New method to reduce risk of depression in dementia being tested in Sweden
Many who suffer from dementia abandon everyday activities more quickly than necessary, which in turn heightens an already increased risk of depression. Now Joanne Woodford, a researcher at the U-CARE research programme, is implementing an intervention in Swedish health care that uses limited financial resources in an attempt to reverse this trend.
Dementia is a rapidly growing challenge both in Sweden and globally. All over the world the number of patients is exploding and by 2050 is expected to exceed 115 million people. In Sweden close to 100,000 people with dementia live in their own homes. International priorities strive for a high quality of life for dementia patients, but in reality this patient group and those close to them commonly experience depression.
“Studies show that up to half of all dementia patients display symptoms of depression,” says Joanne Woodford, a researcher at Uppsala University and U-CARE, the Swedish government’s strategic research programme. “The reasons are complex of course, but a strong contributing factor is that many dementia patients discontinue everyday activities, sometimes because those close to them unnecessarily take over many household duties out of misguided kindness. Passivity accelerates the negative spiral, and now we need tools to help the patients and those close to them restore routines, activity and quality of life.”
U-CARE studies how people suffering from physical illness and those close to them are affected psychologically and financially and what help they need to deal with the situation. It also develops self-help programmes for problems identified. Joanne Woodford, formerly a researcher at the University of Exeter focusing on increased access to psychological treatments, was initially recruited as a scientific advisor to U-CARE, a collaboration so successful that in August 2017 she accepted an offer to move her own research to Uppsala University.
“I find myself in a very favourable setting here with excellent opportunities for scholarly collaboration and continued development of the work I did in England. Above all, I hope I can adapt a model to Swedish circumstances that can make it possible for health care to provide support to dementia patients with a small amount of funding,” says Woodford. The need for new interventions for those afflicted with dementia and those close to them is approaching an emergency. In addition to the individual suffering, dementia costs Sweden nearly SEK 63 billion annually, and Woodford recently received funding from the Swedish Research Council for a four-year project called “Behavioural activity-based self-help for depression in people with dementia living in the community: Development, feasibility and evaluation”.
“Traditional cognitive behavioural therapy (CBT) produces good results, but it requires a large amount of health care resources,” says Woodford. “A CBT alternative based on self-help also requires good access to a specially trained staff. That is why in England we have developed an intervention that caregivers, with a short training period, can use to provide people afflicted with dementia and those close to them with tools to restore everyday life. An implementation study produced promising results, and we are now ready to begin comparable work in Sweden building on existing knowledge.”
Experience from England points to several success factors. They include identification of the right health care personnel to perform the work and functional settings in which patients and those close to them can be involved without experiencing the risk of stigmatisation. Another key is the possibility of offering various forms of assistance based on what the individual receiving care needs.
“Even though the intervention is easy to understand and use, we soon saw that health care personnel need better understanding of both mental illness and dementia. It is also advisable to conduct physical meetings with patients in some other place than the health service’s own premises, such as in the home. In England many dementia patients preferred personal meetings and handbooks to online discussions, but I perceive that Sweden has completely different information technology habits. In four years we will know much more, and then we hope, in cooperation with Professor Paul Ferrand at the University of Exeter, to be able to combine new results with knowledge from both England and New Zealand, where there is great interest among researchers in conducting similar studies. If we succeed, our model can have great benefits for both individuals and society at large.”
Magnus Alsne