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Palliative assessment and advance care planning in severe dementia: an exploratory randomized controlled trial of a complex intervention

Patients with advanced dementia often receive poor end-of-life care. We aimed to design and pilot a palliative care and advance care plan (ACP) intervention. Patients had undergone emergency hospital admission and had severe dementia. The intervention consisted of a palliative care patient assessment which informed an ACP discussion with the carer, who was offered the […]

Survival of community-dwelling older people: the effect of cognitive impairment and social engagement

Objectives: To examine the association and interaction between cognitive impairment and social support and mortality.; Design: Prospective cohort study.; Setting: Fifty-three family practices in the United Kingdom.; Participants: Community-dwelling people (aged > or =75) participating in the Medical Research Council Trial of the Assessment and Management of Older People in the Community (10,720 individual subjects […]

Clinical effectiveness of a manual based coping strategy programme (START, STrAtegies for RelaTives) in promoting the mental health of carers of family members with dementia: pragmatic randomised controlled trial

Objective: To assess whether a manual based coping strategy compared with treatment as usual reduces depression and anxiety symptoms in carers of family members with dementia.; Design: Randomised, parallel group, superiority trial.; Setting: Three mental health community services and one neurological outpatient dementia service in London and Essex, UK.; Participants: 260 carers of family members […]

Cost effectiveness of a manual based coping strategy programme in promoting the mental health of family carers of people with dementia (the START (STrAtegies for RelaTives) study): a pragmatic randomised controlled trial

Objective: To assess whether the START (STrAtegies for RelatTives) intervention added to treatment as usual is cost effective compared with usual treatment alone.; Design: Cost effectiveness analysis nested within a pragmatic randomised controlled trial.; Setting: Three mental health and one neurological outpatient dementia service in London and Essex, UK.; Participants: Family carers of people with […]