Evaluating interventions for Behaviours that Challenge (BtC) in dementia care - what instruments do specialist practitioners working in the UK use?

Written feedback was examined from participants who attended the February 2019 consultation. This informed the 35-item online survey that followed (May-June 2019). One item questioned practice on instruments used by specialist BtC practitioners to evaluate the effects of their interventions. Analysis of quantitative and qualitative data from this question is summarised in this article. We discuss what might be useful instruments for practitioners to use in routine practice in recognition of what might be considered clinically significant BtC in family and care home settings. We conclude that more work needs to be done with respect to evaluation of BtC work in family care settings. This should focus on use of instruments for recognition of BtC and evaluation of how families cope with BtC following the specialist interventions they have received

The CAREGIVERSPRO-MMD Platform as an Online Informational and Social Support Tool for People Living With Memory Problems and Their Carers: An Evaluation of User Engagement, Usability and Usefulness

People living with dementia or cognitive impairment (PwD) and their carers often have unmet needs for informational and social support postdiagnosis. Web-based platforms have the potential to address these needs, although few have been developed for use by both PwD and carers. The CAREGIVERSPRO-MMD platform was developed to provide both user groups with informational and peer-to-peer social support. Platform logging data were analyzed to assess the extent to which PwD (n = 37) and carers (n = 37) engaged with the platform and its social/informational features in their daily lives. Participants also provided feedback on the usefulness and usability of the platform. The majority of PwD and carers found the platform and its social/informational features useful and usable, and significant subsets of both groups utilized the platform regularly. However, carers engaged with the informational and social features to a greater extent than PwD, and users highlighted that PwD typically required regular support to use the platform

Conceptualising comorbidity and multimorbidity in dementia: A scoping review and syndemic framework

BackgroundOlder people and people with dementia experience a high prevalence of multiple health conditions. The terms ‘comorbidity’ and ‘multimorbidity’ are often used interchangeably to describe this, however there are key conceptual differences between these terms and their definitions. This has led to issues in the validity and comparability of research findings, potentially inappropriate intervention development and differences in quality of health care.ObjectiveTo review how the terms ‘comorbidity’ and ‘multimorbidity’ are defined within peer-reviewed dementia research and propose an operational framework.DesignA scoping review of definitions within dementia research was carried out. Searches took place across five databases: Academic Search Premier, CINAHL Complete, MEDLINE, PsycARTICLES and PsycINFO. PRISMA-ScR guidelines were followed.ResultsContent analysis revealed five key themes, showing significant overlap and inconsistencies from both within, and between, the comorbidity and multimorbidity definitions; 1. Number of conditions; 2. Type of health conditions; 3. The co-occurrence of conditions; 4. The inclusion of an index disease (or not); 5. Use of medical language. The analysis also revealed gaps in how the underlying concepts of the definitions relate to people with dementia living with multiple health conditions.ConclusionThis scoping review found that current definitions of comorbidity and multimorbidity are heterogeneous, reductionist and disease-focussed. Recommendations are made on the design of research studies including transparency and consistency of any terms and definitions used. A syndemic framework could be a useful tool for researchers, clinicians and policy makers to consider a more holistic picture of a person with dementia’s health and wellbeing

The Role of Models and Formulations in the Management of Behaviors that Challenge in Dementia

The British Psychological Society’s Briefing Paper for Behaviors that Challenge (BtC) in dementia states that psychological formulation helps in the development of effective and well targeted treatments [1]. While not explicitly using the term psychological formulation, the 2018 NICE UK Dementia Guidelines support the use of systematic problem-solving approaches in the management of BtC. The current paper gives an overview of the content of a number of formulation models developed in this area and contrasts two established models. This article looks at two different ways of understanding people’s agitation – one which emphasizes the reasons for their behaviour in terms of the person with dementia [2] and the other called DICE [3] which puts equal emphasis on the roles of both caregivers and the environment in explaining behaviors. We suggest that, while the Newcastle Model tacitly suggests a role for caregivers and the environment in BtC, the explicit emphasis in DICE encourages a more holistic understanding of agitation

ViPER - Introducing a service to deliver restorative supervision for nursing students, to improve retention and raise the quality of student experiences.

Abstract ID 239:Introduction:Restorative Supervision (RS) is increasingly being delivered to post qualified healthcare staff, via the growth of the PNA role (NHS England,2023). The benefits of delivering this to pre-registration students in education have been previously documented. The potential of RS to support student personal and professional development has been demonstrated (Stacey et al, 2017: Stacey et al, 2020). The restorative function of supervision is most valued when facilitated in an environment where humanistic principles are present (Sheppard et al, 2018). This approach may be suitable for nursing students, who manage significant emotional demands in clinical practice, alongside additional challenges resulting from their academic studies.The aim of this project was to support student’s health and wellbeing skills and coping strategies. A dedicated ‘Nursing Student Advocate Support (NSAS) Lead’ was appointed to deliver different modes of RS to nursing students (including group sessions, individual 1-1’s and telephone contacts).To sustain the project in the long term, RS training was developed and offered to HEI staff.Methods:The impact of the service was evaluated over the timeline of the project. Qualitative feedback from student mentimeter surveys was used to collect anonymous data. This type of data collection can provide valuable insights into student experiences of educational programmes (Mohyn et al., 2022).Results:Qualitative data from students demonstrated that RS was a positive experience for all those who engaged in it. Five common themes emerged (anxiety, communication, competing priorities, employment, family commitments). Results suggest that RS supports a nurturing educational environment which develops student professional practice. Facilitating RS in a safe environment enables increased self-awareness and time out for student reflection.Conclusion:RS was found to support growth in students’ self-efficacy, self-esteem and problem-solving skills

Digital technologies and dementia - training guide

This practical guide for group facilitators is now available to support training for people living with dementia/cognitive impairment in the use of digital technologies. The guide gives top tips including the importance of simple steps and the need for repetition, repetition, repetition, along with prepared staged worksheets for facilitators to use. The guide uses learning from the delivery of CAREGIVERSPRO-MMD research project, carried out at the University of Hull https://caregiversprommd-project.eu/

Improving the ‘victim journey’ when reporting domestic abuse cyberstalking to the police – A pilot project evaluation

CCriminal justice responses to stalking in England and Wales have come under increased scrutiny following the Joint Criminal Justice Inspectorate report in 2017. In response, police forces throughout England and Wales attempted to improve their handling of stalking. In one UK police force, a project was developed to improve the identification, investigation and victim journey for domestic abuse cyberstalking offences. The project included a specialist investigation team along with a dedicated and co-located Independent Domestic Violence Advisor. This article draws on research conducted during the evaluation of the project and will evidence high levels of victim engagement, positive reports from victims and a 100% success rate in obtaining restraining orders. These findings highlight the valuable role of specialist teams with integrated, independent support for victims and suggest that the victim journey can be improved through collaborative projects between the police and specialist organisations

The use of a bespoke website developed for people with dementia and carers: Users’ experiences, perceptions and support needs

Background: Current policy emphasises the role of digital technologies in facilitating the management of long-term conditions. While digital resources have been developed for carers, there has been little attention to their development for people with dementia. The Caregiverspro-MMD website was developed as a joint resource for people with dementia and carers, delivering access to information, informal content, games and peer support. Research Design and Methods: This study explored the experiences of dyads consisting of people with dementia and carers of using the website. Interviews and focus groups were conducted with 43 participants. Findings: Thematic analysis identified 10 subthemes grouped under three superordinate themes which highlight participants’ experiences of and responses to the website functions; important aspects of the website design and delivery; and barriers to use. Discussion: Findings highlight the value of a credible information source which negated the need for arduous online searches, the pleasure associated with playing games and interacting with others online. However, participants were reluctant to share personal information online, preferring to create ‘informal content’ which celebrated everyday life, and were reluctant to ‘friend’ people online who they had not met in person. The importance of training and support to use the website was highlighted. Health problems, lack of interest or difficulties using technology, and time were all identified as barriers to use

Training people with dementia/cognitive impairment and their carers in the use of web-based supportive technologies (Innovative practice)

Little is known about the training and support people with dementia and their carers need to use digital solutions. This paper shares learning from a bespoke programme that successfully trained people with dementia or mild cognitive impairment and their informal carers to use a social networking website. This work was undertaken as part of the European Horizon 2020 Caregiverspro-mmd trial (ISRCTN15654731). The training methods described offer an improved understanding of how best to deliver digital skills training that meets the needs of a diverse client group. The effectiveness of the programme is evidenced with qualitative and quantitative data

High prevalence of the neonicotinoid clothianidin in liver and plasma samples collected from gamebirds during autumn sowing

Since neonicotinoid insecticides were introduced to the agricultural market, evidence of the negative impacts of these systemic compounds on non-target species has accumulated. Birds are one of the largest groups of species to inhabit farmland, but the extent of neonicotinoid exposure in avian communities is poorly understood and very little is known about how any exposure may affect wild birds. Here, free-living gamebirds were used as a model group to measure the extent of avian exposure to the neonicotinoid clothianidin via seed treatment. During a typical sowing period of winter cereals treated with clothianidin, blood and liver samples were collected simultaneously from individual hunted gamebird carcasses, both pre- (n = 18) and post-sowing (n = 57) and were analysed for clothianidin via LC/MS-MS. Body weight, fat score and faecal parasite load were also quantified in the birds to ascertain whether any of these health parameters were associated with clothianidin exposure under field conditions. Clothianidin was detected in 6% of individuals sampled pre-sowing and 89% of individuals sampled post-sowing. The frequency of clothianidin detection in plasma samples and the concentration of clothianidin in liver and plasma samples decreased significantly between the first week and 2-4 weeks post-sowing. Faecal parasite load was positively associated with concentrations of clothianidin in the liver (but not plasma) of partridge species, but there was no association between clothianidin concentration and fat score or body weight, for either sample type. This study provides clear evidence that treated seed is a source of pesticide exposure for gamebirds following autumn sowing. These findings have implications for gamebirds worldwide where seed treatments are in use, and will aid the design of any future avian biomonitoring studies for agrochemical compounds