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AwareCare: a pilot randomized controlled trial of an awareness-based staff training intervention to improve quality of life for residents with severe dementia in long-term care settings

Published online by Cambridge University Press:  30 July 2012

Linda Clare ,
Rhiannon Whitaker ,
Robert T Woods ,
Catherine Quinn ,
Hannah Jelley ,
Zoe Hoare ,
Joan Woods ,
Murna Downs  and
Barbara A. Wilson
Linda Clare*
Affiliation:
School of Psychology, Bangor University, Bangor, Gwynedd LL57 2AS, UK
Rhiannon Whitaker
Affiliation:
North Wales Organisation for Randomised Trials in Health (NWORTH), Bangor University, Y Wern, Normal Site, Holyhead Road, Bangor, Gwynedd LL57 2PZ, UK
Robert T Woods
Affiliation:
Dementia Services Development Centre, Bangor University, 45 College Road, Bangor, Gwynedd LL57 2AS, UK
Catherine Quinn
Affiliation:
School of Psychology, Bangor University, Bangor, Gwynedd LL57 2AS, UK
Hannah Jelley
Affiliation:
School of Psychology, Bangor University, Bangor, Gwynedd LL57 2AS, UK
Zoe Hoare
Affiliation:
North Wales Organisation for Randomised Trials in Health (NWORTH), Bangor University, Y Wern, Normal Site, Holyhead Road, Bangor, Gwynedd LL57 2PZ, UK
Joan Woods
Affiliation:
Dementia Services Development Centre, Bangor University, 45 College Road, Bangor, Gwynedd LL57 2AS, UK
Murna Downs
Affiliation:
Bradford Dementia Group, School of Health Studies, Bradford University, Horton A Building, Richmond Road, Bradford BD7 1DP, UK
Barbara A. Wilson
Affiliation:
Medical Research Council Cognition and Brain Sciences Unit, 15 Chaucer Road, Cambridge CB2 2EF, UK
*
Correspondence should be addressed to: Professor Linda Clare, School of Psychology, Bangor University, Bangor, Gwynedd LL57 2AS, UK. Phone: +44 1248 388178. Email: [email protected].
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Abstract

Background: The extent to which care home residents with severe dementia show awareness is influenced by the extent to which the environment provides opportunities for engagement and by the way in which care staff interact with them. We aimed to establish whether training care staff to observe and identify signs of awareness in residents with severe dementia resulted in improved quality of life for residents.

Methods: In this pilot cluster randomized trial, care staff in four homes (n = 32) received training and supervision and carried out structured observations of residents using the AwareCare measure (n = 32) over an eight-week period, while staff in four control homes (n = 33) had no training with regard to their residents (n = 33) and no contact with the research team. The primary outcome was resident quality of life. Secondary outcomes were resident well-being, behavior and cognition, staff attitudes and well-being, and care practices in the home.

Results: Following intervention, residents in the intervention group had significantly better quality of life as rated by family members than those in the control group, but care staff ratings of quality of life did not differ. There were no other significant between-group differences. Staff participating in the intervention identified benefits in terms of their understanding of residents’ needs.

Conclusions: Staff were able to use the observational measure effectively and relatives of residents in the intervention homes perceived an improvement in their quality of life.

Keywords

family caregiversobservationwell-beingbehaviorcognitionresponsivenessstaff attitudescare practices
Type
Research Article
Information
International Psychogeriatrics , Volume 25 , Issue 1 , January 2013 , pp. 128 - 139
Copyright
Copyright © International Psychogeriatric Association 2012

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