Table 12 Observational Study Designs: Descriptive Studies (case report/case series) – Team-Based/Multi-Agency/Integrated Support Role –Level IV Evidence

Stevenson et al., 2006 [50]

United Kingdom

N = 65 people with dementia

N = 28 health workers, social service workers and voluntary sector organisations (surveys)

N = 8 carers (semi-structured interviews)

• N = 22 people with dementia experienced a multiagency enhanced community assessment and support team (EAST) with three care workers and two team coordinators (social worker and a registered mental health nurse) based in the local health centre. Coordinated and comprehensive assessment and care management service was provided to older people with a confirmed diagnosis of dementia

• N = 23 people with dementia referred to a psychogeriatric admission ward

• N = 20 people with dementia referred to a psychogeriatric day hospital

No control group

• Naturalistic, descriptive, survey for a 1 year period

• Assessment of needs (CarenapD)

• Activities of daily living: Bayer-Activities of daily living (BAYER ADL)

• Mini-mental state examination (MMSE)

• Behavioural psychopathology in Alzheimer’s Disease (BEHAVE-AD)

• Surveys with health workers, social service workers and voluntary sector organisations

• 64 % of surveys returned. 78 % found EAST beneficial in management of the referred individual and 94 % agreed that it was useful.

• Carers found EAST beneficial and appreciated the regularity of visits, the monitoring, attention and emotional support, the practical assistance, advice and information and the improved awareness and access to resources.

• Number of unmet needs in EAST group was initially 13 and reduced to seven

• 9 % of people initially referred to EAST required psychogeriatric inpatient assessment and none required day hospital support

• 68 % of EAST participants were maintained in their own homes

• Use of psychogeriatric day hospital placements and inpatient assessment beds reduced; no EAST participants required admission to the psychogeriatric day hospital.

Preliminary level IV evidence for a multiagency community team EAST to comprehensively assess and support at home patients with dementia who previously would have been referred to the local psycho geriatric admission ward and day hospital, with a consequent reduction in the utilisation of these hospital facilities. Health workers, voluntary agencies and carers were positive about the service.