Extrait

Background and study aims There are approximately 700,000 people with dementia in the UK, many of whom will require nursing or residential care home accommodation when their illness has progressed to the point at which they can no longer live independently in their own homes with safety. Living Well with Dementia - the theme of the 2009 National Dementia Strategy for England involves helping people with dementia to maintain their independence within their own homes and ensuring that the quality of their lives are maintained. The loss of independence and quality of life associated with the transition to living in a Care Home are apparent, and the NHS and Social Services support of sufferers to live safely in their own homes for as long as possible are beneficial to this. Assistive Technology and Telecare, when individually tailored to a patient's needs and integral to their careplan, offer a way in which the home of a person with dementia can be made safer for them by reducing the specific risks associated with the memory and orientation difficulties that accompany the illness. Particular risk to continued independence, such as wandering away from home in the middle of the night and becoming lost or setting fires with forgotten pans on the cooker or cigarettes put down in unsafe places, can be tackled by specific pieces of technology, linked to a 24-hour response centre. While it might seem obvious that such interventions are beneficial, only a well conducted clinical trial can provide high quality evidence that these technologies really do help to maintain independent living for people with dementia. We aim: To establish whether assistive technology and telecare interventions safely extend the time that people with dementia can continue to live independently in their own homes and whether this is cost-effective. To establish whether these technologies can significantly reduce the number of incidents involving serious risks to safety and independent living, including acute admissions to hospital, reduce stress in family and other informal caregivers and increase quality of life for dementia sufferers and their caregivers. To collect qualitative and quantitative data from dementia sufferers and their formal and informal caregivers and members of the NHS and Social Services teams who care for them about the experience of receiving these technologies. Who can participate? Older adults with memory difficulties and a fair Access to Care Services assessment that indicates significant need. What does the study involve? Participants will be visited at home where an assessment will be made to see how electronic devices could possibly help. Questions will be asked about the health of the participant and the services they use, and the carer will also be asked about their own health. After this we will arrange for the devices to be installed and arrange occasional follow-up visits over the next two years. What are the possible benefits and risks of participating? The main benefit of taking part is the participant knowing that this research will help us to treat people like them more effectively in the future. The devices they are given may help to support them better at home, and if the participant is put into the group which is offered the wider range of newer devices this may mean that fewer home visits from carers are needed. The carer could be helped as they may have less concerns about harm coming to the person they care for. Controlled trials carry potential risks of negative consequences for participants, since some participants will be forgoing access to a potentially beneficial component of care during the duration of the trial. The electronic devices may not work properly, or may not meet the needs of the person you care for in the right way. Electronic devices may support people in a way which means that they need fewer visits from care workers. This might cause some people to feel less supported or lonelier. We do not know whether there will be any difference between the standard and newer devices in this regard. It is important to note that, in either group, if the care and support the person you care for receives does not adequately meet their needs, it will have to be changed and they may not be able to stay in the study. Where is the study run from? The study is based at the Institute of Psychiatry, King’s College London, but research workers and Principle Investigators will be based at the participating sites across the country. When is the study starting and how long is it expected to run for? The trial will begin in January 2013 and will run for four years. Who is funding the study? The Department of Health’s Health Technology Assessment programme. Who is the main contact? Rebecca Gathercole [email protected]

Critère d'inclusion

• Mental health, neurology and aging

Liens

• isrctn
• ictrp