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Providing activity for people with dementia in care homes: a cluster randomised controlled trial


Wenborn, Jennifer, Challis, David, Head, Jenny, Miranda-Castillo, Claudia, Popham, Carolyn, Thakur, Ruchi, Illes, Jacqueline, Orrell, Martin


International Journal Of Geriatric Psychiatry, Volume: 28, No.: 12, Pages.: 1296-1304

Year of Publication



Background: Activity levels remain low in care homes, but activity engagement can enhance residents’ quality of life.; Aim: This study aimed to assess an occupational therapy programme designed to enable care home staff to increase activity provision.; Method: A cluster randomised controlled trial with blinded assessment of outcome was conducted. A total of 210 residents with dementia in 16 care homes were recruited. Intervention homes received the programme, and control homes were provided usual care. Primary outcome is quality of life; secondary measures are dependency, challenging behaviour, depression, anxiety, severity of dementia and number and type of medication.; Results: Quality of life decreased overall with statistically significant change in staff ratings (p < 0.001). At follow-up, staff-rated quality of life was slightly lower in the intervention group (mean difference in staff ratings = -1.91, 95% CI -3.39 to -0.43, p = 0.01). There were no significant differences between the two groups for self-rated quality of life or secondary outcomes.; Conclusion: The results may be related to the following: wide variability in how the intervention was implemented, such as low staff attendance at the education and coaching sessions, and patchy provision of additional activities to residents; or the residents' severity of dementia or the choice of outcome measures. Future studies need to pay more attention to process measures such as implementation and fidelity strategies, and outcome measures that better capture the focus of the intervention such as level of engagement and activity.; Copyright © 2013 John Wiley & Sons, Ltd.

Bibtex Citation

@article{Wenborn_2013, doi = {10.1002/gps.3960}, url = {}, year = 2013, month = {may}, publisher = {Wiley-Blackwell}, volume = {28}, number = {12}, pages = {1296--1304}, author = {Jennifer Wenborn and David Challis and Jenny Head and Claudia Miranda-Castillo and Carolyn Popham and Ruchi Thakur and Jacqueline Illes and Martin Orrell}, title = {Providing activity for people with dementia in care homes: a cluster randomised controlled trial}, journal = {Int J Geriatr Psychiatry} }


activities of daily living, activity, aged, aged, 80 and over, care homes, cluster analysis, dementia, education, female, health personnel, humans, male, mental disorders, nursing homes, occupational therapy, older people, psychology, quality of life, standards

Countries of Study


Types of Dementia

Dementia (general / unspecified)

Types of Study

Cost and service use study, Randomised Controlled Trial

Type of Outcomes

ADLs/IADLs, Behaviour, Depression and Anxiety, Quality of Life of Person With Dementia, Service use or cost reductions (incl. hospital use reduction, care home admission delay)


Nursing Homes

Type of Interventions

Non-pharmacological Treatment

Non-Pharmaceutical Interventions

Occupational Therapy