gms | German Medical Science

Background and Purpose: Guidelines emphasize the need for proper analysis of challenging behavior (CB) in nursing home residents with dementia. One way of shifting the approach to CB from treatment-focused to analysis-focused is the use of dementia-specific case conferences (DSCCs). The two DSCCs – the Norwegian TIME and the German WELCOME-IdA – are compared and analyzed regarding their implementation strategies. The overall aim is to ease implementation of DSCC into routine care.

Methods: For the comparison the template for intervention description and replication (TIDieR) is used. Similarities and differences of the DSCCs and the implementation strategies were analyzed and discussed.

Results: Both interventions rely on a bio-psychosocial construct of CB. While TIME is an interdisciplinary approach, WELCOME-IdA is monodisciplinarily oriented to nurses. The description and analysis of CB is guided in both DSCCs by structured assessments. In TIME, the assessments are performed prior to the DSCC, and in WELCOME-IdA the assessment are performed during the DSCC. Both DSCCs include a fixed process and role structure, last 60-90 minutes and are performed monthly. The implementation strategies of both approaches address different organization levels, include a steering group and face-to-face trainings. For WELCOME-IdA on-the-job trainings are offered, whereas in TIME the first DSCC is supervised by a trainer. Manuals and handouts are used for both approaches to further facilitate the implementation of DSCCs.

Conclusions: The success of the implementation of DSCC depends on intervention characteristics and the implementation process. TIME and WELCOME-IdA are currently evaluated in large scale evaluations. The process evaluations will give further insights into the implementation processes.