill, M., Poland, F. and Wilson, M.  (2014) “Digging deep: how organisational culture affects care home residents' experiences”Ageing and Society 36 (1). 

FITS programme

“FITS into Practice – reducing anti-psychotic prescribing”

In 2013-2015 ADS delivered and evaluated the Focussed Intervention Training and Support (FITS) programme. The project was funded by the Alzheimer’s Society and HC-One. It followed an initial trial which found the programme reduced the use of antipsychotics in care homes by 50%. These drugs are inappropriately prescribed to 144,000 people with dementia, and double the risk of death, treble the risk of stroke and can leave people unable to walk or talk.

This programme was to translate that initial trial into practice which could be replicated across the UK. 10 groups of Dementia Care Coaches were trained and supervised by a Dementia Practice Development Coach to implement person-centred care in their care homes and reduce the inappropriate use of anti-psychotic medications in their care homes. This approach was successful in reducing the use of anti-psychotics, improving person-centred approaches in care homes and improving the knowledge and confidence of staff in delivering person-centred care.

Practitioners can now study to undertake the role of Dementia Practice Development Coach in their own organisations. The FITS into Practice programme is the basis of the ‘Advanced Practice in Delivering Person-Centred Dementia Care’ Module (LINK). For further information about this programme please contact dementia@worc.ac.uk

A copy of the research report can be viewed and downloaded here. A project summary is also available. Two publications are available reporting the findings of this programme:

-          Latham, I & Brooker, D (2017) Reducing anti-psychotic prescribing for care home residents with dementia.  Nurse Prescribing 15 (10)

-          Brooker, D., Latham, I., Evans, S., Jacobson, N., Perry, W., Bray, J., Ballard, C., Fossey, J., and Pickett, J. (2015) FITS into Practice: translating research into practice in reducing the use of anti-psychotic medication for people with dementia living in care homes. Ageing & Mental Health 20 (7)

Related links

 Alzeimers Society

Department of Health

HC-One

 

Care Fit for VIPS

 

vips-banner

Care Fit for VIPS is a free, online toolkit to help care homes improve the quality of their dementia care. If you have a part in running a care home, domiciliary care service or day centre where there are people with dementia, Care Fit for VIPS is for you.

Background information

The work was commissioned and funded by the West Midlands Strategic Health Authority as part of their programme to reduce the use of anti-psychotic medication in dementia. The Care Fit for VIPS toolkit and website is currently run and managed by:

Crystal Presentations Ltd Both_logos

What is VIPS?

The underlying concept for the toolkit uses Professor Dawn Brooker’s widely recognised VIPS framework of person-centred care as described in: Brooker, D. (2007) Person Centred Dementia Care: Making services better, and the 2015 second edition.

Book_Ed2

 

VIPS stands for:

  • V = Values people – Values and promotes the rights of the person
  • I = Individual’s needs – Provides individualised care according to needs
  • P = Perspective of service user – Understands care from the perspective of the person with dementia
  • S = Supportive social psychology – Social environment enables the person to remain in relationship

The guiding principles behind VIPS are:

  • Do my actions show that I respect, value and honour this person?
  • Am I treating this person as a unique individual?
  • Am I making a serious attempt to see my actions from the perspective of the person I am trying to help? How might my actions be interpreted by them?
  • Do my actions help this person to feel socially confident and that they are not alone?

The Care Fit for VIPS toolkit

The original toolkit was designed with care homes in mind, but two further versions have been developed around domiciliary care and day centres. All versions of the toolkit follow the same format and consist of three main parts:

VIPs three_areas

 

The toolkit is easy to use and easy to navigate, making it practical and attractive to users. It is also completely free to access and use. If you would like help using the toolkit, dedicated education, or assistance from ADS to complete the toolkit and provide advice on prioritising changes, please contact us to find out more about our services. You may also be interested in the short video below which tells you a bit more about the Care Fit for VIPS toolkit.

The VIPS framework and concepts used by the toolkit also underpin many of the training and education programmes offered by ADS, meaning that the Care Fit for VIPS toolkit can be used in tandem with the courses to complement and reinforce some of the learning points.

In addition, the VIPS framework underpins the set of reflective questions in the resource pack which accompanies the Stand By Me training DVD, produced in partnership with ADS. The Care Fit for VIPS toolkit can therefore provide a useful means of support for managers and staff.

Future potential

Although it was originally designed with care homes in mind, the concept and format of the toolkit could readily be adapted to meet the needs of a range of environments or organisations, as has already been done for domiciliary care services and day centres. We are always interested in hearing your views on how the toolkit could be taken forwards, and are actively seeking further funding to develop this useful and important resource in the future.

Contact information

The toolkit can be found online.

To get in touch with ADS about the toolkit or the services we offer, please contact dementia@worc.ac.uk.

An introduction to Care Fit for VIPS