A collaboration between the Wellbeing and Health for people with Dementia (WHELD) training programme and a team of researchers has found that care homes using dementia “carer champions” to deliver person-centred care lessen agitation in people with dementia and reduce their use of antipsychotic drugs.
Outcomes on health and social care costs, agitation and quality of life were obtained from 69 care homes that participated in the WHELD training programme. The results were analysed by a team jointly led by the University of Exeter, King’s College London and Oxford Health NHS Foundation Trust.
The WHELD intervention was found to have clinical and economic benefits when used with residents who had clinically significant agitation.
The intervention increased the time an average care home resident engaged in social interaction, from two minutes to 10 minutes of activity in a six-hour period. The interaction was focused around the interests of the resident, involving them in decisions that affected them.
The training programme also included GP training with the aim of reducing prescriptions for antipsychotics. The programme was found to cause a drop in residents’ levels of agitation, which in turn also decreased their contact with GPs, saving further costs.
In addition, thousands of pounds a year were saved because there was a reduction in emergency and routine hospital admissions.
King’s College London Health Economics Lecturer and author Renee Romeo said: “As a person’s dementia progresses they will need more intensive care and support and often residential care is seen as the best option by those who care for them.
“Our research can assist commissioning decisions around care and treatment options in these settings. By providing the evidence, that effective and affordable care responses following consultation around individual preferences do exist. The failure to recognise and introduce such interventions is not only ethically questionable but very costly.”
Alzheimer’s Society Policy Director Sally Copley said that, as 70% of people in care homes have dementia, it was essential that staff working there have the right training to provide good quality dementia care. She added: “With many care homes on the brink of collapse and the NHS under pressure, cost-efficient initiatives like WHELD could make all the difference.”
However, she stressed that specialist training costs money, and concluded that “without Government investment in social care to allow innovative solutions like WHELD to be put in practice, it won’t be possible to provide this for everyone who needs it”.
The Alzheimer’s Society has urged Matt Hancock to take “bold steps” in the forthcoming Green Paper and “commit to the sustainable social care funding that people with dementia have already waited too long for”.
The paper, Improving the Quality of Life of Care Home Residents with Dementia: Cost-effectiveness of an Optimised Intervention for Residents with Clinically Significant Agitation in Dementia, was published in “Alzheimer’s and Dementia: The Journal of the Alzheimer’s Association” and is available here.
Last reviewed 29 November 2018