Achieving Quality and Effectiveness in Dementia Using Crisis Teams (AQUEDUCT)
Description: In the UK over 700,000 older people have dementia. This has major impact on services (costing over £17 billion a year) and family carers (who save the UK over £6 billion of further costs a year). Dementia research is a national priority and home-orientated care is a key objective of the National Dementia Strategy. People with dementia prefer to remain at home but fluctuations in their health and social circumstances require skilled management to prevent breakdown in their care. In recent years, crisis teams to help people with dementia be supported at home have been rapidly developing, and now form an important part of mental health services for older people. Managing crises at home can increase the skills of staff, family carers, and people with dementia enabling them to avoid (or delay) hospitalisation or long term care, and reducing costs. Admission to hospital can increase confusion and carries risks of over medication and poor quality care. We talked to many people with dementia, family carers, and staff about crises and how to manage them. They described current systems as a 'muddle' and welcomed a study to provide a more coordinated, proven approach. We reviewed the research literature and current practice but found little evidence on managing crises in dementia and no best practice guidance for crisis teams. We have already developed a Home Treatment Protocol and manual that teams can use to help manage crises, for people with dementia and their family carers. The proposed study works with family carers, people with dementia and staff to develop a model of best practice for dementia crisis teams. We will develop a Resource Kit for achieving high quality care including: Home Treatment Protocol; training and guidance on achieving best practice for dementia crisis teams. We will get feedback on the Resource Kit to improve it. We will carry out a clinical trial for people with dementia referred to dementia crisis teams. Half of the teams will use the Resource Kit and half will provide usual care. At three and six months we will compare the number of hospital admissions, quality of life, satisfaction with services, and costs of care for people using the Kit with those who do not. We will follow national ethics guidance for including people with dementia and carers in research. The research team includes leading experts in dementia care research (eg psychiatry, psychology, research methods) who have significant experience leading major studies. This study could lead to major improvements in how services are organised which could have major benefits for people with dementia and their carers to help avoid hospital admissions, improve satisfaction with services and quality of life, and reduce costs of care.
Amount: £2,092,000
Funding type: research
Funder scheme: Programme Grants for Applied Research
Start date: 2014-09-15
End date: 2023-11-30
Investigator: Martin Orrell (lead)
Institution: Nottinghamshire Healthcare NHS Foundation Trust
Funded outputs count: 18
Funder award ID: RP-PG-0612-20004
OpenAlex ID: G618682426