Table 14 Observational Study Design: Analytics Studies (cohort studies) - Support/Key Worker Roles – Level II – 2 Evidence

Woods et al., (2003) [52]

United Kingdom

N = 128 carers of people with dementia who were new referrals to participating services (admiral nurse services or conventional services)

N = 55

Admiral Nurse service with experience mental health nurses with special interest and additional training in dementia care

Focus primarily on carers, work exclusively where there has been a diagnosis of dementia, and may continue to provide support after the person with dementia has entered residential care or has died

N = 73

Conventional services: multi-disciplinary community mental health teams (occupational therapists, clinical psychologists, psychiatrists, social workers)

See work with the caregiver as secondary to the person with dementia

Usually do focus on dementia and support is no longer provided if client moves into residential care or if the person dies.

Caregiver strain and distress: General Health Questionnaire

Institutional placement

Severity of Dementia: Clinical Dementia Rating Scale

Quality of Relationship

81 % follow-up data; 104 interviews at follow-up (43 Admiral Nurse, 61 comparison)

Significant between group differences for sub-scales anxiety and insomnia favouring the Admiral Nurse group on the General Health Questionnaire

No significant differences in outcome for the person with dementia in relation to survival at home

Significant reductions in General Health Questionnaire scores for both groups

Quality of the pre-morbid relationship between carer and the person with dementia was associated with distress at follow-up

Preliminary level IV evidence for both a conventional multi-disciplinary community mental health service and Admiral Nurse service to result in lower distress scores for caregivers over an 8-month period. Caregivers receiving the Admiral Nurse service also showed a greater reduction in anxiety and insomnia that those receiving a conventional service. Outcomes for people with dementia (in terms of institutional placement) were no worse in the Admiral Nurse group, despite the carer focus.