We missed the announcement by the Department of Health (DH) just before Christmas about the UK’s first ever trial (‘The ATTILA Trial’) to measure how much longer people with dementia can live safely and independently in their own homes when they are provided with a specialised telecare package. Kings College London and sites in London, Birmingham, Manchester, Newcastle, Oxford and Norwich will be involved in a £1.8m four-year randomised controlled trial, with publication expected in…2018. DH announcement. Trial details here and here. Heads-up thanks to Celia Price of JustChecking.
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Let’s hope that they learn from the mistakes made in the telecare/telealth WSD projects.
I have particular concerns about the way that “volunteers” will be recruited, assessed, matched, and then prescribed with AT products and services. Every individual will be different not only with respect to their cognitive loss but also their family support, their coping mechanisms, their dexterity, their functional capabilities and their education level.
To optimise the impact of telecare, the researchers will need to select very carefully between both models of telecare delivery and the actual devices available. There are very few professionals who can do this – let’s hope that they will be included in the study and that the packages that will be offered will be personalised – and that means bespoke solutions NOT an offering based on the catalogue of a single supplier!
I share Jo’s concerns in this and the more I contemplate it the bigger that fear is. There is a tendency to think of dementia as a fixed set of conditions – forgetting, wandering, sundowning – but it is so very variable in its impact. It is also variable in the speed of decline so it will be difficult to effectively be sure that any intervention has had a quantifiable outcome.
Why the focus on cities – what about the potential for those with dementia in small communities and rurally?
And we have to wait 5 years for the results … which people will be doubtful about as Jo has outlined. I would prefer to see that money being used to establish best practice, personalised, AT dementia supports.
Oh and the name – sorry that conjures up completely the wrong image for me!
The neighbour that brings the cooked lunch around, unnoticed by any care provider, everyday and the ten minutes chatting with the person is what assists in keeping them out of residential care.
Jeremy Kyle, Loose Women and Emmerdale (how do I know these titles anyway?) are what orientates them to day and time as well as the calendar clock and memo minder.
The photographs of them as young children and adults keeps them safe in the knowledge that this is ‘home’ as well as the memory prompts and smart tablet apps.
I think differentiating one set of factors with so many variables is a very difficult one to prove. Our continuing and expanding knowledge and evidence base of this condition enables our services across the board to help people deal with dementia more effictively as a holistic approach. To segregate one aspect and concentrate on its benefits in order to show that it is the one thing that helps is to diminish the work of so many others.
Look at it as a whole system (ooh) and show that’s worth. Bit hard that though, innit?