Development & user-testing of a communication intervention decision-making support tool for non-specialist SLTs working with people with Alzheimer's

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There are 850,000 UK dementia cases, with Alzheimer's disease (AD) accounting for two-thirds. The cost of dementia in the UK is expected to more than double in the next 25 years (Alzheimer's Research UK). Language difficulties occur in all dementia sub-types, affecting e.g. word-finding, and understanding others. Worsening language difficulties correlate with increased problem behaviours. People with AD experience declining ability to communicate thoughts and needs, and increasing difficulties with social interaction and sustaining relationships. Communication challenges negatively affect caregivers. Speech and language therapists (SLTs) are healthcare professionals with expertise in assessing and treating language and communication disorders. Few SLTs work in specialist dementia services - most encounter people with AD within a non-specialist caseload, e.g. during acute hospital admission or within a general community therapy team. As AD diagnosis improves, non-specialist SLT services need effective ways to manage referrals, determining which people with AD would benefit from what communication intervention at what time point. The project's primary aim is to coproduce with stakeholders and user-test a communication intervention decision-making support tool for non-specialist SLTs treating AD. It applies research methods in linguistics to healthcare to tackle the neglected communication-related social and psychological impacts of AD. It addresses the ESRC's priority areas of mental health and innovation in healthcare, specifically the challenges of SLT service delivery in dementia, with implications for service-user/carer relationships and quality-of-life. This is a four stage project. Stage 1 involves a scoping review of communication interventions in AD. Stage 2 seeks to understand the experiences, practice and needs of non-dementia specialist SLTs through thematic analysis of focus groups. Stage 3 comprises stakeholder workshops to coproduce a communication intervention decision-making support tool, using experience-based co-design and consensus methodologies. Stage 4 user-tests the tool in non-specialist SLT services to explore and address issues of change using implementation science theory.