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Systematic care for caregivers of people with dementia in the ambulatory mental health service: designing a multicentre, cluster, randomized, controlled trial

DOI: 10.1186/1471-2318-9-21

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Abstract:

In our ongoing, cluster, randomized, single-blind, controlled trial, the participants in six mental health services in four regions of the Netherlands have been randomized per service. Professionals of the ambulatory mental health services (psychologists and social psychiatric nurses) have been randomly allocated to either the intervention group or the control group. The study population consists of community-dwelling people with dementia and their informal caregivers (patient-caregiver dyads) coming into the health service. The dyads have been clustered to the professionals. The primary outcome measure is the patient's admission to a nursing home or home for the elderly at 12 months of follow-up. This measure is the most important variable for estimating cost differences between the intervention group and the control group. The secondary outcome measure is the quality of the patient's and caregiver's lives.A novelty in the SCPD is the pro-active and systematic approach. The focus on the caregiver's sense of competence is relevant to economical healthcare, since this sense of competence is an important determinant of delay of institutionalization of people with dementia. The SCPD might be able to facilitate this with a relatively small cost investment for caregivers' support, which could result in a major decrease in costs in the management of dementia. Implementation on a national level will be started if the SCPD proves to be efficient.NCT00147693Estimates state that the rapidly aging western European population will peak at about 2040 [1]. An aging population demands more healthcare and challenges the healthcare budget. Two-thirds of the people with dementia (also referred to as "patients" in this study protocol) are cared for at home [2]. Care at home is often intensive and burdensome. Informal caregivers of these patients carry a greater burden than informal caregivers of other chronically ill people [3], and they are at a greater risk of depression [4-6]. The

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