R.J. Woolley

Enriching opportunities for people living with dementia in nursing homes: An evaluation of a multi-level activity-based model of care

This paper reports on the evaluation of the Enriched Opportunities Programme in improving well-being, diversity of activity, health, and staff practice in nursing home care for people with dementia. Participants were 127 residents with a diagnosis of dementia or enduring mental health problems in three specialist nursing homes in the UK. A repeated measures within-subjects design was employed, collecting quantitative and qualitative data at three points over a twelve-month period in each facility with follow-up 7 to 14 months later. Two-way ANOVAs revealed a statistically significant increase in levels of observed well-being and in diversity of activity following the intervention. There was a statistically significant increase in the number of positive staff interventions but no change in the number of negative staff interventions overall. There was a significant reduction in levels of depression. No significant changes in anxiety, health status, hospitalisations, or psychotropic medication usage were observed. The Enriched Opportunities Programme demonstrated a positive impact on the lives of people with dementia in nursing homes already offering a relatively good standard of care, in a short period of time. The refined programme requires further evaluation to establish its portability.

Enriching opportunities for people living with dementia: The development of a blueprint for a sustainable activity-based model

The aim of this paper is to describe the process of building a multi-level intervention called the Enriched Opportunities Programme, the objective of which is to provide a sustainable activity-based model for people with dementia living in long-term care. It is hypothesised that five key elements need to work together to bring about a sustainable activity-based model of care. These elements are specialist expertise–the staff role of Locksmith was developed as part of this programme; individualised assessment and case work; an activity and occupation programme; staff training; and management and leadership. These elements working together are known as the Enriched Opportunities Programme. This paper reports on the processes undertaken to develop Enriched Opportunities from its inception to the present, and focuses on lessons learnt from the literature, an expert working group and action research in four UK study sites. A blueprint for evaluation in other long-term care facilities is described.

The feasibility of care mapping to improve care for physically ill older people in hospital

BACKGROUND providing dignity in health care for older people is an important policy and clinical objective but requires implementation using reliable methods. Our objective was to investigate the feasibility of a person-centred observational practice development method known as dementia care mapping (DCM) in hospital wards for physically ill older people, including those who do not have dementia. METHODS DCM (version 8) was conducted in three elderly care general hospital wards and in two community hospitals. Summary statistics were calculated from the DCM data to assess feasibility and adequacy of the DCM coding system. RESULTS fifty-eight participants were mapped for 84 observation hours/414 patient hours (4,968 5-min time frames). There was a relatively high proportion (942/2,376; 40% time frames) of missing data in the community hospitals due to time patients spent away from the area under observation. All 3,624 of the time frames with patient-observed data could be coded utilising the existing Behaviour Category and Mood/Engagement Value coding frameworks. DISCUSSION the results from this preliminary study are promising and indicate that DCM is potentially feasible in elderly care general hospital wards, without the need for major modification.