'A lot of people think it's just a Mickey Mouse role': Role ambiguity among dementia support workers within secondary care and community hospital settings.

Purpose: Dementia support workers (DSWs) are employed to improve the hospital care for patients living with dementia. An evaluation sought to understand the perspectives and experiences of DSWs and related healthcare practitioners within one health board, to identify any role ambiguity and inform future role development.Design/methodology/approach: Framework analysis was used to synthesise data from semi-structured interviews and focus groups with dementia support workers, and a wider group of related healthcare practitioners.Findings: Thirteen semi-structured interviews were conducted with DSWs. Two focus groups were held with DSWs (n = 2 and 4) and two with associated healthcare practitioners (n = 3 and 5). Participants described inconsistencies in the understanding and delivery of the DSW role. Role ambiguity was identified as a key theme.Originality/value: This paper offers insight into challenges experienced by DSWs and addresses factors that could help improve and support the DSW role, and potentially the experience of other staff, and patients/people living with dementia. Overall, this evaluation highlights both the value of the DSW role in supporting the needs of patients/people living with dementia and the potential for person-centred activities to be used as therapeutic interventions.

Evaluation of Dementia Actif, a dementia-friendly exercise and wellbeing programme: mixed-methods study.

BACKGROUND: Dementia Actif provides group physical activity opportunities to support and enhance the quality of life for people living with dementia (PLWD) and their carers. The activities offer include physical exercise classes, Boccia league, online activities, and various clubs (eg, gardening). The overall aim of this study was to evaluate the Dementia Actif programme delivered in one local authority area in North Wales, UK. METHODS: A mixed-methods evaluation of Dementia Actif focused on four key workstreams (WS). Data collection took place between January and June, 2023. WS1 consisted of a rapid literature review. The search included articles and grey literature published between 2012 and 2022. All study designs were included, with keywords limited to the English Language. CINAHL (EBSCO), PsycInfo, ProQuest, PubMed, Web of Science were searched. WS2 consisted of interviews and focus groups with professional stakeholders (n=32) from Health, Social Care, and Third Sector services who refer PLWD to Dementia Actif, within one local authority area in North Wales. WS3 consisted of researcher observation of activities delivered by the Dementia Actif Service , including exercise classes and wellbeing activities within leisure centres across the local authority area. WS4 consisted of interviews with PLWD and their carers (n=12) who accessed Dementia Actif, including analysing specific case studies. FINDINGS: Following the screening process, the final literature sample included 18 papers. The sample papers, from the UK, USA, and Canada, were reviewed and analysed to inform the findings. The findings from the rapid literature review showed a lack of global evidence of approaches focused on measuring social interaction, wellbeing, and building on community assets to address the needs of PLWD and their unpaid carers. Results from SW2-WS4 indicated the positive impact of an active/wellbeing model for supporting PLWD and their carers, in particular the use of preventive community-based resources to support unpaid carers and reduce the need for admission to acute secondary and residential care. INTERPRETATION: The analysis indicates the benefits of low-cost social activities on overall wellbeing outcomes, including giving PLWD and their carers voice, choice, and control over their own wellbeing outcomes to connect them with their community. This evaluation argues the potential to use Dementia Actif approaches to address complex needs. However, this was based on a small sample, which might impact on the broader applicability of the findings. FUNDING: Gwynedd County Council, North Wales.

Beyond social prescribing-The use of social return on investment (SROI) analysis in integrated health and social care interventions in England and Wales: A protocol for a systematic review.

With increasing costs of healthcare in England and Wales following the COVID-19 pandemic, finding alternatives to traditional medical interventions is more important than ever. Social prescribing provides a way of addressing health and well-being through using non-medical methods that may help relieve costs to the NHS. Evaluating interventions, such as social prescribing, which have high social (but not easily quantifiable) value, can be problematic. Social return on investment (SROI) is a method of assigning monetary values to both social value as well as traditional assets, so provides a way of evaluating social prescribing initiatives. This protocol outlines the steps that will be taken in a systematic review of the SROI literature surrounding social prescribing-type integrated health and social care interventions based in the community in England and Wales. Online academic databases such as PubMed Central, ASSIA and Web of Science will be searched, as will grey literature sources such as Google Scholar, the Wales School for Social Prescribing Research (WSSPR) and Social Value UK. Titles and abstracts from the articles returned by the searches will be reviewed by one researcher. Those selected for full text review will be independently reviewed and compared by two researchers. Where the researchers disagree a third reviewer will help resolve any differences. Information collected will include identifying stakeholder groups, assessing the quality of SROI analyses, identifying intended and unintended changes of social prescribing interventions, and comparing social prescribing initiatives in terms of SROI costs and benefits. Quality assessment will be independently conducted on the selected papers by two researchers. The researchers will discuss to obtain consensus. Where there is disagreement, a third researcher will resolve these cases. A pre-existing quality framework will be developed and used to assess the quality of the literature. Protocol registration Prospero registration number: CRD42022318911.