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. 2023 Sep;29(6):903-914.
doi: 10.1111/jep.13852. Epub 2023 May 4.

Weaving Evidence into Action for Veterans with Dementia (WEAVE): Evaluation of implementation into long-term care practice

Claudia Meyer  1   2   3   4 , Xanthe Golenko  5   6 , Elizabeth V Cyarto  7   8 , Fleur O'Keefe  9 , Gwen Bonney  10 , Mina Min  10 , Safa Alrababah  5 , Elizabeth Robinson  1 , Judy Lowthian  1   8   11
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Weaving Evidence into Action for Veterans with Dementia (WEAVE): Evaluation of implementation into long-term care practice

Claudia Meyer et al. J Eval Clin Pract. 2023 Sep.

Abstract

Rationale: Veterans living with dementia in long-term care have complex needs, with variable manifestation of symptoms of dementia that interact with their lived experience. Best practice dementia care prioritises nonpharmacological interventions; of which few have strong evidence. Implementation of evidence is complex, with evaluation of outcomes and processes necessary.

Aims and objectives: This paper details the evaluation of implementation, at veteran and organisational level, of the Weaving Evidence into Action for Veterans with Dementia (WEAVE) programme.

Methods: A Type 2 hybrid effectiveness-implementation design was used, underpinned by the Implementation Framework for Aged Care (IFAC). Programme intervention incorporated music therapy, exercise, reminiscence therapy and/or sensory modulation, offered over a 24-week period. Evaluation components included: (1) programme effectiveness for veterans with dementia for responsive behaviour, physical wellbeing, cognitive status, emotional state, medications and falls (at baseline, 8-week, 16-week and 24-week); and (2) implementation outcomes of reach and adoption, feasibility and acceptability, fidelity (via interviews) and a preliminary cost analysis.

Results: Thirty-eight veterans participated in the 24-week programme, with high levels of engagement in interventions of their choice. Statistically significant improvements were seen across all veteran-level outcome measures, for functional capacity and reduced neuro-psychiatric and depressive symptoms. Ten staff members were interviewed, highlighting co-designed core elements were feasible and acceptable, and the momentum generated by resident and staff enthusiasm. Cost analysis included costs of programme set-up and running the 24-week intervention.

Conclusion: Key components of programme success were the therapeutic leaders, adherence to core elements of programme design, and veterans' choice in meaningful activity. Cost analysis supports deliberations for upscale across further care homes.

Keywords: aged; dementia; health care; long-term care; outcome assessment; programme evaluation; veterans.

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References

REFERENCES

    1. World Health Organization. Dementia Key Facts. 2020.
    1. Guideline Adaptation Committee. Clinical Practice Guidelines and Principles of Care for People with Dementia. Guideline Adaptation Committee; 2016.
    1. Livingston G, Sommerlad A, Orgeta V, et al. Dementia prevention, intervention and care. Lancet. 2017;396:413-446.
    1. National Collaborating Centre for Mental Health (UK). Dementia: A NICE-SCIE guideline on supporting people with dementia and their carers in health and social care. British Psychological Society (UK); 2007.
    1. Brooker D. Person-Centred Dementia Care: Making Services Better. Jessica Kingsley; 2007.

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