Increasing the amount of social interaction for people with dementia in care homes to just one hour a week improves quality of life, when combined with personalised care, according to a UK study.
The large-scale trial led by the University of Exeter, King’s College London and Oxford Health NHS Foundation Trust found that the approach also saved money in the long term.
“We’ve shown that this approach significantly reduces agitation and saves money”
The Improving Wellbeing and Health for People with Dementia (WHELD) trial is the largest non-pharmacological randomised control trial in people with dementia living in care homes to date.
Previous research has found that in many care homes, residents have as little as two minutes of social interaction per day, noted the researchers behind WHELD.
For their new study, funded by the National Institute of Health Research and published today in the journal PLOS Medicine, key care home staff were “upskilled” to deliver person-centred care.
The so-called WHELD intervention involved simple measures such as talking to residents about their interests and involving them in decisions around their own care.
When combined with just one hour a week of social interaction, the programme improved quality of life and significantly reduced agitation and aggression in people with dementia, said the researchers.
The trial involved nearly 850 people with dementia across 69 care homes in South London, North London and Buckinghamshire, with residents randomised to either WHELD or normal care.
“We must roll out approaches that work to do justice to some of the most vulnerable people in society”
Two “care staff champions” at each home were trained over four day-long sessions, to take simple measures such as talking to residents about their interests and decisions around their own care.
The quality of interactions of positive care between care staff and residents with dementia was collected as a care-home-level assessment in 62 of the participating care homes.
There was a statistically significant 19.7% greater increase in the proportion of positive care interactions from baseline to nine months in the WHELD group compared to the control group.
Importantly, the approach also saved money compared to standard care, according to the researchers, though there was an initial outlay needed to pay for training and supervision.
However, the researchers noted that prescriptions of antipsychotic medications were “stable” across the study in both treatment groups, with no reduction in antipsychotic use.
They said the next key challenge would be to roll out the programme to the 28,000 care homes in the UK to benefit the lives of the 300,000 people with dementia living in these facilities.
Dr Jane Fossey from Oxford Health, said: “Taking a person-centred approach is about getting to know each resident as an individual – their interests and preferences – and reflecting these in all aspects of care.
“It can improve the lives of the person themselves and it can be rewarding for carers too,” she said. “We’ve shown that this approach significantly reduces agitation and saves money. Rolling out the training nationwide could benefit many other people.”
“It is vital that staff have the right training to provide good quality dementia care”
Lead study author Professor Clive Ballard, from Exeter University, said: “While many care homes are excellent, standards still vary hugely.
“We have previously found that the average amount of social interaction for people with dementia was just two minutes a day,” he said. “It’s hardly surprising when that has a knock-on effect on quality of life and agitation.
“Our approach improves care and saves money,” he said. “We must roll out approaches that work to do justice to some of the most vulnerable people in society.
“Incredibly, of 170 carer training manuals available on the market, only four are based on evidence that they really work. That is simply not good enough – it has to change,” he added.
Dr Doug Brown, director of research at the Alzheimer’s Society, said it was “vital” that care home staff had the right training to provide good quality dementia care.
“This study shows that training to provide this type of individualised care, activities and social interactions can have a significant impact of the well-being of people living with dementia in care homes,” he said.