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EPIC

Enhancing Person-centred care in Care homes

Overview

Evaluating the effectiveness and cost effectiveness of Dementia Care Mapping™ (DCM™) to enable person-centred care for people with dementia and their carers: A cluster randomised controlled trial in care homes (EPIC trial).

The EPIC trial is a large multi-centre trial led by Professor Claire Surr at Leeds Beckett University. Professor Murna Downs, Head of the School of Dementia Studies is a co- applicant on the project and, with Ms Juni West, is responsible for ensuring implementation of the DCM intervention.

At least two-thirds of people living in care homes have dementia and many develop distressing behaviours such as agitation. Distressing behaviours such as agitation have been linked to unmet needs in people with dementia and they can be reduced by delivering care that is more supportive of each individual’s specific and often complex needs. Research shows that training in Person-Centred Care provides staff with the skills they need to prevent and support distressing behaviours. However, without extra support for staff to build on their training, these benefits soon disappear. The trial will provide definitive evidence about the effectiveness and cost effectiveness of Dementia Care Mapping in reducing distressing behaviours such as agitation in care home residents.

Methods

The study will involve 750 people with dementia and care staff in 50 care homes. Care homes have been recruited from the North of England, London and Oxford areas. Of the 50 care homes recruited to the study 20 homes will continue to deliver their usual care. Thirty care homes will be randomly allocated to have staff trained to use Dementia Care Mapping™ in addition to delivering their usual care.

We will compare changes in behaviours such as agitation in residents, their quality of life, the number of NHS services they need, and the numbers and types medications used to treat or manage distressing behaviours they are prescribed/given. We will look at these things at the start of the study, after 6 months and after 16 months. The study will also measure quality of staff interactions with residents, how staff feel about their job, their general health and feelings of stress and the number of staff resignations and sickness in both groups of homes.

Funding

The study is funded by the Health Technology Assessment Programme of the National Institute for Health Research (project number 11/15/13).