This is not an evaluation report of a service or intervention. It does not seek to make any assessment of the effectiveness or cost effectiveness of the Forget-Me-Not reminiscence service. Instead it is a briefing report that highlights the information and data currently collected and collated to help develop a logic model and provide advice on data monitoring to encourage the project to think broadly about what may be required to assess and track its progress in the future.
It is known that the provision of high quality approaches to providing meaningful and enjoyable activities are a key part of enabling people residing in care homes to 'live well' with dementia (Department of Health, 2009).
However a recent evaluation of 17 care homes across three regions of the country, revealed that residents spent less than 13 per cent of the waking day engaged in any meaningful activity (Ballard et al, 2011). Consequently forget-Me-Not is potentially a valuable service.
Looking at the five constituencies that make up Devon, the East Devon constituency has an older age profile compared to the other districts i.e. 29.7% of the total East Devon population are aged 65 years and over (Devon County Council, 2014).
Applying 2007 prevalence rates to ONS population projections of the 65 and over population, an estimated 4,091 people are predicted to have dementia in East Devon by 2025, which represents 22.2% of the total population aged 65 and over in Devon predicted to have dementia by then (POPPI 2014).
This briefing document looks the theory underpinning Reminiscence Therapy (RT) and includes them in the logic model to understand the service delivered by the Forget-Me-Not intervention hosted by the East Devon Voluntary Services Agency (EDVSA).
Our fieldwork interviewing of stakeholders, volunteers, care co-ordinators and staff enabled us to assess and validate anticipated outcomes from the service as specified in EDVSA’s business plan (2015).
This report makes suggestions on drastically modifying the current Forget-Me-Not feedback form to make it a more effective tool to assess what was actually delivered in the sessions. Importantly: the number of attendees, the number of staff supporting and the number of volunteers in attendance need to be captured for each session. If added and inputted into the data base this will help with later unit cost analysis and will become a useful measure of quality.
In the absence of any data from existing forms it is recommended that the outcome measures included on the feedback form to be included in a one off survey of care co-ordinators and care homes to discern whether there is any further demonstrable impact on beneficiaries. These questions should not be asked at the end of each session.
Other information captured by the feedback questionnaire should be captured in a one-off enquiry at the start of the relationship with a care home/venue. The information should then inputted on to the existing care home database for later analysis. Additional demographics should also be captured at the start of the relationship with a new e.g. number of patients with dementia.
We make two suggestions for moving forward and capturing evaluation data the acceptance and pursuance of which will depend on funds available and EDVSA’s ambition.
Firstly we suggest that a feasibility trial could be conducted in one home that has most exposure to the service. The prime outcome measure could be the Euro Quality of Life wellbeing measure (EQ5d) to be completed by staff before and after the trial. Quality-adjusted life year (QALY) calculations can be derived with impact validated through interviews with families, the care staff and journals kept by volunteers. This is a standard research methodology used when presenting evidence to the National Institute for Health and Care Excellence (NICE) and an approach supported by the Dunhill Medical Trust.
Our logic model will reflect that more value accrues from the Forget-Me-Not service than simply that stemming from the impact it has beneficiaries. Unlike traditional trials that take a health service or service provider perspective our second suggestion of doing a social return on investment analysis (SROI) will assess and assume that values can occur for a range of different stakeholders.
This report will outline the benefits and challenges of doing both of these approaches.
Kimberlee, R., & Kok, M. East Devon forget-me-not reminiscence service: A review of data collection and the development of a logic model