Activities per year
Objective: To establish whether or not full evaluation of LSW was feasible.
Design: Mixed-methods feasibility study.
Methods: In-depth interviews and focus groups explored experiences of LSW
and best practice with people with dementia, family members and dementia care staff. A systematic review explored best practice and theories of change for LSW. These stages helped to identify the outcomes and resources to explore in
the feasibility study. A representative sample survey of health and social care dementia care providers in England established LSW practice in different settings. A survey of a self-selected sample of family members of people with dementia explored how LSW is experienced. Two small outcome studies
(stepped-wedge study in six care homes and pre-test post-test study in inpatient specialist dementia care wards) explored the feasibility of full evaluation of LSW in these settings.
Settings: Survey: generalist and specialist care homes; NHS dementia care settings; and community dementia services. Feasibility study: care homes and NHS inpatient dementia care wards.
Participants: NHS and social care services, people with dementia, family carers, care home staff and NHS staff.
Main outcome measures: Spread of LSW and good practice, quality of life (QoL) for the person with dementia and carers, relationships between people with dementia and family carers, staff attitudes about dementia, staff burnout, resource use and costs.
Review methods: Narrative review and synthesis, following Centre for Review and
Results: Good practice in LSW is identifiable, as are theories of change about how it might affect given outcomes. Indicators of best practice were produced. LSW is spreading but practice and use vary between care settings and are not always in line with identified good practice. Two different models of LSW are
evident; these are likely to be appropriate at different stages of the dementia journey. The feasibility study showed some positive changes in staff attitudes towards dementia and, for some people with dementia, improvements in QoL. These may be attributable to LSW but these potential benefits require full
evaluation. The feasibility work established the likely costs of LSW and highlighted the challenges of future evaluation in care homes and inpatient dementia care settings.
Limitations: There was insufficient evidence in the literature to allow estimation of outcome size. We did not carry out planned Markov chain modelling to inform decisions about carrying out future evaluation because of the dearth of outcome data in the literature; low levels of data return for people with dementia
in the hospital settings; lack of detected effect for most people with dementia; and questions about implementation in the research settings.
Conclusions: LSW is used across different health and social care settings in England, but in different ways, not all of which reflect ‘good practice’. This large, complex study identified a wide range of challenges for future research, but also the possibility that LSW may help to improve care staff attitudes towards
dementia and QoL for some people with dementia.
Future work: Full evaluation of LSW as an intervention to improve staff attitudes and care is feasible with researchers based in or very close to care settings to ensure high-quality data collection.
Funding: The National Institute for Health Research Health Services and Delivery Research programme.
- life stories
- service evaluation
Narrative in Question Seminar Programme, Interdisciplinary Centre for Narrative Studies, University of York
Kate Gridley (Keynote/plenary speaker)28 Feb 2017
Activity: Participating in or organising an event › Seminar/workshop/course
Kate Gridley (Speaker) & Savitch Nada (Speaker)3 Nov 2016
Activity: Talk or presentation › Oral presentationFile
19 Jun 2014
Activity: Talk or presentation › Oral presentation
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