Management of Challenging Behaviour in dementia at home and in care homes
Award Number
RP-PG-0606-1067Programme
Programme Grants for Applied ResearchStatus / Stage
CompletedDates
2 August 2007 -1 August 2013
Duration (calculated)
05 years 11 monthsFunder(s)
NIHRFunding Amount
£2,082,734.00Funder/Grant study page
NIHRContracted Centre
Humber Teaching NHS Foundation TrustContracted Centre Webpage
Principal Investigator
Professor Esme Moniz-CookPI Contact
E.D.Moniz-Cook@hull.ac.ukWHO Catergories
Economic Impact of DementiaTools and methodologies for interventions
Disease Type
Dementia (Unspecified)CPEC Review Info
| Reference ID | 71 |
|---|---|
| Researcher | Reside Team |
| Published | 12/06/2023 |
Data
| Award Number | RP-PG-0606-1067 |
|---|---|
| Status / Stage | Completed |
| Start Date | 20070802 |
| End Date | 20130801 |
| Duration (calculated) | 05 years 11 months |
| Funder/Grant study page | NIHR |
| Contracted Centre | Humber Teaching NHS Foundation Trust |
| Contracted Centre Webpage | |
| Funding Amount | £2,082,734.00 |
Abstract
We propose a programme of inter-related studies to evaluate whether providing family and staff carers with training and support in behaviour management for dementia symptoms, enables them to improve their coping strategies (process), minimise behavioural symptoms (intermediate outcome) and thus enhance well being in older people with dementia (definitive outcome). Building on our research on functional analysis as a treatment for challenging behaviour in care homes, together with international innovation from the US and Australia, we will develop a training and support programmes for staff supporting people and family carers to access specialist knowledge 24 hours a day; evaluate these within two pragmatic randomised controlled trials; and conduct a cost consequence analysis of methods for implementing functional analysis into regular practice Pharmacological treatment for challenging behaviour has raised strong concerns due to the associated increased risk of cerebrovascular adverse events, falls, accelerated cognitive decline and reduced quality of life for people with dementia (Ballard 2005). Functional analysis (Moniz- Cook et al 2001; 2003; Teri et al 2005) is, we suggest, a ‘clinically sensible’, ‘scientifically grounded’ individually tailored person-centred intervention for family and staff carers. There are no UK studies of significant improvement following use of functional analysis in dementia, despite guidance that suggests that this is the treatment of choice. Sustainable research is now urgently required to develop person-centred interventions for challenging behaviour that are ‘standardised, yet flexible, scientifically grounded yet clinical sensible’ (Teri et al 2005). There is also a need explore the cost effectiveness of different models of delivery of within current health care provision. The interrelated innovations proposed will examine clinical and quality of life outcomes and cost consequences of functional analysis in the management of challenging behaviour in community and care home settings. To develop this programme we have drawn together clinical psychologists who are national and international experts and set this programme in Yorkshire, where previous feasibility research has been carried out.
Plain English Summary
Dementia often brings behaviours that families and staff carers find difficult to understand and cope with. These behaviours are often described as behavioural and psychological symptoms in dementia, BPSD and when carers have difficulty in managing these they are described as ‘challenging behaviour’. These behaviours are often treated with drugs which are known to have harmful side effects and research shows that they often do not work. Department of Health guidelines suggest that psychological treatments are better and should be used but this does not occur because there are not enough expert clinical psychologists available to help staff and family care givers to use these treatments. We are proposing to draw together national and international experts in the psychological treatment of choice (functional analysis) and to develop an interactive DVD so that staff have 24hour access to expert knowledge of this treatment. We will test the use of this within two large studies and also evaluate the cost consequences of carers using this method. Should we succeed we anticipate improved mental health for both people with dementia and their family carers.