Abstract
BackgroundA dementia diagnosis can prevent people from participating in society, leading to a further decline in cognitive, social and physical health. However, it may be possible for people with dementia to continue to live meaningful lives and continue to participate actively in society if a supportive psychosocial environment exists. Resilience theory, which focuses on strengthening personal attributes and external assets in the face of serious challenges, may provide a scaffold on which an inclusive multifaceted psychosocial supportive environment can be built. This protocol paper describes a study to determine the feasibility of conducting a multifaceted complex resilience building psychosocial intervention for people with dementia and their caregivers living in the community.MethodsThis is a non-randomised feasibility study. Ten participants with dementia and their primary caregivers living in the community will be recruited and receive the CREST intervention. The intervention provides (a) a 7-week cognitive stimulation programme followed by an 8-week physical exercise programme for people with dementia and (b) a 6-week educational programme for caregivers. Members of the wider community will be invited to a dementia awareness programme and GP practices to a dementia training workshop. Trained professionals will deliver all intervention components. Outcomes will assess the feasibility and acceptability of all study processes. The feasibility and acceptability of a range of outcomes to be collected in a future definitive trial, including economic measurements, will also be explored. Finally, social marketing will be used to map a route toward stigma change in dementia for use in a subsequent trial. Quantitative feasibility outcome assessments will be completed at baseline and after completion of the 15-week intervention while qualitative data will be collected at recruitment, baseline, during and post-intervention delivery.ConclusionThis feasibility study will provide evidence regarding the feasibility and acceptability of a comprehensive multifaceted psychosocial intervention programme for people with dementia and their caregivers (CREST). The results will be used to inform the development and implementation of a subsequent RCT, should the findings support feasibility.Trial registrationISRCTN25294519 Retrospectively registered 07.10.2019
Highlights
A dementia diagnosis can prevent people from participating in society, leading to a further decline in cognitive, social and physical health
We interviewed a sample of people with mild-moderate dementia (n = 6) [23], carers (n = 28) [24] and 12 informal caregivers/care partners [25]
The evidence drawn from 22 reviews evaluating 197 studies indicated that both group cognitive stimulation therapy and physical exercise have recognisable benefits for people with dementia. Utilising this evidence and drawing on the expertise of the research team, we identified three successful psychosocial interventions, namely, cognitive stimulation, physical exercise and education, which we hypothesised could be combined to create a novel multifaceted psychosocial resilience-building intervention simultaneously targeting the personal attributes and external assets of people with dementia
Summary
A dementia diagnosis can prevent people from participating in society, leading to a further decline in cognitive, social and physical health It may be possible for people with dementia to continue to live meaningful lives and continue to participate actively in society if a supportive psychosocial environment exists. This diagnosis can lead to marginalisation within the health services [9] and may prevent people with dementia from participating in society [8, 10] It may be possible for people with dementia to continue to live a meaningful life, retain many abilities and continue to actively participate in society, if there is a supportive psychosocial environment that maximises functioning and social connectedness [5, 11, 12]. Resilience theory is promising as it focuses upon strengthening people’s resources in the face of serious challenges and difficulties [13], and may, by enhancing people’s strengths and valued relationships, provide a scaffold upon which an inclusive supportive psychosocial environment can be built
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