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Impact of Improving Wellbeing and Health in Dementia (WHELD) trial

Published Online: February 7th 2018

Video of care home dementia champions speaking emotionally about the impact of the Improving Wellbeing and Health for People with Dementia (WHELD) training programme.

This project was funded by the National Institute for Health Research (NIHR) under its Programme Grants for Applied Research Programme (grant: RPPG-0608-10133). It was led by the University of Exeter Medical School, Oxford Health NHS Foundation Trust and Kings College London. Video produced by and shared courtesy of Oxford Health NHS Foundation Trust.

Dementia care improved by just one hour of social interaction each week

Increasing the amount of social interaction for people with dementia living in care homes to just one hour a week improves quality of life when combined with personalised care. A large-scale trial led by the University of Exeter, King’s College London and Oxford Health NHS Foundation Trust found that the approach also saves money.

Previous research has found that in many care homes, residents have as little as two minutes of social interaction per day. The new study, funded by the National Institute of Health Research and published today in the journal PLOS Medicine here, up-skilled key care home staff to deliver person-centred care. That involves simple measures such as talking to residents about their interests and involving them in decisions around their own care. When combined with just one hour a week of social interaction, the programme improved quality of life and reduced agitation and aggression in people with dementia.

Professor Clive Ballard, of the University of Exeter Medical School, who led the research, said: “While many care homes are excellent, standards still vary hugely. We have previously found that the average amount of social interaction for people with dementia was just two minutes a day. It’s hardly surprising when that has a knock-on effect on quality of life and agitation.”

“Our approach improves care and saves money. We must roll out approaches that work to do justice to some of the most vulnerable people in society. Incredibly, of 170 carer training manuals available on the market, only four are based on evidence that they really work. That is simply not good enough – it has to change.”

The trial involved more than 800 people with dementia across 69 care homes in South London, North London and Buckinghamshire. Two ‘care staff champions’ at each home were trained over four day-long sessions, to take simple measures that such as involve talking to residents about their interests and decisions around their own care. Importantly, the approach also saved money compared to standard care. Researchers say the next key challenge is to roll the programme to the 28,000 care homes in the UK to benefit the lives of the 300,000 people with dementia living in these facilities.

Dr Jane Fossey from the Oxford Health NHS Foundation Trust, said: “Taking a person-centred approach is about getting to know each resident as an individual – their interests and preferences – and reflecting these in all aspects of care. It can improve the lives of the person themselves and it can be rewarding for carers too. We’ve shown that this approach significantly reduces agitation and saves money. Rolling out the training nationwide could benefit many other people.”

The results are the findings of the Improving Wellbeing and Health for People with Dementia (WHELD) trial, the largest non-pharmacological randomised control trial in people with dementia living in care homes to date.

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