Author: Rothera I, Jones R, Harwood R, Avery A J, Fisher K, James V, Shaw I, Waite J
Journal: International Journal of Geriatric Psychiatry, 2008
Volume/pages: Vol 23, pp65-72

About the study
This study evaluates the effectiveness of a special multiagency home support service for older people with dementia comparing with a 'standard' service both in similar areas of Nottingham. Data were collected through small group work and one-to-one interviews with people with dementia, their carers, careworkers and other professionals. Responses were split into five categories that illustrate the major differences between the two services.

Findings
The study found that by allowing careworkers greater autonomy and flexibility in adapting their work routines, the specialist service was able to be more responsive to the changing needs of each individual thus enabling a more personalised service. This was reinforced by encouraging careworkers to build relationships with their clients rather than the discontinuity that exists in the standard service in order to discourage attachment between careworker and service user. The standard service was task orientated, discouraging an individualised service while the specialist service was designed to be as individualised as possible. Clients were actively encouraged to be involved in decision-making and the structures allowed time and flexibility to encourage and support greater independence.

Key messages

• By allowing careworkers flexibility and autonomy over their workload, services are able to be more responsive to people's changing needs and wishes.
• Long-term relationships between people with dementia and their careworkers allows continuity and individualised services to be delivered leading to greater independence for the client and a reduced burden for their carers.