School of Nursing and Midwifery, Trinity College Dublin and Department of Economics, National University of Ireland, Galway

This report presents the findings of an evaluation of the Memory Matters Community Dementia Project in Carlow/Kilkenny (2014-2016), one of five projects funded under the HSE & Genio Dementia Programme to develop and test innovative individualised supports for people at an advancing and complex stage of dementia.

Aims

This project adopted a reablement approach, with a focus on helping people maintain their abilities, rather the conventional home care approach of doing things for people, and providing flexible, person-centred and responsive home care services. The project also developed educational initiatives for statutory and voluntary service providers in the region, including reablement training for home helps. Assistive technology was also made available to support people to live as independently and safely as possible. A comprehensive evaluation of the project was undertaken, using mixed methods and underpinned by the RE-AIM framework, which assessed project activity in terms of reach, effectiveness, adoption, implementation and maintenance.  

Outcomes

Fifty-five people with dementia and their family carers received Memory Matters supports through the project, two-thirds of whom were supported to remain at home. The individualised nature of the supports and their flexibility facilitated reablement activities and the experience of people with dementia and their families of the supports were positive. The flexibility of supports was of particular benefit to family carers.

Findings

The personalised Memory Matters supports were delivered using existing resources for community care services. The evaluation found that people with advanced dementia could be supported to remain at home for an average cost to the HSE of €607 per week, which is significantly lower than the costs of long-stay residential care. When the costs of family caring was included, the cost of supporting a person with dementia to remain living at home was lower than long-stay residential care for more than 80% of the people supported by the project.

The assistive technology provided reassurance to family members, but had limited application in supporting the person with advanced dementia.

The education initiatives were positively evaluated and staff participating reported increasing confidence in adopting a reablement approach to community care.