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Improving Care for Falls in Dementia: Development of the Difrid Intervention

Lookup NU author(s): Dr Louise Allan, Claire BamfordORCiD, Dr Alison WheatleyORCiD


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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 intervention was achieved through use of a modified 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 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 draft 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.

Publication metadata

Author(s): Allan L, Bamford C, Wheatley A

Publication type: Conference Proceedings (inc. Abstract)

Publication status: Published

Conference Name: Alzheimer's Association International Conference (AAIC)

Year of Conference: 2018

Online publication date: 23/07/2018

Acceptance date: 02/04/2018

Publisher: Alzheimer's Association