A Web-Based Psychoeducational Program for Informal Caregivers of Patients With Alzheimer’s Disease: A Pilot Randomized Controlled Trial PerCEN trial participant perspectives on the implementation and outcomes of person-centered dementia care and environments. Improved Strain and Psychosocial Outcomes for Caregivers of Individuals with Dementia: Findings from Project ANSWERS. PerCEN: a cluster randomized controlled trial of person-centered residential care and environment for people with dementia. Acceptability and feasibility results of a strength-based skills training program for dementia caregiving dyads. The effects of a multicomponent dyadic intervention on the mood, behavior, and physical health of people with dementia: a randomized controlled trial Clinical effectiveness of a manual based coping strategy programme (START, STrAtegies for RelaTives) in promoting the mental health of carers of family members with dementia: pragmatic randomised controlled trial Evaluating the MESSAGE Communication Strategies in Dementia training for use with community-based aged care staff working with people with dementia: a controlled pretest-post-test study. Individual cognitive stimulation therapy for dementia: a clinical effectiveness and cost-effectiveness pragmatic, multicentre, randomised controlled trial. A randomized crossover trial to study the effect of personalized, one-to-one interaction using Montessori-based activities on agitation, affect, and engagement in nursing home residents with Dementia. Assistive devices caregivers use and find helpful to manage problem behaviors of dementia. Impact of Antipsychotic Review and Nonpharmacological Intervention on Antipsychotic Use, Neuropsychiatric Symptoms, and Mortality in People With Dementia Living in Nursing Homes: A Factorial Cluster-Randomized Controlled Trial by the Well-Being and Health for People With Dementia (WHELD) Program. The implementation of integrated emotion-oriented care: Did it actually change the attitude, skills and time spent of trained caregivers? [Development and evaluation of a training program for nursing home professionals to improve communication in dementia care].
Background Although several face-to-face programs are dedicated to informal caregivers of persons with dementia , they are not always accessible to overburdened or isolated caregivers . Based on a face-to-face intervention program , we adapted and design ed a Web-based fully automated psychoeducational program ( called Diapason ) inspired by a cognitive approach . Objective This study aim ed to evaluate through a pilot unblinded r and omized controlled trial the efficacy and acceptability of a Web-based psychoeducational program for informal caregivers of persons with Alzheimer ’s disease ( PWAD ) based on a mixed methods research design . Methods We recruited and r and omized offline 49 informal caregivers of a PWAD in a day care center in Paris , France . They either received the Web-based intervention and usual care for 3 months ( experimental group , n=25 ) or only usual care ( control group , n=24 ) . Caregivers ’ perceived stress ( PSS-14 , primary outcome ) , self-efficacy , burden , perceived health status , and depression ( secondary outcomes ) were measured during 3 face-to-face on-site visits : at baseline , at the end of the program ( month 3 ) , and after follow-up ( month 6 ) . Additionally , semistructured interviews were conducted with experimental group caregivers at month 6 and examined with thematic analysis . Results Intention-to-treat analysis did not show significant differences in self-perceived stress between the experimental and control groups ( P=.98 ) . The experimental group significantly improved their knowledge of the illness ( d=.79 , P=.008 ) from baseline to month 3 . Of the 25 participants allocated to the experimental group , 17 ( 71 % ) finished the protocol and entirely viewed at least 10 of 12 online sessions . On average , participants used the website 19.72 times ( SD 12.88 ) and were connected for 262.20 minutes ( SD 270.74 ) . The results of the satisfaction question naire showed that most participants considered the program to be useful ( 95 % , 19/20 ) , clear ( 100 % , 20/20 ) , and comprehensive ( 85 % , 17/20 ) . Significant correlations were found between relationship and caregivers ’ program opinion ( P=.01 ) . Thus , positive opinions were provided by husb and s and sons ( 3/3 ) , whereas qualified opinions were primarily reported by daughters ( 8/11 ) . Female spouses expressed negative ( 2/3 ) or neutral opinions ( 1/3 ) . Caregivers expected more dynamic content and further interaction with staff and peers . Conclusions In this study , quantitative results were inconclusive owing to small sample size . Qualitative results indicated/showed little acceptance of the program and high expectations from caregivers . Caregivers did not rule out their interest in this kind of intervention provided that it met their needs . More dynamic , personalized , and social interventions are desirable . Our recruitment issues pointed out the necessity of in-depth studies about caregivers ’ help-seeking behaviors and readiness factors . Trial Registration Clinical trials.gov NCT01430286 ; http:// clinical trials.gov/ct2/show/NCT01430286 ( Archived by WebCite at http://www.webcitation/6KxHaRspL ) BACKGROUND Well-being and various forms of agitation in people with dementia can be improved in a person-centered long-term care setting . Data obtained during the Person-Centered Dementia Care and Environment ( PerCEN ) r and omized controlled trial shed light on the factors that influenced the adoption and outcomes of person-centered interventions in long-term care from the perspective of study participants . METHODS Data were obtained from PerCEN participants : individual semi-structured interviews with care managers ( 29 ) , nurses and care staff ( 70 ) ; telephone surveys with family members ( 73 ) ; staff reports of care approaches ; and 131 field note entries recorded by the person-centered care and environment facilitators .  Data were interpreted inductively using content analysis , code building , theme development , and synthesis of findings . RESULTS All data sources confirmed that , when adopted , the person-centered model increased the number and variety of opportunities for resident interaction , improved flexibility in care regimens , enhanced staff 's attention to resident needs , reduced resident agitation , and improved their well-being . Barriers and enablers for the person-centered model related to leadership , manager , staff and family appreciation of the model , staff 's capacity , effective communication and team work among direct care staff , care service flexibility , and staff education on how to focus care on the person 's well-being . CONCLUSIONS Successful knowledge translation of the person-centered model starts with managerial leadership and support ; it is sustained when staff are educated and assisted to apply the model , and , along with families , come to appreciate the benefits of flexible care services and teamwork in achieving resident well-being . The Australian New Zeal and Clinical Trials Registry number is ACTRN 12608000095369 PURPOSE This study examined the efficacy of a newly developed intervention , Acquiring New Skills While Enhancing Remaining Strengths ( ANSWERS ) , for family caregivers of individuals with dementia .  ANSWERS was design ed for dyads comprised of an individual with dementia and his/her family caregiver . Using a strength-based approach , ANSWERS combined educational skills ( traditionally used with caregivers ) and cognitive rehabilitation skills training ( traditionally used with individuals with dementia ) into a single protocol for addressing the dyad 's care issues and needs . Key domains addressed by the intervention included : education about dementia and memory loss ; effective communication ; managing memory ; staying active ; and recognizing emotions and behaviors . This analysis focused on outcomes for caregivers . DESIGN & METHODS The Stress Process Model guided the study 's hypotheses and design . Caregiving dyads were r and omly assigned to the control or intervention conditions . Intervention dyads received 6-curriculum guided sessions with an intervention specialist . Data came from in-person baseline interviews with caregivers conducted prior to r and omization and follow-up interviews conducted approximately 14.56 weekspost-baseline . RESULTS Intervention caregivers , compared to controls , had decreased care-related strain as indicated by lower emotional health strain , dyadic relationship strain , role captivity , and higher caregiving mastery . Additionally , intervention caregivers had improved well-being as indicated by fewer symptoms of depression and anxiety . IMPLICATION S ANSWERS was efficacious in improving key strain and psychosocial outcomes for caregivers . Features essential to the success of ANSWERS included a strength-based approach for selecting , developing , and implementing care goals , as well as teaching caregivers educational and cognitive rehabilitation skills for addressing care needs BACKGROUND There is good evidence of the positive effects of person-centered care ( PCC ) on agitation in dementia . We hypothesized that a person-centered environment ( PCE ) would achieve similar outcomes by focusing on positive environmental stimuli , and that there would be enhanced outcomes by combining PCC and PCE . METHODS 38 Australian residential aged care homes with scope for improvement in both PCC and PCE were stratified , then r and omized to one of four intervention groups : ( 1 ) PCC ; ( 2 ) PCE ; ( 3 ) PCC + PCE ; ( 4 ) no intervention .  People with dementia , over 60 years of age and consented were eligible . Co- outcomes assessed pre and four months post-intervention and at 8 months follow-up were resident agitation , emotional responses in care , quality of life and depression , and care interaction quality . RESULTS From 38 homes r and omized , 601 people with dementia were recruited . At follow-up the mean change for quality of life and agitation was significantly different for PCE ( p = 0.02 , p = 0.05 , respectively ) and PCC ( p = 0.0003 , p = 0.002 respectively ) , compared with the non-intervention group ( p = 0.48 , p = 0.93 respectively ) . Quality of life improved non-significantly for PCC+PCE ( p = 0.08 ) , but not for agitation ( p = 0.37 ) . Improvements in care interaction quality ( p = 0.006 ) and in emotional responses to care ( p = 0.01 ) in PCC+PCE were not observed in the other groups . Depression scores did not change in any of the groups . Intervention compliance for PCC was 59 % , for PCE 54 % and for PCC+PCE 66 % . CONCLUSION The hypothesis that PCC+PCE would improve quality of life and agitation even further was not supported , even though there were improvements in the quality of care interactions and resident emotional responses to care for some of this group . The Australian New Zeal and Clinical Trials Registry Number is ACTRN 12608000095369 PURPOSE The current article provides an in-depth description of a dyadic intervention for individuals with dementia and their family caregivers . Using a strength-based approach , caregiving dyads received skills training across 5 key areas : ( a ) education regarding dementia and memory loss , ( b ) effective communication , ( c ) managing memory loss , ( d ) staying active , and ( e ) recognizing emotions and behaviors . Results of the acceptability and feasibility of the intervention protocol s are also presented . DESIGN AND METHODS Caregiving dyads were r and omly assigned to participate in the intervention . Participants in the treatment condition were asked to complete a series of evaluation questions after each intervention session and an overall evaluation of the program . Data were also collected from the intervention specialists who implemented the protocol s. RESULTS Overall , the evaluation data indicated that the content and process of the intervention were viewed as highly acceptable and feasible by both participants and intervention specialists . IMPLICATION S This article highlights the merit of using a strength-based approach for working with caregiving dyads with dementia and how a single intervention protocol can be used to address the goals of both care partners . Furthermore , the intervention program was found to be highly acceptable and feasible , which is an important aspect of developing dyadic protocol Purpose The effects of a multicomponent dyadic intervention on the mood , behavior , and physical health of people with dementia living in the community were evaluated in a r and omized controlled trial . This multicomponent dyadic intervention is a translated and adapted version of an intervention that has been shown to be effective for people with dementia in the US . Patients and methods People with dementia living in the community and their family caregivers ( N=111 caregiver-care recipient dyads ) were r and omly assigned to the intervention and comparison group . The intervention group received home-based physical exercise training , psycho-education , communication skills training , and pleasant activities training during 3 months directed at both the person with dementia and the caregiver .  Mood , behavior , and physical health were measured at baseline , 3 months , and 6 months . The effects of the study were determined by using generalized estimating equations based on an intention-to-treat analysis . Results Analyses showed no beneficial effects over time on any of the outcome measures . Conclusion This study showed no effects . The negative results in this study compared to the study that has been carried out in the US might be explained by the translation , adaptation , and shortening of the intervention used in the US , and a different social context . In addition , the results might be explained by the lack of room for improvement and by experiencing the intervention as too much of a burden . Furthermore , improving physical health might only be effective if the physical exercises are of moderate-to-high-intensity and are tailored in accordance with participants ’ preferences and needs . For future studies , because dyads often commented positively about the pleasure and support they received , it might also be valuable to measure quality of life outcomes such as relationship quality , pleasure , and self-esteem in dyadic focused interventions Objective To assess whether a manual based coping strategy compared with treatment as usual reduces depression and anxiety symptoms in carers of family members with dementia . Design R and omised , parallel group , superiority trial . Setting Three mental health community services and one neurological outpatient dementia service in London and Essex , UK . Participants 260 carers of family members with dementia . Intervention A manual based coping intervention comprising eight sessions and delivered by supervised psychology graduates to carers of family members with dementia . The programme consisted of psychoeducation about dementia , carers ’ stress , and where to get emotional support ; underst and ing behaviours of the family member being cared for , and behavioural management techniques ; changing unhelpful thoughts ; promoting acceptance ; assertive communication ; relaxation ; planning for the future ; increasing pleasant activities ; and maintaining skills learnt . Carers practised these techniques at home , using the manual and relaxation CDs . Main outcome measures Affective symptoms ( hospital anxiety and depression total score ) at four and eight months . Secondary outcomes were depression and anxiety caseness on the hospital anxiety and depression scale ; quality of life of both the carer ( health status question naire , mental health ) and the recipient of care ( quality of life-Alzheimer ’s disease ) ; and potentially abusive behaviour by the carer towards the recipient of care ( modified conflict tactics scale ) . Results 260 carers were recruited ; 173 were r and omised to the intervention and 87 to treatment as usual .  Mean total scores on the hospital anxiety and depression scale were lower in the intervention group than in the treatment as usual group over the eight month evaluation period : adjusted difference in means −1.80 points ( 95 % confidence interval −3.29 to −0.31 ; P=0.02 ) and absolute difference in means −2.0 points . Carers in the intervention group were less likely to have case level depression ( odds ratio 0.24 , 95 % confidence interval 0.07 to 0.76 ) and there was a non-significant trend towards reduced case level anxiety ( 0.30 , 0.08 to 1.05 ) . Carers ’ quality of life was higher in the intervention group ( difference in means 4.09 , 95 % confidence interval 0.34 to 7.83 ) but not for the recipient of care ( difference in means 0.59 , −0.72 to 1.89 ) . Carers in the intervention group reported less abusive behaviour towards the recipient of care compared with those in the treatment as usual group ( odds ratio 0.47 , 95 % confidence interval 0.18 to 1.23 ) , although this was not significant . Conclusions A manual based coping strategy was effective in reducing affective symptoms and case level depression in carers of family members with dementia . The carers ’ quality of life also improved . Trial registration Current Controlled Trials ISCTRN70017938 AIMS AND OBJECTIVES The study aims to evaluate the effects of a communication skills training programme on community aged care staff 's knowledge of communication support in dementia and on staff 's care experience . BACKGROUND Dementia can lead to impairments in communication . Therefore , quality community-based dementia care requires that staff be skilled communicators , equipped to facilitate interactions with people with dementia . The current investigation evaluated the effectiveness of the MESSAGE Communication Strategies in Dementia for Care Staff training programme with respect to knowledge of communication support and the staff/caregiver experience . DESIGN A multi-centre controlled pretest/post-test design with r and omised cohort allocation was used . Outcome measures were completed at baseline , immediately after training ( training group only ) , and at three-month follow-up . METHODS Thirty-eight care staff working in community aged care participated and completed all outcome measures ( training = 22 ; control = 16).Training and control groups completed the following outcome measures : knowledge of communication support strategies , self-efficacy , preparedness to provide care , strain in nursing care and attitude to dementia care . Staff in the training group provided written feedback on the training . RESULTS A significant improvement in knowledge scores from baseline was found for the training group both immediately after training and at three-month follow-up . There was also a significant training effect for self-efficacy and preparedness to provide care . No significant difference was found for the control group for any measure . No significant training effects were found for measures of strain or attitudes to dementia care . Feedback from staff suggests that the training was well received . CONCLUSIONS The MESSAGE training was positively received by staff and had a significant effect on care staff knowledge , and confidence to provide care for people with dementia . RELEVANCE TO CLINICAL PRACTICE The easily accessible multimedia training programme is well received by staff and has the potential to improve quality of care BACKGROUND Group cognitive stimulation therapy programmes can benefit cognition and quality of life for people with dementia . Evidence for home-based , carer-led cognitive stimulation interventions is limited . OBJECTIVES To evaluate the clinical effectiveness and cost-effectiveness of carer-delivered individual cognitive stimulation therapy ( iCST ) for people with dementia and their family carers , compared with treatment as usual ( TAU ) . DESIGN A multicentre , single-blind , r and omised controlled trial assessing clinical effectiveness and cost-effectiveness . Assessment s were at baseline , 13 weeks and 26 weeks ( primary end point ) . SETTING Participants were recruited through Memory Clinics and Community Mental Health Teams for older people . PARTICIPANTS A total of 356 caregiving dyads were recruited and 273 completed the trial . INTERVENTION iCST consisted of structured cognitive stimulation sessions for people with dementia  , completed up to three times weekly over 25 weeks . Family carers were supported to deliver the sessions at home . MAIN OUTCOME MEASURES Primary outcomes for the person with dementia were cognition and quality of life . Secondary outcomes included behavioural and psychological symptoms , activities of daily living , depressive symptoms and relationship quality . The primary outcome for the family carers was mental/physical health ( Short Form question naire-12 items ) . Health-related quality of life ( European Quality of Life-5 Dimensions ) , mood symptoms , resilience and relationship quality comprised the secondary outcomes . Costs were estimated from health and social care and societal perspectives . RESULTS There were no differences in any of the primary outcomes for people with dementia between intervention and TAU [ cognition : mean difference -0.55 , 95 % confidence interval ( CI ) -2.00 to 0.90 ; p-value = 0.45 ; self-reported quality of life : mean difference -0.02 , 95 % CI -1.22 to 0.82 ; p-value = 0.97 at the 6-month follow-up ] . iCST did not improve mental/physical health for carers . People with dementia in the iCST group experienced better relationship quality with their carer , but there was no evidence that iCST improved their activities of daily living , depression or behavioural and psychological symptoms . iCST seemed to improve health-related quality of life for carers but did not benefit carers ' resilience or their relationship quality with their relative . Carers conducting more sessions had fewer depressive symptoms . Qualitative data suggested that people with dementia and their carers experienced better communication owing to iCST . Adjusted mean costs were not significantly different between the groups . From the societal perspective , both health gains and cost savings were observed . CONCLUSIONS iCST did not improve cognition or quality of life for people with dementia , or carers ' physical and mental health . Costs of the intervention were offset by some reductions in social care and other services . Although there was some evidence of improvement in terms of the caregiving relationship and carers ' health-related quality of life , iCST does not appear to deliver clinical benefits for cognition and quality of life for people with dementia . Most people received fewer than the recommended number of iCST sessions . Further research is needed to ascertain the clinical effectiveness of carer-led cognitive stimulation interventions for people with dementia . TRIAL REGISTRATION Current Controlled Trials IS RCT N65945963 . FUNDING This project was funded by the National Institute of Health Research ( NIHR ) Health Technology Assessment ( HTA ) programme and will be published in full in Health Technology Assessment ; Vol . 19 , No. 64 . See the NIHR Journals Library website for further information BACKGROUND Increasingly more attention has been paid to non-pharmacological interventions as treatment of agitated behaviors  that accompany dementia . The aim of the current study is to test if personalized one-to-one interaction activities based on Montessori principles will improve agitation , affect , and engagement more than a relevant control condition . METHODS We conducted a r and omized crossover trial in nine residential facilities in metropolitan Melbourne , Australia ( n = 44 ) .  Personalized one-to-one activities that were delivered using Montessori principles were compared with a non-personalized activity to control for the non-specific benefits of one-to-one interaction . Participants were observed 30 minutes before , during , and after the sessions . The presence or absence of a selected physically non-aggressive behavior was noted in every minute , together with the predominant type of affect and engagement . RESULTS Behavior counts fell considerably during both the Montessori and control sessions relative to beforeh and . During Montessori activities , the amount of time spend actively engaged was double compared to during the control condition and participants displayed more positive affect and interest as well . Participants with no fluency in English ( all from non-English speaking background s ) showed a significantly larger reduction in agitation during the Montessori than control sessions . CONCLUSION Our results show that even non-personalized social contact can assist in settling agitated residents . Tailoring activities to residents ' needs and capabilities elicit more positive interactions and are especially suitable for people who have lost fluency in the language spoken predominantly in their residential facility . Future studies could explore implementation by family members and volunteers to avoid dem and s on facilities ' re sources . TRIAL REGISTRATION Australian New Zeal and Clinical Trials Registry - ACTRN12609000564257 PURPOSE Use of assistive devices in caring for individuals with dementia has not been systematic ally examined , particularly as it concerns managing behavioral symptoms . We tested a nonpharmacologic intervention to manage behaviors that involved instructing families in effective communication techniques , simplifying tasks and the home environment and using assistive devices . This paper describes the assistive devices provided to families assigned to intervention , extent of use of issued devices , their perceived helpfulness , and cost . DESIGN AND METHODS Following each treatment session , occupational therapists ( OT ) documented time spent training in the use of strategies to manage problem behaviors . For families receiving assistive devices  , OTs asked caregivers after 4 months whether they continued to use the device ( yes/no ) , and extent to which it helped manage the targeted problems ( not at all , somewhat , very helpful ) . We also tracked the costs associated with ordering , delivering and installing devices . RESULTS Of 272 caregiver-patient dyads enrolled in the original trial , 136 were r and omized to the intervention group , of whom 63 received one or more assistive devices .  Of 13 intervention sessions , an average of 4 ( 31 % ) involved discussing or training caregivers in using assistive devices . A total of 197 devices ( 3 per dyad ) were issued of which 87.6 % were reported in use at 4 months . Caregivers reported that overall , devices were somewhat to very helpful . Devices ranged in cost from US$ 4.80 to US$ 282.93 with an average cost per dyad of US$ 152.52(SD = US$102.70 ) which included the device , its ordering , delivery and installation OBJECTIVE This study evaluated the impact of antipsychotic review , social interaction , and exercise , in conjunction with person-centered care , on antipsychotic use , agitation , and depression in people with dementia living in nursing homes . METHOD A cluster-r and omized factorial controlled trial with two replications was conducted in people with dementia in 16 U.K. nursing homes . All homes received training in person-centered care .  Eight homes were r and omly assigned to antipsychotic review , to a social interaction intervention , and to an exercise intervention for 9 months , with most homes assigned to more than one intervention . The primary outcome measures were antipsychotic use , agitation , and depression . Secondary outcome measures were overall neuropsychiatric symptoms and mortality . RESULTS Antipsychotic review significantly reduced antipsychotic use by 50 % ( odds ratio 0.17 , 95 % confidence interval [ CI ] 0.05 to 0.60 ) . Antipsychotic review plus the social interaction intervention significantly reduced mortality ( odds ratio 0.26 , 95 % CI 0.13 to 0.51 ) compared with the group receiving neither . The group receiving antipsychotic review but not the social intervention showed significantly worse outcome in neuropsychiatric symptoms compared with the group receiving neither ( score difference + 7.37 , 95 % CI 1.53 to 13.22 ) . This detrimental impact was mitigated by concurrent delivery of the social intervention ( -0.44 , CI -4.39 to 3.52 ) . The exercise intervention significantly improved neuropsychiatric symptoms ( -3.59 , 95 % CI -7.08 to -0.09 ) but not depression ( -1.21 , CI -4.35 to 1.93 ) . None of the interventions had a significant impact specifically on agitation . CONCLUSIONS While reductions in antipsychotic use can be achieved by using a " real world " intervention , this may not be of benefit to people with dementia in the current climate of more judicious prescribing unless nonpharmacological interventions such as social interaction or exercise are provided in parallel Background : Successful implementation is a vital precondition for investigating the outcome of care innovation . This study concerned the evaluation of the implementation of  integrated emotion-oriented care ( IEOC )  in psychogeriatric nursing home wards . The main question was whether the trained caregivers actually applied the knowledge and techniques of IEOC during their daily work . Methods : The study was conducted within the framework of a r and omized clinical trial into the effectiveness of  IEOC  in 16 wards . Preceding the experimental period , staff from 16 wards were educated and trained to work with a st and ardized care plan , result ing in a similar level of quality of care at the start of the trial . On the experimental wards IEOC was then implemented by training on the job in addition to training courses for personnel . To examine the implementation effectiveness , a self-report question naire , ‘ Emotion-oriented Skills in the Interaction with Elderly People with Dementia ’ , was administered at baseline and after 7 months to a sample of caregivers from the experimental and the control wards . In addition , participant observation was conducted on four experimental and four control wards , and time spent by care personnel on different type of care tasks was registered . Results : The implementation of IEOC result ed in increased emotion-oriented skills and more knowledge of the residents among the caregivers . Providing IEOC was not more time consuming for the caregivers than providing usual care . Conclusion : This study shows that the implementation of  IEOC  was effective . It is recommended that in intervention studies the correct application of a new intervention or care approach is examined before jumping to conclusions about the effectiveness of the intervention or care approach itself The purpose of this study was to develop and evaluate a skill training aim ed at increasing the social competence of caregivers of nursing home residents suffering from dementia . Herewith , the professional burden and occupational stress of the caregivers should be reduced and the quality of life of dementia patients should be increased . The contents of the training focused on problems and strategies in the communication with dementia patients and the communication with colleagues . The effectiveness of the intervention was tested in a controlled training study using a multiple control group design and process measurement . The participants of the trainings were 53 nursing home professionals , who were in daily contact with residents suffering from dementia . The results of the study verify effects for all relevant variables . The " social competence " of the caregivers increased and their " work stress " decreased while the " quality of life of dementia patients " increased . Therefore it can be concluded that training the social competence of nursing home professionals is a method to indirectly reduce their work stress and support dementia patients . The results of research in this program underline very clearly that the developed training is an effective option to improve the situation of dementia care in nursing homes . To make the intervention widely applicable we are currently developing a " multiplier program " in a follow-up project
ABSTRACT Objectives : To up date previous review s and provide a more detailed overview of the effectiveness , acceptability and conceptual basis of communication training- interventions for carers of people living with dementia .