Support at Home – Interventions to Enhance Life in Dementia (SHIELD)

Support at Home – Interventions to Enhance Life in Dementia (SHIELD)

United Kingdom

Department of Health (DH)

2302592

01-08-2007

60

• Alzheimer’s disease and other dementias

Dementia

Background: Approximately 700,000 people in the UK have dementia and it has been estimated that by 2025 there will be one million people with dementia in the UK rising to 1.7 million by 2051 (Alzheimer’s Society, 2007). Around a third of people with dementia are severely affected and need help with activities of daily living, and of these 50% live at home with a carer. People with dementia frequently have complex needs because cognitive impairment often coexists with additional mental health problems, disabilities, physical illness and social problems. There is an urgent need to find more useful and effective interventions to help reduce the impact of dementia on people with dementia, carers, and society.
Description: This is a major research project focusing on three interventions: Maintenance Cognitive Stimulation Therapy (MCST) to improve quality of life for people with dementia; an Experienced Carer Package (ECP) to support carers; and an intensive Home Treatment Package (HTP). The HTP package will look at developing, evaluating and implementing ways for professionals to intensively support and manage people with dementia experiencing crises at home, and prevent admissions to hospital or care homes. The options under consideration will include home adaptations and the use of assistive technology.

Currently, approximately 700,000 people in the UK have dementia. Family carers of people with dementia experience greater strain and distress than many other groups of carers, and a wide range of informational, emotional, financial and social support needs have been recognised. Research into support for family carers suggests that peer support interventions are worthy of further investigation. The SHIELD Carer Supporter Programme (CSP) aims to build on existing peer and lay support programmes to tailor a peer support programme for family carers of people with dementia in which more experienced family carers provide support to newer family carers. SHIELD CSP is the first large-scale, systematic study of its kind in the UK and is a collaboration between the statutory and voluntary sectors. The CSP intervention will be tested in a randomised controlled trial studying wellbeing and quality of life of the family carers and the care-recipient with dementia. 300 family carers of people with dementia and the relative they care for will be recruited to the study, and randomly allocated to receive one of four conditions: support from an experienced carer; involvement in reminiscence group work; both support from an experienced carer and reminiscence work; or treatment as usual alone. Reminiscence work will be conducted in groups, following the ‘Remembering Yesterday, Caring Today’ programme. Participants will be followed for up to 1 year post-baseline. Data will be collected on the impact of the interventions on the family carer, person with dementia and the carer supporters. Cost and resource use data will also be collected. The main analysis will be cost-effectiveness, with a range of secondary analyses planned. The dissemination plan considers academic and lay needs. SHIELD CSP is part of the 5 year “Support at Home – Interventions to Enhance Life in Dementia (SHIELD)” programme funded by the National Institute for Health Research