Cooper, Claudia; Zabihi, Sedigheh; Akhtar, Amirah; Lee, Teresa; Isaaq, Abdinasir; Le Novere, Marie; Barber, Julie; ... Duffy, Larisa; + view all Cooper, Claudia; Zabihi, Sedigheh; Akhtar, Amirah; Lee, Teresa; Isaaq, Abdinasir; Le Novere, Marie; Barber, Julie; Lord, Kathryn; Rapaport, Penny; Banks, Sara; Duggan, Sandra; Ogden, Margaret; Walters, Kate; Orgeta, Vasiliki; Rockwood, Kenneth; Butler, Laurie T; Manthorpe, Jill; Dow, Briony; Hoe, Juanita; Hunter, Rachael; Banerjee, Sube; Budgett, Jessica; Duffy, Larisa; - view fewer (2024) Feasibility and acceptability of NIDUS-professional, a training and support intervention for homecare workers caring for clients living with dementia: a cluster-randomised feasibility trial. Age and Ageing , 53 (4) , Article afae074. 10.1093/ageing/afae074.

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Abstract

Introduction: In the first randomised controlled trial of a dementia training and support intervention in UK homecare agencies, we aimed to assess: acceptability of our co-designed, manualised training, delivered by non-clinical facilitators; outcome completion feasibility; and costs for a future trial. // Methods: This cluster-randomised (2:1) single-blind, feasibility trial involved English homecare agencies. Intervention arm agency staff were offered group videocall sessions: 6 over 3 months, then monthly for 3 months (NIDUS-professional). Family carers (henceforth carers) and clients with dementia (dyads) were offered six to eight complementary, individual intervention sessions (NIDUS-Family). We collected potential trial measures as secondary outcomes remotely at baseline and 6 months: HCW (homecare worker) Work-related Strain Inventory (WRSI), Sense of Competence (SoC); proxy-rated Quality of Life (QOL), Disability Assessment for Dementia scale (DAD), Neuropsychiatric Inventory (NPI) and Homecare Satisfaction (HCS). // Results: From December 2021 to September 2022, we met agency (4 intervention, 2 control) and HCWs (n = 62) recruitment targets and recruited 16 carers and 16/60 planned clients. We met a priori progression criteria for adherence (≥4/6 sessions: 29/44 [65.9%,95% confidence interval (CI): 50.1,79.5]), HCW or carer proxy-outcome completion (15/16 (93.8% [69.8,99.8]) and proceeding with adaptation for HCWs outcome completion (46/63 (73.0% [CI: 60.3,83.4]). Delivery of NIDUS-Professional costs was £6,423 (£137 per eligible client). WRSI scores decreased and SoC increased at follow-up, with no significant between-group differences. For intervention arm proxy-rated outcomes, carer-rated QOL increased, HCW-rated was unchanged; carer and HCW-rated NPI decreased; DAD decreased (greater disability) and HCS was unchanged. // Conclusion: A pragmatic trial is warranted; we will consider using aggregated, agency-level client outcomes, including neuropsychiatric symptoms.

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