Dementia in Residential Care: Education Intervention Trial

Project Team:Chris Beer (Principle Investigator)

Kelly Banz (Study Coordinator)Nada Eltaiba (Social Researcher)

Jenny Tasker (Research Assistant)

Design Overview of DIRECT

Outcome: Quality of Life (primary)

Outcome: Quality of Care (Secondary)

Input: Educational Program

Clinicians…. (GPs and RACF staff)

Residents

Who is involved in the project?

• People With Dementia

• Carers

• RACF staff (managers, nurses, nurse aides)

• General Practitioners

About the educational program

• The content of the program will be aspects of high quality dementia care

• Will be delivered to GPs who have patients in RCF, and RCF staff (for example, Nurses, Nurse aides, nursing managers)

• Intervention takes place over 12 months• Possible delivery methods include

multimedia or workshops

More about the educational program

• The development of the educational package is through Action Research

• Stakeholder participation increases “buy-in”

• Our program aims to be cost effective and time effective, NOT resource intensive

• We think it will result in changed actions and attitudes

About the Primary Outcome

• Measure quality of life of PWD, probably using ADRQL and brief structured environmental observations

• Also measure cognitive impairment, medication, etc

• Do these at baseline, 6mo, and 12 mo

About the Secondary Outcome

• Measure GPs’ and RCF staff’s satisfaction with their ability to delivery high quality dementia care at baseline and 12 months

Study design

• There are three intervention groups and one control group

RACF

GP+ -

+ Patients whose GPs and RACF staff do receive educational

package

Patients whose GP do but whose RACF staff

do not receive educational package

- Patients whose GPs do not but whose

RACF staff do receive educational package

Patients whose GPs and RACF staff do not

receive educational package

Study timelineRecruitment

Education

Assessment

now +6 months +12 months +18 months +24 months

Qualitative research Qualitative research follow-up

Quantitative Research

What does this study NOT address?

• Factors other than quality of care that affect quality of life

• Community based care

• Specialists (Geriatricians, etc)

• Non-dementia residents (eg, mild cognitive impairment)

What is the project about?(Why are we doing it?)

• We want to improve the quality of life of dementia patients by translating high quality care in an Australian setting

• Our aim is to deliver education which addresses needs that have been directly identified by those who will receive it

What is special about this research project compared to others?

• By using quality of life as the end-point, we ensure that the educational program has a measurable impact on something important and sustainable.

• A qualitative research process– gathering information from survey and focus group respondents BEFORE designing the package– has not been used in Australian dementia education before.

What are the potential benefits to RCFs and GPs of participation?

• Long term training for improving quality of care

• Increased quality of life for patients

• Quantitative data for presentation to government and advocacy bodies for funding and other purposes

What are the potential benefits? (cont’d)

• The action research/qualitative process ensures the education meets identified needs

• Because of the “toolbox” nature, education can be further tailored to each doctor’s/facility’s needs

• This is an “intention-to-treat” protocol, in other words, deals with the “real world”

• So, if our educational program is NOT easy to use and thus results in a small outcome, that is still useful data

The role of GPs and RCFs in the study

• The role is three-fold

• Participation in the trial (50:50 chance)

• Recruitment of patients

• Participation in the educational program development (optional but beneficial!)

RCF and GP involvement in the qualitative research process

• Three kinds of involvement:

• Focus Groups

• Interviews

• Surveys

What would make your participation easier?

• Please contact us with suggestions!

And in Conclusion…

• THANKS FOR YOUR INTEREST!!!