Care for dementia patients improves with carer involvement: research

29 April, 2015

A major clinical study has revealed care for hospitalised patients with dementia can be significantly improved by incorporating advice from carers, with the TOP 5 program resulting in increased carer satisfaction and reduced risks for patients.

The Clinical Excellence Commission's research into the TOP 5 program began in 2012 and is today published in the International Journal for Quality in Health Care. The program involves a patient's primary carer sharing five tips about the patient with clinicians on admission. The tips are then used by the hospital team to develop a strategy to better manage patient care. The program takes about 20 minutes to implement for each patient.

The research study, led by CEC Director of Patient Based Care, Dr Karen Luxford, and funded by HCF Research Foundation, examines the impact of the TOP 5 program on patient's hospital care across 17 public and four private hospitals during 2012 and 2013.

Almost 100 per cent of carers in the study reported high satisfaction with the way staff had used the TOP 5 strategies (97 per cent), 85 per cent agreed TOP 5 had benefited the patient and 82 per cent said the patient was calmer. Carers who had experience of a previous hospital admission reported higher levels of satisfaction with staff when TOP 5 was in place compared to previous admissions without TOP 5.

"This is very important and timely research. The Australian Bureau of Statistics reports that over 298,000 Australians have dementia and the number of people with dementia will reach almost 400,000 by 2020," Dr Luxford said.

"There is no denying that dementia is affecting more individuals and families and this research shows that improved care and outcomes for this vulnerable patient group are now achievable using simple strategies."

"We saw fewer falls among patients with dementia in the TOP 5 ward than in the control ward and a reduction in the use of anti-psychotic drugs. This reduction in particular is a significant step forward in patient safety as the use of anti-psychotics in patients with dementia has been linked to increased mortality and morbidity, including increased risk of stroke," she said

The CEC has developed a TOP 5 Toolkit to support NSW public hospitals who want to implement the program. The CEC report is also available. The TOP 5 program was originally developed by the Central Coast Local Health District in NSW.

Phase 2 of this research program has also been funded by the HCF Research Foundation and will look at the benefits for patients and carers of implementing the TOP 5 Program in different care settings such as transition between hospitals, aged care facilities, ambulance and the community.