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P2‐019: IMPROVING CARE FOR FALLS IN DEMENTIA: DEVELOPMENT OF THE DIFRID INTERVENTION
Author(s) -
Allan Louise M.,
Wheatley Alison,
Bamford Claire
Publication year - 2018
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1016/j.jalz.2018.06.703
Subject(s) - intervention (counseling) , context (archaeology) , dementia , nursing , delphi method , focus group , multidisciplinary approach , health care , psychology , psychological intervention , observational study , medicine , computer science , sociology , political science , paleontology , social science , disease , pathology , artificial intelligence , anthropology , law , biology
Background:People with dementia living in their own home experience ten times as many incident falls than people without dementia (Allan et al., 2009). Little is known about how best to deliver services to people with dementia following a fall. This study aimed to develop an intervention to improve care for this patient group following a fall requiring healthcare attention. Methods:We used an integrated, mixed-methods approach to intervention development which combined theory generated via a realist synthesis and data on current provision and pathways gathered through a prospective observational study as well as qualitative interviews, focus groups, and ethnographic observation. We developed a set of Context-Mechanism-Outcome configurations (CMOcs) which theorise how the composition of an intervention may help to address the specific challenges of rehabilitation with PWD following a fall. Consensus on how this theory should translate into a new interventionwas achieved through use of amodified Delphi panel approach with a group of 24 experts. Results:The CMOcs developed for the intervention covered three broad areas: Ensuring that the circumstances of rehabilitation are optimised for PWD; compensating for the reduced ability of PWD to self-manage; and equipping the workforce with the necessary skills and information to care for this patient group. Consensus was achieved on 52 statements over two rounds of surveys. The statements were compiled and used to model the intervention and finalise the protocol for a feasibility study and the intervention manual. The intervention will be a complex multidisciplinary intervention taking place mainly in the patient’s home over a period of 12 weeks. Conclusions: This intervention has the potential to improve outcomes of falls in people with dementia. It is now being tested in a feasibility study.