The Enriched Opportunities Programme: A cluster randomised trial of a new approach to living with dementia and other mental health issues in ExtraCare housing schemes and villages.

Abstract

People living in extra care housing have a variety of mental health needs. Whilst many people opt for extra care housing as a means of enhancing quality of life, it is recognised that around 30% will experience significant mental health problems notably dementia and depression. This often leads to them having to move out of extra care housing or becoming isolated within their apartment. The Enriched Opportunities Programme (EOP) was developed by ExtraCare Charitable Trust and Professor Brooker and her research team as a means of ensuring that people experiencing mental health problems can continue to enjoy a good quality of life. EOP brings together what is known as best practice in a structured, systematic and proactive way. Key facets of the programs include a specialist staff role ¿the EOP Locksmith¿; staff training; individualized case work; liaison with health and social care teams; activity & occupation; and leadership. This report summarises a recently completed 2 year cluster randomised controlled trial. 5 extra care housing schemes were randomly assigned to receive the EOP for an 18 month period. A further 5 housing schemes were randomly assigned to receive a placebo intervention consisting of employing an extra member of staff called a Project Support Worker Coach (PSWC) for the same time period. We followed the lives of the 268 most vulnerable residents living in all these extra care housing schemes and villages. We compared the results for people receiving the EOP intervention with the PSWC intervention and analysed the differences. The process of implementing EOP and the impact on people¿s lives has been very positive. The main advantages in the EOP schemes were that residents were Half as likely to have to move out into a care home ¿ Far less likely to spend time in hospital as an in-patient ¿ More likely to have a GP visit ¿ More likely to see a community physiotherapist, occupational therapist and a chiropodist More likely to have their mental health problems diagnosed In addition residents in the EOP schemes and villages ¿ Rated their Quality of Life more positively ¿ Reported decreased symptoms of depression over time ¿ Reported greater feelings of social support and inclusion There were also a number of advantages enjoyed by participants in both the EOP and the PSWC interventions. Residents in both interventions reported ¿ Greater opportunity to be active ¿ Greater use of community facilities ¿ More fun ¿ Greater variety of things to do. This report will be of interest to all those involved in the provision of extra care housing and to those implementing the National Dementia Strategy.