Exploring the abilities of performing complex daily activities in dementia: the effects of supervision on remaining independent

Abstract

Objectives: The aim of this study was to explore the remaining abilities of people with dementia (PwD) in performing daily activities.

Method: Informal carers of community-residing PwD were recruited across England via mail out and carer support groups. Carers completed the revised Interview for Deteriorations in Daily Living Activities in Dementia 2 to rate the PwD’s initiative and performance of daily activities. Six complex instrumental activities of daily living (IADLs) were selected: shopping, preparing a hot drink, using the telephone, preparing a cold meal, house work, and engaging in social activities, all of which were broken down into three sub-tasks. Data were analysed using Chi-square tests and linear regression analysis, assessing the contributions of hours of IADL care, hours of supervision, and dementia stage for each activity.

Results: 581 carers of people with mild, moderate, and severe dementia completed the questionnaire. The ability to perform individual activities deteriorated from mild to moderate to severe dementia, with PwD remaining the most able to perform subtasks of preparing a hot drink and a cold meal. Subtask performance varied across activities, with some better maintained than others across severity stages. Linear regression models showed that hours of supervising PwD explained a greater proportion of the variance of each IADL than IADL care hours.

Conclusion: PwD should be supervised to continue engaging in activities, thereby avoiding performing everything for the PwD. Findings can have implications for PwD living in nursing homes, and future research should explore the remaining IADL abilities of nursing home residents.

Keywords:

• Activities of daily living
• care planning
• community care
• dementia

Acknowledgements

We wish to thank staff at the following National Health Service trusts for their support in recruiting participants: Manchester Mental Health and Social Care Trust; Southend University Hospital; Black Country Partnership; Surrey and Borders Partnership; Lincolnshire Partnership; Derbyshire Community Health Services; Lancashire Care; Leicestershire Partnership; Southern Health; and North Essex. We also wish to thank Division 4 Greater Manchester NIHR Clinical Research Network for recruiting participants to this study through Manchester Mental Health and Social Care NHS Trust. Our thanks also extend to the JoinDementiaResearch Network as well as the following carer support groups for allowing us to recruit carers through their networks: Crossgates, Later Life Living, Life Story Network, Together Dementia, Bury Carer’s Centre, and LMCP Care Link.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

CG is part-funded by the National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care North West Coast (NIHR CLAHRC NWC). The views expressed are those of the authors and not necessarily those of the NHS, NIHR or Department of Health and Social Care.