Supporting best care for dementia patients

Supporting best care for dementia patients

Dr Darshini Ayton applies her significant experience in mixed methods research to problems surrounding the healthcare experiences of people experiencing delirium and/or dementia.

MyCare Ageing

This project builds on the landmark 6-PACK in-hospital falls prevention randomised controlled trial, the world’s largest hospital inpatient falls prevention program.

6-PACK showed patients with dementia or delirium to be at high-risk of falls, and revealed a systemic perceived lack of resources to help carers prevent falls in this patient group. In 2017 Dr Ayton was funded by the Mason Foundation to investigate the acceptability and feasibility of implementing the Volunteer Dementia and Delirium Care (VDDC)© program at Alfred Health. This project showed that whilst senior managers and clinicians were supportive of providing volunteers to support patients with dementia and/or delirium, concerns around the responsibility for coordinating and supporting volunteers was a major barrier to implementation.

In 2019, and funded by the Monash Partners Medical Research Future Fund Rapid Translation Project, she addressed this barrier by leading a co-design project to develop MyCare Ageing in partnership with Baptcare, a not-for-profit organisation that coordinates 700 Victorian volunteers; clinicians; consumers; and implementation researchers. The final program provides one-on-one tailored psychosocial and practical support for people with dementia and/or delirium during hospitalisation and during their transition home, and facilitates access to existing community services to prevent ED presentations and unplanned hospital admissions.

Dr Ayton and her team at Baptcare trained 50 volunteers, predominantly students from the FMNHS at Monash University. Implementation commenced at Peninsula Health, Monash Health and Alfred Health, but was interrupted due to COVID-19. Implementation is planned to be relaunched in 2021.

The impacts of MyCare Ageing will be evaluated in a stepped wedge RCT from 2021-2025 via a recently awarded NHMRC Investigator grant.

Watch Darshini talk about communicating with older people about falls prevention at the Victorian Active Ageing Partnership Forum 2019

Project contact: MyCare Ageing Project Manager, Dr Lauren Bruce (Lauren.Bruce@monash.edu)

BetterBrains: Person-Centred, Multi-Domain, Primary Prevention Strategies to Delay Memory Decline

This NHMRC-funded collaboration is between the Turner Institute for Brain and Mental Health (A/Profs Yen Ying Lim (CIA) and Matthew Pase (CIC)), and the Health and Social Care Unit at Monash University (Dr Darshini Ayton CIF; Dr Stephanie Pirotta – Senior Clinician), Melbourne eResearch Group and the Florey Institute of Neuroscience and Mental Health.

BetterBrains is a person-centred, multidomain, prevention intervention to delay cognitive decline that is being assessed via a randomized controlled trial (RCT). Modifiable risk factors will vary between individuals, so an effective solution needs to be person-centric.

BetterBrains will incorporate individual’s risk factor profiles to better target interventions, empower individuals to select and enact risk mitigation strategies that will be effective in their daily lives, and leverage existing community services around the individual to promote long-term engagement.

The program comprises four behaviour change modules that correspond to key risk factors for cognitive decline and dementia. BetterHearts addresses vascular risk, BetterMood addresses poor mood, BetterMind addresses low cognitive engagement, and BetterSleep addresses poor sleep. The BetterBrains coaches will engage with participants via phone, a smartphone app and website to provide motivational interviewing, positive health messaging and support them in the self-management of their identified risk factors.

Project contact: BetterBrains Senior Clinician and Research Fellow, Dr Stephanie Pirotta (Stephanie.Pirotta@monash.edu)

Global Dementias: Examining structural vulnerability and dementia outcomes

An ARC-funded collaboration with the Faculty of Arts at Monash University (CIA Dr Narelle Warren) and the Health and Social Care Unit (CID Dr Ayton).

This project aims to examine the social and cultural dimensions of dementia by using a comparative ethnographic approach to examine the experiences of people living with dementia in Australia, Malaysia and India.

We expect to generate new anthropological knowledge about structural inequalities by examining how dementia is responded to in diverse geographic, cultural and social settings. Expected outcomes include the creation of a new evidence-base on dementia, and the production of briefing documents to guide global health frameworks. The project should provide significant benefits for people living with dementia by providing locally relevant strategies to respond to dementia and resultant disability.

Project contact: Dr Darshini Ayton (Darshini.Ayton@monash.edu)