'Dementia is not an inevitable decline in all areas'

A therapy which supports people with dementia to achieve everyday goals is being rolled out to 13 NHS trusts, care homes and local authorities. The trial to assess the use of goal-oriented cognitive rehabilitation in routine practice comes after an initial randomised control trial found promising results. 

Goal-oriented cognitive rehabilitation involves practitioners working with people who have dementia and their carers to establish goals that will help them maintain their lifestyle. For example, some may aim to cook food without burning it, or remember the names of loved ones. Practitioners work with individuals and their carers to put strategies in place to help them achieve these goals. 

The original GREAT trial, led by the University of Exeter, was a single-blind randomised control trial and involved 475 people across eight sites in the UK. Half of the participants received ten cognitive rehabilitation sessions over three months and later had four top-up sessions over six months. The other half of the subjects acted as a control group and carried on with life as normal. 

The study, funded by the National Institute for Health Research (NIHR) and supported by the Alzheimer's Society, found that those who took part in the therapy showed significant improvement in the areas they had identified, after both the original sessions and 'top-up' sessions. Family carers agreed that their performance had improved and both participants and carers were happier with the participants' abilities in the areas identified.

Thanks to funding from the Alzheimer's Society, University of Exeter researchers are now working to train staff in NHS trusts, local authorities and other social care organisations to assess whether this approach can be incorporated into routine practice in dementia care. So far 13 organisations have signed up for the 'GREAT into Practice' trial and researchers are still recruiting. 

Project Manager for GREAT into Practice Dr Krystal Warmoth, a Psychology Research Fellow at the University of Exeter, said the REACH project had shown that cognitive rehabilitation could help people achieve the goals that mattered most to them. 'This is essential in demonstrating that dementia is not an inevitable decline in all areas, and in providing people with the simple tools to live as well as possible with the condition. We're excited to roll this out so more people can benefit.'

Professor of Clinical Psychology of Ageing and Dementia Linda Clare, who leads the research programme, said she and her team's work focused on supporting people to live as well as possible with dementia. 'There's plenty that we can do, and exactly what strategy we put in place depends on individual needs. Helping people to maintain their lifestyles is really important to retaining independence, functional ability and overall quality of life.'

For more information on the implementation study, contact Warmoth on [email protected].

Read an article in The Psychologist about Clare's work as Chair of the British Psychological Society's Dementia Advisory Group.