Understanding what makes good dementia friendly initiatives in health care

Lead Investigator: Professor Claire Goodman

Institution: University of Hertfordshire

Grant type: PhD studentship

Duration: 3 years

Amount: £79,240

Scientific Title: A realist evaluation of interventions that support the creation of dementia friendly environments in health care.

Why did we fund this project?

Comments from members of our Research Network:

'An excellent step forward into good research, very needed research for all patients with dementia and all mental health needs.'

'The provision of supportive, dementia-appropriate care across health and social care services is a huge issue and it is encouraging that the problem is being seriously addressed.'

'I consider that this research will greatly assist people with dementia, their carers and the health care services.'

What do we already know?

The experience of people with dementia and their carers is adversely affected when health care services fail to provide dementia-appropriate advice, care and ongoing support. This is a situation that is made worse when the person with dementia has additional health needs. Many people diagnosed with dementia have other co-existing medical conditions and consequently, people with dementia and their carers often need to use a range of health care services in addition to those that focus on dementia care.

NHS Organisations and professionals have not always had the awareness or knowledge to ensure that how and where they provide care takes into account the needs of someone with dementia. A recent study found that people with dementia were more likely to spend longer in Accident and Emergency departments than people with similar problems and of an equivalent age but who did not have dementia. 

To address this issue, hospitals and other NHS organisations have developed strategies and guidelines, invested in staff training, dementia-friendly design and appointed Dementia Champions across the workforce whose role is to support good practice. The picture across the country is variable. Little is known about why some organisations and professionals are more successful than others in engaging with dementia-friendly initiatives. More information is needed about what supports and sustains the uptake of these initiatives, their effectiveness and cost, and how success is, and should be, defined and measured.

What does this project involve?

This project aims to:

  • Understand what key factors or mechanisms support the development of dementia-friendly initiatives and their uptake
  • Develop a framework to evaluate their impact for people with dementia, their carers and the wider community.

To do this, the researchers will investigate what is currently available within the research literature on different initiatives and how effectiveness is measured within these, and identify different locations within the NHS where dementia-friendly initiatives have been adopted. 

The researchers will use a variety of techniques to understand what affects the success of these initiatives, and so develop an evaluation framework to help with the development of dementia-friendly initiatives in the future.

How will this benefit people with dementia?

Dementia is often viewed by health care professionals as an isolated condition, but people with dementia often have multiple health care needs. These other health needs are sometimes obscured by the dementia diagnosis. 

It is important to understand what are the most effective and efficient ways of increasing awareness and understanding of dementia across the health care service. 

The findings will inform planning and commissioning of services for people with dementia and their carers, it will contribute to an understanding of how effectiveness can be measured from the perspective of both the service and people with dementia and their carers. It also has potential to inform future work and commissioning of services to support a public health agenda for dementia.