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Rehab based on goals being rolled out for dementia patients

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A therapy that helps people with dementia achieve everyday goals is being rolled out to health and care providers, after a successful trial.

Exeter University is leading a programme to train health and care professionals in the technique known as “goal orientated cognitive rehabilitation”, as part of further research to see whether it can be incorporated into routine practice.

“This is essential in demonstrating that dementia is not an inevitable decline in all areas2

Krystal Warmoth

Thirteen organisations including NHS trusts, local authorities and care homes have already signed up to take part in the study, which is funded by the charity Alzheimer’s Society.

The therapy involves practitioners working with people with dementia and their carers to establish the goals that are most important to them when it comes to maintaining their lifestyle.

These could include cooking food without burning it, remembering the names of loved ones or relearning how to use a mobile phone or cashpoint. The practitioner then works with the person and carers to put in place strategies to achieve the goals.

The latest phase of the project builds on a successful randomised controlled trial involving 475 participants across eight sites in the UK.

“Helping people to maintain their lifestyles is really important to retaining independence”

Linda Clare

Half of those who took part received 10 cognitive rehab sessions over three months and then four top- up session over six months, while the other half continued with their lives as usual.

Funded by the National Institute for Health Research and supported by the Alzheimer’s Society, the trial – known as the GREAT trial – found significant improvement in the goals people had identified after both the 10-week course of therapy and the top-up sessions.

The new study – called GREAT into Practice –will see university researchers provide training to NHS and social care staff.

GREAT into Practice project manager Krystal Warmoth, from the University of Exeter, said results so far had demonstrated the value of cognitive rehab.

“Our research has shown that cognitive rehabilitation can help people achieve the goals that matter most to them,” said Ms Warmoth.

“This is essential in demonstrating that dementia is not an inevitable decline in all areas, and in providing people with the simple tools to live as well as possible with the condition,” she said.

“Setting individual goals and tailoring care to each person had clear benefits”

Doug Brown

Research programme lead Professor Linda Clare said it showed there was much that could be done to help people with dementia maintain a good quality of life.

“There’s plenty that we can do, and exactly what strategy we put in place depends on individual need,” she said.

“Helping people to maintain their lifestyles is really important to retaining independence, functional ability and overall quality of life,” she added.

Doug Brown, chief policy and research officer at Alzheimer’s Society, said the research was helping to challenge misconceptions.

“This research shows people with early-stage dementia can learn new skills to help them maintain their independence, social lives and personal safety,” he said.

Alzheimer's Society

Dr Doug Brown

Doug Brown

“The personalised nature of this therapy highlights that everyone with dementia is different, so setting individual goals and tailoring care to each person had clear benefits,” said Dr Brown.

While 13 organisations have signed up to take part in the GREAT into Practice study, he hoped many more would follow suit.

The full list of organisations signed up so far are:

  • Devon Partnership NHS Trust
  • Somerset Care
  • Bristol Dementia Wellbeing Service
  • Hampshire County Council
  • Hertfordshire Partnership NHS Foundation Trust
  • Betsi Cadwaladr University Health Board
  • Home Instead Senior Care
  • Sunrise Senior Living
  • Torbay Council
  • Devon County Council
  • Birmingham and Solihull Mental Health NHS Foundation Trust
  • Berkshire Healthcare NHS Foundation Trust
  • Kent and Medway NHS Partnership Trust


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