Using the CLEAR Dementia model at home: What works for whom and why?
Research type
Research Study
Full title
Using the CLEAR Dementia model at home: What works for whom?
IRAS ID
304443
Contact name
Emma Berry
Contact email
Sponsor organisation
Queens University Belfast
Clinicaltrials.gov Identifier
N/A, N/A
Duration of Study in the UK
0 years, 10 months, 23 days
Research summary
Summary of Research
Dementia is a neurodegenerative condition which leads to functional decline and high dependence on others such as family members. Individuals with dementia may present with Behavioural and Psychological Symptoms (BPSD) which are recognised as being unmet needs which can be a heavy burden for caregivers. This paper proposes evaluating the application of the CLEAR model to dementia care within the home environment to reduce BPSD and reduce the caregiver burden. The CLEAR model is a standard intervention already being used by the Dementia Home Support Team in the Northern Health and Social Care Trust (NHSCT). A structured interview of a survey using within subjects longitudinal design containing both open and closed ended questions will be applied. Family caregivers (FCs) and Health Care Professionals (HCPs) will complete measures of BPSD (Cohen Mansfield Agitation Inventory) and caregiver burden (Zarit Burden Interview) pre and post the application of the program model. A quantitative analysis will be conducted using within subjects (repeated measures) ANOVA. Open-ended questions will be built into the structured interview of a survey. This will be conducted to capture the experiences with HCPs and FCs. A thematic analysis will be applied to capture HCP's and FC's experience using the model in the home environment. It is envisaged that the findings will have implications such as theoretical and service development in adapting the CLEAR model to the home environment for the individual with dementia. The application of the CLEAR model to the home environment is a service that already exists. The structured interview of a survey aims to evaluate if the CLEAR model reduces caregiver burden and reduces behavioural and psychological symptoms of dementia.Summary of Results
This study looked at how a dementia support approach called CLEAR Dementia Care works when used in people’s own homes, from both family carers’ and professionals’ perspectives. Family carers filled in questionnaires before and after using the service, which measured the person’s behaviour (such as agitation) and how stressed or burdened the carer felt. Health care professionals who delivered CLEAR Dementia Care at home also took part in short interviews about their experiences.
The questionnaire scores showed that there were some small, reliable changes in behaviour and carer burden over time, but these changes were not large enough to count as clearly meaningful improvements in everyday life. In other words, while there may have been slight shifts, the service did not produce big, obvious changes in the measured outcomes during the study period.
From the interviews with professionals, four main ideas emerged about using CLEAR Dementia Care at home. First, the home is a unique and important setting, and its layout, routines and family dynamics shape how support works. Second, caring for a person with dementia at home brings particular challenges, such as balancing safety, independence and family relationships. Third, there are key features of CLEAR that can make it helpful at home (for example, tailoring strategies to the individual and their environment). Fourth, there are also barriers, such as limited time, resources or difficulties fitting the approach into everyday home life.
Overall, these findings can help improve both the theory behind CLEAR Dementia Care and how services deliver it in people’s homes, so that support can be better adapted to the real world needs of people living with dementia and their families.REC name
London - Surrey Research Ethics Committee
REC reference
22/LO/0088
Date of REC Opinion
5 May 2022
REC opinion
Further Information Favourable Opinion