Successful dementia training program goes overseas

An innovative, Australian training program, which has been proven to keep people living with dementia at home for longer, will be introduced into the Netherlands later this year.

The Going to Stay at Home (GTSAH) program, a replication and update of a highly successful randomised controlled trial, was completed in August last year by dementia specialist, HammondCare, and will be piloted in aged care facilities in Rotterdam.

“This is exciting news and highlights the significant results of the Australian program,” said Assoc Prof Colm Cunningham, director of the Dementia Centre, which conducted the research project for HammondCare.

82% still living at home

The results of the GTSAH research show that around 82% of people on the program were still living at home, with their carer, after twelve months. Only 18% (17.6%) of people on the program were in permanent residential aged care 12 months after training. This compares to similar people living with dementia who had received respite care only, where 53% (52.9%) had moved to permanent residential aged care after twelve months.*

The other main benefits identified for people on the program, which includes a residential one-week course for family carers and the person living with dementia, were a significant reduction in behavioural and psychological symptoms of dementia, particularly a decrease in aggressive behaviours. Carers also reported greater knowledge and information about looking after a person with dementia, particularly concerning managing behaviours that they found challenging.

Assoc Prof Cunningham said the training program filled an important information gap for a person with dementia and also their carer: “After a diagnosis of dementia, there may be a lack of support and people can feel very isolated. This program is all about informing and empowering carers by creating a better understanding about how the future might look and what it might involve, when living with dementia.

“The results demonstrate that knowledge, coping skills and capacity of family carers can be significantly increased, which in turn means the person with dementia can stay at home for longer, which is the best end result.”

The research results show that at the start of the program, 76.7% of carers reported they did not have adequate information on managing behaviours associated with dementia. At 6 months, this proportion had fallen to 25.6% and at 12 months, to 5.4%.

The research program, was held over 18 months at two locations in Tamworth (NSW) and southern Sydney (Miranda), and involved 192 carers and people with dementia. The residential training program runs for a week and covers a variety of topics for both carers and people with dementia.

Reduces demand on hospital services

A/Prof Cunningham said the GTSAH training program could significantly help reduce the demand on Australian hospital services: “With an ageing Australian population and over 900,000 people projected to be living with dementia by 2050, it is crucial we identify ways of helping support people to live well at home, for as long as possible and for as long as they choose.

“A cost-benefit analysis conducted in 1997 of the original carer training indicated a saving to the health budget of $8850 per couple – which would mean savings of many millions of dollars for the public health system.”**

A/Prof Cunningham said the GTSAH program was particularly suitable to people in rural and remote areas, who did not have easy access to respite services, and also for people with younger onset dementia (YOD). Nearly a quarter of the participants in the program had younger onset dementia (YOD) and one program was specifically run for people with younger onset dementia and their carers.

The program was funded by the Aged Care Services Improvement and Healthy Ageing Grant from the Australian Department of Health.

About the Going to Stay at Home program

The Going to Stay at Home Program was developed based on a successful carers training program run at Prince Henry Hospital in the mid 1980s. The program provided a week-long residential training course, under residential respite arrangements, in groups of six at two locations (Tamworth, NSW and Miranda in Sydney) during 2014. Over 192 people were included in the trial. The aim of the trial was to improve knowledge, coping skills and capacity of family carers. For carers, the course covered topics like combating isolation, medical aspects of dementia, planning for the future, coping with changing life roles, nursing skills, nutrition, exercise, communication and how best to use community services. The program for people with dementia included focusing on sensory stimulation, environmental orientation, ‘brain training’, physical activity, reminiscence, self-expression, creativity, social interaction and relaxation. Couples were assessed prior to the program, and then followed-up at six and 12 months.

* Time to permanent placement in aged care homes of GTSAH participants with dementia was compared with people with dementia in receipt of HammondCare residential or cottage respite (without the carer training component).

**Brodaty, H., Gresham, M., Luscombe, G. (1997). International Journal of Geriatric Psychiatry Feb 12 (2): 183-192