Community Care

Evaluation of the Memory Matter Carlow/Kilkenny Community Dementia Project

Brady, A-M., Ciblis, A., Hynes, G., Keogh, B., Daly, L., Kennelly, B., Bracken-Scally, M., McCarron, M.
School of Nursing and Midwifery, Trinity College Dublin and Department of Economics, National University of Ireland, Galway.
2017
This report presents the findings of an evaluation of the Memory Matters Community Dementia Project in Carlow/Kilkenny (2014-2016), one of five projects funded under the HSE & Genio Dementia Programme to develop and test innovative individualised supports for people at an advancing and complex s
tage of dementia. This project adopted a reablement approach, with a focus on helping people maintain their abilities rather the conventional home care approach of doing things for people, and providing flexible, person-centred and responsive home care services. It developed educational initiatives for statutory and voluntary service providers in the region, including reablement training for home helps. Assistive technology was also made available to support people to live as independently and safely as possible. A comprehensive evaluation of the project was undertaken, using mixed methods and underpinned by the RE-AIM framework. The individualised nature of the supports provided by the project and their flexibility facilitated reablement activities and the experience of people with dementia and their families of the supports were positive. The flexibility of supports was of particular benefit to family carers. The personalised Memory Matters supports were delivered using existing resources for community care services. The evaluation found that people with advanced dementia could be supported to remain at home for an average cost to the HSE of €607 per week, which is significantly lower than the costs of long-stay residential care. When the costs of family caring were included, the cost of supporting a person with dementia to remain living at home was lower than long-stay residential care for more than 80% of the people supported by the project. The education initiatives were positively evaluated and staff participating reported increasing confidence in adopting a reablement approach to community care.

Evaluation of the Community Outreach Dementia Project Leitrim

Brady, A-M., Bracken-Scally, M., Hynes, G., Keogh, B., Daly, L., Kennelly, B., Ciblis, A., Pittalis, C. and McCarron, M.
School of Nursing and Midwifery, Trinity College Dublin and Department of Economics, National University of Ireland, Galway.
2017
This report presents the findings of an evaluation of the Community Outreach Dementia Project (CODPL) in Leitrim, a rural country in Ireland with a relatively high population of older people.
This project is one of five projects funded under the HSE & Genio Dementia Programme to develop and test innovative individualised supports for people at an advanced stage of dementia. Through designing and providing flexible and responsive supports, the project’s aim was to enable individuals with dementia presenting with complex needs to remain in their own homes longer and prevent unnecessary hospitalisation. The project also provided carer respite, educational programmes for staff and made assistive technology available. A comprehensive evaluation of the project was undertaken, underpinned by the RE-AIM framework and using mixed methods. A key finding of the evaluation was that more personalised supports could be provided when the person with dementia and their family carer were recognised and assessed as a unit of care. Families’ experiences of the CODPL supports were very positive. They found the supports provided by the project to be of good quality and valued the flexibility of service delivery and the relief it gave them. The uptake of assistive technology was lower than anticipated, indicating the limited application of such technology for people with advanced dementia. The education programmes developed by the project complemented existing programmes and were positively evaluated by participants. The evaluation found that people with advanced dementia could be supported to remain at home for an average cost to the HSE of €504 per week, and concluded that this was a good use of resources since the vast majority, the costs were lower than the costs of long-stay residential care.

Person-centred Care in the Community

Downs, M..
Genio
2015
The learning paper describes the key concepts of person-centred dementia care and identifies the areas that can be addressed to ensure its successful application in the community.
It discusses four key concepts that need to be addressed to enhance the well-being of people with dementia in the community. These are personhood, psychological needs, the bio-psychosocial model and the person’s perspective. Key elements to providing a person-centred approach to care in the community are then identified. These are tackling the impact of negative imagery and language; supporting family members; managing risk; and measuring effectiveness, each of which is discussed in detail.

Community Supports Model for People with Dementia

Genio
2016
The Community Supports Model for people with dementia described in this learning paper from Genio was the result of a service design process that formed part of the HSE & Genio Dementia Programme.
The process identified the most effective elements of innovation across four community dementia projects funded under the programme. The paper describes and discusses five essential components that make up the model: the consortium model of delivery; the existence of a single point of contact coordinating services and supports; mechanisms to reinforce timely and sensitive diagnosis, post-diagnostic information sessions and support groups; personalised supports (for community connecting, maintaining ability, responsive and quality respite, and tailored use of assistive technology). It also identifies ‘underpinning enablers’. The intention is that the Community Supports Model described in this paper will be used to inform and guide the remodelling of existing services and transform them into personalised responses that will at the same time be accompanied by a reconfiguration of resources.