1. Mixed Economy for Care in Dementia (MECADA) project Consultation group meeting 19th March 2008: More findings and ideas for dissemination
Georgina Charlesworth,
Fiona Poland, Xanthippe Tzimoula, Paul Higgs
Welcome to those who have now joined us and thanks to those who are continuing to contribute
Acknowledgements
The Befriending and Costs of Caring (BECCA) project (ISRCTN ) was funded by the Health Technology Assessment (HTA) Programme (project no 99/34/07) granted to Charlesworth (University College London), Mugford, Poland, Harvey, Price, Reynolds and Shepstone (University of East Anglia). Befriender expenses were funded by Norfolk and Suffolk Social Services, the King’s Lynn and West Norfolk Branch of the Alzheimer’s Society and an AdHoc grant from the Department of Health to North East London Mental Health Trust. XT is currently funded by the ESRC (RES grantholders:Charlesworth, Higgs and Poland). The views and opinions expressed in this paper are those of the authors and do not necessarily reflect those of the Department of Health or ESRC.

2. Overview
MECADA aims
What we discussed last time (Nov 07)
Further findings
Requests from the academic advisory group
Discussion

3. Aims of MECADA
Describe pattern of change in the ‘mixed economy’ of care for carers of person with dementia in relation to psychological and social characteristics of carers
Study the how different contributions from different welfare providers (statutory, voluntary and family) can affect each other over 2 years (e.g. service replace family carer or facilitate care)

4. Definitions ‘Mixed economy’ ‘Crowding in’ (complementarity)
Same services being available from a number of different providers e.g. health or social services (statutory sector), private sector, voluntary / charitable organisations or family & friends.
‘Crowding in’ (complementarity)
People who receive a service from one provider are more likely to receive support from other providers
‘Crowding out’ (substitution)
Receiving a service from one provider reduces use of support from elsewhere
N.B the ‘service provider’ could be family or friends in this context

5. From last meeting (November 07)

6. Issues raised
Using services and benefits may open the door to other services
People can be encouraged by those who support them to try new options
Peoples’ personal experiences and personality are also important influences on choices
Being involved with other people can allow carers to tap alternative viewpoints and expertise to address problems

7. Key issues for dissemination
Use of findings to demonstrate:
the importance of gaining different types of support
the need for more targeted forms of support, especially befriending for the most isolated

8. Methods of dissemination
Feeding into different types of carers’ network activities e.g.
Alzheimer’s Society and Age Concern and their websites
Booklets
Magazines
Meetings, radio and word of mouth
Presentations in trainings for workers e.g. Social Work; Crossroads

9. Findings

10. Findings at baseline 2 in 3 carers were using 1 or more service
Carers expressing higher burden were more likely to be using services
4 in 5 non-spouses used services compared to only 3 in 5 spouses
Carers using 1 or more service were no more or less likely to be female, urban, isolated or in receipt of family support

11. Findings for ‘at home’ carers over 2 years
The person with dementia is more likely to move into residential / nursing / continuing carer if their main carer is:
a non-spouse
depressed
For ‘at home’ carers
Both family support and service use increase over time
3 in 20 carers still do not use services. This is NOT due to family support.
Carers using most services are also whose with most contact with family, friends and neighbours.

12. Requests from Academic Advisory group

13. West Suffolk (from April 02)
BECCA areas
North Norfolk (Nov03)
Norwich (from April 02)
Gt Yarmouth (from Aug 02)
King’s Lynn (Jan 03)
Lowestoft (from Nov 02)
West Suffolk (from April 02)
Ipswich (from Nov 02)

14. Locality differences
Between April 2002 and March 2006, what were the characteristics of each locality in terms of:
Local commissioning of voluntary and private sector services
NHS respite provision & continuing care
Services available to rural populations

15. Discussion