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Case Study C
Trial regarding care provided to consumers with severe
Dr C wants to study the care provided to rest home residents
with severe dementia. Dr C believes that conventional care for such
consumers is task-focused, concerned primarily with the consumer's
physical needs and daily activities. Dr C thinks conventional care
may be neglecting consumers' psychosocial needs, meaning that many
consumers with dementia are spending many hours alone and
emotionally distressed. Dr C thinks that part of the problem may be
that a dementia diagnosis is treated as diminishing a consumer's
personhood, leading staff to reduce their efforts to establish and
maintain relationships with the consumer.
Dr C proposes a study that would randomly allocate consumers
with severe dementia into two groups, each group receiving a
different type of care. Group 1 would receive conventional care,
which focuses on physical task-oriented practices and physical
needs. Group 2 would receive "interactive care", an alternative to
conventional care that is intended to maintain personhood as
dementia progresses. "Interactive care" includes a greater focus on
the psychosocial needs of the consumer. At this stage, there is
very little evidence about the benefits or risks associated with
"interactive care". However, Dr C believes that the proposed study
could supply evidence that would lead to improvements in the care
provided to consumers with dementia.
It is not known whether the research would be in the
participants' best interests. They would have to undergo additional
assessments as part of the research, but the additional assessments
could benefit the participants if the increased contact with the
researchers was beneficial to them, or changes in their condition
were picked up that would not otherwise have been noticed. On the
other hand, there is a risk that some participants may find the
additional contact distressing.
The proposed trial would take place over four months.
Researchers would assess the participants' agitation levels,
psychiatric symptoms and quality of life before and directly after
the trial period, and then again four months after the conclusion
of the trial.
The fact that a consumer has dementia does not necessarily mean
that he or she is unable to provide informed consent. Some may be
capable of providing informed consent with appropriate support, or
they may have intermittent periods when they are able to provide
consent to participate in the research. Dr C also proposes to
include in the study consumers who are not able to consent.
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