Dementia care improved by just one hour of social interaction each week

Increasing the amount of social interaction for people with dementia living in care homes to just one hour a week improves quality of life when combined with personalised care.

Bangor University's Dementia Services Development Centre at the School of Healthcare Sciences contributed to a large-scale trial led by the University of Exeter, King’s College London and Oxford Health NHS Foundation Trust, which found that the approach also saves money.

Previous research has found that in many care homes, residents have as little as two minutes of social interaction per day.

The new research, funded by the National Institute of Health Research and published today in the journal PLOS Medicine, upskilled key care home staff to deliver person-centred care. That involves simple measures such as talking to residents about their interests and involving them in decisions around their own care.

When combined with just one hour a week of social interaction, the programme improved quality of life and reduced agitation and aggression in people with dementia.

Professor Clive Ballard, of the University of Exeter Medical School, who led the research, said: “While many care homes are excellent, standards still vary hugely. We have previously found that the average amount of social interaction for people with dementia was just two minutes a day. It’s hardly surprising when that has a knock-on effect on quality of life and agitation.

The trial involved more than 800 people with dementia across 69 care homes in South London, North London and Buckinghamshire. Two ‘care staff champions’ at each home were trained over four day-long sessions, to deliver more personalised care and structured social activities. Importantly, the approach also saved money compared to standard care.  Researchers say the next key challenge is to roll out the programme to the 28,000 care homes in the UK to benefit the lives of the 300,000 people with dementia living in these facilities.

Dr Jane Fossey from the Oxford Health NHS Foundation Trust, said: “Taking a person-centred approach is about getting to know each resident as an individual - their interests and preferences - and reflecting these in all aspects of care. It can improve the lives of the person themselves and it can be rewarding for carers too. We’ve shown that this approach significantly reduces agitation and saves money. Rolling out the training nationwide could benefit many other people.”

The results are the findings of the Improving Wellbeing and Health for People with Dementia (WHELD) trial, the largest non-pharmacological randomised control trial in people with dementia living in care homes to date.

Dr Doug Brown, Director of Research at Alzheimer’s Society, said: “70% of people living in care homes have dementia, so it is vital that staff have the right training to provide good quality dementia care.

“A person-centred approach takes into account each individual's unique qualities, abilities, interests, preferences and needs. This study shows that training to provide this type of individualised care, activities and social interactions can have a significant impact on the well-being of people living with dementia in care homes. It also shows that this kind of effective care can reduce costs, which the stretched social care system desperately needs. 

“Alzheimer’s Society is committed to improving dementia care through research. That means getting interventions like this put into practice, and funding further research to improve the quality of life for people with dementia in their own homes, care homes and hospitals.”

The project included collaboration from University College London, the London School of Economics, the universities of Hull, Nottingham and Bangor, and Alzheimer’s Society.

Professor Bob Woods, of Bangor University’s Dementia Services Development Centre, who contributed to the development of the intervention and its evaluation, commented:

‘In Wales, concerns continue to be raised about the over-use of anti-psychotic medication to reduce agitation in people with dementia living in care homes. This study shows clearly that there is an affordable alternative. We should be aiming for even more than one hour a week of personalised, structured social activities for our care home residents with dementia’

Publication date: 7 February 2018