Research

Evidence for Practice/Research news

This section aims to keep readers up to date with research in dementia care and the current best evidence to support practice. We aim to provide a channel of two-way communication between researchers and practitioners, so that research findings  influence practice and practitioners’ concerns are fed into the research agenda.  

We welcome contributions such as: 

  • Information on recently-completed studies that are available  to readers 
  • Notice of the publication (recent or imminent) of peer reviewed research papers with practical relevance to dementia
  • Requests or offers for sharing research information and experience in particular fields of interest.
  • Short comment on important research papers recently published, drawing practitioners’ attention to new evidence and key points that should inform practice.

Please contact sue@dementiapublishing.community

The research papers summarised below by Hazel Heath are selected for their relevance and importance to dementia care practice. We welcome suggestions of papers to be included. If you would like to contribute a summary or a short comment on an important research paper recently published, drawing practitioners’ attention to new evidence and key points that should inform practice, please contact sue@dementiapublishing.community 

VIPS practice model in primary healthcare 

Professionals in services that had used the VIPS practice model in Norway for over 12 months were interviewed. These included nursing home physicians and managers/ leaders of domestic care, day centres and activity services.  

The findings after VIPS implementation show a change in focus from task to person, a more person-centred work environment, more effective interventions, an enhanced professional level in discussions and changes in co-operation between stakeholders. The authors conclude that regular use of the VIPS practice model appears to change the work culture for the benefit of both service users and frontline staff. Staff were more focused on the needs of service users, resulting in care interventions tailored to the individual with dementia, loyalty to care plans and fewer complaints from next of kin. 

Mjørud M, Røsvik J (2021) You can tell it works – Experiences from using the VIPs practice model in primary healthcare. Dementia (London). Published Dec 2nd 2021. 

doi.org/10.1177/14713012211053979 

 

Palliative approach in primary care settings 

A palliative approach to care aims to meet the needs of patients and caregivers throughout a chronic disease trajectory, and it can be delivered by non-palliative specialists.  

This scoping review sought to address the gap in understanding the perspectives and experiences of primary care providers on an integrated palliative approach in dementia care and the impact of existing programs and models to this end. It identified difficulty with prognostication and a lack of intersectoral collaboration but that a palliative approach significantly impacts on community-dwelling individuals, specifically those in the later stages of dementia.  

The authors identify a need for high-quality research studies examining the integrated palliative approach models and initiation of these models sooner in the care trajectory for persons living with mild and moderate stages of dementia in the community. 

Vellani S, Puts M, Iaboni A et al (2021) Integration of a Palliative Approach in the Care of Older Adults with Dementia in Primary Care Settings: A Scoping Review.  Canadian Journal on Ageing 1-17. Published Nov 8 2021. https://doi:10.1017/S0714980821000349

 

Dementia cafés  

Using semi structured interviews with people living with dementia and partners, this study examined how a co-designed dementia café impacted on the self-reported social health of community dwelling people with dementia and their care partners in the North-West of England. It identified that participating in the cafés led to a sense of belonging and purpose that was beneficial to well-being and social health for all participants. The authors conclude that community-based initiatives that provide opportunities for peer support for individuals and care partners are essential so that people living with dementia may rebuild their confidence as well as retaining opportunities to socialise. 

Innes A, Chesterton L, Morris L et al (2021) Perspectives of people living with dementia and their care partners about the impact on social health when participating in a co-designed dementia café. Health & Social Care in the Community Early View. Published Aug 18 2021.  

doi.org/10.1111/hsc.13545 

Dementia and incontinence 

Through semi-structured interviews with people living at home with dementia, carers and healthcare professionals, this study details the causes, consequences of and potential solutions for incontinence problems. Multifaceted and complex problems were identified which layered dementia, physical, psychosocial, societal and care system factors and highlighted contextual variation. This new knowledge provides a basis for developing urgently needed practical and implementable interventions for this underserved population, the authors say. 

Murphy C, DeLaine C, Macaulay M et al (2021) Problems faced by people living at home with dementia and incontinence: causes, consequences and potential solutions. Age and Ageing 50 3 944-954. doi.org/ 10.1093/ageing/afaa262 

 

Music-based initiatives 

While studies have been conducted in care homes, research into the impact of ‘music-making’ in community settings is limited. In this study, ten music-making sessions were scheduled for community-dwelling people living with dementia and care-partners, once a month. Semi-structured interviews explored the participants’ experiences. Self-report questionnaires captured ‘in the moment’ experiences. The findings demonstrate that participating in the music-making café benefitted the  

self-reported well-being of participants through a sense of camaraderie, creating a ‘level playing field’ and group participation in music making. The authors conclude that participating in music-making is a powerful medium to promote well-being for community-dwelling people living with dementia and care-partners. 

Smith SK, Innes A, Bushell S. Music-making in the community with people living with dementia and care-partners – ‘I’m leaving feeling on top of the world’. Health & Social Care in the Community Early View. Published April 6 2021. doi.org/10.1111/hsc.13378 

 

Ethnic minority support 

Many European countries are now encountering an increasing number of older people from diverse ethnic minority groups who have been diagnosed with dementia. Although family care is predominantly used as a care pathway among families with immigrant backgrounds, research into caregivers’ experiences of providing care for a family member with dementia is limited. This systematic review of qualitative literature identified that, while most family caregivers highlight the value of being able to care for a family member with dementia, they experience controversies and challenges due to their lack of dementia health literacy and perceived barriers to seeking healthcare support. The authors highlight the importance of implementing models of care that facilitate and complement family caregivers’ role in caring for family members living with dementia from minority ethnic groups. 

Lillekroken D, Halvorsrud L, Gulestø R, Bjørge H (2021) Family caregivers’ experiences of providing care for family members from minority ethnic groups living with dementia: A qualitative systematic review. Journal of Clinical Nursing Early View. Published Nov 16 2021. doi.org/10.1111/jocn.16127 

 

Horticultural Therapy (HT) 

While there is evidence of the positive effects of HT among older adults, there has been limited systematic evaluation of the benefits of HT on physical functioning and psychological health.  This systematic review and meta-analysis suggested that HT can significantly improve upper body flexibility and aerobic endurance in older adults. Besides, HT was found to be effective for promoting emotional functioning, well-being, subjective social functioning and quality of life among older people, including those with dementia.  No negative events were found. 

Lin Y, Lin R, Liu W, Wu W (2021) Effectiveness of horticultural therapy on physical functioning and psychological health outcomes for older adults: A systematic review and meta-analysis. Journal of Clinical Nursing Early View. Published Oct 24 2021.  

doi.org/10.1111/jocn.16095 

 

Multisensory environments (MSE) in assisted bathing 

This study used a multisensory environment intervention (comprising aromatherapy, colour-changing lights and music) when assisting older people living with dementia with bathing.  The authors concluded that MSE is a helpful, nonpharmacological behavioural intervention. All participants experienced an overall increase in duration of positive operational behaviours and an overall decrease in the duration of negative operational behaviours. MSE also improved the overall bathing experience. 

Lorusso L, Bosch S, Park NK et al (2021) Investigating the Feasibility of Multisensory Environments to Improve the Assisted Bathing Experience for Veterans With Dementia: A Clinical Trial. HERD Health Environments Research Journal. Published Nov 11 2021. doi.org/10.1177/19375867211053861 

 

Communication in acute hospital wards  

Using conversational analysis focused on ‘hard-to-interpret’ talk (where there are problems with hearing, speaking or understanding), this study examined video recordings of healthcare professional (HCP) interactions with people living with dementia (PLWD) across three acute inpatient wards in a large UK teaching hospital. ‘Repair’ is a common response in ordinary interaction but this study identified a range of HCP approaches to avoid direct ‘repair’, including non-committal responses, continuers such as ‘yeah’ or nods, the use of repetitions, responding to the emotional tone displayed in the PLWD’s utterance, closing the current topic and shifting to the next and treating the PLWD’s talk as related to the task at hand. The authors suggest that the use of these approaches may be one way in which HCPs manage respecting the personhood of the PLWD, by preserving face and enabling a continuation of an interaction in which the PLWD can take an active part. This paper provides an empirical demonstration of the high level of interactional skill involved in dementia care work. It also illustrates how these skills can be described and specified, and hence incorporated into recommendations for communication with PLWD. 

Pilnick, A., O’Brien, R., Beeke, S et al (2021) Avoiding repair, maintaining face: Responding to hard-to-interpret talk from people living with dementia in the acute hospital. Social Science and Medicine 2021, 282, pp.114156. doi: 10.1016/j.socscimed.2021.114156 

www.sciencedirect.com/science/article/abs/pii/S0277953621004883 

 

Humanoid robots as companions 

In recent years, researchers have tried to improve the quality of life of people living with dementia by utilizing new technologies such as robots. This study investigated the application of humanoid robots focusing on: (1) cognitive-communication improvement (2) psychomotor therapy and (3) music therapy. The results indicate that having humanoid robots as companions may serve as an effective therapy that helps people living with dementia with their cognitive function, motor skills, language and communication skills. The authors suggest that humanoid robots can also help reduce cognitive decline by helping people to perform exercises. 

Sather R, Soufineyestani M, Khan A, Imtiaz N. (2021) Use of Humanoid Robot in Dementia Care: A Literature Review. Journal of Aging Science 9, 3, 1000249. Published:  April 7 2021.  

 

Dementia in public space 

For people living with dementia at home, neighbourhoods and public spaces become dementia care settings. Also, there is a shift from emphasising a person’s loss and decline to a focus on strength and capacity. This paper aimed to identify assets that contribute to the wellbeing of people with dementia living in a community context. Using the Asset-Based Community Development framework, in-depth and walking interviews, this study identified an inventory of physical, social and institutional assets to contribute to participants wellbeing, to help them gain relief and confidence and to support their sense of belonging and inclusion. The authors conclude that an asset-based perspective of people living with memory problems and dementia can be a valuable framework to promote engagement to support dementia-informed community development, public space design and healthcare innovations to improve the wellbeing of people living with memory problems and develop communities which are sustainable, accessible and inclusive for all. 

Sturge J, Klaassens M, Allyson Jones C et al (2021) Exploring assets of people with memory problems and dementia in public space: a qualitative study. Wellbeing, Space and Society 2, 100063. Published Nov 13 2021.  

doi.org/10.1016/j.wss.2021.100063 

 

Nature-based video for sundown syndrome 

Ten participants living in a dementia care unit, who were experiencing an episode of sundowning, had their tranquillity levels assessed using a range of methods including comments. A research intervention comprising a six-minute nature-based slideshow video accompanied with classical music was then used and the assessments were repeated. Assessments following the intervention showed increased levels of tranquillity, mitigation of sundowning symptoms, more positive participant behaviours and more positive comments. The authors suggest that such simple, short-duration, interventions can not only assist in mitigating symptoms of sundowning in care homes but could be used by home care workers and family caregivers. 

Rados R, Kim J, Kono S, Horton J (2021) Nature-Based Video with Music for Individuals Experiencing an Episode of Sundown Syndrome. Journal of Long-Term Care pp.294–302. Published Sept 29 2021. doi: doi.org/ 10.31389/jltc.69