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“An evidence-based programme for care home residents living with dementia improved their quality of life and reduced agitation and other symptoms of dementia. A major study across the UK found that the Well-being and Health for People Living with Dementia (WHELD) programme was effective and cost less to deliver than usual care.

The WHELD programme supports care home staff to deliver patient-centred interventions for residents with dementia. It seeks to reduce reliance on antipsychotic drugs and uses social interaction, personalised activities and exercise to improve care.

Most person-centred interventions used in care homes are not based on scientific evidence. WHELD was tested in a large clinical trial, which showed that it improved quality of life for people with dementia. The programme also reduced agitation and the overall burden of neuropsychiatric symptoms such as depression or aggression.  A reduction in the number of hospital and GP visits made the approach less expensive to deliver than usual care.

What’s the issue?

A third of people with dementia in the UK (288,000) live in care homes. Those in care homes tend to have more severe dementia than those living in the community. Agitation and a range of other behavioural and psychological symptoms make it challenging to care for these people.

Person-centred care is the gold standard of care for people with dementia. Yet previous research has found that many care home residents have as little as two minutes of social interaction each day. There is currently no effective, evidence-based intervention to help staff care for these patients without using drugs.

In the first stages of this programme, researchers reviewed 40 studies on psychosocial interventions for people with dementia in care homes. These studies supported the use of person-centred approaches such as reminiscence therapy, in which photographs or other mementoes are used to help someone recall life events and memories. Walking, seated exercise, circle dance or other pleasant activities of the person’s choice were also found to help.

The researchers then looked at training manuals for person-centred care in dementia. Only four out of 170 manuals described interventions with proven benefits.

The team developed the first version of the WHELD programme based on the most practical and effective therapies. It combined person-centred care, management of agitation and non-drug approaches. A first randomised controlled trial tested this version of WHELD in 16 care homes over a period of nine months. It found that reviews of antipsychotic medication halved the use of these drugs. This increased the behavioural and psychological symptoms of dementia unless the medication review was combined with personalised activities. The combination of review plus social interaction significantly improved quality of life and reduced the risk of dying among people with dementia by 30%.  Exercise reduced symptoms of agitation.”

For more details on this programme click here

The NIHR Research Design Service South Central are offering an Essential Guide to Grant Applications masterclass.

The masterclass on writing a convincing funding application with good structure, flow and argument will take place online from Tuesday 2nd to Thursday 4th March 2021.

You can register your interest for on our Eventbrite page

Two opportunities are currently being advertised:

“Opportunity 1

Expressions of interest are invited from senior social care colleagues who are interested in developing social care research in the region.  This one-year post will enable a senior social care colleague to undertake one session (one half day) per week of dedicated research activity.  You will work closely with other members of the project including, an academic colleague from the University of Lincoln (CRN speciality lead for Health Services Research), a fixed term Research Associate, the CRN East Midlands and relevant stakeholders.

The main focus of the post is to understand the research agenda within social care, identify key research priorities and consider how they can translate into NIHR CRN portfolio research.  The role will facilitate connections between academic partners and relevant stakeholders, leading to the development of a network of stakeholders.

Click here for details on submitting an expression of interest.

Opportunity 2

Applicants are invited for a Research Associate for a period of one year to contribute to the development of the social care research culture and research capacity in the area.

Working closely with colleagues from the University of Lincoln and the CRN, the post holder will contribute to a shift change in the priority given to social care research and the achievement of funded research within the region.  The post holder will develop an understanding of the landscape of social care in Lincolnshire and establish a group of key stakeholders who will contribute to the development of social care research awareness and potential research priorities. In order to improve capacity for driving research developments in agreed priority areas the post holder will network and collaborate with social care providers, academic partners and research forums and organisations within the region.”

For more information click here

If any of our ENRICH homes are interested in finding out more, please contact Mo Ray (mray@lincoln.ac.uk) for an informal discussion – this is a wonderful opportunity to help shape social care research in our area.

The National Institute for Health Research are funding exciting new pre-doctoral opportunities for Local Authority and LA commissioned service based individuals.

“This pilot scheme is being designed, alongside a companion pre-doctoral fellowship scheme, to support individuals based in local authorities or local authority commissioned services to develop as health and/or social care researchers.
The scheme will fund individuals of any profession to obtain a PhD by research whilst concurrently developing their professional skills within their existing employment.
Although full details have yet to be formalised, this scheme will be fully salaried and mirror the HEE/NIHR Integrated Clinical Academic (ICA) Programme’s doctoral scheme. Prospective applicants should refer to the applicant guidance documentation for that scheme in the interim, ignoring the ICA specific eligibility criteria that pertain to professional status and clinical (as opposed to broader professional) practice.
Eligibility for support will be dependent on a proposal that includes a partnership with, or employment by, a local authority or local authority commissioned service.
This new funding represents a completely new and exciting opportunity for all individuals based within local authorities or local authority commissioned services, but especially for those without social worker or clinician status. Local authority associated clinicians and social workers are welcome to apply for support from this focussed scheme or from the ICA Programme, but cannot apply to both concurrently.”

Indicative timescales

Application forms available: 1 March 2021
Deadline for application submission: Late April 2021
Award uptake by successful applicants: From 1 April 2022
For more information click here

The National Institute for Health Research are funding exciting new pre-doctoral opportunities for Local Authority and LA commissioned service based individuals.

“This pilot scheme is being designed, alongside a companion doctoral fellowship scheme, to support individuals based in local authorities or local authority commissioned services to develop as health and/or social care researchers.
The scheme will fund individuals of any profession to undertake Masters level academic training and prepare an application for a doctoral fellowship whilst retaining their existing employment and practice.
Although full details have yet to be formalised, this scheme will be fully salaried and mirror the HEE/NIHR Integrated Clinical Academic (ICA) Programme’s pre-doctoral scheme. Prospective applicants should refer to the applicant guidance documentation for that scheme in the interim, ignoring the ICA specific eligibility criteria that pertain to professional status and clinical (as opposed to broader professional) practice.
Eligibility for support will be dependent on a proposal that includes employment by a local authority or local authority commissioned service.
This new funding represents a completely new and exciting opportunity for all individuals based within local authorities or local authority commissioned services, but especially for those without social worker or clinician status. Local authority associated clinicians and social workers are welcome to apply for support from this focussed scheme or from the ICA Programme, but cannot apply to both concurrently.”

Indicative timescales

Application forms available: 28 January 2021
Deadline for application submission: 18 March 2021
Award uptake by successful applicants: from 1 September 2021
For more information click here

An NIHR study reports that care home residents on multiple medications have an increased risk of falling.

“The research, which included 84 UK care homes, found that residents taking multiple medicines had an increased risk of falling. Risk was also increased with a regular prescription for antidepressants or benzodiazepines (sedative drugs).

Two-thirds of the residents in the study were living with dementia. Researchers suggest that care homes should emphasise non-drug approaches such as massage, music or art therapies. These interventions could help residents with depression and common symptoms of dementia such as agitation or sleep disturbance.

What’s the issue?

When older people fall, they can sustain serious and life-threatening, or life-changing, injury. Those living in care homes are three times more likely to fall than those living in their own homes.

One explanation could be the medication commonly taken by care home residents. Combinations of drugs could increase risk, as could medicines that act on the brain. This includes medications for depression, anxiety, and the behavioural and psychological symptoms of dementia.

What’s new?

This study is a more detailed analysis of the (as yet unpublished) Falls in Care Homes (FinCH) study in which researchers analysed care and medication records of residents at 84 UK care homes.

They included 1,655 people with an average age of 85. Two-thirds of the participants were women.

Two-thirds of those surveyed had dementia and on average, each resident was taking six different drugs. About half (816) took regular medications that act on brain.

The study found that the number of regular drugs prescribed was an independent risk factor for falling. Taking more than one regular drug that acts on the brain, such as an antidepressant or sedative, also increased risk. However, the study did not find a link between falls and antipsychotic drugs.

Over a three-month period, the study found that:

  • almost one in three residents (519 or 31%) had one or more falls
  • the risk was higher in those taking antidepressants and sedatives
  • older residents were more likely to fall than their younger counterparts
  • men had more falls than women
  • residents with dementia had 75% more falls than those without dementia.

Even when age, gender and a diagnosis of dementia were taken into account, the link between medication and falls remained.

For every additional drug prescribed, the chances of falling increased 1.06 times. This means that for 100 falls in people taking no drugs, there would be 106 falls in people taking one drug, 112 among people taking two drugs, and 118 among people taking three.

Why is this important?

This is a large study, which is representative of the UK care home population.  It concludes that antidepressants and benzodiazepines should be used only when absolutely necessary and stopped as soon as possible. Multiple drug-taking should be kept to a minimum.

The study did not include the duration of drug taking, or other conditions such as arthritis that may have reduced individuals’ stability.

But the findings suggest that alternative, non-drug-based therapies based upon the principles of “person centred care” would be safer. Adequate training and staffing levels in care homes will be needed to support non-drug approaches to depression and to symptoms associated with dementia.

The researchers emphasised that their findings should not be interpreted to conclude that antipsychotics are safe, but simply that this study did not find an associated risk of falls.

This study supports current NICE guidance on the association between drug use and falls in older people, and it provides newer data.

What’s next?

Non-drug approaches to depression and the symptoms of dementia are not commonly in place in care homes. The researchers say more work is needed to develop and evaluate new behavioural strategies.

But they believe a move towards alternative approaches will lead to a more multidisciplinary approach to prescribing and a reduction in the medication given to care home residents.”

This study used data from a project that was funded by the NIHR under its Health Technology Assessment (HTA) programme.

“The NIHR Doctoral Fellowship funds individuals from a range of health and social care professions to undertake a PhD in an area of NIHR research.

The Fellowship funds:

  • full salary support, including protected time to concentrate on research
  • PhD fees and research costs
  • a bespoke training and development programme to meet individual needs

Applicants from clinical or social care practice are able to include up to 20% clinical time as part of the Fellowship, to ensure the maintenance of their clinical competence whilst undertaking the Fellowship.

Full details of the remit of research funded by the NIHR and eligibility criteria can be found in the guidance notes.”

Click here for more details

“The NIHR Advanced Fellowship funds post-doctoral individuals from a range of health and social care professions who haven’t yet been awarded a chair. Whether you are someone who has recently been or about to be awarded a PhD, or someone with several years of post-doctoral experience, you could be eligible to apply for an Advanced Fellowship.
The Fellowship funds:
  • full salary support, including protected time to concentrate on research
  • research costs
  • a bespoke training and development programme to meet individual needs
Applicants who are active clinicians or social workers can request for up to 40% of their time to be dedicated to clinical service/development/practice, which will be covered by the Fellowship.
Full details of the remit of research funded by the NIHR and eligibility criteria can be found in the guidance notes.”
Click here for more details

The next Home Care Research Forum (HCRF) meeting will take place on Wednesday 25th November 2pm – 3.30pm. This will be a virtual forum using Zoom. 

“The following speakers are presenting at this event: 

  • Dr Tushna Vandrevala & Dr Emma O’Dwyer (Kingston University) – Job satisfaction and well-being for live-in carers: Why we need to start thinking about their personal identity
  • Alex Thomas and Diana Jablonskyte (Saint Michael’s Hospice) – Hospice at home service

This event is free and open to all, however, booking is essential. If you would like to attend please e-mail laura.cole@kcl.ac.uk  to book a place and receive the Zoom link.”

Please tweet using #hcrf @adalinecole

NIHR School for Public Health Research (SPHR)

Call Launch Date: 08 October 2020

“The renewed SPHR will conduct world-leading research in public health which responds to and meets the needs of local populations, local government, public health bodies and public health practitioners, and which addresses the nation’s changing demographics and priority areas for public health research. The renewed school will aim to continue to strengthen research in public health more broadly, build capacity and fund groundbreaking, internationally relevant research that is key to improving public health policy and practice.

There is a strong emphasis within the application for the renewed school on how the potential members have previously contributed to improvements and changes to public health policy and practice and how they intend to fund and support novel and ambitious research projects, programmes and schemes; as well as developing research capacity and supporting the next generation of future leaders spanning academic and practice research.

From 1 April 2022 and for a five year period, funding of at least £25 million will be available to support the school in these functions for both the research and capacity building contracts that the school will deliver.

Stage 1 deadline for submission: Thursday, 28 January 2021 at 1:00pm

Stage 2 (if selected at Stage 1) – Business plan development May/June 2021″

To apply click here