Focused Intervention Training and Support (FITS)
Alzheimer's Society is rolling out an evidence based training programme for care home staff to reduce the use of antipsychotic drugs in people with dementia. The programme is being rolled out to over 100 care homes with the support of the Department of Health, the University of Worcester and HC-One care homes.
Many people with dementia develop behavioural and psychological symptoms. These symptoms can be a result of the care a person is receiving, their environment and social interactions. Antipsychotics are a group of medications that are commonly used to treat these symptoms in people with dementia.
In some cases, these drugs can have a short term beneficial effect. However, they can result in serious side effects including sedation, reduced mobility, falls, worsening of dementia symptoms and increased risk of stroke and death.
The Department of Health reviewed the use of antipsychotic drugs for people with dementia and concluded that two-thirds of prescriptions are inappropriate; the government has made a commitment to substantially reduce the use of antipsychotic drugs in people with dementia in the UK.
FITS training programme
Alzheimer's Society researchers have developed the 'Focused Intervention Training and Support' (FITS), an evidence-based training programme designed for care home staff. The programme aims to train staff to deliver person-centred care to help safely manage behavioural symptoms as an alternative to using medication.
A research study previously funded by the Society was designed to test whether the FITS programme could reduce the need for people to be treated with antipsychotic drugs. The study was carried out over a period of nine months across 12 care homes.
The programme was shown to successfully reduce the use of antipsychotics by 40% in comparison to usual care, without worsening behavioural symptoms.
Implementation study - FITS into Practice
FITS into Practice has scaled up the FITS training programme and delivered it to staff from 106 care homes across the country. The key findings of the national study were:
- Improvements in knowledge and attitudes of care home staff
- A 30 per cent reduction in the use of antipsychotic medications with residents
- Residents were more alert, active and communicative
- There were improvements in the physical environments of the care homes, care staff experience, and relationships with family and external professionals
- Almost 40 per cent of the care homes in the study didn't complete the training, due partly to competing time pressures and high staff turnover within homes (only 67 of the care homes completed the training in full)
- Successful implementation of training required protected time for staff to put learning into practice, a supportive management and organisational structure and stability within staff teams.
FITS training is feasible to deliver on a large scale, reduces the prescription of inappropriate antipsychotics and empowers teams to work in a person-centred way. Provided that the right facilitators are in place, it is a valid way to improve quality of life for people with dementia in care homes.