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Effect of the Meeting Centres Support Program on informal carers of people with dementia: Results from a multi-centre study
- Authors:
- DROES R-M, et al
- Journal article citation:
- Aging and Mental Health, 10(2), March 2006, pp.112-124.
- Publisher:
- Taylor and Francis
Because of the complex nature of the problems that carers of persons with dementia encounter, several comprehensive support programs for carers were developed in the past decade. One such program is the Meeting Centres Support Program (MCSP) that integrates different types of support for persons with dementia and their carers, which have proved to be effective in practice and/or research. Within the framework of a study into the national implementation of the MCSP, it was investigated whether the positive effects found in carers that participated in the first Amsterdam Meeting Centres, were also achieved in other regions of The Netherlands. A pre-test–post-test control group design with matched groups was applied. In total, 94 carers in the MCSP in eight meeting centres and 34 carers of dementia patients who frequented regular psychogeriatric day care (PDC) in three nursing homes were included in the study. During the study period 23 carers of the MCSP group and 21 carers of the PDC group dropped out. At baseline and after seven months indicators of burden (psychological and psychosomatic symptoms, feelings of burden and time between start of support and institutionalization of the persons with dementia) were measured, as well as potential determinants of burden (sense of competence, coping strategies, experienced support, loneliness and the emotional impact of behaviour problems). Though on a group level no effect was found, either in psychological and psychosomatic symptoms or in the determinants of burden, a subgroup of carers who felt lonely (n?=?22) at baseline benefited significantly more from the MCSP than from PDC in terms of psychological and psychosomatic symptoms. A majority of MCSP carers (82.1%) experienced less burden and more professional support. After seven months significantly fewer persons with dementia in the MCSP (4%) were institutionalized as compared to the patients in PDC (29%). Patients in the MCSP participated for a longer period of time before institutionalization. Although the effect on sense of competence of carers that was found in the Amsterdam study was not found in this multi-centre study, the effect on burden and delayed institutionalization of the person with dementia were confirmed. The integrated MCSP also proved more effective than PDC in decreasing psychological and psychosomatic symptoms in lonely carers. Further dissemination of the MCSP is therefore recommended.
Intermediate care
- Authors:
- ROSE Steve, JOHNSON Kathy, (comps.)
- Publisher:
- National Health Service. Health Management Specialist Library
- Publication year:
- 2006
- Pagination:
- 6p.
- Place of publication:
- Sheffield
Intermediate care is a core element of the Government’s programme for improving services for older people. A King’s Fund report 1 has defined intermediate care as: “Those services which will help to divert admission to an acute care setting through timely therapeutic interventions which aim to divert a physiological crisis or offer recuperative services at or near a person’s own home.” Ideally lasting no longer than a period of 6 weeks, an intermediate care episode can encompass a range of services including: rapid response, hospital at home, residential rehabilitation, supported discharge and day rehabilitation. Delivery of intermediate care has evolved and changed since its inception, for example, there is now more focus on: people with dementia and mental health problems; people who are homeless; and extra care housing - this model has an important part to play as a setting for intermediate care particularly for people with dementia. Such broadening of the intermediate care model is necessary since evidence suggests that the six week model outlined in the original guidance is insufficient in many instances, for example frail older people.
Effect of Meeting Centres Support Programme on feelings of competence of family carers and delay of institutionalization of people with dementia
- Authors:
- DROES R.-M., et al
- Journal article citation:
- Aging and Mental Health, 8(3), May 2004, pp.201-211.
- Publisher:
- Taylor and Francis
The study tested the hypotheses that integrated support, in which patients and carers are both supported by one professional staff member, will be more effective in reducing the feelings of (over)burden of carers and in positively influencing some potential determinants of experienced burden than non-integrated support, such as psychogeriatric day-care. A quasi-experimental pre-test/post-test control group design was applied with matched groups and measurements at baseline and after seven months. Fifty-five of the eighty dyads (31% dropped out) of persons with mild-to-moderate dementia and their carers who presented for four community meeting centres and three day-care centres in nursing homes over an 18 month period, were included in the study. The carers in the Meeting Centres Support (MCS) Programme participated in an integrated family support program together with the persons with dementia, while the carers in the control group only received respite through psychogeriatric day-care. Standardized questionnaires were applied to measure some indicators of burden experienced by the carers (feelings of stress, life dissatisfaction, psychological and psychosomatic complaints), as well as some potential determinants of experienced burden (feeling of competence, coping strategies, experienced support and loneliness). Furthermore, as an indicator of feelings of (over)burden of the carer, the time between start of participation in one of the programs and institutionalization in a nursing home was calculated. After seven months the carers in the MCS group (n = 36), compared to the carers in regular psychogeriatric day-care (n = 19), showed a moderate positive effect on the feeling of competence (effect size 0.45). No effect was found on feelings of stress, dissatisfaction or psychological and psychosomatic complaints. However, as compared to the control group in regular day-care, the persons with dementia in the MCS Program participated for a longer period of time before they were placed in a nursing home. The MCS Program proved more effective than psychogeriatric day-care in influencing the feeling of competence of the carers, and seems to lead to an increased delay of nursing home placement of the person with dementia, as compared to regular day-care. Because of the small sample and limited power of the study, and the possible influence of the selection of carers on the study outcome, further research into the value of meeting centres for carers of people with dementia is recommended.
Adult day service use and reductions in caregiving hours: effects on stress and psychological well-being for dementia caregivers
- Authors:
- GAUGLER Joseph E., et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 18(1), January 2003, pp.55-62.
- Publisher:
- Wiley
The objective of this study was to determine whether adult day service use interacts with decreases in primary caregiving hours (i.e. the time caregivers spent on activities of daily living/instrumental activities of daily living, memory problems, and behavior problems for patients) to alleviate caregiver stress and negative mental health over time. The findings suggest that adult day services are potentially effective in restructuring caregiving time and providing respite to family members.
Winter support for older people with mental illness
- Authors:
- LONDON Carlyle, CRAIG Eric
- Journal article citation:
- Nursing Times, 98(34), August 2002, pp.40-41.
- Publisher:
- Nursing Times
This article describes a pilot project to engage older people with mental health problems with day care services to maintain their well being during winter and to prevent unnecessary admissions into hospital. The authors describe the operation of the scheme which took place at a mental health Trust in London.
Day care: do carers gain?
- Author:
- WALDER Sue
- Journal article citation:
- Journal of Dementia Care, 3(5), September 1995, pp.28-29.
- Publisher:
- Hawker
One of the aims of day care for people with dementia is to relieve stress and enhance the well-being of carers. Reports on a study which aimed to show how far this was being achieved.
Better for the break
- Authors:
- LEVIN Enid, MORIARTY Jo, GORBACH Peter
- Publisher:
- HMSO/National Institute for Social Work. Research Unit
- Publication year:
- 1994
- Pagination:
- 205p.,bibliog.
- Place of publication:
- London
Based on a study of respite services for the carers of confused elderly people that aimed to: establish and compare the characteristics and problems of groups of confused elderly people and their carers using different types and mixes of respite services; to elicit the carers', older people's and practitioners' views of these services so that guidelines for practice can be based upon them; and to examine the effectiveness of different types and mixes of respite services in terms of their acceptability, their impact on the carers' psychological health, their impact on the older people, and their effects on the admission of elderly people to permanent residential care.
Experiences of community care: case studies of UK practice
- Authors:
- LYNCH Bruce, PERRY Richard
- Publisher:
- Longman
- Publication year:
- 1992
- Pagination:
- 318p.,bibliog.
- Place of publication:
- Harlow
Illustrates the range of initiatives in community care and provides advice on how to foster, facilitate and encourage work at a local level. Looks at translating ideas into practice, staffing, training, supervision and support, users of community care projects, funding and resources, and inter-agency work.
Old people's health and experiences of the caring services: accounts from rural communities in North Wales
- Author:
- WENGER G. Clare
- Publisher:
- Liverpool University Press
- Publication year:
- 1988
- Pagination:
- 117p., tables, bibliog.
- Place of publication:
- Liverpool
Reports on a survey of health and attitudes to health, contact with and attitudes to health services, the social services, social security and related agencies, and implications for social policy.