Australian research has backed an innovative home-based program which specially trains nurses and occupational therapists to support people living with dementia and their families.

“We know that 75 percent of people with dementia in Australia are living in the community, not in residential care, and many want to continue to stay at home” said Professor Lindy Clemson from the University of Sydney’s Faculty of Medicine and Health.

However, evidence-based services that help people with dementia live well at home for longer – known as reablement programs – have remained a huge gap in dementia care in Australia.

That’s why Professor Clemson and a team of researchers from the University of Sydney and Flinders University brought COPE, a reablement program from the US, to Australia.

COPE-trained occupational therapist Kylie Lemsing from Hammond Care, said that “having something that’s practical, in the home, that is flexible, it’s a joy in that respect to actually work through those things with someone who is struggling.”

“What motivates me is that you can see change…. I find it so rewarding to actually spend time with them (COPE recipients),” she said.

COPE (Care Of People with dementia in their Environments) is an occupational therapy and nursing program which works with both the person with dementia and the carer, to support them living independently in their homes. 

The research team implemented COPE across 17 organisations to determine whether the program would be effective for the health professionals that work with people with dementia in Australia.

Under the study, occupational therapists and nurses in government services, aged care organisations and private practice took part in the COPE practitioner training and program delivery.

Professor Clemson told HealthTimes that the COPE program is the first of its kind to be rolled out in Australia. “This is a very structured, intensive program with really positive outcomes.”

She said that what makes COPE a unique program is that is works with both the carer and the person with dementia, from a nursing and occupational therapy standpoint.

“We are giving carers those occupational therapy skills. And sometimes, it is just a matter of understanding your loved one, and the way their environment is set up.”

The researchers found that carers would identify up to three different problems around one of their loved one’s activities. As part of COPE, occupational therapists then work closely with the carers to explore different strategies they can use to help the person with dementia cope better with their everyday activities. 

“There was one case where the person would always want to go out to visit their mother, who had long since passed away. It was found that the picture of their family was right near the door, and so it was a matter of taking the photo away”, Professor Clemson said.

“We’re looking at people's homes in terms of falls prevention. We are looking at things like aids and equipment, and how to support people in their activities of daily living”, Professor Clemson said.

“There’s also a nursing component in the project. It’s been exciting to actually do a research project and end up with a lot more understanding of how it can be implemented across different health contexts.”

Results from the study were published in The Gerontologist and showed that implementing COPE is possible in multiple health systems, and the results were similar to outcomes from US studies. People with dementia were found to be more engaged in activities, and the wellbeing of carers improved significantly.

The research team also conducted a cost-benefit analysis of COPE, which demonstrated the economic gains that the program could deliver to Australia’s health system.

“This analysis showed that there was a reduction in long term hospital-based healthcare. It is just a no-brainer; we should be investing more in these type of programs, because the evidence is there now.”

A significant part of this investment is in the COPE-training of nurses and occupational therapists, which is now being offered to organisations nationwide.

“These things take time. At the moment, for the therapists who are being trained, this is either being paid for by their work, or they are paying for it personally. So, how we fund training is really an important issue.”

“Then there are other questions we need to consider, too. When you become trained and try to implement it into your organization, how do you get referrals? We thought it would be a lot quicker, but it actually took time for people to be referred”.

For the nurses and occupational the therapists who have been trained in the COPE program, it has been a rewarding experience to see the benefits of the program for people with dementia and their carers.

“You may think that your loved one looks bored or unhappy, but maybe you can do some things to help include them differently in situations”, Professor Clemson said.

For example, carers may try getting their loved one to do a simple jigsaw puzzle, or involve them in decluttering the kitchen or weeding the garden.

“It takes a number of COPE sessions to work through these problems and give the carer those occupational therapy skills”, Professor Clemson said.

For more information on the COPE program and training, visit https://copeprogram.com.au