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Background The Family Carer Decision Support (FCDS) intervention has been designed to inform family carers about end of life care options available to a person living with advanced dementia. The FCDS intervention demonstrated a statistically significant impact in reducing family carer decision uncertainty on establishing goals of care at the end of life and, improved family carer satisfaction on quality of care in a study conducted in the United Kingdom. Methods The aim of this research is to adapt the application of the FCDS for use in different countries. Funding supported through the EU Joint Programme – Neurodegenerative Disease Research (JPND) project has supported the scaling up of the FCDS transnationally in the United Kingdom; Republic of Ireland; Netherlands; Canada; Czech Republic ; and, Italy. Launched in April 2019, this presentation will report on present activities including: a) description of the FCDS intervention; b) strategy for implementing the FCDS in care homes; c) study design employed for the evaluation of the FCDS; and d) work packages and that will be deployed to achieve intended outcomes Results Expected project outcomes of this work will include a) develop guidelines to facilitate transnational use of the FCDS within care homes; (b) staff education material including web learning resources; (c) family carer informational material including web learning resources; (d) measures and tools to evaluate the uptake and outcome of the FCDS intervention; (e) establish a transnational FCDS community of practice across study care homes; (f) estimated costs of providing the FCDS intervention; (g) evidence of enhancing decision making among family members regarding resident care and satisfaction with care. Conclusion Recent research revealed that care home structures and staff play an important role in the successful implementation and adoption of innovations such as the FCDS intervention, this is further examined in this transnational study. [ABSTRACT FROM AUTHOR]

Background Dementia and loneliness are both complex phenomenon's that impact on both mental and physical health. Research has identified that loneliness can increase a person's risk of mortality as much as smoking or alcohol consumption. People with dementia are at particular risk of loneliness and social isolation. This can negatively impact on a person with dementia's health. To effectively address loneliness in dementia, we must first understand how people with dementia experience loneliness. Methods Interviews were conducted with people living with dementia. Participants comprised of eight community-dwelling individuals, aged 55 years and older (mean = 63.8; range = 55-77), who were each diagnosed with dementia at least one year prior to interview (range = 1.16 – >5 years). Interviews were conducted in participants' homes using a semi-structured format and lasted between 37-74 minutes. Results Three key themes emerged: the importance of maintaining meaningful relationships, maintaining independence and socio-cultural influences on individual perceptions of loneliness and dementia. The results emphasise the importance of maintaining both a sense of self and meaningful relationships with others post-diagnosis for individuals who identified themselves as "not lonely". People living with dementia reported that the maintenance of social connection aids in fostering a sense of self-worth and self-management, which in turn mitigates feelings of loneliness. The majority of participants existing social connections with others was established prior to their diagnosis, although the maintenance of these relationships may have required an adjustment of their premorbid routines and method of social engagement. Conclusion Human contact and a meaningful relationship are superior in preventing loneliness. Individual feelings of loneliness or lack thereof are not directly correlated to the coping mechanisms most commonly employed by individuals with dementia. Further exploration is need to understand how people with dementia, who live at home, perceive or experience loneliness. [ABSTRACT FROM AUTHOR]

Background Early recognition of stroke symptoms and immediate response is necessary to ensure timely access to treatment of stroke. However, many individuals fail identify symptoms of stroke or delay in seeking medical attention. The Irish Heart Foundation launched the "Act Fast" campaign which included three waves of broadcasting on national television and radio, throughout 2010 and 2011. Stroke awareness campaigns may have the potential to influence behaviour and response to stroke. Methods A non-experimental, descriptive, quantitative, cross-sectional study was conducted. The Stroke Action Test (STAT)1 was used to investigate how participants would respond to specific symptoms of stroke. A convenience sample (n=89) of older adults attending an outpatient clinic in a university teaching hospital completed the questionnaire. The mean age of respondents was 79.6 years (SD =9.3). Results Just 4.5% (n=4) of respondents identified what all 4 letters of FAST represent. Overall, 48% (n=43) of respondents recognised all 6 symptoms of stroke and 100% (n=89) recognised at least 2 symptoms of stroke as per STAT. The stroke symptom most frequently recognised was sudden numbness of the face, arm or leg at 99% (n=88). The stroke symptom least frequently recognised was sudden trouble seeing in one or both eyes at 56% (n=50). Despite this 81% (n=64) of respondents would not respond appropriately to 50% of symptoms of stroke described in the STAT. 52% (n=46) of respondents identified irregular heart beat as a risk factor for stroke. Finally, 29% (n=26) of respondents had heard of thrombolysis while just 2% (n=2) had heard of thrombectomy. Conclusion Awareness of stroke symptoms does not necessarily influence response to stroke in older adults. Future stroke awareness campaigns should consider FAST2 which speaks to treatment (thrombolysis or thrombectomy) as well as time. [ABSTRACT FROM AUTHOR]

Background Over one third of people with dementia in Ireland reside in Long Term Care (LTC) settings. Dementia palliative care is complex; healthcare staff in LTC settings have requested specific guidance to support practice. This participatory action research project will introduce national evidence-based guidance documents relating to pain, hydration/nutrition, and medication management, into three LTC settings in Munster, using a tailored Work-based Learning approach, informed by a baseline multi-modal situational analysis. Methods Site and staff data were collected using a site profile tool; staff demographic and learning needs surveys; and the 'VOCALISE' readiness-to-change survey, in the three sites. Results Within the sites, 42-88% of residents had probable/definite dementia. Multidisciplinary input varied considerably between sites. In total, 69 staff (predominantly nurses and healthcare attendants) completed learning needs surveys. Many reported prior dementia education (range 53-76% across sites). This was twice as often on hydration/nutrition and medication topics than pain. Reflecting this, staff in all sites identified knowledge deficits, but particularly in pain identification, assessment and management. Other learning needs included supporting and communicating with families; resident care planning and advance care planning; and resident 'comfort'. Of 58 staff with completed VOCALISE data, 33% were rated as 'ready to change', 14% 'not', and the remainder ambivalent. Interestingly, staff had high confidence in the ability of change to happen, but low motivation scores; and overall ambivalence towards their own power to make change happen. Some barriers were site-specific, but overall, staffing levels, managing risk during change and perceived reluctance in others were common barriers to change, as was the possibility that patient wishes hadn't informed the change process. Conclusion Our baseline data highlights that education and change implementation needs to be tailored to the recipient site, recognising site-specific barriers to change. We will now use this data in our Work-based Learning intervention. [ABSTRACT FROM AUTHOR]