523 - The design and implementation of Comprehensive Resilience-building psychosocial Intervention (CREST) for people with memory problems/dementia in the community: a pilot study

Abstract

Background:

In Ireland, approximately 65,000 people live with memory problems/dementia (PWMP). Most live in the community, supported by informal caregivers such as relatives. A comprehensive resilience-building psychosocial intervention (CREST) to strengthen intra- and interpersonal resources was piloted by PWMP and caregiver dyads, local GPs, and the community.

Methodology:

An advisory forum of PWMP, caregivers, and dementia advocacy representatives provided guidance on the intervention design and materials (e.g., interview guides), to ensure they addressed the needs of PWMP and caregivers. The 15-week CREST intervention comprised three components: cognitive stimulation therapy for PWMP (CST; 7 weeks), physical exercise for PWMP and partners from the community (8 weeks), and dementia education for key supporters of PWMP: caregivers (6 weeks), GPs, and the community (one-off events). Intervention processes (e.g., recruitment, data collection measures) were evaluated at each stage by PWMP and caregivers through qualitative (verbal feedback, interviews) and quantitative methods (ratings, questionnaires), to ensure they were feasible and acceptable.

Findings:

Nine PWMP/caregiver dyads were recruited and completed the CREST intervention; attendance was consistently high (90-95%) throughout. The dyads reported that the recruitment materials, phone calls, and letters from the research team were helpful and easy to understand. Feedback from PWMP, caregivers, event attendees, and programme facilitators confirmed that the intervention content and delivery were acceptable. Minor changes were recommended, and changes which facilitated participation by the PWMP during this pilot (e.g., giving verbal rather than written feedback, larger-print handouts) were implemented immediately. The PWMP enjoyed the CST activities (e.g., collages, tasting childhood sweets) and the “bit of fun” the group shared; some also perceived improvements in concentration and confidence. The PWMP enjoyed the group Exercise sessions, particularly the social aspects (e.g., “banter”, exercising with partners), and some reported improved fitness and feeling less breathless. Caregivers felt better informed about managing dementia and communicating with PWMP and enjoyed sharing experiences with other caregivers. Attendees at the community and GP education events reported improved knowledge of dementia.

Conclusion:

The involvement of the PWMP and caregivers was valuable to the iteration of the pilot CREST intervention. Consultations with both groups are ongoing to inform future research priorities.