The neglected psychological support needs for carers of people with dementia in the UK could soon be addressed with a major multicentre trial led by University of Manchester psychologists and funded by the National Institute for Health and Care Research (NIHR)
Lead researchers Dr Lydia Morris and Professor Katherine Berry will trial the new course which has been shown to improve the way carers and people with dementia communicate with each other across England.
Difficulties communicating can result in a person with dementia losing confidence, withdrawing during interactions, or feeling disconnected from and devalued by the other person.
However, University of Manchester led research has shown that interventions focusing on communication can improve the person with dementia's communication and behavioural symptoms.
Carers reported positive experiences of using the method called Empowered Conversations, a detailed study of the experience of 15 carers published in the journal Aging & Mental Health showed.
And a second NIHR-funded study, published in Pilot and Feasibility Studies found it was possible to measure participants psychological health, quality of life and service use when trialling the course.
Now the research team are able to progress to a multi-centre trial of the method across three proposed sites in England, thanks to the NIHR funding. The course will be offered across Greater Manchester with Greater Manchester Mental Health NHS Foundation Trust as the lead site.
The course, pioneered by Manchester's Dr Lydia Morris and Professor Warren Mansell brings a glimmer of hope to the 700,000 people supporting a family member, partner, or friend with dementia.
Empowered Conversations uses evidence based psychological and communication theories to support carers to improve relationships and reduce stress.
For example, it uses Mentalisation Theory, which is about understanding our own thoughts and feelings while recognising that others have their own minds with different perspectives.
Professor Berry from The University of Manchester is also Mental Health Co-Theme Lead at the NIHR Manchester Biomedical Research Centre and Co-Director of the Complex Trauma and Resilience Research Unit at Greater Manchester Mental Health NHS Foundation Trust.
She said: "In dementia care, relationships often change dramatically, for example, a child may become the carer of a parent, or a spouse may shift from partner to caregiver. Carers often face a painful conflict between remembering the person as they used to be and coping with who they have become.
"Seeing someone who looks the same physically but has changed in memory, personality, and communication can feel confusing, distressing and bring a sense of loss and grief.
"Stress associated with these changes in close relationships can make it harder to understand and interpret another person's thoughts and feelings. While some carers adapt by adjusting their expectations and priorities, this kind of coping does not happen easily or automatically. This is where learning skills in mentalisation can help."
Among the positives, carers said the course resulted in changes to themselves, their relationships, and their communication skills.
Participants also described letting go of their expectations of what the person should be able to do and replacing that with more realistic goals.
Dr Morris, who is a Senior Clinical Lecturer and Clinical Psychologist at the University, added: "In a landscape where provision of post-diagnostic dementia support is variable or limited, it appears that Empowered Conversations can offer carers an intervention that is appreciated and accessible.
"Communication difficulties are associated with increased carer stress and burden and can contribute to the breakdown of the interpersonal relationship between the carer and person with dementia.
"Training does exist, but it focuses on practical communication skills without addressing the emotional and relational contexts of care and communication.
"However, the carers we worked with reported positive experiences of participating in Empowered Conversations and valued meeting people who, despite sometimes different circumstances, shared their understanding of supporting someone with dementia.
"The course supported participants to rethink communication and have a greater appreciation of the other person's perspective during everyday interactions."
- Image is AI generated
