S. Kaasalainen and Hunter
Rationale and Objectives of Study: Within LTC, over 75% of residents have dementia, a life-limiting disease, with life expectancy ranging from 3- 10 years from the time of diagnosis. Hence, there is growing recognition that these individuals would benefit from a palliative approach to care, with greater focus on improving the quality of their life that is left. The Namaste Care program has great potential to improve quality of life, dignity and comfort for LTC residents by engaging them in meaningful and therapeutic activities throughout the later stages of the disease trajectory. Emerging evidence supports this program, with reductions in antipsychotic and hypnotic use, and behavioural symptoms. However, no systematic research has been done to examine the effects of the Namaste Care program on resident outcomes within Canada. The main goal of this study is to evaluate the feasibility and acceptability of an innovative program, called Namaste, to improve end-of-life care in dementia and to examine the 6-month effects of the intervention on LTC residents' quality of life, pain, functional ability, agitation, anxiety, depression, psychotropic use as well as costs.
Research Plan: This study will use multiple methods, including a one group, pre- post-test design, and a smaller qualitative component. Data will be collected at Shalom Village, in Hamilton, Ontario as well as a LTC home in Saskatoon, SK. Residents (N=40) will be recruited to participate in the intervention study; approximately 20 at each site. Feasibility outcomes have been developed to address (a) reach of the intervention, (b) dose delivered and, (c) intervention fidelity. Specific measurement variables and indicators of success will be examined. The acceptability of the NamasteCare intervention will be assessed using focus groups with staff and individual interviews with family members. The primary outcome will be resident quality of life. Secondary outcomes include depression, pain, functional ability, agitation, medication use, and costs.
Significance of Study: This study has strong linkages and support from knowledge users and collaborators to facilitate timely uptake to practice. The results of this proposed study will generate preliminary data to refine the intervention and its implementation to develop a large randomized controlled study to evaluate this program in a more rigorous manner. The Namaste program shows promise to improve resident outcomes, specifically quality of life for LTC residents with dementia in the later stages of their lives.
Funded by the Canadian Alzheimer's Society (2015-2017)