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Alzheimer's Disease

Assistive technology and telecare to maintain Independent living at Home for people with Dementia (ATTILA)

ATTILA

The purpose of the study is to find out if telecare can safely extend the time people with dementia can continue to live independently in their own homes, and whether this is cost effective.  It also aims to find out if it can reduce the volume of acute, unplanned admissions to hospital, if it reduces stress in families and unpaid care-givers, and whether it can increase the quality of life of people living with dementia.

Why carry out the research?

There are approximately 700,000 people with dementia in the UK, many of whom will require nursing or residential care home accommodation when their illness has progressed to the point at which they can no longer live independently in their own homes with safety. Living Well with Dementia - the theme of the 2009 National Dementia Strategy for England involves helping people with dementia to maintain their independence within their own homes and ensuring that the quality of their lives are maintained. The loss of independence and quality of life associated with the transition to living in a Care Home are apparent, and the NHS and Social Services support of sufferers to live safely in their own homes for as long as possible are beneficial to this. Assistive Technology and Telecare, when individually tailored to a patient's needs and integral to their careplan, may offer a way in which the home of a person with dementia can be made safer for them by reducing the specific risks associated with the memory and orientation difficulties that accompany the illness. 

Particular risk to continued independence, such as wandering away from home in the middle of the night and becoming lost or setting fires with forgotten pans on the cooker or cigarettes put down in unsafe places, can be tackled by specific pieces of technology, linked to a 24-hour response centre. While it might seem obvious that such interventions are beneficial, only a well conducted clinical trial can provide high quality evidence that these technologies really do help to maintain independent living for people with dementia. 

We aim to:
  • To establish whether assistive technology and telecare interventions safely extend the time that people with dementia can continue to live independently in their own homes and whether this is cost-effective. 
  • To establish whether these technologies can significantly reduce the number of incidents involving serious risks to safety and independent living, including acute admissions to hospital, reduce stress in family and other informal caregivers and increase quality of life for dementia sufferers and their caregivers. 
  • To collect qualitative and quantitative data from dementia sufferers and their formal and informal caregivers and members of the NHS and Social Services teams who care for them about the experience of receiving these technologies. 
How is the research being undertaken?

This is a multi-centre, randomised controlled trial. We aim to recruit 500 people with memory difficulties and their carers.

Participants will be visited at home where an assessment will be made to see how electronic devices could possibly help. Questions will be asked about the health of the participant and the services they use, and the carer will also be asked about their own health. Participants will be randomised to one of two groups, the experimental group or the control group. The experimental group will receive specific types of assistive technology and telecare determined by the needs identified in the assessment. The control group will be offered standard devices such as a smoke alarm and pendent alarm, but none of the newer devices available. 

After this we will organise for the devices to be installed and arrange occasional follow-up visits over the next two years.

Where is it happening?

The centres are based across the UK in Cambridge, Lancashire, London, North Staffordshire, Oxford and Suffolk. All assessments are conducted in the participant’s own home.

Who is involved?

The study is funded by the Health Technology Assessment (HTA) Programme, part of the National Institute for Health Research (NIHR). Professor Robert Howard is the Chief Investigator and the trial is managed by Rebecca Gathercole. ATTILA is supported by the Dementias and Neurodegenerative Diseases Research Network (DeNDRoN) and the Mental Health Research Network (MHRN).

What is the timescale?

Patient recruitment started in August 2013 and will continue until June 2015, followed by a follow-up period of two years until June 2017. Analysis and dissemination should be completed by the end of 2017.

For more information, please contact:

Chief Investigator - Professor Robert Howard
robert.j.howard@kcl.ac.uk

Trial Manager - Rebecca Gathercole

rebecca.gathercole@kcl.ac.uk
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