On 20th February 2024, Alzheimer’s Society and NIHR came together to host a three-day event for existing DEM-COMM fellows. During the event, teams worked with experts in the field to develop and pitch a research project to address different challenges within the dementia workforce. The event facilitated the researchers to explore and discuss existing challenges, before dividing into teams to create innovative solutions to try to address some of these identified challenges.
On day three, a panel of judges heard pitches of each proposed solution from each team. The judges’ recommendations were then used by Alzheimer’s Society to award funding to the successful research teams. From a total of six pitched projects, five were awarded funding. Three projects were funded in full and the remaining two projects were awarded seed funding.
Details of the successful research teams and project abstracts are included below.
Fully Funded Sandpit Projects
Personalising Domiciliary Dementia Care: Co-Design of an App Matching Care Preferences of Care Workers and People Living with Dementia
Research Team: Dr Rasa Mikelytė (Grant Holder), Dr Chris Poyner, Dr Lis Grey, Dr Katie Breheny, Dr Ilianna Lourida, Dr Daniel Soria
Grant Holder Institution: University of Kent
Total Grant Value: £110,000
Project Abstract:
The delivery of person-centred dementia care in community settings is undermined by high levels of care worker stress, burnout, and high staff turnover. Improving the experience of domiciliary care for all stakeholders is paramount. Previous research has suggested that matching the skills/characteristics of care workers to the needs and preferences of people with dementia can enhance the quality of domiciliary care. This study aims to personalise domiciliary care through the co-design and development of a novel app-based system that employs machine learning to match the preferences of people living with dementia, their family/friend supporters and care providers, as well as enabling a ‘live’, needs-informed rostering.
The study will consist of three work packages (WPs). WP1: a review summarising evidence on what 'good' domiciliary care is for key stakeholder groups. WP2: eight focus groups with key stakeholder groups of community-dwelling people with dementia, their supporters, and domiciliary care professionals (including care workers and managers of care organisations). WPs 1 and 2 will inform WP3: the iterative co-design of the app, which will involve co-design workshops with representatives from key stakeholder groups, iterative development of the computational elements of the app by a computer science researcher, and development of the app interface, working with web developers. Intersectoral costs and outcomes will be considered throughout the project, which will inform a full economic evaluation in the future. We will document the development process, and use the resulting prototype to pursue additional funding for further development and pilot-testing of the app.
AIMed: Optimising treatment regimens using computer-systems for people living with dementia
Research Team: Dr Subhashisa Swain (Grant Holder), Dr Jiamin Du, Dr Nuno Tavares, Dr Jaheeda Gangannagaripalli
Grant Holder Institution: Nuffield Department of Primary Care Health Sciences, University of Oxford
Total Grant Value: £224,000
Project Abstract:
Background: People living with dementia (PLwD) often have multiple long–term conditions and take multiple medications. Medication reviews exists in the current system, but is time consuming, expensive, and ineffective resulting in adverse outcomes.
Objective: We propose to develop an artificial intelligence (AI) approach to assist healthcare professionals undertake medication reviews and identify inappropriate medications prompting an action for deprescribing in PLwD, especially at later stages of the condition.
Methods: The AI model will use graph neural networks (GNN) and reinforcement learning in the simulation data of 10,000 people registered in the UK primary care, which later will be translated into an application/software. We will develop the AI model using an experience- based co-design approach by involving PLwD, carers, health and social care professionals, and different stakeholders. The model will flag inappropriate combinations of medications and suggest medications to be deprescribed, highlight key changes to people’s needs based on their healthcare records, and existing NHS guidelines, such as STOPP/START or NO TEARS.
Outcome: We hypothesize this approach has the potential to reduce pressure and requirement for regular medication reviews by health care professionals, hospital admissions, medication waste, health and social care costs, and provide insights towards improving integration of different care systems to optimize the medication plans for nursing home residents.
Future plans: To test the feasibility of the AI model and the software extending into other chronic conditions, patient populations, health and social care systems. Following this, we would conduct trials of the model, economic analysis, adoptability and scaling-up in the health and social care.
DEcision-Making support Model for whole-pathway dementia workforce COMMissioning (DEMM-COMM)
Research Team: Dr Joseph Kwon (Grant Holder), Dr Ting Cai, Dr Smruti Bulsari, Dr Pippa Collins, Dr Sujin Kang
Grant Holder Institution: Nuffield Department of Primary Care Health Sciences, University of Oxford
Total Grant Value: £50,000
Project Abstract:
Background: Sustainable investment in dementia workforce should encompass the entire dementia intervention pathway, including prevention, diagnosis and care. Existing health economic models often concentrate on specific segments of the pathway and overlook workforce constraints. This project aims to develop a health economic model for the entire pathway of dementia intervention which guides workforce investment decisions by local UK commissioners and evaluate them regarding cost-effectiveness and health inequality reduction.
Methods: The first part of the project will be model conceptualisation, involving extensive engagement with stakeholders including commissioners at Integrated Care Systems (ICS), care professionals, and people living with dementia and their caregivers. This engagement will take place in a region overseen by a specific ICS to capture local stakeholders’ workforce investment priorities and strategies. The conceptual model will include a graphical representation of the current local dementia intervention pathway, entry points for new investments, high priority health economic outcomes, and subgroups of equity relevance. The second part will be model parameterisation which translates the conceptual model into a statistical one generating quantitative outcomes within a virtual environment. Diverse data sources, such as electronic health records and cohort surveys, will be used. The parameterised model will be used to assess the cost-effectiveness and health inequality impact of workforce investments recommended by local stakeholders.
Expected outputs: (1) Conceptual model and a framework to guide future model conceptualisations of dementia interventions; (2) prototype of the parameterised model.
Patient and public involvement and dissemination: these will occur throughout the project via stakeholder engagements and feedback.
VR Journey into dementia care
Research Team: Dr Megan Rose Readman (Grant Holder and Co-PI), Dr Megan Polden (Co- PI), Dr Sarah Smith, Dr Sarah Fox, Dr Annabel Farnood, Dr Olivia Luijnenburg
Grant Holder Institution: University of Liverpool
Total Grant Value: £43,000
Project Abstract:
Following a dementia diagnosis, it is not uncommon for people to experience a ‘shrinking world’, leading to social isolation. Local communities can be influential in supporting people to feel less isolated and safe to maintain connection within their neighbourhoods. To achieve this, it is important that both the dementia workforce and people living in the community are aware of the challenges people living with dementia face and how they could support them.
Our project aims to foster dementia-friendly attitudes, awareness, and skills among young people who will create the future workforce. We will develop an immersive solution-based virtual reality (VR) learning platform, targeted towards young people (ages 12-14) to be delivered in schools. Through the VR platform, young people will experience the challenges individuals living with dementia face in every-day community settings, i.e. GP surgeries and supermarkets. Using the VR platform people will experience a solution-based-learning game and can ‘play’ as either a carer or an employee, encouraging players to explore different ways they can support a person living with dementia in that community setting. The platform will be co-developed alongside community workers, people living with dementia, carers, teachers and young people to ensure it reflects their experience and is appropriate for the target population. The platform will be piloted and evaluated in three schools across the UK with an aim to recruit a sample of up to 100 young people. Evaluations will focus on whether the platform has increased awareness and education of dementia in young people.
The M-DROC project: Developing a Dementia Recovery College Tailored for Muslim Communities
Research Team: Dr Sanda Umar Ismail (Grant Holder) and Dr Emmanuel Nwofe Grant Holder Institution: University of LiverpoolTotal Grant Value: £43,000
Project Abstract:
This research underscores a critical issue within the dementia workforce: the lack of cultural diversity and sensitivity, leading to inadvertent stigmatisation of faith and minority ethnic communities in traditional Dementia Recovery Colleges (DROC). While DROCs aim to support people with dementia post-diagnosis, their one-size-fits-all approach falls short of addressing the unique needs of diverse populations.
As the diagnosis of dementia is projected to increase sevenfold in minority ethnic populations as opposed to twofold in white backgrounds, faith leaders can play a vital role in influencing health behaviours. This project proposes an integrated working between the formal dementia workforce in healthcare settings and the ‘hidden’ untapped dementia workforce involving faith leaders within the community to create a more inclusive and accessible approach to dementia care.
The methodology comprises two main work packages: 1) the co-design of the M-DROC model using an experience-based co-design approach that will involve mental health practitioners, Muslim faith leaders, individuals living with dementia and their relatives, friends, and carers, and 2) a feasibility study informed by appreciative inquiry to evaluate implementation prospects and scalability.
Expected outcomes include developing a pathway inclusive of professional skills and cultural influence to reduce barriers to dementia diagnosis, improve community awareness, enhance equitable dementia care, and establish a culturally sensitive model that can improve the professional workforce while also being applicable to other minority populations. This approach aligns with national initiatives aimed at enhancing health outcomes for people with dementia in all communities.