Description of the intervention
dementia, anxiety
AIDS
GREAT CR involves a course of individual sessions conducted in the home setting. Realistic and personally-meaningful goals are agreed in collaboration with the CR practitioner. The practitioner, person with dementia and carer then collaboratively develop and implement a plan to support behaviour change leading to goal attainment, addressing the identified needs using evidence-based rehabilitative strategies. These include both enhanced learning techniques and compensatory approaches, such as environmental modification and introduction of memory aids. The personalised focus allows for considerable flexibility, ensuring that individual needs are directly addressed, and plans can be adapted as necessary to support goal attainment. At a behavioural level, rehabilitation strategies establish new behavioural routines and provide an experience of success in tackling challenges encountered in everyday situations; this in turn encourages development of a solution-focused approach that can be applied in other situations, and helps to build or rebuild confidence, which can lead to wider benefits. Neuroimaging findings suggest changes are underpinned by increased activation in relevant compromised brain areas [In the GREAT trial [Offering an average of six one-hour sessions with flexibility to tailor the number to individual needs.Working on one goal, or possibly two if time allowed, and focusing on the types of rehabilitation strategy that were directly relevant to the chosen goals.Augmenting the goal-oriented work with additional components, such as anxiety management, only where specifically indicated, rather than including these components in all cases as was done in the GREAT trial.Allowing flexibility in delivery so that qualified practitioners could either deliver the intervention themselves or involve unqualified assistants or technicians in conducting planned sessions.We prepared a range of resources to support implementation and intervention delivery. See Additional Text 2 for details.The primary intervention outcome in GREAT CR is goal attainment, quantified using the Bangor Goal-Setting Interview (BGSI) [