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NIHR Signal Training programme to improve communication between staff and patients with dementia in hospital shows promise
Communication with people with dementia can be challenging for healthcare professionals. A new two-day training programme shows potential to help professionals become more confident in managing difficult situations on the ward. After analysis of 41 videoed exchanges between 26 healthcare professionals and 26 people with dementia in acute hospitals, researchers identified particular challenges. These included requests for action, such as asking them to take a drink or get out of bed, and at the ...
NIHR Signal Antidepressants do not help treat depression in people living with dementia
Antidepressants do not reduce symptoms of depression in people with dementia compared with placebo (dummy pills). Measured 6 to 13 weeks after starting the treatment, there is little or no difference in participants’ symptoms, but an increased chance of unwanted side effects. The review did not identify enough data to determine if antidepressants have an effect in the longer-term. This Cochrane review included randomised controlled trials of any antidepressant drugs compared to placebo. P...
NIHR Signal Case managers improve outcomes for people with dementia and their carers
Using a case manager to coordinate health and social care improves the challenging behaviour of people with dementia and reduces the burden on caregivers. Quality of life of caregivers improves the most when case managers have a professional background in nursing. This NIHR-funded review compared the effectiveness of standard community treatment and interventions with case managers overseeing the interventions for people living with dementia. It considered evidence from 14 trials in a number of...
NIHR Signal Person-centred care improves quality of life for care home residents with dementia
A person-centred care intervention for people with dementia living in care homes improved their quality of life, reduced agitation and improved interactions with staff. It may also save costs compared with usual care. The WHELD intervention involves training staff in person-centred care, with a focus on improving social interactions and appropriate use of antipsychotic medications. An early study suggested it could halve antipsychotic use. This larger-scale NIHR trial conducted across 69 UK nu...
NIHR Signal A third of people with dementia have treatable vision problems
New data shows that around a third of people with dementia have serious vision problems, such as cataracts or short sightedness, more than the general population of that age. Levels are higher still for people with dementia in care homes – about half have vision problems. Yet this study showed that many of the people with dementia and vision impairment had not received the right treatment. This often involves simple measures. For many, spectacles could have improved poor sight. A quarter ...
NIHR Signal Coordinating care for people with long term conditions and dementia: room for improvement
New evidence shows that almost one fifth of people with dementia also have other serious conditions such as stroke, diabetes and visual impairment. Services are not currently designed to provide adequate integrated care for people with dementia plus other conditions. For instance, people with dementia are less likely to get diabetes checks or cataract surgery than those without dementia. Carers are not routinely contacted, and there is a lack of guidance for health professionals covering more th...
NIHR Signal Stopping Donepezil may be linked to nursing home placement for people with Alzheimer’s disease, but a “cause and effect” not conclusive
This follow up study examined whether the drugs donepezil or memantine affected the chance that people with Alzheimer’s disease could continue to live in the community, rather than move permanently to a nursing home. One or both of the drugs was taken for a year and then participants could have any treatment thereafter. The study found that stopping donepezil doubled the risk of going into a nursing home up to a year afterwards, compared with continuing to take donepezil. However, there wa...
NIHR Signal A coping programme moderately reduces depression and anxiety in carers of people with dementia
This NIHR-funded trial found that a programme to support carers of people with dementia was moderately effective in reducing carers’ depression and anxiety scores for up to two years. It was also cost-effective. The programme consisted of eight sessions delivered by psychology graduates, covering topics such as managing difficult behaviour, accessing support and planning for the future. One in three people over 65 develop dementia and family are often the primary caregivers. The findings o...
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