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COPE program offers alternative to traditional dementia care

A new program aimed at helping people with dementia live well at home is showing promising results and could change dementia care in Australia.

University of Sydney and Flinders University researchers brought Care of People with dementia in their Environments (COPE), a US program, to Australia and partnered with 17 organisations across NSW and SA to see if the program proved effective for the many different services that work with people with dementia in Australia.

“The fact is that 75 per cent of people living with dementia in Australia live at home. Many want to continue to do so, but with care provided by family and difficulties accessing support, most struggle,” said Professor Lindy Clemson from the University of Sydney’s Faculty of Medicine and Health and Charles Perkins Centre.

“We know from the Royal Commission that people want services that help them to remain independent. These are known as reablement programs but until now Australians have not had access to evidence-backed services,” said Clemson.

The COPE program is a multi-visit tailored intervention for people with mild to moderate dementia. Trained occupational therapists and nurses provide families with skills to manage challenging care problems at home. The program also trains family members to better provide specialised care to loved ones.

Over a four-year period, the research found that people with dementia were more engaged in activities as a result of the intervention. Carers also reported higher levels of wellbeing including greater ability to manage day-to-day caregiving and understand their loved one’s behaviour.

“The unique difference with the COPE program is its equal focus on supporting the family just as much as the person with dementia,” said Associate Professor Kate Laver, co-lead investigator from Flinders University.

“This helps address feelings of stress and overload on both sides, and research suggests this kind of program is much more effective than pharmacological treatments for dementia.

“Sometimes it could be as simple as adapting the person’s daily routine or changing the way that the family respond to particular situations but the change you will see can be tremendous. For example, changing someone’s daily routine so that they are more relaxed in the evening and sleep better overnight can be very beneficial for family members.”

The research suggests that, in the long run, COPE could have positive economic implications for the health system by delaying hospitalisations and entry into residential aged care among other savings.

However, lack of funding could initially hamper uptake.

“At the moment, our analysis shows the costs are mostly borne by the person with dementia and their family. There needs to be policy change and financial incentives for families to be involved in these programs,” said Laver.

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