Changing practice in dementia care
Changing practice in dementia care in care homes: developing and testing evidence-based interventions at the end of life
How people with dementia die, and the type of end of life interventions they should receive have been widely discussed and partially introduced across the NHS and care home sector.
These discussions focus particularly on place of care, and the adaptation of existing approaches, to provide palliative care for people with dementia. There remains however, a limited understanding of how this population experience the end of life and if the recognition of an end stage of life in dementia can improve service provision and influence place of care.
The EVIDEM end of life project is lead by CRiPACC staff members Catherine Evans and Claire Goodman and funded by National Institute for Health Research. It will last for four years.
The project aims to establish the different possible trajectories to death for older people with dementia living in a care home to inform the development of dementia-specific interventions that support healthcare professionals, community workers and care home staff in palliative care for older people with dementia in care homes.
The study uses a two-phase design with the phase one findings directly informing phase two that intends to develop and test a toolkit for providing end of life care for people with dementia resident in a care home.
Aims
To explore and document the need for support and end of life care of older people with dementia living in a care home environment and develop and test dementia specific interventions that support the provision of palliative care for this population group.
Objectives
- To describe the different characteristics of older people with dementia residing in a care home and their respective pathways to death.
- To describe the care and support needs of older people with dementia living in a care home and their carers.
- To establish how care staff, and NHS primary care practitioners define, assess and provide end of life care for older people with dementia resident in a care home.
- To describe how different contexts and models of care in care home environments influence an older person with dementia's experience of end of life care.
- To identify the treatments and interventions received, and services and resources used, leading up to an older person's death.
- To establish if dementia specific educational support and assessment tools can improve experiences and outcomes for older people with dementia dying in care homes (phase two of the study).
Read further information on the EVIDEM programme. If you have any queries regarding EVIDEM-EoL, please contact Claire Goodman.