1. Summary of the Study Background - In Scotland, it is estimated that there are approximately 20,000 people with dementia residing within care homes, where there is demonstrable need to advance practice. Care home residents with moderate and advanced dementia experience many challenges in their daily lives and are particularly vulnerable to stress and distress. Complementary therapies, such as reflexology and hand massage are thought to be of potential benefit for people with dementia. Existing evidence suggests that complementary therapies can assist people with dementia to feel more relaxed, alleviate agitation and have a positive impact on quality of life. Study Aim – This study aims to use Action Research with a mixed method approach to the data collection to introduce and evaluate the contribution of complementary therapies to person centred care of nursing homes residents with dementia. Research Participants – The research participants will be the care home staff, Visiting Family and Friends and as far as possible the care home residents. Study Sites – This research will be conducted in 2 care homes with two action cycles lasting approximately 40 weeks. These cycles will include planning, acting and reflecting on emerging evidence. Methodology – The study will follow an Action Research methodology. This collaborative methodology promotes partnership with the care home staff and as far as possible, is inclusive of individuals with dementia and their visiting family. Methods - Cycle 1 is conducted in care home A and will include; 30 semi-structured interviews with the care home staff and visiting family. 4-6 resident centred case studies introducing taster sessions of complementary therapy. 2 focus groups or small group interviews with the care home staff and family. Preparatory cycle 1 builds the evidence for the implementation cycle 2 in care home B. Cycle 2 will include; 2 focus groups with a maximum of 12 care staff where the outcome will be an implementation protocol Protocol is then piloted within the second study care home with a maximum of 10 residents. Data Analysis – Various analysis methods will be used during cycle 1 such as content analysis or thematic analysis, where the researcher will identify emerging themes from the interviews and focus groups based on the data gained. Cross case analysis will be used for the resident centred case studies, where case studies will be analysed individually to show how the complementary therapy has impacted on the resident’s life but also brought together when measuring the neuro-psychiatric behaviour’s presented. Cycle 2 analysis methods will become clearer as the process is underway as it is an emergent design. Objective 1 To elicit care staff and visiting family and friends perceptions of the actual or potential use of complementary therapies for residents with dementia. Objective 2 To collaboratively (with care staff, relatives and residents) prepare resident centred case studies exploring the introduction of selected complementary therapies into the weekly care plan for 4-6 residents with advanced dementia. Objective 3 To reflect with care staff and visiting family and friends to gather evidence on the experience of introducing complementary therapy at the level of the individual resident and the wider care home community. Objective 4 To co-construct an implementation plan with the care staff to embed the optional use of complementary therapy within dementia care based on cycle 1’s evidence. Objective 5 To fully implement complementary therapies into dementia care based on the agreed plan and evaluate in terms of the impact on neuropsychiatric behaviours related to dementia. Objective 6 To reflect with care staff on the overall experience of the introduction of complementary therapies within dementia care Cycle 1 Care home A Bryan Mitchell’s PhD Research Project - An Action Research Study to Introduce and Evaluate the Contribution of Complementary Therapies to Person Centred Care of Nursing Home Residents with Dementia Cycle 2 Care home B Cyclical Process Contact Details This study is part of the Alzheimer Scotland Centre for Policy and Practice at the University of the West of Scotland. If you would like further information please contact the researcher or supervision team with the contact details provided. Doctoral Student – Bryan Mitchell 01698 283100 ext. 8413 Bryan.Mitchell@uws.ac.uk Director of Studies – Professor Debbie Tolson 01698 283100 ext. 8669 Debbie.Tolson@uws.ac.uk 1 st Supervisor – Dr Karen Watchman 01698 283100 ext. 8639 Karen.Watchman@uws.ac.uk 2 nd Supervisor – Professor Graham Jackson 01698 283100 ext. 8680 Graham.Jackson@uws.ac.uk Complementary therapies that will be included throughout the research process and their individual therapeutic benefits There are 3 complementary therapies that will be provided throughout the duration of this research. These are, Body Massage, Aromatherapy and Reflexology. Each has their own benefits but this is dependent on how the individual interacts to the therapy. A list of the possible benefits are below. Body Massage Pain relief, increase circulation, reduce stress, relaxation, reduce anxiety, improve skin and aid in general wellness. Aromatherapy Pain relief, enhance mood, reduce stress, reduce anxiety, general feeling of wellbeing, increase circulation, relaxation, encourage restful sleep, improve skin and aid digestion. Reflexology Pain relief, relaxation, reduce stress, reduce anxiety, aid mobility, enhance mood, aids digestion and aids post-operative recovery