Background

Occupational therapists are health and social care professionals who enable people to live life their way – helping people to keep up their every day activities and remain independent for as long as possible after they develop dementia. In the UK people with dementia may see an occupational therapist for an initial assessment if they attend a Memory Clinic or Service. Otherwise, occupational therapy input tends to occur at a much later stage and primarily in response to family carer stress.

Researchers in The Netherlands have developed a Community Occupational Therapy in Dementia programme (COTiD) for people with mild to moderate dementia and their family carers (Graff et al.; Dementia Journal, 2006). The COTiD programme consists of ten, one hour sessions of home based occupational therapy over five weeks. The occupational therapist, the person who has dementia and their family carer work in partnership to identify problems in carrying out valued activities and potential solutions that are then put into practice. The programme showed benefits to the person with dementia in terms of their ability to carry out activities, their quality of life and mood. Carers’ quality of life, mood and sense of competence also improved and the programme was cost effective (Graff et al., BMJ 2006, 2008).

COTiD appears to have great potential for adoption in the UK as it addresses key objectives of the National Dementia Strategy.

The Valuing Active Life in Dementia (VALID) research study aims to develop a similar programme to meet the needs of the UK population.

Objectives:

The VALID Programme objectives are to:

1. Adapt COTiD to develop the COTiD-UK intervention and training programme to maximise its suitability for use in the UK.
2. Conduct a survey to establish the feasibility of implementing COTiD within the context of UK health and social care services.
3. Conduct an exploratory trial / feasibility study of COTiD-UK versus treatment as usual to field test the outcome measures.
4. Evaluate the effectiveness of COTiD-UK in improving functional independence of people with dementia through a multi centre, pragmatic, single blind, randomised controlled trial.
5. Determine the cost-effectiveness of the COTiD-UK in comparison with treatment as usual.
6. Evaluate the implementation of COTiD-UK through a monitoring study and budget impact analysis.
7. Ensure that the process and results of the VALID research programme are thoroughly disseminated.