Improving personal care assistance for people living with dementia in care homes by co‑developing and testing staff training that improves support with personal care and reduces refusals of care.
Why the research is needed?
Over half of the people living with dementia in the UK are in the advanced stages. People living with moderate and advanced dementia need help with personal care activities. These include washing, dressing and going to the toilet. Sometimes the person living with dementia may refuse help with care. Refusals of care can cause distress and have negative consequences, including uncompleted care, poor hygiene, or infections. Caregivers may use restraint or medications to complete necessary care or refer to mental health teams. Refusals of care are common in care-home settings. Guidance calls for more care-home staff training for dementia care.
What are we doing?
We are collaborating with people working in care‑home communities to co‑produce a staff‑training intervention that improves personal care assistance for people living with dementia in care homes and reduces refusals of care. In the first stage, we are learning about refusals of care and staff‑training contexts in four care homes through semi‑structured interviews with managers, staff, residents and relatives, alongside a review of documented processes and policies. We are consulting with key individuals, including residents, staff, relatives, dementia specialists and clinical psychologists, and meeting with a co‑production team of researchers, residents, staff and relatives to develop the OPTIMISED‑DEMCARE training intervention.
After testing the training in two care homes and refining it, we will move into Stage 2, which involves implementing whether delivering the training is feasible and whether research processes work in care‑home settings. This includes a cluster‑randomised feasibility trial and process evaluation in which the training will be delivered in six care homes, all care staff will be invited to take part, and two additional homes will be invited to participate without receiving the training. We will assess staff and resident participation, engagement with the training, questionnaire completion, and examine barriers and facilitators to delivery, research processes, and how care homes use the training.
How are we working with communities, services and organisations?
We will work closely with our Lived Experience Advisory Group (LEAG). They are a group of care home residents, relatives of care home residents, and care home staff.
We have close relationships with, and are supported by, Redlands House Care Home, Norwich and Cavell Court Care Home, Care UK, in Norwich. Our research is also supported by several other care homes across the East of England and beyond.
What will the impact and benefits of this research be?
The anticipated benefits of the research include improved personal care, hygiene and relationships with care‑home staff for people living with dementia, along with fewer refusals of care and reduced distress, restraint and moves to inpatient services. For care‑home staff, the research aims to build confidence, competence, emotional intelligence and skills, enhance job satisfaction, and reduce distress.
What do we have planned for knowledge mobilisation and implementation?
We will share the results through care‑home organisations and groups, via forums and newsletters, and through meetings with care‑home communities, as well as using social media and a study website, and publishing and presenting for both practice and academic audiences. Beyond this study, we aim to test the OPTIMISED‑DEMCARE training further in a future trial, implement the training in care homes, and explore its potential for other caregiver groups, including home‑care workers, hospital staff and family carers.
Related papers, outputs and resources
Articles are forthcoming.
Who is involved?
- Principal Investigator: Dr Tamara Backhouse, University of East Anglia
- Professor Eneida Mioshi, University of East Anglia
- Dr Anne Killett, University of East Anglia
- Rowan Harwood, University of Nottingham
- Yun-Hee Jeon, University of Sydney
- Associate Professor Mizanur Khondoker, University of East Anglia
- Dr. Scarlett Fountain, University of East Anglia
- Peter Davis, Lived Experience Advisory Group Lead
Get in contact
Email Dr Tamara Backhouse at Tamara.Backhouse@uea.ac.uk.
