Colleen Doyle

This study examined the impact of befriending on depression, anxiety, perceived social support and loneliness in older people living in residential aged care homes. A pragmatic randomized controlled trial compared depressive symptoms (Geriatric Depression Scale-15), anxiety symptoms (Geriatric Anxiety Inventory), loneliness (UCLA loneliness scale), and perceived social support (Lubben Social Network Scale) measured at baseline, 8 weeks and 16 weeks post baseline for people randomized to receive either befriending or usual care. Trial registration ANZCTR N12619000676112. Among N = 345 participants, a significant reduction in depressive symptoms for people receiving befriending compared to the control group: 0.76 points lower on GDS at 8 weeks and 0.95 lower at 16 weeks (Cohen's d = -0.458). Loneliness (UCLA) was 2.39 units lower than the control group at 8 weeks and 2.71 units lower at 16 weeks (Cohen's d -0.481). There was no significant difference for anxiety symptoms or perceived social support. Befriending led to a small improvement in depressive symptoms and loneliness in older people living in residential aged care. The improvement in depressive symptoms and loneliness indicates that befriending may be a useful supplement to psychological services for those living in residential aged care.

Depression and cognitive impairment are disabling conditions that commonly occur together in older adults. The interaction is challenging when choosing appropriate measurement scales. This review a...

Background: With increasing numbers of people living with dementia relying on family to care for them at home, there is an urgent need for practical and evidence-based programs to support carers in maintaining their mental health and well-being. The objective of this study was to evaluate the acceptability and feasibility of a modified STrAtegies for RelaTives (START) program delivered online (START-online). Method: A mixed-methods non-blinded evaluation of START-online (using Zoom as videoconferencing platform) for acceptability and feasibility (completion rates and qualitative feedback through surveys and focus groups) and quantitative evaluation. This occurred at the National Ageing Research Institute, in metropolitan Victoria, Australia. Results: Twenty-nine eligible carers were referred, 20 (70%) consented to the study. Of these, 16 (80%) completed all 8 sessions, 2 completed only 3 sessions, and 2 withdrew. Carers’ qualitative feedback indicated that the therapist interaction was valued, content and online delivery of the program was acceptable. Feedback was mixed on the appropriate stage of caring. Conclusion: START-online was feasible and acceptable for carers, including those living outside of metropolitan areas who might otherwise be unable to access face-to-face programs. With the recent COVID-19 pandemic necessitating social distancing to avoid infection, interventions such as this one have increasing relevance in the provision of flexible services.

To investigate electronic care notes to better understand reporting and management of neuropsychiatric symptoms (NPS) by residential aged care (RAC) staff.We examined semi-structured care notes fro...

Background: Our objective was to explore what people receiving and providing care consider to be ‘good’ in-home care for people living with dementia. Methods: We conducted 36 in-depth interviews and two focus groups with key stakeholders in Australia in the first quarter of 2018. Participants included those receiving care (4 people living with dementia, 15 family carers) or providing care (9 case managers, 5 service managers, 10 home care workers). Qualitative thematic analysis was guided by Braun and Clarke’s six-step approach. Results: Consensus was reached across all groups on five themes considered as important for good in-home dementia care: 1) Home care workers’ understanding of dementia and its impact; 2) Home care workers’ demonstrating person-centred care and empathy in their care relationship with their client; 3) Good relationships and communication between care worker, person with dementia and family carers; 4) Home care workers’ knowing positive practical strategies for changed behaviours; 5) Effective workplace policies and workforce culture. The results contributed to the co-design of a dementia specific training program for home care workers. Conclusions: It is crucial to consider the views and opinions of each stakeholder group involved in providing/receiving dementia care from home care workers, to inform workforce training, education program design and service design. Results can be used to inform and empower home care providers, policy, and related decision makers to guide the delivery of improved home care services. Trial registration: ACTRN 12619000251123.

Background: Home care service providers are increasingly supporting clients living with dementia. Targeted and comprehensive dementia-specific training for home care staff is necessary to meet this need. This study evaluates a training programme delivered to care staff (paid personal carers) of clients living with dementia at home. Methods: This study is a pragmatic stepped-wedge cluster-randomised controlled trial (SW-CRT). Home care workers (HCWs) from seven home care service providers are grouped into 18 geographical clusters. Clusters are randomly assigned to intervention or control groups. The intervention group receives 7 h of a dementia education and upskilling programme (Promoting Independence Through quality dementia Care at Home [PITCH]) after baseline measures. The control group receives PITCH training 6 months after baseline measures. This approach will ensure that all participants are offered the program. Home care clients living with dementia are also invited to participate, as well as their family carers. The primary outcome measure is HCWs’ sense of competence in dementia care provision. Discussion: Upskilling home care staff is needed to support the increasing numbers of people living with dementia who choose to remain at home. This study uses a stepped-wedge cluster-randomised trial to evaluate a training programme (PITCH) for dementia care that is delivered to front-line HCWs. Trial registration: anzctr.org.au; ACTRN12619000251123. Registered on 20 February 2019.

This study is the first to obtain data on the prevalence of, contributors to, and supports required for, pandemic-related distress within the residential aged care sector in Australia. A nested mix...

Prospective memory (PM) is a critical determinant of whether a person is able to lead an independent life. Because PM declines in late adulthood, an important question is therefore whether, and if so, which types, of PM interventions might lead to meaningful benefits. In the present study, we randomly assigned older adults to one of four conditions, in three of which participants received a structured PM intervention (Restorative, Compensatory, and Combined Restorative and Compensatory); the fourth was an Active Control condition. The results showed that there were significant gains on the PM training task used for both the Restorative and Combined conditions. We then analyzed change in PM tasks that were independent of the PM training task (Near Transfer). Only the Combined condition led to post-training improvement. Finally, we analyzed performance on measures of untrained cognitive abilities and everyday functioning: Far transfer effects were not evident for any intervention. These data align with prior literature in showing that interventions that target a single cognitive ability do not reliably generate far transfer effects, and additionally extend our understanding of these effects in two important ways. Firstly, they indicate that, even when the memory challenges that older adults are most concerned about are the direct target of restorative training, transfer effects to untrained cognitive domains may be difficult to achieve. Secondly, they indicate that for older adults whose primary goal is to enhance PM function, combining Restorative and Compensatory approaches is an effective approach. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Background: This protocol describes an ongoing study of the impact of befriending on depression, anxiety and loneliness in older people living in residential aged care facilities in Australia. While systematic reviews of befriending have indicated positive benefits of befriending for people in a range of ages and settings, there have been no randomised controlled trials (RCTs) of befriending for older people living in residential aged care with depression and no studies of the cost effectiveness of befriending in residential aged care facilities (RACFs) in Australia. Methods and analysis: We are conducting a single blind pragmatic RCT comparing two groups of older people living in RACFs, one receiving an intervention consisting of weekly befriending for 4 months from a trained volunteer and the other receiving treatment as usual. Participants undergo eligibility screening for depression (GDS-15 ≥ 4) and cognitive impairment (GPCog ≥ 4) and assessments at three measurement time points: baseline prior to randomisation, 2 months post-baseline and 4 months post-baseline. The primary outcome measure is depression, and secondary outcome measures are anxiety, loneliness, social isolation and quality of life. The economic evaluation will take the form of a cost-utility analysis based on the outcome of quality of life. The primary and secondary outcomes will be analysed using negative binomial and logistic regressions utilizing the Generalised Estimating Equations approach. Discussion: To our knowledge, this is the first RCT evaluating the effectiveness of befriending on older people with depression living in residential aged care. It is expected that the befriending intervention will reduce the severity of depression symptoms experienced by older people living in residential aged care. If the intervention proves effective it may be incorporated into volunteer training programs and adopted as a way of supporting older people’s mental health. Trial registration: Trial registered with the Australian and New Zealand Clinical Trial Registry (ANZCTR) Number: ACTRN12619000676112, registered 06/05/2019 – retrospectively registered.