INTERDEM Academy: a training and career development initiative vital to capacity building of early stage psychosocial dementia researchers in Europe

Introduction

In all aspects of research it is vital to develop the researchers and academics of the future by ensuring that there are suitable career paths and career development opportunities. To demonstrate its wholehearted support for the career development of early stage researchers Aging & Mental Health has devoted a special section to the work of the INTERDEM Academy. To our knowledge this is a unique move by an academic journal and demonstrates that we aim to remain at the forefront of academic ideas and opportunities. All the eight original papers in this unique special section have an early stage researcher from the INTERDEM Academy as first author, and all have been through the usual appraisal process. Moreover, we have also given opportunities to talented postdoctoral researchers (Klinkenberg, Oliveira) to act as assistant editors for this special section helping to develop their own skill sets.

The INTERDEM academy

The European INTERDEM (early and timely INTERventions in DEMentia) network emerged in 1999 from the need to raise the quantity and quality of the evidence on psychosocial interventions for people with dementia in Europe. INTERDEM aims to establish a critical mass of methodological expertise and robust evidence of interventions to improve dementia care, policy and practice through international and interdisciplinary collaborations and the active involvement of people with dementia and their carers (Moniz-Cook, Vernooij-Dassen, Woods, & Orrell, 2011). The future of INTERDEM depends on the current generation of early stage researchers working within the network to lead the way in developing cutting edge research in psychosocial interventions for dementia. The European ‘INTERDEM Academy’ (PRIDE ESRC/ NIHR grant, ref ES/L001802/1WP5) was initiated in 2014 to help develop interdisciplinary capacity and train early-career researchers to carry out high-quality psychosocial research for people with dementia, and to support their career trajectories to give them a deeper understanding of the nature of dementia and dementia care; and a comprehensive research training including methodological excellence, creative innovation and intellectual leadership (European University Association, 2013) with the right skill sets for the future needs of the European workforce (European parliament resolution 19 January 2011 on a European initiative on Alzheimer's disease and other dementias (2010/2084 - INI). The INTERDEM Academy with 200 members (55% PhD students), from 66 academic centres in 19 countries The career development strategy of the network involves (1) a biannual programme for students/researchers consisting of Summer and Winter Schools which include; opportunities to discuss their work with peers/academics, workshops, expert masterclasses; and (2) travelling fellowships for early-career researchers to carry out 3–6 months’ activities in another academic institution affiliated with INTERDEM to extend their skills and enhance their research network. The Academy has supported the international exchange of knowledge and experience of 8 researchers (7 females, 1 male).

By harnessing the strategic excellence of the Academy, INTERDEM has been able to secure large funding programmes aimed at building further capacity in dementia research. For example, the Interdisciplinary Network for Dementia Utilising Current Technology (INDUCT—H2020 Marie Skłodowska Curie Actions – Innovative Training Networks grant, €3.8 million, agreement number 676 265) was established in 2016 to develop a multi-disciplinary, inter-sectorial educational research framework for Europe to improve technology and care for people with dementia and to provide the evidence to show how technology can improve the lives of people with dementia. INDUCT funded 15 PhD early-stage researchers in Europe. Together with the INTERDEM Academy, INDUCT provides comprehensive training program for these 15 Early Stage Researchers to acquire a deep understanding of the nature of dementia and needs in relation to the use of technology and to equip them with the right skills needed for work in academia, industry or the health and social sector. In sum, within the timeframe of 3 years INTERDEM Academy has been established as the premier quality multi-disciplinary, and multi-professional education, capacity building and dementia care research network in Europe.

Advancing dementia research

Current attempts to treat or cure dementia have failed systematically (Saarelainen et al., 2017). Whilst advances in the biomedical field are discouraging, developments on the area of psychosocial interventions have demonstrated promising effects on the quality of life and well-being of people living with dementia and their care supporters (Oyebode & Parveen, 2016). Previous research has established that relevant and robust psychosocial interventions can be as effective as pharmacological treatment and impose less risk to the health of these individuals (Olazaran et al., 2010).

The first manuscript by Kerpershoek et al. (2017) propose that research on needs and quality of life of people with dementia and their caregivers is of high priority in the context of the accessibility and acceptance of tailored (in)formal care and support. Using baseline data from the European prospective cohort study Actifcare (Access to timely formal care) the authors report on a cross sectional survey on service use, needs, and quality of life offered to 451 dyads of community-dwelling people with dementia and their caregivers in 8 different European countries. Interestingly, the study results show that informal carers reported almost twice as many needs as people with dementia, which might lead to conflicts in decision-making between dyads in the acceptance of care. The authors concluded that professionals should be trained in recognizing and dealing with such decisional conflicts.

Staff training is essential to the development and maintenance of an able and trained dementia workforce. A Maltese study by Scerri and Scerri (2017) investigated the effectiveness of a 14-hour training programme delivered to 425 qualified nurses working in long-term care facilities. It was shown that after training, nurses’ knowledge, attitudes, and confidence was significantly increased. The authors noted that there is a need for care home managers to invest in staff development programmes.

Schaap, Dijkstra, Finnema, and Reijneveld (2017) point out that staff providing long term care for people with intellectual disability often lack the knowledge or skills to address changing needs and behavior of their clients due to aging and/or dementia. In their qualitative study, they have evaluated the use and implementation of Dementia Care Mapping with the RE-AIM Framework to support care professionals working in twelve group homes. The staff rated Dementia Care Mapping positively regarding its reach, efficacy, adoption, implementation, and maintenance, and thought DCM gave them insight as to how to provide more tailored and person-oriented care.

In addition to training of professionals it is also important to address the impact of dementia on family carers and to increase their competencies for example in dealing with communication difficulties. Communication impairments in people living with dementia can contribute to relationship stress in family and professional carers. A systematic review carried out by Morris, Horne, McEvoy, and Williamson (2017) evaluated the effectiveness and acceptability of training interventions with a communication component aimed at these target groups. The interventions were shown to be beneficial to improve carer knowledge and communication skills, but not challenging behavior or caregiver burden. More research is needed to determine the ‘active ingredients’ of these types of interventions.

Furthermore, providing care to a person with dementia can risk high physical, psychological, emotional and social impact on caregivers. The RCT carried out by Zwingmann et al. (2017) showed that a dementia care management intervention can be effective to decrease caregivers’ objective burden due to caring, subjective burden due to behavior change and perceived conflicts between needs and responsibilities to care compared to a control group receiving care as usual. The authors found that even small to medium effects might help to decreases the risk of health impairments and raise satisfaction, engagement and personal growth in caregivers.

For people with dementia themselves it is important to get the opportunity to maintain an active and meaningful life, despite the disease. Leisure activities, such as gardening, offer an opportunity for people with dementia to feel safe and included through cultivating a sense of enjoyment and purpose. A qualitative study by Noone and Jenkins (2017) highlighted that participating in gardening activities can allow people living with dementia to express and reconnect with elements of their embodied selfhood and agency, creating a real sense of community. The authors hope their study will inspire further research on gardening initiatives for people with dementia.

Finally, the last contribution in this special section addresses the topic of delirium, a neuropsychiatric syndrome that frequently occurs in older adult inpatients with preexisting cognitive, physical and/or functional impairments. There is a relative scarcity of research into the impact of delirium on (in)formal caregivers. The pilot study by carried out Martins et al. (2017) addresses this gap by investigating the experiences of family members and nurses of older adult inpatients recruited from a university hospital in Portugal and report moderate to high levels of distress in both groups. The authors concluded that distress in informal and formal caregivers during delirious episodes of older adult inpatients may affect their capacity to deliver care.

The editors of this special section hope this pioneering initiative will serve to emphasise the importance of providing better career development opportunities for PhD students and postdoctoral researchers. The following articles should provide a better understanding of the excellent of the INTERDEM Academy in the development and evaluation of psychosocial interventions for dementia in Europe and stimulate further research to improve dementia care, policy and practice.

Conflict of interest statement

Prof Verhey leads the INTERDEM Academy and is a coapplicant on both the PRIDE and the INDUCT grants. Prof Orrell is the lead applicant for both the PRIDE and INDUCT grants.

Disclosure statement

No potential conflict of interest was reported by the author(s)